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Biomedical subjects

D Paterson

Publications and source records attributed to D Paterson.

50 records · Page 3Linked to original sources
PubMed1986

The nuclide bone scan in the diagnosis of Perthes' disease.

The prognosis in the management of Perthes' disease depends entirely on appropriate treatment following an early and accurate diagnosis of the condition and on the state of revascularization at the time of diagnosis. Early diagnosis is vital for a congruous femoral head to be obtained at the conclusion of treatment. The nuclide bone scan provides, at present, the most sophisticated investigation to enable such an early diagnosis to be made. A scan should be performed in all patients with a suggestive presentation in routine roentgenograms and in cases of transient synovitis with unusual features or that fail to subside rapidly or that recur.

Child↗
PubMed1985

E. coli peritonitis and bacteremia cause increased blood-brain barrier permeability.

Impaired mental status is a poorly understood manifestation of sepsis and may be associated with altered permeability of the blood-brain barrier. To examine the possibility that sepsis affects permeability of the blood-brain barrier, rats were infected with a peritoneal implant consisting of sterilized feces, barium sulfate, and 10(8) colony forming units (CFU) of Escherichia coli. Using this model, reproducible episodes of peritonitis with bacteremia resulted. Rats were sacrificed hourly after 5 min circulation of 100 mg horseradish peroxidase. Animals were perfused-fixed and the brains removed. Representative coronal sections were stained for peroxidase reaction product and cerebral blood vessels were examined microscopically for evidence of HRP staining and extravasation. The number of stained cerebral vessels from infected rats was increased at all times compared to uninfected control rats. Extravasation of horseradish peroxide within neuropil was significantly higher in hours 1, 4 and 5 as compared to controls. The lack of significant increase in hours 2 and 3 may suggest transient closing or repair of the tight junctions. We conclude that peritonitis and bacteremia are associated with increased permeability of the blood-brain barrier.

Animals↗
PubMed1984

Treatment of nonunion with a constant direct current: a totally implantable system.

There is now sufficient basic research and clinical experience to establish that electrical stimulation produces osteogenesis. Furthermore, electrical stimulation significantly helps union where impaired bone healing exists. The implanted bone growth stimulator is one effective method of electrical stimulation. It can be used in a wide variety of problems: delayed union and nonunion of bones with or without chronic infection and in failed posterior spinal fusion. Successful treatment of congenital pseudarthrosis of the tibia has been encouraging. The implanted bone growth stimulator technique requires a simple operation with strict adherence to detail. There is minimal postoperative discomfort and a short hospital stay. The average time to union is 16 weeks. The Osteostim can be used in the presence of chronic infection and internal fixation. Above all, the technique does not require any cooperation from the patient. The implanted bone growth stimulator should be accepted as a method of treatment for delayed and nonunion of bones, as it is at least as effective as other more conventional methods of surgical treatment for this situation. It has been proved that electrical stimulation produces osteogenesis. Orthopedic surgeons should no longer be skeptical about this.

Adult↗
PubMed1983

The technetium phosphate bone scan in the diagnosis of osteomyelitis in childhood.

We reviewed the technetium phosphate scans of 280 patients who had been referred with a clinical diagnosis of osteomyelitis in order to establish the diagnostic accuracy of this procedure. Strict criteria were established to define two subgroups: one of patients with proved osteomyelitis and one of patients who definitely did not have osteomyelitis. The scan correctly identified osteomyelitis at fifty-five of sixty-two sites, and was correctly negative in seventy-four of seventy-nine patients without osteomyelitis. The scan correctly distinguished all cases of cellulitis or soft-tissue abscess from osteomyelitis, but identified osteomyelitis in eight of thirty-nine patients with septic arthritis. The phosphate bone scan maintained this accuracy through any duration of symptoms, and performed almost equally well at all skeletal sites and in all age groups.

Abscess↗
PubMed1978

Aneurysmal bone cysts of the spine.

Aneurysmal bone cysts are uncommon lesions, especially in the spine. Seventy-eight cases have been previously documented in the English literature and an additional fourteen cases are now reported. There is a definite predilection for the lumbar region and the neural arch is the part of the vertebra most commonly affected. It is recommended that treatment should consist of total excision or when this is not possible, curettage. Radiotherapy should be reserved for those few cases where operation is inadvisable.

