Search PubMed⌕ Search

Biomedical subjects

J Walton

Publications and source records attributed to J Walton.

At least 91 records · Page 5Linked to original sources
PubMed1987

Pinch skin grafting or porcine dermis in venous ulcers: a randomised clinical trial.

Chronic venous ulcers are common, and even with effective compression or elevation large ulcers may take months to heal. Pinch skin grafting may allow healing from epithelial islands throughout the surface area of the ulcer, and a prospective randomised trial was therefore conducted comparing this treatment with porcine dermis dressings. Most patients were treated as outpatients, 25 ulcers being randomised to treatment with pinch skin grafts and 28 to treatment with porcine dermis. Though the groups were well matched, the mean healing rate in the first week was 15 cm2 for pinch skin grafts compared with 3.5 cm2 with porcine dermis (p less than 0.02). By life table analysis 64% of ulcers treated by pinch grafts were healed at six weeks and 74% by 12 weeks compared with 29% and 46% of ulcers, respectively, treated with porcine dermis dressings (chi2 = 4.1; p less than 0.05). All ulcers that failed to heal within 12 weeks included an area posterior to the medial malleolus, where local compression may have been inadequate. Pinch skin grafting improves the rate of healing in large venous ulcers and is a simple technique that may be performed as an outpatient procedure under local anaesthesia.

Bandages↗
PubMed1987

Controlled trial of occlusive dressings in healing chronic venous ulcers.

Fifty-six patients with chronic venous ulcers present for a mean of 2.4 years were randomized to either a new occlusive hydrocolloid dressing (Granuflex, Squibb Surgicare) or a porous non-adherent dressing (N A, Johnson and Johnson). In all patients, dressings were applied beneath a standard graduated compression bandage. There was no difference between the two groups, with complete healing in 21 out of 28 (75 per cent) of occlusive dressing patients and 22 out of 28 (78 per cent) with N A dressings by 12 weeks. Careful graduated compression bandaging achieves healing even in the majority of so-called resistant chronic venous ulcers; there was no additional benefit from applying occlusive dressings which tend to be expensive.

Adult↗
PubMed1987

Minor psychiatric morbidity in a casualty population: identification, attempted intervention and six-month follow-up.

The prevalence of minor psychiatric morbidity (MPM) was investigated in 523 adults presenting to the casualty section of an Australian public hospital. Relationships between subject characteristics and the level of MPM were also examined, together with the acceptability of an offer of short-term intervention and the effectiveness of this intervention in reducing distress. Threshold morbidity on initial presentation to casualty was 41% (using the GHQ-12 with the customary 1/2 cut-off point) and the probable prevalence was estimated to be about 27%. The intervention was initially offered to a random sample of those identified as being 'under stress' (GHQ of three or above), but as there was a 90% rejection rate, it was offered to all symptomatic subjects. Overall, 26% accepted our offer of intervention. Those who accepted intervention and those who rejected it did not differ in their improvement in MPM during the subsequent six months. However, these groups improved slightly more than the group that was eligible for intervention but to whom it was not offered. Forty-seven per cent of subjects who were 'under stress' on initial presentation to casualty fell below the GHQ-12 threshold at the six-month follow-up; this compared with a shift of only 26% in the opposite direction (i.e., non-stressed to stressed). Regression to the mean offered the most parsimonious explanation for these GHQ changes.

Adult↗
PubMed1986

A prospective randomized clinical trial of intracoronary streptokinase versus coronary angioplasty for acute myocardial infarction.

