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Biomedical subjects

G Horne

Publications and source records attributed to G Horne.

At least 37 records · Page 2Linked to original sources
PubMed1996

Albumin levels and mortality in patients with hip fractures.

AIM: The aim of the study was to examine the serum albumin levels of patients admitted with hip fractures to see whether there was any relationship between serum albumin and subsequent mortality. METHODS: A group of 39 consecutive patients with hip fractures was followed for a period of 12 months. The serum albumin was determined preoperatively. No patient was lost to follow up. RESULTS: Ten patients died at 12 months. Those who died had a significantly lower serum albumin level than those alive at the end of the follow up period. CONCLUSIONS: The results of this study show that preoperative serum albumin determination in patients with hip fractures is a useful guide to postfracture mortality.

Aged↗
PubMed1996

Oestradiol and immunoreactive inhibin-like secretory patterns following controlled ovarian hyperstimulation with urinary (Metrodin) or recombinant follicle stimulating hormone (Puregon).

Inhibin (and its alpha-subunit) may be of particular value as a marker for follicular development in in-vitro fertilization (IVF) in comparison with the classic follicle stimulating hormone (FSH)-dependent marker oestradiol in patients following pituitary desensitization and treatment with recombinant FSH (rFSH). This preparation lacks luteinizing hormone (LH), which is essential for thecal cell androgen secretion and thus oestradiol production. Our study has assessed oestradiol and immunoreactive inhibin-like secretion following ovarian stimulation with rFSH or a purified urinary FSH preparation (Metrodin) (uFSH). A randomized, assessor-blind study was initiated using patients receiving a single treatment cycle of IVF (using fresh embryos) following pituitary desensitization with intranasal buserelin (500 microg daily) and the i.m. injection of either rFSH (n = 38) or uFSH (n = 17). Ovarian ultrasound examinations were performed and bloods (10 ml) collected prior to FSH treatment and every 1-2 days until ovulation induction with human chorionic gonadotrophin. LH and FSH concentrations were measured by an immunoradiometric assay, and inhibin-like immunoreactivity by a radioimmunoassay and an enzyme-linked immunosorbent assay, both with alpha-subunit specificity. Oestradiol concentration was measured with a coated tube radioimmunoassay. Following desensitization, basal LH, FSH and oestradiol concentrations were measured, as was that of immunoreactive inhibin. Following treatment with either rFSH or uFSH, LH concentrations remained low while FSH concentrations rose to a plateau of 5.6-6.7 IU/l in both groups. In contrast, the concentration of oestradiol was higher (P < 0.05) with rFSH than with uFSH in the last four days of treatment, a pattern that was repeated for inhibin-like immunoreactivity. The change in oestradiol and inhibin concentrations during treatment was approximately 2-fold higher with rFSH. The total number of follicles obtained with rFSH was similar to that with uFSH. However, the number of follicles with a diameter of >/= 15 mm was higher the rFSH group, and there was a concomitant increase in the number of oocytes recovered. Oestradiol concentration and inhibin-like immunoreactivity (determined by either method) were associated with total follicle number and number of follicles >/= 15 mm in diameter, as well as with each other (P < 0.001). When ovarian hormone output was normalized per follicle produced, oestradiol output was higher for rFSH than for uFSH P = 0.04). Inhibin output was clearly higher using rFSH than uFSH. There were seven pregnancies (one miscarriage) with rFSH and two with uFSH. Despite similar concentrations od FSH in patients, rFSH (Puregon) appears to be more potent in vitro in terms of follicular number, ovarian hormone secretion (both concentration and output/follicle) and oocyte recovery. In both groups, LH concentrations of approximately 1.3 IU/l were sufficient to support oestradiol secretion similar to that normally found in IVF programmes using human menopausal gonadotrophin preparations containing large amounts of LH. Despite known problems of specificity with the assays od inhibin, its measurement was of similar value to oestradiol as a marker of follicular development.

Adult↗
PubMed1995

Osteosarcoma in New Zealand 1981-7: an overview.

AIMS: To examine the incidence, and results of treatment of osteosarcoma in New Zealand between 1981 and 1987. METHOD: Data was obtained from the Cancer Registry for all patients registered with osteosarcoma between 1981 and 1987. RESULTS: There were 104 patients in the study group. There was a peak incidence in the second decade with a second smaller peak in the seventh and eight decades. The overall 5 year survival rate was 29%. For the group aged under 30 years there was a 44% 5 year survival rate. Those aged over 60 years had a 3.2% 5 year survival. Survival rates were better when treated with surgery and chemotherapy and where the tumour was of the appendicular skeleton. CONCLUSION: This is a mixed group of patients. The 5 year survival rates appear to be at the lower end of the spectrum of the results reported for similar groups in other countries.

Adolescent↗
PubMed1995

The incidence of hip fractures in Maori and non-Maori in New Zealand.

AIMS: To investigate the incidence of hip fractures in Maori and nonMaori in New Zealand. METHODS: The number of femoral neck fractures in patients over 60 in New Zealand for the years 1989-91 were obtained. The population data for 1991 was obtained from the 1990 census. The number of fractures was standardised for age, and the rate of fractures per 100,000 of population calculated. RESULTS: The age standardised rates of hip fracture per 100,000 of population 1989-91 for Maori males was 197, Maori females 516, nonMaori males 288 and nonMaori females 827. These rates were higher than the rates recorded between 1973 and 1975. CONCLUSIONS: The age-specific hip fracture rate is rising in New Zealand. However in Maori males the rate is not rising.

Age Distribution↗
PubMed1995

The quarantine of fertilized donated oocytes.

