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Biomedical subjects

R E Booth

Publications and source records attributed to R E Booth.

At least 109 records · Page 6Linked to original sources
PubMed1988

The effect of early bladder catheterization on the incidence of urinary complications after total joint replacement.

A prospective, randomized study was performed in 54 female total arthroplasty patients to determine whether straight catheterization in the recovery room might reduce the incidence of postoperative urinary infection, urinary retention, and urinary catheterization. Thirty-one patients were straight catheterized in the recovery room; 23 were not. Overall, 13% of the patients developed a urinary tract infection postoperatively, 60% of the patients required at least one catheterization, and 13% of the patients required a Foley catheter. No beneficial effect of straight catheterization in the recovery room after arthroplasty was demonstrated.

Aged↗
PubMed1987

Treatment of the septic hip with total hip arthroplasty.

Forty-three patients, 23 with definite infection and 20 with probable infections before total hip arthroplasty (THA), were compared to 41 matched uninfected patients. The 43 infected patients were treated by 45 operative procedures: eight Girdlestone resections, 12 revisions of total hips, and 25 conversions from infected nontotal hip surgery to total hip arthroplasties. (Two revision THAs were converted to Girdlestones). The average follow-up period was 38.8 months, with a range of six-118 months. The statistically significant negative prognosticators were gross sepsis at surgery, number of previous operations, and elevated erythrocyte sedimentation rate (ESR). The type of infecting organism did not affect the outcome. The prosthesis survival rate for total hip arthroplasties revised for sepsis was 83%. The prosthesis survival rate for other infected hips treated by total hip arthroplasty was 100%. All groups except Girdlestone resections improved postoperatively. While Girdlestone resection offered acceptable pain relief, total hip arthroplasty provided unequivocally superior function (p = 0.0001).

Adult↗
PubMed1986

Conversion total hip replacement. Review of 140 hips with greater than 6-year follow-up study.

The authors compared 140 conversion with 433 primary total hip arthroplasties with a 40-month minimum follow-up period. All replacements were performed with a transtrochanteric technique. No conversion total hip arthroplasty had prior cementation. Pain was the indication for surgery. The average number of prior operations was 1.3 and the average number of months to total hip arthroplasty was 65.4. The patient characteristics for the two groups were similar. The overall results were uniformly good to excellent (94% or better) at greater than 6-year mean follow-up in both groups. The authors review important differences between the two groups. None of the differences are statistically significant. The overall results of conversion total hip arthroplasty were good to excellent, and the presence of a preoperative infection did not significantly alter the clinical results. The absence of prior bone cement in conversion total hip arthroplasty is proposed to explain these findings.

Hip Prosthesis↗
PubMed1986

Aseptic loosening after total hip arthroplasty. Incidence, clinical significance, and etiology.

Three hundred forty-one consecutive Charnley total hip arthroplasties were reviewed after a 3-10-year follow-up period to correlate the radiographic signs of aseptic loosening to clinical outcome, femoral cementing technique, and epidemiologic patient characteristics. High-grade femoral demarcation at the bone-cement interface (75-100%) correlated with a significantly higher incidence of unsatisfactory follow-up clinical scores. The incidence of high-grade femoral bone-cement demarcation and the associated radiographic signs of aseptic loosening had a direct correlation with the quality of the femoral cementing technique (P less than .01). Trochanter nonunion or trochanter separation demonstrated a highly significant correlation with high-grade femoral bone-cement demarcation (P less than .001). Patients having secondary total hip arthroplasty for failed cup arthroplasty or endoprosthesis had a higher rate of unsatisfactory pain and function scores, compared with those having arthroplasties performed after failed internal fixation. Male patients or patients with a high activity level demonstrated a twofold greater incidence of high-grade femoral demarcation (P less than .05). Patient weight by itself did not demonstrate any effect on radiographic outcome.

Age Factors↗
PubMed1986

Spinal stenosis.

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Humans↗
PubMed1985

The use of epidural steroids in the treatment of lumbar radicular pain. A prospective, randomized, double-blind study.

Seventy-three patients with lumbar radicular pain syndromes were treated in a prospective, randomized, double-blind fashion with either seven milliliters of methylprednisolone acetate and procaine or seven milliliters of physiological saline solution and procaine. All patients had radiographic confirmation of lumbar nerve-root compression, consistent with the clinical diagnosis of either an acute herniated nucleus pulposus or spinal stenosis. No statistically significant difference was observed between the control and experimental patients with either acute disc herniation or spinal stenosis. Long-term follow-up, averaging twenty months, failed to demonstrate the efficacy of a second injection of epidural steroids administered to the patients whose pain did not respond within twenty-four hours to an injection of either eighty milligrams of methylprednisolone acetate combined with five milliliters of 1 per cent procaine or two milliliters of sterile saline combined with five milliliters of 1 per cent procaine. Therefore, a decision to use epidural steroids must be made with the realization that we failed to demonstrate its clinical efficacy in this study and that reports of serious complications of this procedure have been published.

Adrenal Cortex Hormones↗
PubMed1985

Recurrent posterior dislocation of the shoulder: treatment using a bone block.

Acute posterior dislocations of the shoulder are uncommon. Recommended surgical treatments for recurrent posterior dislocation include soft-tissue advancement, posterior glenoid osteotomy, rotational osteotomy of the humerus, and posterior bone block. The posterior bone-block procedure successfully prevented recurrent dislocation in our series of five patients. The patients ranged in age from seventeen to forty-four years, and have been followed for two and one-half to eight years. All returned to unrestricted activity and recreational sports. The complications included a later anterior dislocation of the shoulder in one patient and an unsightly scar requiring revision in two patients. There were no complaints of pain. Radiographs showed decreased density of the bone block in two patients, but graft resorption did not occur.

