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Biomedical subjects

D Russell

Publications and source records attributed to D Russell.

302 records · Page 17Linked to original sources
PubMedDate not supplied

Biomechanical study of canine spinal fracture fixation using pins or bone screws with polymethylmethacrylate.

Five configurations of pins or screws interconnected with polymethylmethacrylate (PMMA) were applied to isolated canine lumbar spines (L2 to L5) in which a complete fracture-luxation had been produced at L3 to L4. Twenty-five repaired spines and five intact control spines were subjected to four-point bending and tested once to failure in ventral flexion. The purpose of this study was to determine the effects of pin number, pin angle, and use of 3.5-mm cortical bone screws instead of smooth 3.2-mm diameter pins on rigidity and ultimate strength of spinal fractures repaired by the implant-PMMA fixation technique. Bending moment versus the angular deformation curves were recorded. Rigidity, bending moment at 10 degrees angular deformation, moment at failure, and deformation at failure of each type of fixation were compared using analysis of variance. Spinal segments stabilized with eight pin-PMMA fixation had significantly greater rigidity and strength at failure than four pin-PMMA fixations (P < .05). Furthermore, spinal segments stabilized with eight pins angled away from the fracture failed at significantly greater bending moment than those with eight pins angled toward the fracture (P < .05). However, for four-pin fixation, greater strength was achieved by angling pins in the bone toward the fracture site (P < .05). Screw-PMMA fixations failed by screw bending and were less rigid and weaker at failure than the corresponding configuration of pin-PMMA fixation (P < .05).

Animals↗
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Exogenous lipid pneumonia related to smoking weed oil following cadaveric renal transplantation.

A 30-year-old female presented shortly after cadaveric renal transplantation with respiratory distress typical of a bacterial infection. Following initial improvement, she developed progressive respiratory failure, initially felt to be secondary to cytomegalovirus infection. Two bronchoalveolar lavages were nondiagnostic, and an open lung biopsy was performed, which revealed a pulmonary alveolar proteinosis (PAP) reaction and exogenous lipid pneumonia (ELP). The ELP was considered to be secondary to the use of marijuana, in the form of weed oil, that was smoked daily for over 10 years and stopped just before renal transplantation. This is the first description of both PAP and ELP following renal transplantation, and the first description of ELP related to smoking weed oil. Physicians should be aware of the different forms of marijuana available and of their potential medical complications.

Adult↗
PubMedDate not supplied

Cerebral microembolus detection in an unselected acute ischemic stroke population.

OBJECTIVE: The aims of this study were firstly to determine prevalence, frequency, and clinical significance of cerebral microemboli in an unselected acute ischemic stroke population and secondly to examine how this information may improve ischemic stroke subtype classification. METHODS: We intended to perform transcranial Doppler (TCD) microembolus monitorings of the middle cerebral artery (MCA) in the symptomatic hemisphere for 45 min in 120 consecutive patients with internal carotid artery territory ischemia. The first examination was performed within 72 h from start of symptoms and the second 5 +/- 1 days later. Platelet and coagulation system activation were measured following TCD monitoring in 38 patients. The strokes were subtyped using the TOAST classification criteria, and the patients' clinical status was assessed at discharge using the Scandinavian Stroke Scale and the Barthel Index. RESULTS: Microembolus monitoring was technically possible in 83 (69.2%) of the 120 patients. Thirty-two (26.6%) patients had an inadequate temporal bone acoustic window or were too restless to allow long-time monitoring. In 5 (4.2%) patients the relevant MCA was occluded. Twenty-two (26.5%) of the 83 patients had microemboli despite the fact that over 90% were receiving an antiplatelet or an anticoagulant treatment. The mean frequency of microemboli was 6.7 +/- 13.6 per 45 min. Microemboli were more prevalent in assumed cardioembolic stroke than in other subtypes of ischemic stroke (p = 0.047). We found no association between the presence of cerebral microemboli and the clinical outcome or the parameters for platelet or coagulation system activation. The presence of microemboli was not associated with in-hospital deaths (p = 0.17), whereas MCA occlusion was (p = 0.01). CONCLUSIONS: Cerebral microemboli are frequent in unselected acute ischemic stroke patients despite antiplatelet or anticoagulant treatment. TCD detection of microemboli provides valuable pathophysiological information and may, therefore, improve current ischemic stroke subtype classification.

Acute Disease↗
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The effectiveness of one-to-one risk communication interventions in health care: a systematic review.