The fertilization and subsequent cryopreservation of donated oocytes have enabled the resulting embryos to be quarantined for a minimum of 6 months, and to be thawed and replaced only after the donor has had a second negative human immunodeficiency virus (HIV) test. In the study described here, a total of 39 women had 56 embryo transfers, and 12 pregnancies (21% per transfer) were achieved. The logic of the protocol for minimizing the risk of infection of the recipient, which is in line with that of semen donation, is presented, together with an argument for the feasibility of such an approach.

Adult↗
PubMed1994

Islet cell antibodies predict insulin-dependent diabetes in United States school age children as powerfully as in unaffected relatives.

Islet cell antibodies (ICA) in the sera of nondiabetic relatives of patients with insulin-dependent diabetes (IDD) are predictive of the disease, a finding that permits the design of intervention strategies to prevent it. However, 85% or more of patients with new onset IDD have no affected relative. We therefore screened 9,696 schoolchildren between the ages of 5 and 18 yr (mean age 10.7 yr) in Pasco County, Florida for ICA in three surveys during 1984/5, 1987/8, and 1990/1 and have followed them prospectively. Approximately 4,000 of these children have been followed for nearly 8 yr. ICA titers > or = 10 Juvenile Diabetes Foundation units on replicate tests were detected in 57 of the children (0.59%). 10 children have developed diabetes so far, and all had ICA detected beforehand. The likelihood of developing IDD among the ICA-positive children was compared with 2,959 age-matched nondiabetic first degree relatives of IDD probands who were screened for ICA by our laboratory during the same time period and also followed prospectively. Of 103 (3.5%) ICA-positive relatives, 31 have developed IDD. Life table analysis reveals no statistically significant differences in the probability of developing IDD between the ICA-positive schoolchildren and ICA-positive first degree relatives (P = 0.3). The estimated risk of developing IDD by 7 yr in the ICA-positive schoolchildren was 45% (95% confidence interval 15-74%) compared with 43% (confidence interval 22-63%) in the relatives. We conclude that ICA appear to be as predictive of IDD in low-risk schoolchildren as they are in high-risk relatives. These data suggest that it is feasible to predict IDD by screening a general population of schoolchildren for ICA and that those found to be positive could be considered, in addition to relatives, for intervention protocols to prevent the disease.

Adolescent↗
PubMed1994

Dislocation of posteriorly stabilized total knee arthroplasties.

Two cases of dislocation of an Insall-Burnstein II knee are reported. They occurred when a rotational force was applied to the loaded knee positioned in extreme flexion. Both dislocations were reduced closed and were found to be stable in the reduced position. The patients did well, and revision surgery was not required. No case of dislocation of this particular posterior stabilized total knee system has been reported previously.

Aged↗
PubMed1993

Preoperative assessment of the acetabulum.

Preoperative assessment of the acetabulum requires a good knowledge of the normal acetabular anatomy, good plain radiographs, and a knowledge of the various defect patterns that may influence the surgeon's ability to achieve secure fixation of the component at surgery. In certain situations, special radiographic techniques are advantageous.

Acetabulum↗
PubMed1993

Hip fractures: an increasing health care cost.

Studies in several countries have indicated that there is likely to be a dramatic increase in the number of hip fractures in the early part of the 21st century. At a time when health care costs are coming under close scrutiny internationally, the added financial burden of the increasing number of fractures is of concern. This study analyzes the cost of treating hip fractures in New Zealand in 1990 and projects forward the costs of treatment and the percentage of that portion of the government's health budget for the years 2001 and 2011.

Aged↗
PubMed1992

Air cushion mower foot injuries.

AIMS: This study was undertaken to identify significant physical, social and psychological problems resulting from injuries caused to the feet by air cushion mowers. METHODS: Thirty-four patients seen with air cushion mower injuries were reviewed, either by personal assessment, or by questionnaire. RESULTS: A large number of patients had significant symptoms relating to their soft tissue or bone injuries, the majority experiencing some pain, and those who had amputations difficulty in some aspects of walking. CONCLUSIONS: Better education of the dangers of the misuse of these mowers may reduce the incidence of significant forefoot injuries.

Accidents, Home↗
PubMed1992

Enoxaparin prophylaxis for deep vein thrombosis in orthopaedic surgery.

Seventeen patients undergoing elective total hip or knee joint replacement were given enoxaparin prophylaxis against deep vein thrombosis. Four patients developed clinical evidence of deep vein thrombosis, confirmed by venography. Two patients developed disseminated intravascular coagulation.

Aged↗
PubMed1992

Is continuation of a gonadotrophin-releasing hormone agonist (GnRHa) necessary for women at risk of developing the ovarian hyperstimulation syndrome?

A total of 28 women scheduled for in-vitro fertilization used buserelin and human menopausal gonadotrophin (HMG) for ovarian stimulation. One group (I) of 17 women was given human chorionic gonadotrophin (HCG 10,000 IU) to trigger ovulation, but the resulting embryos were electively cryopreserved because of the risk (serum oestradiol greater than or equal to 3500 pg/ml) of developing the ovarian hyperstimulation syndrome (OHSS). Six women continued the buserelin therapy in the luteal phase and eleven did not. In group II (n = 11), the HMG injections were discontinued because of an exaggerated ovarian response and the HCG was omitted. Six of these women continued the buserelin injections until the onset of menses and five did not. In both groups, the ovarian response to induction of ovulation (serum oestradiol concentrations and number of follicles) was similar for those who did or did not continue buserelin therapy. There was no difference in the rate of ovarian quiescence (weekly fall in serum oestradiol concentration following the stimulation) between those women who did or did not continue the buserelin therapy in either group. The serum luteinizing hormone concentrations remained low in all women in both groups. We conclude that the omission of buserelin therapy after discontinuing the HMG in women at risk of developing OHSS does not affect subsequent ovarian quiescence.

Adult↗