We randomly assigned 56 patients who presented within 12 hours of their first symptoms of acute myocardial infarction to treatment with either intracoronary streptokinase or coronary angioplasty. The mean (+/- SD) duration of symptoms (3.0 +/- 1.2 hours in the group treated with angioplasty vs. 3.6 +/- 1.8 in the group treated with streptokinase; P not significant) and time to recanalization (4.1 +/- 1.4 hours vs. 4.8 +/- 1.7 hours; P not significant) were similar in both groups. Coronary recanalization was achieved in 83 percent of the patients treated with angioplasty and in 85 percent of those treated with streptokinase (P not significant). Residual luminal stenosis in the coronary artery was significantly decreased after angioplasty, as compared with streptokinase therapy (43 +/- 31 percent of patients vs. 83 +/- 17; P less than 0.001). Residual stenosis of 70 percent or more was present in 4 percent of the angioplasty-treated patients and in 83 percent of the streptokinase-treated patients (P less than 0.01). Ventricular function after therapy was assessed by serial contrast ventriculograms. Increases in both global ejection fraction (8 +/- 7 percent vs. 1 +/- 6; P less than 0.001) and regional wall motion (+1.32 +/- 1.32 SD vs. +0.59 +/- 0.79 SD; P less than 0.05) were greater for the angioplasty group. We conclude that angioplasty and streptokinase produce similar rates of early coronary reperfusion during evolving transmural myocardial infarction. However, angioplasty is significantly more effective in alleviating the underlying coronary stenoses, and this may result in more effective preservation of ventricular function after therapy.

Angiography↗
PubMed1986

A double-blind, placebo-controlled, crossover study of verapamil in exertional muscle pain.

Eleven patients, comprising three cases of McArdle's disease and eight with an exertional muscle pain syndrome (EMPS) of unknown cause, entered a double-blind crossover study of verapamil and placebo. None of the patients with McArdle's disease responded to verapamil, but two patients with unclassified EMPS experienced a striking improvement in symptoms and two others showed a partial response. No patient responded to placebo. Six of the eight cases with unclassified EMPS, including the four patients who responded to verapamil, had symptoms that indicated possible abnormalities of muscle metabolism, and four showed nonspecific biochemical, electromyographic, and muscle biopsy abnormalities. The two other EMPS patients had symptoms that suggested that a primary muscle disease was unlikely. They showed no laboratory evidence of muscle disorder, but had abnormal profiles on personality (MMPI) testing. Calcium antagonists, such as verapamil, may be useful in the treatment of some patients with benign exertional myalgia, but the mechanism of action of the drug in such cases is unclear.

Adult↗
PubMed1985

The prevalence of retained testes in Dunedin.

A cohort of approximately 500 boys was screened for retained testes at ages five and seven years and when the boys were aged three, five, seven and nine years, their parents were questioned about hospitalisation for surgery. Orchidopexy for retained testes had been performed on 15 of the 536 boys (2.8%) while one other had orchidopexy for high retractile testes (0.2%). Eighty-one percent of this surgery was performed between the seventh and ninth years of age.

Child↗
PubMed1985

The effect of water intake on body temperature during rugby matches.

The effect of drinking up to 1 litre of fluid on water deficit, sweat loss and rectal temperature was determined during three separate rugby matches played in thermoneutral environments. Each player was allotted a litre of fluid and encouraged to drink 500 ml before the start of the game and a further 500 ml at half-time. The players were weighed and rectal temperatures determined before and after the matches. Rectal temperatures were markedly elevated after all three matches and reached levels which may have been high enough to have impaired performance towards the end of the game. The volume of fluid ingested by the players had no influence on final rectal temperatures. The majority of the players had sweat rate/rectal temperature relationships similar to those of heat-acclimatized subjects. It is concluded that, in a thermoneutral environment, the ingestion of volumes of fluid up to 1 litre has no significant beneficial effect on thermoregulation during rugby games, and that the role of the clothing worn may have a greater influence on thermoregulation than was hitherto envisaged.

Adult↗
PubMed1985

Human tumour cell lines established in vitro from tumours after long-term passage as nude mouse xenografts. Comparative fingerprinting of their concanavalin-A acceptor glycoproteins.

Two human colon cancer xenografts (EC and AC) were established in tissue culture only after long-term passage in nude mice. Earlier attempts to establish cell lines were unsuccessful. The epithelioid cells retain their tumourigenicity after in vitro growth, giving rise to tumours with a take rate of 60-80%. After reimplantation, the xenografts retain a similar morphology to that of the original human tumours. Both cell lines show human karyology. Comparative mapping of Concanavalin-A acceptor glycoproteins provides a fingerprint characteristic of each cell line. These glycoprotein patterns are similar to those shown by HT-29, an established colon cancer cell line.

Animals↗