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Biomedical subjects

E B Evans

Publications and source records attributed to E B Evans.

At least 37 records · Page 2Linked to original sources
PubMed1987

The effect of implant axial and torsional stiffness on fracture healing.

A study was performed to compare the mechanical properties of healing transverse femoral osteotomies fixed with either (a) plates of high or low axial stiffness (compression or slotted plates) but equivalent bending and torsional stiffnesses, or (b) rods of high or low torsional stiffness (solid or slotted rods) but equivalent bending and axial stiffnesses. Compression and slotted plates were implanted contralaterally in one group of adult mongrel dogs and solid or slotted rods were implanted contralaterally in a second group as fixation for transverse osteotomies. We found that the compression-plated femora regained strength and stiffness earlier than the slotted-plated femora and healed with less callus formation. The femora fixed with rods healed with no significant differences in properties at any time interval. Also, the femora fixed with rods had mechanical properties close to those of the slotted-plated femora and lower than those of the compression-plated femora at the same time intervals. We concluded that contact compression caused the differences in the healing results and was more important than differences in torsional or axial rigidity of the implant.

Animals↗
PubMed1987

Colorectal cancer: a large unselected Australian series.

An unselected prospective consecutive series of 575 patients with a single adenocarcinoma of the colon and of 331 patients with a single adenocarcinoma of the rectum registered between 1971 and 1984 at the Princess Alexandra Hospital is reported. The tumours were staged according to the Australian Clinicopathological Staging (ACPS) System. Approximately one-quarter of the patients were incurable when they presented. For curative operations for carcinoma of the colon, the operative mortality was 3%. For curative operations for carcinoma of the rectum, the operative mortality was 1% for abdominoperineal resection and 4.5% for anterior resection. The relative 5 year survival for all patients was 54.5%. The findings are compared with other large Australian series as well as with series from the United Kingdom and the United States.

Adenocarcinoma↗
PubMed1986

Emergency right hemicolectomy in colon carcinoma: a prospective study.

The morbidity and mortality in right hemicolectomy for carcinoma of the colon is examined, with particular attention to the influence of emergency surgery and advanced disease. Of the 244 patients who had surgery, 57 required emergency surgery and 187 elective surgery. The overall mortality was 5.7% with no difference statistically between the elective and emergency groups. Anastomotic complications were significantly greater in the groups undergoing emergency resection and elective palliative surgery when compared with elective curative surgery. All patients with advanced disease had a higher morbidity and mortality, both in elective and emergency surgery. The factors most important in relation to mortality and morbidity were thus advanced disease, advanced age and cardiorespiratory complications. This being the case, it is felt that the present management of emergency right hemicolectomy with anastomosis should continue to be the treatment of choice for obstructing or perforated carcinomas of the right colon.

Age Factors↗
PubMed1986

Unstimulated renal venous renin ratio predicts improvement in hypertension following nephrectomy for unilateral renal disease.

The ability of renal venous renin ratio (RVRR) to predict the blood pressure response to nephrectomy was studied in 45 hypertensive patients followed for at least 1 year after nephrectomy. Twenty patients had unilateral chronic parenchymal renal disease (UCPR) and 25 patients had unilateral renal artery stenosis (RAS). The RVRR procedure was performed according to a strict protocol which included sodium restricted diet (40 mmol daily) and hospital admission, with one set of unstimulated samples collected after overnight recumbency, and at least one further set collected after sympathetic nervous system stimulation induced by tilting or i.v. diazoxide. In only 3 of 12 patients with serum creatinine 0.15 mmol/l or higher and presumed bilateral renal disease was hypertension improved. If these 12 patients are excluded, RVRR was a good predictor of outcome, but only if the question of unstimulated and stimulated ratios was considered. Whereas inclusion of stimulated ratios increased the predictive accuracy to 81% in RAS, and avoided two false-negatives, in UCPR the stimulated ratio created four false-positives. Since there were no false-negatives and six true-negatives in UCPR, overnight recumbent RVRR was a perfect predictor of outcome in this sub-group. It appears that RVRR without sympathetic stimulation is most reliable in UCPR, and RVRR during sympathetic stimulation in RAS, raising the question that renin regulation may be different in these two conditions.

Adolescent↗
PubMed1986

Skeletal suspension in the management of severe burns in children. A sixteen-year experience.

From 1966 to 1983, skeletal suspension was used at the Shriners Burns Institute, Galveston, Texas, for the treatment of 626 burned pediatric patients who had 1128 affected extremities. Skeletal suspension was used for 863 acutely burned extremities (76.5 per cent) to facilitate skin-grafting and in 265 extremities (23.5 per cent) for functional positioning in the surgical correction of burn-acquired deformities. In a retrospective examination of these patients, there were fifty complications (4.4 per cent) related to the skeletal suspension, of which forty-five (4.0 per cent) were infections. All infections resolved with removal of the pins or the administration of antibiotics, or both. With this established low rate of complications, skeletal suspension continues to be a useful adjunct in the care of the severely burned pediatric patient.

Acute Disease↗
PubMed1985

Tumoral calcinosis: a case report and review of the literature.

Tumoral calcinosis rarely occurs in the hand. It is an uncommon familial disease suggesting an autosomal recessive gene pattern, often with laboratory findings of hyperphosphatemia and normocalcemia. Our patient had bilateral hand involvement, including local calcinosis cutis of the skin and bone changes not previously reported in the literature. At a 2-year follow-up after two lesions were excised from her left hand, one lesion had completely resolved and the other recurred. Two large symptomatic lesions and one area of local calcinosis cutis in her right hand have recently been excised.

