Biomedical subjects
Publications and source records attributed to J S Marsh.
Ankle injuries occur with considerable frequency in the pediatric population, although diagnosis is rarely straightforward. In this paper, we highlight the more common pitfalls in diagnosis and management, calling upon classic and contemporary literature and our own combined 30-year experience in managing pediatric lower extremity problems.
Youth sports are becoming increasingly popular in America. Previous studies have shown that children and adolescents are not small adults in their response to exercise and stress. Intensive competition and training may be associated with acute and chronic illness and injury. In addition, we comment on the injury risks that are generated by pressures to perform, injuries from urbanized non-team sports, and legislation underway to minimize these injuries. We also provide insight into psychological and sociological trends in the pediatric athlete and discuss the roles of the pediatrician, coach, trainer, and parent and the ways in which these roles impact upon injury and prevention in this population.
OBJECTIVE: The objective of this study was to characterize the Doppler waveform in the cartilaginous capital femoral epiphysis of healthy neonates with the aid of power Doppler and duplex Doppler imaging. SUBJECTS AND METHODS: In this prospective study, both hips were examined in 63 neonates. We used conventional sonographic imaging and power Doppler imaging. Spectral Doppler tracings were obtained when possible. Spectral analysis and resistive index measurements were performed. RESULTS: The examination was completed in 97 hips, revealing pulsatile arterial blood flow with a low-velocity, low-resistance, reproducible waveform. Mean resistive index was 0.48 +/- 0.11. Additional time spent on the Doppler study was documented in all patients and averaged 6 min. CONCLUSION: The arterial blood flow pattern in the femoral chondroepiphysis of healthy neonates has been described. The additional time spent doing the Doppler examination is acceptable. In future studies, this pattern of blood flow can be compared with that of abnormal hips and those undergoing treatment for developmental dysplasia.
An expression is derived relating retinal image size to object size when the object is seen through a pupil forming an aperture stop for the eye. The image size is related to object position, pupil position, and state of accommodation of the eye on the assumption that the chief ray determines the image of an out-of-focus object. Data obtained by Biersdorf and Baird agree with the expression. The expression is used as the basis of a quantitative discussion of Hennessy's informal experiment and Roscoe's zoom lens hypothesis.
The efficacy of a program of transfusion of previously deposited autologous blood for patients undergoing total hip-replacement surgery was studied by comparing five different parameters for a group of fifty consecutive patients who deposited blood for autologous transfusion and a randomly chosen, closely matched control group of fifty patients who received only homologous blood. Sixty-two per cent of the patients in the group that deposited autologous blood did not receive additional homologous blood while in the hospital. The patients who deposited autologous blood had a mean preoperative hematocrit of 36 per cent, compared with 39 per cent for the control group, but the average postoperative hematocrits of the two groups did not differ (33 per cent). There was no significant difference in the average total loss of blood or need for replacement of blood between the groups. Transfusion-related complications developed in two patients in the control group. We concluded that previous deposit of autologous blood for transfusion is an effective method for reducing the need for transfusion of homologous blood and for avoiding the attendant complications of transfusion of homologous blood. This method of the replacement of blood should be considered for patients who are to undergo a major orthopaedic procedure on the hip.
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The EEC common agricultural policy (CAP) is examined as a food policy, including the adequacy of its response to consumers' needs; the suggestion is made that, although some successes can be claimed, the overall picture is not satisfactory. Some of the work on food standards within the EEC is recorded, and attention is drawn to the nutritional aspects of CAP and to the implications of EEC actions for world food policy.
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Sickle-cell disease is a well-recognized clinical entity. The pathophysiology of this hemoglobinopathy has been described in detail by numerous investigators since the first case report appeared in 1910. Orthopaedic manifestations of sickle-cell disease account for much of the morbidity associated with this disorder, including pain, osteonecrosis, arthritis, and sepsis. Effective management of these bone and joint sequelae reflect accurate diagnosis, understanding of this disorder's pathophysiology, and knowledge of available medical and surgical treatment alternatives. In this review, the authors summarize the major orthopaedic manifestations of sickle-cell disease with special emphasis placed upon osteonecrosis and osteomyelitis, since these conditions are the most disabling and serious complications in patients with sickle-cell disease.
We retrospectively reviewed five patients with chronic acquired dislocation of the radial head, treated with open reduction and ligament reconstruction with a slip of the triceps tendon. Three of the cases were posttraumatic, one was a dislocation resulting from a mass-occupying lesion, and one case was caused by recurrent radial head subluxation occurring after an initial traumatic episode. An ulnar osteotomy was used in one case to allow reduction of the radial head. All patients had a good postoperative functional and radiographic outcome, without postoperative complications. In two cases, there was slight loss of motion in relation to the contralateral extremity. Reconstruction of the annular ligament by using a strip of the triceps fascia is a safe and effective treatment in the treatment of chronic acquired radial head dislocation.