Adolescent↗
PubMed1977

Surgical repair of a large incomplete cleft sternum.

Congenital deformities of the chest are not uncommon, are frequently symptomatic, and are readily correctable. This applies particularly to malfusion of the manubrium and upper sternum, which results in a bony deficiency together with divarication of the sternomastoid muscles and the sternoclavicular joints. Such defects of the sternum are best corrected as soon after birth as possible. Two patients are reported who had such a defect, and the technique for a satisfactory repair is described.

Humans↗
PubMed1976

The early diagnosis and treatment of congenital dislocation of the hip.

In 1964, a screening programme was commenced in South Australia to diagnose and treat congenital dislocation of the hip in the neonatal period. The purpose of this paper is to present the findings of a statistical review of cases seen at the Queen Victoria Hospital during 1971 and 1972. Related factors, and the recommended method of treatment, are discussed, along with problems of early diagnosis and treatment of newborn children found to have unstable hips.

Age Factors↗
PubMedDate not supplied

Rapid on-site defibrillation versus community program.

INTRODUCTION: For patients who suffer out-of-hospital cardiac arrest, the time from collapse to initial defibrillation is the single most important factor that affects survival to hospital discharge. The purpose of this study was to compare the survival rates of cardiac arrest victims within an institution that has a rapid defibrillation program with those of its own urban community, tiered EMS system. METHODS: A logistic regression analysis of a retrospective data series (n = 23) and comparative analysis to a second retrospective data series (n = 724) were gathered for the study period September 1994 to September 1999. The first data series included all persons at Casino Windsor who suffered a cardiac arrest. Data collected included: age, gender, death/survival (neurologically intact discharge), presenting rhythm (ventricular fibrillation (VF), ventricular tachycardia (VT), or other), time of collapse, time to arrival of security personnel, time to initiation of cardiopulmonary resuscitation (CPR) prior to defibrillation (when applicable), time to arrival of staff nurse, time to initial defibrillation, and time to return of spontaneous circulation (if any). Significantly, all arrests within this series were witnessed by the surveillance camera systems, allowing time of collapse to be accurately determined rather than estimated. These data were compared to those of similar events, times, and intervals for all patients in the greater Windsor area who suffered cardiac arrest. This second series was based upon the Ontario Prehospital Advanced Life Support (OPALS) Study database, as coordinated by the Clinical Epidemiology Unit of the Ottawa Hospital, University of Ottawa. RESULTS: The Casino Windsor had 23 cases of cardiac arrests. Of the cases, 13 (56.5%) were male and 10 (43.5%) were female. All cases (100%) were witnessed. The average of the ages was 61.1 years, of the time to initial defibrillation was 7.7 minutes, and of the time for EMS to reach the patient was 13.3 minutes. The presenting rhythm was VF/VT in 91% of the case. Fifteen patients were discharged alive from hospital for a 65% survival rate. The Greater Windsor Study area included 668 cases of out-of-hospital cardiac arrest: Of these, 410 (61.4%) were male and 258 (38.6%) were female, 365 (54.6%) were witnessed, and 303 (45.4%) were not witnessed. The initial rhythm was VF/VT was in 34.3%. Thirty-seven (5.5%) were discharged alive from the hospital. CONCLUSION: This study provides further evidence that PAD Programs may enhance cardiac arrest survival rates and should be considered for any venue with large numbers of adults as well as areas with difficult medical access.

Aged↗
PubMedDate not supplied

Skeletal age estimation in leg length discrepancy.

Sixty hand radiographs of children with known leg length discrepancy were reported independently in a "blind" manner by four radiologists using the Greulich and Pyle Atlas. Significant variation was found. Fifty percent of the children were assigned a skeletal age that differed by more than 1 year between radiologists; 10% varied by more than 2 years (p less than 0.05). Female skeletal age was considerably underestimated by an average of 11 months. Skeletal age estimation is one source of error in the timing of surgery for leg length equalization, especially when a single estimate is used. Skeletal age also appears to be more variable in children with leg length discrepancy.

Adolescent↗