OBJECTIVES: To assess whether risk-communication interventions are associated with changes in patient knowledge, attitudes, and behaviors, and to identify aspects of these interventions that modify these effects. DESIGN: Systematic review. DATA SOURCES: 96 studies from the period 1985-1996 retrieved by electronic searching of eight databases, hand searching of four journals, contacting key authors, and reference list searching. MAIN OUTCOME MEASURES: The effect size of the principal outcome was identified from each study. Outcomes measuring behavioral change were preferred; if these were not available, knowledge, anxiety, or risk perceptions were used, according to the focus of the study. Data were available to calculate the principal effect sizes for 82 of the studies. ANALYSIS: Meta-regression. RESULTS: The methodologic qualities of the studies varied. Nevertheless, risk-communication interventions generally had positive (beneficial) effects. Interventions addressing treatment choices were associated with larger effects than were those in other contexts, such as prevention or screening. Interventions using individual risk estimates were associated with larger effects than were those using more general risk information. Two design variables were identified as effect modifiers: randomized controlled trials were associated with smaller effects than other designs, and dichotomous outcomes were associated with larger effects than continuous outcomes. CONCLUSIONS: Risk communication interventions may be most productive if they include individual risk estimates in the discussion between professional and patient. Patient decisions about treatment appear more amenable to change by these interventions than attendance for screening or modification of risky behavior.

Communication↗
PubMedDate not supplied

Acquired bilateral superior oblique palsy: a localising sign in the dorsal midbrain.

Bilateral superior oblique palsy is an uncommon ocular motility problem, the commonest cause being closed head trauma. Two cases, both adults, are presented in whom bilateral superior oblique palsy occurred as a result of neoplastic infiltration of the dorsal midbrain in the region of the anterior medullary velum. In the absence of a history of head trauma, the presence of an acquired bilateral superior oblique palsy is a definite sign of a single lesion in the region of the decussation of the trochlear nerves and appropriate imaging is indicated.

Adolescent↗
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Organizational and employee predictors of outcomes of long-stay nursing home residents.

OBJECTIVE: Use three types of functional ability as predictors of nursing home patient outcomes. DESIGN: Best-subsets regression analysis. SETTING: 10 nursing homes. RESULTS: Initial functional ability was the most important predictor. Organizational variables such as workload, stress, and morale also explained some of the variance in patient outcomes. Characteristics of organizational structure predicted outcomes as well as employee self-reports and could be substituted for them without substantially reducing the explained variance. CONCLUSION: Future research projects should explore the causal relationship between structure and outcomes.

Activities of Daily Living↗
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Gross motor performance measure for children with cerebral palsy: study design and preliminary findings.

This project investigated the validity, reliability and responsiveness of the Gross Motor Performance Measure (GMPM). The GMPM was developed as an observational instrument to measure changes in quality of movement in children with cerebral palsy. Physical therapists from 3 children's treatment centres assessed 107 children with CP, 18 children with head injury and 33 non-disabled children. Assessments were conducted on 2 occasions, 4 to 6 months apart. The measurement protocol included assessment with the GMPM and the Gross Motor Function Measure (GMFM). Validity was tested by comparing changes in GMPM scores to parent and therapist independent ratings of the children's motor performance. Also, a sample (n = 30) of paired assessments was videotaped for 'masked' evaluation by therapists. Inter-rater, intra-rater and test-retest reliability studies (n = 30) were conducted. Responsiveness to change was determined through parent and therapist ratings of the importance of observed changes in quality of movement. Data collection for this study has just been completed. Validation hypotheses have been postulated regarding correlations between changes in GMPM scores; GMFM scores; age of children; diagnosis; severity of condition; parent, therapist and 'masked' evaluator judgement of change. Correlation analysis, t-test and analysis of variance results will be presented. Reliability data for the GMPM and parent/therapist rating scales will be presented using intra-class correlation coefficients. Data supporting responsiveness of the GMPM will be presented using an analysis of variance model for 'stable' and 'responsive' groups.

Adolescent↗
PubMedDate not supplied

Nurses make high tech high touch.

Until nurses at St. Mary's Hospital took the lead in establishing an outpatient infusion unit, oncology patients had to travel up to 100 miles to receive chemotherapy. Today, they need travel only ten minutes to receive the best and latest of a variety of high-tech services.

Ambulatory Care Facilities↗
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Artistic treatment.

Explore the source record for details and available documents.

Art Therapy↗
PubMedDate not supplied

The role of incision design and location in the healing processes of alveolar ridges and implant host sites.

This research examined the nature and role of a linea alba, found consistently at the crest of edentulous ridges in dogs. Angiovist dye was used to outline the microvasculature in these regions. The findings demonstrated a zone of avascularity directly beneath each linea alba. When novel incision designs were used in the gingivae and the outlined mucoperisteal flaps were elevated and then replaced, alterations in underlying bone morphology were noted. In a subsequent study during which implants were placed, a direct relationship was noted between incision design and level of pericervical bone support.

Alveolar Process↗