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A J Sutcliffe

Publications and source records attributed to A J Sutcliffe.

9 recordsLinked to original sources

Early prediction of outcome following head injury in children: an assessment of the value of Glasgow Coma Scale score trend and abnormal plantar and pupillary light reflexes.

A retrospective study of 95 children less than 15 years of age with significant head injury was made to assess the value of Glasgow Coma Scale (GCS) score trend and plantar and pupillary light reflexes during the first 24 hours after injury, in predicting eventual outcome. GCS score trend or reflexes used alone were significantly correlated to outcome. There was also a statistically significant correlation when these parameters in combination were related to outcome. However, the clinical value of the combined use of GCS score trend and reflexes was only slightly greater than the use of GCS score trend alone.

Adolescent

Resuscitation.

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Blood Volume

Burn and trauma associated proteinuria: the role of lipid peroxidation, renin and myoglobin.

Ten trauma patients and 13 burns patients were studied intensively for the first 36 h and subsequent 6 days post injury in order to investigate the mechanism of trauma and burn associated proteinuria. Burns patient's initial maximum proteinuria occurred between 4 and 8 h post injury, whilst trauma patients showed greatest proteinuria within 4 h. In both groups coexisting myoglobinuria or marked elevation of serum renin activity was not found during the first 36 h. Following admission serum lipid peroxides rose in burns patients reaching a maximum between 2 and 8 h following injury, after which levels fell rapidly; in contrast trauma patient's values were initially within normal limits, but rose sharply after 12 h with peaks occurring between 16 h and 7 days post injury. Some patients within both groups showed a recurrent protein leak 2 to 5 days post injury. The data suggest that myoglobinuria or raised renin levels do not play an important role in trauma associated proteinuria.

Adolescent

Proteinuria following trauma.

Thirteen trauma patients admitted to a major injuries unit were classified according to their injury severity. Urinary excretion of total protein, albumin and gamma glutamyl transpeptidase (GGT) activity were assessed over the following 6 days. All patients showed an initial glomerular and tubular proteinuria during the first 24 h which subsided by the second post-trauma day. The excretion of total protein and albumin was positively correlated with injury severity. Those patients with the severest injuries showed a marked recurrent total proteinuria around days 3 to 4 post-trauma which exhibited features of a tubular lesion. The recurrent proteinuria peak coincided with peak levels of serum c-reactive protein (CRP).

Adolescent

Hereditary angioneurotic oedema.

Hereditary angioedema (HAE) is characterised by episodic swelling of the extremities, face, larynx and recurrent abdominal pain, which can mimic the acute abdomen. Trauma of the larynx may result in acute airway obstruction. The management of emergency anaesthesia for Caesarean section of a patient with documented HAE is described and the special problems presented discussed. The methods of prophylaxis available are considered and the use of fresh frozen plasma advocated.

Adult