Biomedical subjects
J R Silver
Publications and source records attributed to J R Silver.
Pulmonary embolism following anticoagulation therapy.
Five patients with traumatic spinal injury received a course of oral anticoagulant therapy with warfarin, heparin, or phenindione for 90 days following injury. These patients, on discontinuation of anticoagulant therapy, developed pulmonary embolus; two of these were confirmed by ventilation perfusion lung scintigraphy, and two were confirmed at post-mortem. The reasons for this are discussed, in particular the importance of delayed anticoagulation, obesity, operations, and mobilization in wheelchairs. The implications for further treatment are discussed.
Electromyographic study of sternocleidomastoid and scalene muscles in tetraplegic subjects during respiration.
An electromyographic investigation of inspiratory respiratory muscles was carried out in six tetraplegic and two normal subjects using needle electrodes. When the normal subjects were using tidal breathing there was no activity present. In the majority of tetraplegic subjects, activity was present in the scalene muscle during tidal breathing. This activity became more marked during deep inspiration. The muscles were hypertrophied and these muscles filled an important respiratory role.
The relationship of heterotopic ossification to passive movements in paraplegic patients.
Heterotopic ossification (HO) occurs in 4-49% of patients with spinal cord injury, but the cause of the complication has not been established. The aim of this study was to investigate clinical factors related to the occurrence of HO. The incidence of HO was determined in 91 consecutive patients with traumatic lesions of the spinal cord who had been admitted to the National Spinal Injuries Centre for management and rehabilitation. Clinical data were analysed. Clinically apparent HO occurred only in 10 of 56 patients in whom the start of passive movements to their paralysed limbs was delayed until 7 days or more from time of injury. The findings of this study are consistent with the view that HO occurs as a result of trauma induced by passive movements carried out on joints where contractures have started to develop.