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Biomedical subjects

D T Reilly

Publications and source records attributed to D T Reilly.

At least 37 records · Page 2Linked to original sources
PubMed1988

Percutaneous transluminal angioplasty for the ischaemic lower limb: the early Dunedin experience.

A consecutive series of 60 percutaneous transluminal angioplasties has been performed in 53 patients with severe peripheral ischaemia over a 4 year period. There were 78 lesions dilated with an initial technical success rate of 78%. Forty-eight lesions were dilated for severe claudication and 30 for rest pain or necrosis. There was a mean followup of 24 months (range 9-56) for the immediately successful angioplasties. When these were analysed according to symptomatic relief, 59% of claudicants with iliac lesions were still improved at 2 years, compared with 86% of those with femoropopliteal lesions. Amongst patients treated for rest pain or necrosis there was a 100% success rate at 2 years for iliac lesions, compared with 49% for femoropopliteal lesions. The overall success of this procedure in this high risk group is reflected by the fact that at 2 years 85% of claudicants and 72% of those with rest pain and necrosis have avoided any further procedure. This encouraging early experience confirms the place of interventional radiology in the management of peripheral vascular disease.

Adult↗
PubMed1988

Dynamic loading of normal joints.

The biomechanics of joints are discussed with regard to the relative motion of the bones controlled by a combination of muscle forces, condylar shape, and ligamentous constraints. The author describes the joint reaction forces that are a result of muscle forces, and provides a detailed description of joint loads to the hip and knee.

Body Weight↗
PubMed1988

Strategies for improving fixation of femoral components in total hip arthroplasty.

As strategies are considered for improving fixation of femoral components in total hip arthroplasty (THA), one is challenged to exceed the standard set by contemporary cement procedures. However, despite the improved ten- to 15-year clinical results anticipated with current cementing techniques, the limited fatigue strength of polymethylmethacrylate warrants continued investigation of alternative systems, particularly for younger patients and in revision arthroplasty. Design considerations for femoral stems for cementless THA include (1) initial mechanical stability afforded by the stem shape, (2) strength and stiffness of the stem, and (3) surface features relating to biocompatibility and attachment to bone. In one approach a fit-and-fill algorithm has been implemented to design stems that maximize contact between prosthesis and cortex in priority areas to achieve stability. Titanium is recommended for the fabrication of such stems because of its corrosion resistance, its biocompatibility, and its modulus, which is lower than that of cobalt-chromium alloy. Long-term fixation of these implants will be dependent upon the maintenance of normal strain patterns in the host bone. Achievement of this goal will require additional strategies that combine optimal fit and optimal material properties of the prosthesis.

Biocompatible Materials↗
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↗
PubMed1986

Is homoeopathy a placebo response? Controlled trial of homoeopathic potency, with pollen in hayfever as model.

The hypothesis that homoeopathic potencies are placebos was tested in a randomised, double-blind, placebo-controlled trial. The study model chosen compared the effects of a homoeopathic preparation of mixed grass pollens with placebo in 144 patients with active hayfever. The homoeopathically treated patients showed a significant reduction in patient and doctor assessed symptom scores. The significance of this response was increased when results were corrected for pollen count and the response was associated with a halving of the need for antihistamines. An initial aggravation of symptoms was noted more often in patients receiving the potency and was followed by an improvement in that group. No evidence emerged to support the idea that placebo action fully explains the clinical responses to homoeopathic drugs.

Adolescent↗
PubMed1986

Effects of total knee replacement design on femoral-tibial contact conditions.

Ten fresh knee specimens with prosthetic components inserted were tested in a loading rig. Compressive and shear force were applied to the femur with the tibia held fixed. The location of the femoral-tibial contact points was measured. The contact reaction forces, the shear forces, and the rocking moments transmitted to the tibial component were calculated. The variations in the test conditions were: high and low compressive force, flexion angles of 0 degree, 45 degrees, and 90 degrees, three curvatures of tibial plastic inserts, and the posterior cruciate retained or resected. When the posterior cruciate was retained, the contact points were close to the center of the component; for cruciate resection, the contacts were close to the anterior of the component. The shear forces and rocking moments were higher for cruciate resection, but the contact reaction forces were lower. There is a wide variety of knee prosthesis designs, but the amount of inherent stability between the femoral and tibial surfaces, and whether the posterior cruciate ligament is retained or sacrificed, are two of the most important design variables. This study shows that cruciate resection increases the shear forces and the rocking moments to the tibial components and that additional fixation means may be necessary to compensate. On the other hand, cruciate retention with low conformity gives higher contact forces, which may lead to more wear in the long term. Cruciate sacrificing designs with intercondylar guiding surfaces are a separate category of design and were not considered in this study.

Biomechanical Phenomena↗
PubMed1986

Computer-aided simulation, analysis, and design in orthopedic surgery.

Three-dimensional computer reconstructions of bony anatomy based on computed tomographic images and radiographs may be used to analyze, simulate, and design certain orthopedic procedures. In osteotomy surgery, the computer-reconstructed models may be used to measure critical angles, surface area, and congruity of the joint surfaces. Computer reconstructions may be used in total joint replacement surgery to simulate the effect of surgical reamers and rasps, to select the geometrically optimum standard implant, or to design a custom implant. In allograft reconstructive surgery, computer reconstructions may be used to measure bony defects and to identify the appropriate allografts for the reconstruction. Plastic models may be sterilized and used as templates to sculpt the allografts immediately preoperatively. In all three applications in orthopedic surgery, three-dimensional, computer-aided reconstructions have the potential to improve results and reduce morbidity.

Bone Transplantation↗
PubMed1983

Young doctors' views on alternative medicine.

A survey was undertaken to explore attitudes to alternative medicine among 100 general practitioner trainees. A positive attitude emerged from the 86 respondents, with 18 doctors using at least one alternative method themselves and 70 wanting to train in one or more. A total of 31 trainees had referred patients for such treatments; 12 of these doctors made referrals to non-medically qualified practitioners. The most commonly used alternative treatments were hypnosis, manipulation, homoeopathy, and acupuncture. A total of 22 doctors had been treated, or had treated themselves, by an alternative treatment, and this personal experience was linked to a greater professional use. These findings indicate that alternative methods of treatment are currently being used to complement orthodox medicine and an expansion in their use appears imminent.

Acupuncture Therapy↗
PubMed1982

Phlebography in the salage of dialysis fistulae.

Provision of long-term satisfactory vascular access for haemodialysis is an increasing problem. The functional life of an arteriovenous fistula can be greatly extended by an active salvage policy to which radiology makes an invaluable contribution. Forty-seven consecutive patients with vascular access problems were studied, 11 undergoing forearm phlebography and 36 phlebography of a malfunctioning fistula. Of the 11 patients with forearm phlebograms, only one patient had a fistula constructed that was not used for dialysis, despite demonstration of a patent forearm venous system; and in three patients operation was avoided after demonstration of inadequate veins. Only three of the 36 fistulograms failed to give useful information, whereas in seven patients operation was avoided by demonstration of a normal fistulogram.

Arteriovenous Shunt, Surgical↗