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Biomedical subjects

D N Quinton

Publications and source records attributed to D N Quinton.

29 records · Page 2Linked to original sources
PubMed1988

Prilocaine leakage during tourniquet inflation in intravenous regional anaesthesia: the influence of fracture manipulation.

Recent evidence has shown that there may be leakage of anaesthetic drugs into the systemic circulation during the tourniquet inflation phase of intravenous regional anaesthesia. This, together with increased pressure in forearm vessels during manipulation of fractures, prompted the measurement of arterial levels of local anaesthetic to assess potential toxicity. Prilocaine levels were measured in nine patients undergoing manipulation of Colles' fractures and six patients undergoing other upper limb procedures. Eleven patients had measurable concentrations of prilocaine in the arterial circulation during the time the tourniquet was inflated, the maximum levels being measured in those patients having fractures manipulated. Considerable vigilance should be ensured during the time of tourniquet inflation in intravenous regional anaesthesia, particularly for fracture manipulation.

Anesthesia, Conduction↗
PubMed1988

Dog-bite lacerations: a controlled trial of primary wound closure.

Dog-bite wounds are often left open because of their reputation for infection if primarily closed. A prospective randomized trial comparing primary closure with leaving the wound open was performed to assess infection and cosmesis. Ninety-six patients with 169 lacerations had thorough surgical debridement and irrigation of their wounds. Ninety-two wounds were sutured and 77 left open. No prophylactic antibiotics were given. A total of 13 wounds developed infection: seven sutured and six unsutured wounds (not statistically significant), giving an overall infection rate of 7.7%. Significantly (P less than 0.01), more wound infections occurred in the hand in both groups compared to the rest of the body, indicating that particular attention should be paid to management of such wounds. It was concluded that dog-bite wounds should receive thorough surgical treatment and can be safely sutured at presentation. Special care should be given to hand wounds.

Adolescent↗
PubMed1987

A controlled trial of pentoxifylline (Trental 400) in intermittent claudication: clinical, haemostatic and rheological effects.

A formulation of pentoxifylline (Trental 400) has been claimed to increase claudication distance by improving red cell deformability and decreasing blood viscosity and platelet aggregation. In order to test this claim 30 stable claudicants recruited from one population took part in a double-blind randomised trial of placebo versus pentoxifylline. Both placebo and pentoxifylline treated patients improved subjectively and increased their claudication distance over the study period. Analysis of the blood results showed that the only apparent change was a tendency towards increased red cell filtration in the group treated with pentoxifylline; but no significant difference was found between claudicants and normal controls in the degree of red cell filterability nor did red cell filterability correlate with claudication distance. Pentoxifylline did not affect claudication distance or have any useful effect on blood flow properties, calling into question both its efficacy and suggested mode of action.

Adult↗
PubMed1987

Comparison of endotracheal and peripheral intravenous adrenaline in cardiac arrest. Is the endotracheal route reliable?

Twelve patients presenting to an accident and emergency department in asystolic cardiac arrest were randomly allocated to treatment with endotracheal adrenaline (five patients) or peripheral intravenous adrenaline (seven patients). Femoral-artery blood samples were taken for assay of adrenaline and noradrenaline. After intravenous adrenaline there was a good clinical and biochemical response, but after endotracheal adrenaline there was no change in serum adrenaline and no measurable clinical response. The endotracheal route of adrenaline administration is not reliable in out-of-hospital cardiac arrest.

Aged↗
PubMed1987

Transcutaneous electrical nerve stimulation in acute hand infections.

Twenty-six patients with severe hand infections requiring operative drainage and admission to hospital were entered into a prospective, randomised, placebo-controlled trial. This was to test the use of a functioning transcutaneous electrical nerve stimulator and a non-functioning transcutaneous electrical nerve stimulator for pain relief in the first three postoperative days. Those patients with a functioning transcutaneous electrical nerve stimulator required significantly less analgesia. They also demonstrated highly significant improvement in their range of total active movement over those patients with a non-functioning transcutaneous electrical nerve stimulator. We recommend the use of transcutaneous electrical nerve stimulator after operation to reduce pain and improve mobility.

Adolescent↗
PubMed1987

Dorsal locking of the metacarpophalangeal joint.

Many causes for metacarpophalangeal joint locking have been documented. However nearly all are from volar entrapment of periarticular structures. The following case, unlike those previously reported in the literature, was one with locking caused by dorsal entrapment. The differences in presentation and its importance to subsequent treatment are highlighted.

Aged↗
PubMed1987

Survival from cardiac arrest in the Accident and Emergency Department.

One hundred consecutive patients who were treated in an Accident and Emergency Department for 'cardiac arrest' were studied prospectively. Of these 30% had arrested within the community, 21% in transit and 49% in hospital. The immediate outcome was that 40 left the A&E Department alive; of these, 13 left hospital alive. The 'survivors' included 3 cases of documented asystole. Patients who were over the age of 65, who arrested out of hospital and at night, were found to have a poor prognosis. The time between arrest and arrival of the ambulance was found to affect outcome. Patients with ventricular fibrillation had the best prognosis and those with electromechanical dissociation the worst.

Aged↗
PubMed1986

A new treatment of stable lateral ligament injuries of the ankle joint.

A support for the treatment of stable injuries of the lateral ligament of the ankle has been designed. One hundred and seventy-five consecutive patients with acute injuries were studied. Unstable injuries were excluded by the use of the radiological anterior stress test. One hundred and forty-four patients with stable injuries were randomly allocated to three treatment groups: double Tubigrip, eversion strapping and the new support. The change in the range of movement was used as an objective measure of improvement. The new support was noticeably better than Tubigrip and eversion strapping.

Adolescent↗