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Biomedical subjects

M R Barnes

Publications and source records attributed to M R Barnes.

At least 37 records · Page 2Linked to original sources

The value of 99Tcm-MDP bone scans in young patients with exercise-induced lower leg pain.

This study compares the bone scan appearances in 32 patients with medial tibial syndrome (MTS) with the appearance in 28 patients with confirmed chronic compartment syndrome (CCS). A distinctive pattern of uptake was seen in 30 patients, 24 of whom had MTS and 6 of whom had CCS. Of the patients with normal scans, only 4 had MTS, the remaining 15 had CCS. Both of these findings are statistically significant and confirm that bone scans are a useful diagnostic tool in the differential diagnosis of exercise-induced lower leg pain.

Adult↗

Popliteal entrapment syndrome: misdiagnosed as a compartment syndrome.

We report a case of popliteal artery entrapment syndrome which was originally diagnosed as a chronic compartment syndrome. The relative occurrence of the two conditions and their very similar symptoms explain the misdiagnosis. The diagnostic methods and surgical treatment for both conditions are discussed and suggestions are made as to possible non-invasive screening methods.

Adult↗

Compartment pressures after closed tibial shaft fracture. Their relation to functional outcome.

We measured pressures in the anterior and deep posterior compartments continuously for up to 72 hours in 20 patients with closed fractures of the tibial shaft treated primarily in plaster casts. All were examined independently after periods of three to 14 months. Pressures above 40 mmHg occurred in seven (35%) and above 30 mmHg in 14 (70%). No patient had the symptoms of compartment syndrome during monitoring. Abnormalities at review did not correlate with the maximum consecutive time periods during which the compartment pressures were raised. Thus, in the absence of symptoms the monitored pressures did not relate to outcome. Routine monitoring in this type of patient is therefore of doubtful benefit.

Adolescent↗

Preventable deaths after head injury: a clinical audit of performance.

A retrospective trauma audit of 267 consecutive patients presenting to the resuscitation room of an accident and emergency department identified 107 (M = 0.73) patients with CNS predominant injuries in a period of 1 year. The mortality rate was 33 per cent. Application of the TRISS method indicated that 18 (51 per cent) of the 35 deaths (Z = 5.74, P less than 0.001) were mathematically unexpected; no unexpected survivors were identified. Subsequent peer review agreed that death was preventable in 11 cases. The peer panel suggested that the lack of an on-site neurosurgical service may have affected the outcome of this group of patients adversely.

Adolescent↗

Femoral head blood flow in femoral neck fractures. An analysis using intra-osseous pressure measurement.

We studied 50 patients with fractures of the femoral neck, 33 intracapsular and 17 extracapsular. Intraosseous pressure was measured by a transducer within the bone to quantify blood flow, and intracapsular pressure by a needle introduced into the joint space. The mean intracapsular pressure was lower in the extracapsular fractures. In these, the mean intraosseous pressure in the femoral head was unchanged by aspiration of the joint. However in the intracapsular fractures aspiration produced a significant decrease in intra-osseous pressure and an increase in pulse pressure within the femoral head. The results suggest that aspiration of intracapsular haematoma produced an increase in femoral head blood flow by relieving tamponade.

Femoral Neck Fractures↗

Deaths following trauma: an audit of performance.

The TRISS methodology was applied to identify preventable trauma deaths in a retrospective audit of 267 (M = 0.908) patients admitted to a teaching hospital through the resuscitation room of its accident and emergency department during a 1-year period. No unexpected survivors were identified; of the 44 deaths (Z = 5.35), 25 (56.8%) were judged preventable by the TRISS method. Those deaths deemed preventable were subjected to peer review by a panel of six consultants. The findings are discussed in respect of recommendations made for UK trauma centre provision by the Working Party Report of the Royal College of Surgeons of England on the management of patients with major injuries.

Adolescent↗

Regulation of histamine H1 receptor-mediated phosphoinositide hydrolysis by histamine and phorbol esters in DDT1 MF-2 cells.

The regulation of histamine-stimulated phosphoinositide turnover by histamine and phorbol esters was examined in intact DDT1 MF-2 cells grown in suspension culture. Histamine increased the incorporation of 32P into phosphatidylinositol (PI) in these cells, and this stimulation was inhibited by the H1 antagonist diphenhydramine but not by the H2 antagonist cimetidine. Pretreatment of cells with histamine or with phorbol 12-myristate 13-acetate (PMA) or other activators of protein kinase C induced a marked decrease in the subsequent stimulation by histamine. PMA, but not histamine, also decreased the ability of epinephrine to stimulate PI labelling through alpha 1-adrenoceptors. Thus, histamine appears to induce homologous desensitization of histamine H1 receptor-mediated PI turnover, whereas direct activation of protein kinase C in the absence of receptor occupancy by agonist induces nonspecific heterologous desensitization of both histamine H1- and alpha 1-adrenoceptor-mediated responses.

Animals↗

Buffers for the reconstitution of aspartate aminotransferase.

The cofactor activation of the apoenzyme of pig heart cytosolic aspartate aminotransferase was studied in various buffers. Cationic buffers are shown to allow maximal reconstitution in the pH range of 5.0 to 9.0. Anionic buffers made up of mono- and dicarboxylates are found to affect reconstitution in a pH-dependent manner. At low pH, the carboxylates strongly inhibit reconstitution, but at high pH, they show less effect. In contrast, the more potent inhibitor Pi shows the opposite pH profile. Dicarboxylates are considerably more inhibitory than monocarboxylates. Substantial protection against inhibition by a number of carboxylates may be achieved by the addition of sodium chloride.

Animals↗

The incidence and prognostic significance of radiological abnormalities in soft tissue injuries to the cervical spine.

The radiographs and initial clinical findings of 73 patients who had sustained trauma to the cervical spine without bony injury in vehicle collisions were reviewed. The patients were also re-examined clinically two years after the injury. Forty eight (65.8%) had abnormal radiographs at presentation--prevertebral soft tissue swelling in 15 (20.6%), degenerative changes in 15 (20.6%), and an angular deformity between two adjacent vertebral bodies in 27 (37.0%). Prevertebral soft tissue swelling was found to have no significance with respect to clinical outcome and showed no association with the presence of an angular deformity. Degenerative changes are associated with a poor prognosis. The presence of an angular deformity was found to carry a good prognosis in this group of patients. The exact mode of injury is not associated with any specific radiographic appearance except that "roll overs" and side collisions are more likely to cause angulation in the cervical spine.

Adult↗

'Whiplash injuries' of the neck: a retrospective study.

This is a retrospective study of 102 patients with whiplash injuries of the neck followed up at approximately 2 years. The results show that 67 patients were asymptomatic by this time and the remaining 35 patients still exhibited symptoms. Prognostic indicators were found to be age, occipital headaches, referred symptoms, interscapular pain, abnormal neurological signs, positive radiological findings and osteoarthritic changes of the cervical spine. Symptoms that persisted for more than 2 months indicated prolonged disability.

Accidents, Traffic↗