Adolescent↗
PubMed1984

Staging of colorectal cancer. The Australian clinico-pathological staging (ACPS) system compared with Dukes' system.

A new system, the Australian Clinico-pathological Staging (ACPS) System, has recently been proposed for the recording and reporting of colorectal carcinoma. This system requires the accurate use of precise definitions, cooperation between surgeons and pathologist, and a complete pathology report. It utilizes all information available--clinical, radiologic, operative, pathologic--before a stage is allotted. This contrasts with Dukes' system, which is based solely on the pathologic examination of the resected carcinoma. It allows classifications of all cases of colorectal cancer seen, whether treated by resection, palliative surgery, local excision or not at all. The stage at presentation and the five-year survival of 490 patients with colorectal cancer are compared using the ACPS and Dukes' systems. Eighty-four cases were not classifiable under Dukes' system, and there was a significant difference in survival in one of the comparable groups of patients.

Adenocarcinoma↗
PubMed1983

Colorectal cancer at the Princess Alexandra Hospital: a prospective study of 729 cases.

The results of treatment of 729 patients with cancer of the large bowel treated at the Princess Alexandra Hospital from January 1971 to December 1980 have been analysed. The majority (540 patients or 74.1%) presented with symptoms requiring investigation, and there was an incidence of acute obstruction of 17.6% (128 patients). In just over half the patients (55.3%) there was a significant delay in diagnosis. The operative mortality rate for curative resections for both rectal and colonic cancer was 2.7%. There was no mortality in 24 curative local resections for rectal cancer. The resection rate for the whole group was 87.4% and the age corrected 5-year survival rates were Dukes' A 99.1%; Dukes' B 78.3%; and Dukes' C 32.4%. These results are compared with those reported in a retrospective study from this Hospital in 1975 and with those from other Australian and overseas centres.

Adult↗
PubMed1982

Pelvic recurrence after curative resection for carcinoma of the rectum.

Cases of carcinoma of the rectum have been prospectively studied from 1971-80. Two hundred and ten patients had curative resections and 25 of these developed clinical pelvic recurrence in the period of follow-up which ranges from one to eleven years. The rate of recurrence is found to be dependent on the level of the lesion and the degree of its local and lymphatic spread. Results from other papers are discussed. Measures to minimise local recurrence are discussed.

Aged↗
PubMed1980

Human anti-chickenpox immunoglobulin in the prevention of chickenpox.

Human anti-chickenpox immunoglobulin (zoster immune globulin, ZIG) was largely ineffective in preventing infection in forty-three high-risk contacts of chickenpox. Twenty-nine of these non-immune infants and children who had been in close contact with cases of varicella became infected, and symptoms developed in twenty-four. Since ZIG may modify chickenpox it should continue to be given to high-risk contacts until the availability of a simple and sensitive test makes it possible to identify those who are susceptible. However, ZIG is not necesary for infants whose mothers have chickenpox or zoster five or more days before delivery, since all such infants (eleven) had varicella-zoster antibody at birth.

Adolescent↗
PubMed1978

Fractures of the femoral shaft treated surgically. Comparative results of early and delayed operative stabilization.

In a study of the results of operative reduction and internal stabilization of eighty-nine femoral fractures, operative reduction was performed within six days in fifty-four of the fractures and between seven and thirty days in thirty-five. Dual Eggers plates were used in sixty-three fractures; intramedullary nails, in eighteen; a nail-plate, in six; and a single plate, in two fractures. The criteria for ultimate healing were roentgenographic demonstration of bridging callus and the ability of the patient to bear full, unsupported weight on the extremity. Healing that occurred later than nine months after fracture was considered to be delayed. In the group treated by early operative management, the incidence of delayed union was 18 per cent and of non-union, 18 per cent. In the group treated by delayed operative management, the incidence of delayed union was 3 per cent and there were no instances of non-union. All ten non-unions, ten of the eleven delayed unions, and five of the six infections occurred in the early operative group.

Adolescent↗
PubMed1977

Fractures of the scapula. An analysis of forty cases and a review of the literature.

In forty patients treated at The University of Texas Medical Branch Hospitals for fifty-two fractures of forty-one scapulae from 1961 through 1973, most of the fractures were the result of vehicular accidents. The thirty-eight fractures involving only the body, neck, or spine of thirty scapulae (without involvement of the acromion, glenoid, or coracoid process) were successfully treated with a sling and early active motion. Three other fractures involving body were associated with three fractures involving the glenoid. The eleven fractures of the acromiom, glenoid, or coracoid process resulted in loss of motion in ten of the eleven shoulders. For fractures of this type we now recommend immobilization in 60 degrees of abduction, 25 degrees of flexion, and 25 degrees of external rotation, with early active abduction exercises. Open reduction is rarely indicated, only when there is disruption of the glenohumeral joint.

Adolescent↗
PubMed1975

A survey of motor vehicle burn accidents in children: report of 45 cases.

The association of burns with motor vehicles was reviewed from the records of 1,532 children treated at the Galveston Shriners Burns Institute since 1966. Forty-five children were burned in or about a motor vehicle. The most common causes were gasoline spillage in moving vehicle accidents, and small children playing with matches unattended in a stationary vehicle. Motor vehicle burn patients had more serious and larger burns than in the general burn population. Of the 34 children burned within the confined space of a motor vehicle, 94% suffered face and/or hand burns. There was a high incidence of respiratory problems. In the moving motor-vehicle fire accident group there were 13 major injuries seen in 17 patients. Of the total motor vehicle occupancy in 38 separate accidents, 19 people died and 66 were hospitalized at the SBI or elsewhere.

Accidents, Traffic↗