Adolescent↗
PubMed1984

A study of computer-assisted tomography. II. Comparison of metrizamide myelography and computed tomography in the diagnosis of herniated lumbar disc and spinal stenosis.

One hundred twenty-two patients with surgically confirmed pathology consisting of either herniated lumbar disc, spinal stenosis, or both were included in this investigation. For each of these patients, preoperative metrizamide myelography and computerized tomography were performed. Each myelogram and CT scan was read blindly so that the neuroradiologist interpreting the study had no knowledge of the patient's surgical pathology, clinical examination, nor any knowledge of the interpretation of the other preoperative test. A painstaking attempt was made to describe precisely both the exact nature of the preoperative myelogram and CT scan interpretations. The correlations between the preoperative interpretation of each test and the observed surgical findings then were analyzed statistically. Based upon this analysis, myelography was found to be more accurate than computed tomography in the diagnosis of herniated lumbar disc (83% vs. 72%). In the diagnosis of spinal stenosis, myelography was slightly more accurate than computed tomography (93% vs. 89%). Based upon the results of this study, the authors conclude that metrizamide myelography is more accurate than computed tomography in the diagnosis of both herniated lumbar disc and spinal stenosis and remains the diagnostic study of choice for these conditions. Furthermore, metrizamide myelography gives the added advantage of visualizing the thoracolumbar junction and, thus, affords the opportunity to diagnose occult spinal tumors.

False Negative Reactions↗
PubMed1984

Disseminated intravascular coagulopathy in a patient undergoing total hip arthroplasty for carcinoma. A case report.

A 78-year-old man was treated by total hip arthroplasty (THA) for metastatic carcinoma of the proximal femur. After operation, disseminated intravascular coagulopathy (DIC) developed. DIC is a known complication of malignancy but is reported infrequently as a complication of THA. Its occurrence in this patient may have been triggered by the release of coagulant proteins from surgical manipulation of the tumor. The disorder was characterized clinically by profuse uncontrollable hemorrhage from the surgical wound. Laboratory abnormalities indicated a consumptive coagulopathy. Guidelines for the diagnosis and management of a patient with DIC are available. Orthopedic surgeons should be alerted to the potential of this serious complication in patients treated by THA for metastatic bone abscess of the hip.

Aged↗
PubMed1983

Effects of thermal therapy on rehabilitation after total knee arthroplasty. A prospective randomized study.

The role of local heat or cold therapy used in conjunction with exercise in the rehabilitation of total knee arthroplasty patients was investigated. Thirty-six osteoarthritic patients were analyzed. Parameters evaluated were range of motion, swelling about the knee, and pain. All patients received the total condylar knee prosthesis and began range of motion rehabilitation fourteen days after operation. Results showed that temperature alteration does not augment passive range of motion after total knee arthroplasty. It was also shown that cold application decreases swelling as compared with heat. Additionally, the application of cold partially alleviates the discomfort of the rehabilitation process in certain patients.

Aged↗
PubMed1982

The detection and prevention of pulmonary embolism in total hip replacement. A study comparing aspirin and low-dose warfarin.

Because of the controversy surrounding prophylaxis for thromboembolism after total hip surgery, we undertook a prospective study comparing the results of the administration of aspirin with that of low doses of warfarin in 194 patients (200 hips) undergoing total hip replacement. The incidences of both clinically apparent and silent (asymptomatic) pulmonary emboli were determined using the objective criteria of preoperative and postoperative levels of arterial blood gases, chest roentgenograms, electrocardiograms, and perfusion lung scans. With this surveillance plan, the accuracy of diagnosis of clinically symptomatic pulmonary emboli was improved and the detection of otherwise silent pulmonary emboli became possible. The group of patients who received low doses of warfarin showed a 6 per cent total incidence of pulmonary emboli compared with a 19 per cent incidence in the group receiving aspirin (p less than 0.05). There was, however, no significant difference when the incidences of only the clinically suspected emboli were compared, the rates for the two groups being 5 and 8 per cent, respectively (p greater than 0.05). There was also no significant difference between men and women with regard to the prophylactic efficacy of aspirin in preventing pulmonary embolism.

Aspirin↗
PubMed1978

Correlates and predictors of recidivism among drinking drivers.

Follow-up interviews on 47 formal DUI clients of an alcohol treatment program were conducted in an effort to find predictors of success. Predictors included historical factors occurring at the time of arrest, stressful events since treatment, length of treatment, time since treatment, and demographic data. Recidivism was conceptualized as a multidimensional construct through self-report measures and arrest records. Findings indicated that punitive actions fail to account for recidivism. Involvement in an accident, however, is significantly and positively related to future success in treatment. The implications of this observation are discussed.

Accidents, Traffic↗
PubMed1977

Treatment of nonunion with constant direct current.

Laboratory experiments show the following relationships between electricity and bone: (1) stressed bone exhibits electronegativity in areas of compression, (2) living, nonstressed bone exhibits electronegativity in areas of bone growth and healing, and (3) the application of low magnitude direct current to bone induces osteogenesis at the negative electrode or cathode. Based on the above principles, a clinical study was performed in which 10-20 microamperes of constant direct current was used in treating nonunion in 57 patients. The results suggest that specific electrical parameters are required for successful osteogenic stimulation in patients. When these electrical parameters are met, a successful healing rate of 70 per cent can be achieved in treating nonunion with direct current. As experience is gained with this new technique in the treatment of nonunion, the results should improve even further. Basic studies exploring the mechanism(s) whereby electricity induces osteogenesis are opening new vistas into our understanding of bone growth and repair. The extension of these basic studies has far-reaching clinical implications.

Adult↗