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Biomedical subjects

D H Jenkins

Publications and source records attributed to D H Jenkins.

At least 19 recordsLinked to original sources
PubMed2000

Substance abuse and withdrawal in the intensive care unit. Contemporary issues.

Because 36% of intentional injury victims are drug dependent, the association between drug abuse and violence, especially in urban settings, is high. Withdrawal syndromes in ICU patients confuse their clinical management, may be extremely difficult to diagnose, are often lethal, need to be suspected, and should be prophylaxed against; therefore, all ICU patients should be considered to be at high risk for drug or alcohol dependence, should be tested for evidence of such drugs, and should be interviewed (together with their family members) for the presence of drug dependence traits. Appropriate patients should be referred for formal evaluation and treatment. Withdrawal syndromes must be promptly recognized, differentiated from traumatic or metabolic deterioration, and immediately treated. As patients are unique, so is their drug dependence. Individualized withdrawal therapy, not a "one method fits all" approach, works best. The mainstay of most withdrawal therapy is supportive care and benzodiazepine therapy. Also, considering the high rate of multiple intoxicants present in trauma patients, withdrawal can occur from multiple agents in a single patient, further compounding these difficulties. Withdrawal from unusual substances, such as GHB, or from therapeutic interventions (e.g., prolonged opioid or benzodiazepine administration) also must be considered.

Alcohol-Related Disorders↗
PubMed1999

Improving the approach to organ donation: a review.

Organ transplantation continues to be hindered by a limited supply of organs. A significant percentage of potential organ donors are lost to either medical failure or inability to obtain consent for donation. In a surgical intensive care unit (ICU) we have refocused our efforts toward aggressive resuscitation, directed by control of coagulopathy, invasive monitoring, and dedicated ICU management while implementing a rapid brain death determination protocol. Over a 6-year period the length of stay until the legal determination of brain death is made has been significantly shortened (12.0 vs. 3.4 hours; p < 0.05), as have associated charges despite this more aggressive approach. As a result, we have eliminated medical failures prior to donation (13% vs. 0%) and increased consent rates (44% vs. 71%; p < 0.05). These efforts have significantly improved the number of organs harvested per eligible donor (1.8 vs. 3.4; p < 0.05). In addition, the number of organs per actual donor has increased and is now markedly greater than the U.S. national average (4.7 vs. 3.7). We believe the approach presented, if widely applied, could potentially improve the current organ supply shortage.

Blood Coagulation Disorders↗
PubMed1988

An epizootic of blindness and encephalitis associated with a herpesvirus indistinguishable from equine herpesvirus I in a herd of alpacas and llamas.

Blindness characterized by dilated unresponsive pupils and funduscopic evidence of varying degrees of vitritis, retinal vasculitis, retinitis, chorioretinitis, and optic neuritis developed in 21 alpacas and 1 llama within a 30-day period. The animals were part of a group of approximately 100 animals imported from Chile one year earlier. The animals had spent 6 months in quarantine and then, for the 6 months preceding the epizootic, were housed at an exotic animal import-export farm, where the disease developed. Four of the affected animals also had signs of neurologic dysfunction. A herpesvirus indistinguishable from equine herpesvirus I was isolated from 4 of the affected animals, and antibody titers diagnostic for equine herpesvirus I were demonstrated in the serum of all but one of the affected animals.

Animals↗
PubMed1988

Carbon fibre reinforcement for chronic lateral ankle instability.

Flexible carbon fibre implants have been used in 40 cases of chronic ankle instability. The carbon fibre implant permits retention of inversion, does not interfere with peroneal function and is simple to insert. Thirty-seven cases were available for review 46 months after surgery. In 35 cases normal stability had been restored, and 22 patients continued to have an excellent result when reviewed. In 13 cases the implant was subsequently removed, and where no other stabilizing operation was carried out instability recurred. The problems necessitating implant removal have been recognized, and the technique modified to prevent their recurring.

Adult↗
PubMed1985

Ligament induction by filamentous carbon fiber.

On the basis of eight years of experimental and clinical investigations, the author recommends carbon fiber on a trial basis to patients with chronic ligamentous instability and where function has been severely compromised because of the injury.

Animals↗
PubMed1984

Flexible carbon fibre in late ligamentous reconstruction for instability of the knee.

Sixty-three knees with chronic ligamentous instability treated with flexible carbon fibre are reviewed. Assessment was by pre-operative and postoperative grading of function in work and sport, together with a subjective evaluation of the result based on stability. Fifteen knees had collateral repairs, seven had cruciate repairs and 41 had combined collateral and cruciate repairs. Overall, 71% of knees showed improvement in function and 67% had good or excellent results subjectively. Clinical examination did not correlate well with the patient's evaluation of the result. Nineteen unselected cases with intra-articular (cruciate) carbon fibre had arthroscopies. Infiltration of collagen tissues into the cruciate replacement was a slower process than at the extra-articular (collateral) site. There was no clinical or macroscopic evidence of synovitis but microscopically there was evidence of synovial irritation.

Arthroscopy↗
PubMed1984

Late repair of the calcaneal tendon with carbon fibre.

Ruptures of the calcaneal tendon which present late may be repaired using carbon fibre to induce a neotendon. The operative technique is described and the results of five cases reviewed. The average muscle power obtained was 88% of normal, and the thickness of the neotendon was 148% of that of the normal side. It would appear that this tendon formation in man is comparable to that previously described in sheep.

Achilles Tendon↗