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Biomedical subjects

C L Barnes

Publications and source records attributed to C L Barnes.

At least 55 records · Page 3Linked to original sources
PubMed1992

Caregivers of elderly relatives: spouses and adult children.

A problem in the provision of home health care for elderly people is the limited number of family members available for caregiving. Current trends in federal, state, and local policy formation suggest an increasing emphasis on the family as an appropriate caregiver. Therefore, it is necessary to examine how family relationships affect the caregivers' responses to their caregiver situation. Data are presented from 206 caregivers enrolled in a larger longitudinal study of family members caring for elderly dependent relatives. The sample is divided into four caregiver groups: (1) spouses who have children, (2) spouses who have no children, (3) adult children who have siblings, and (4) adult children who have no siblings. Measures selected for comparison were perception of burden, caregiver involvement, affective social support, mental health status, and use of community services. Differences were found among the four groups of caregivers. Implications for social work intervention are discussed.

Adult↗
PubMed1992

Vena caval filter use in orthopaedic trauma patients with recognized preoperative venous thromboembolic disease.

This study comprises a series of 35 patients with pelvic or lower extremity fractures requiring surgery who also had a documented significant acute deep venous thrombosis (DVT). The authors treated these with low-dose Coumadin and 36 vena caval filters, which were used prophylactically prior to surgery. The patients received low-dose warfarin after placement of the vena caval filters and were maintained at 1.3-1.5 times the prothrombin control value for 6 weeks to 3 months. In this group of patients, there were no fatal pulmonary emboli and no clinically significant complications from filter placement. There were nine asymptomatic filter complications demonstrated radiographically in eight patients. Additionally, one patient with a tilted vena caval filter required placement of another filter. The combination of vena caval filters and low-dose warfarin appears to be a successful and relatively safe method of managing those patients who have acute DVT and require surgery for their pelvic or lower extremity fractures.

Combined Modality Therapy↗
PubMed1992

Fractures adjacent to humeral prostheses.

In a review of records and radiographs from 1974 through 1988, we identified seven patients who had a humeral fracture after either a total shoulder replacement or a shoulder hemiarthroplasty. All seven patients had complications after the fracture, and five fractures did not unite until an operation was done. All of the fractures that were treated operatively healed without sequelae. Four patients who were managed operatively had satisfactory relief of pain and one had fair relief. One patient who had a non-union refused further treatment for medical reasons. The one fracture that united without operative treatment healed with the tip of the prosthesis outside of the humeral shaft, but persistent pain led to a revision total shoulder replacement. The average time to union after the operation was approximately five months (range, four to seven months). There was a permanent decrease in the motion of the shoulder from preinjury levels in five of the six patients who had union of the fracture.

Aged↗
PubMed1991

Case report 667. Fibrolipomatous hamartoma of the median nerve.

Fibrolipomatous hamartoma of a nerve represents an uncommon soft-tissue tumor which typically involves the median nerve distribution near the wrist. Macrodactyly may or may not be present. The application of MRI using routine T1- and T2-weighted spin echo imaging sequences reveals serpiginous structures with low signal intensity. These structures probably represent the neural elements and associated perineural fibrosis. Further experience may allow for an accurate preoperative diagnosis of this tumor.

Child, Preschool↗
PubMed1991

Duplex scanning in orthopaedic patients.

Duplex scanning with a combination of real-time and Doppler ultrasound is a noninvasive procedure used for the detection of deep vein thrombosis. The technique is described, its use in orthopaedic patients is discussed, and a plan of treatment based on duplex results is reported.

Arthroplasty↗
PubMed1991

Cup arthroplasty, surface replacement arthroplasty, and femoral head resurfacing for osteonecrosis.

Traditional cup arthroplasty and resurfacing arthroplasty of the femoral head and acetabulum have been proposed as bone-conserving procedures for avascular necrosis of the hip. Resurfacing of only the femoral head is not a definitive procedure but is an alternative to cup arthroplasty and resurfacing arthroplasty of the femoral head and acetabulum; hemiarthroplasty is recommended for the young patient with intact acetabular cartilage. Indications, technique, and clinical results are presented.

Femur Head↗
PubMed1991

Duplex scanning versus venography as a screening examination in total hip arthroplasty patients.

Combined B-mode/Doppler (duplex) scanning and venography were compared in routine perioperative screening for proximal deep vein thrombosis (DVT) in 158 total hip arthroplasty (THA) patients. Preoperative scans were performed in the first 60 patients; the low preoperative prevalence of 2% for proximal DVT was thought not to warrant routine preoperative scanning. Postoperatively, duplex scanning had a sensitivity of 79%, a specificity of 98%, and an accuracy of 97% when venography was considered as the gold standard. The postoperative incidence of proximal DVT was 12% in this group of THA patients treated with mechanical and pharmacologic prophylaxis. Including calf vein thrombosis, 30% had DVT postoperatively. This study demonstrates the efficacy of duplex scanning for diagnosing proximal DVT and describes an effective noninvasive method of screening THA patients for the presence of proximal DVT.

False Negative Reactions↗
PubMed1991

Cervical spine instability in rheumatoid patients having total hip or knee arthroplasty.

The records and roentgenographs of 113 rheumatoid patients treated by total hip or knee arthroplasty were analyzed retrospectively. The cervical spine roentgenographs were evaluated for significant atlantoaxial subluxation, atlantoaxial impaction, and subaxial subluxation. One or more of these findings were present in 69 (61%) of the patients. Thirty-five of the 69 (50%) with roentgenographically documented cervical spine instability had no signs or symptoms of instability at the time of admission for joint replacement. This high incidence of cervical spine instability in a select population of rheumatoid patients emphasizes the importance of preoperative evaluation of the cervical spine including flexion and extension lateral roentgenographs.

Adolescent↗
PubMed1991

Preoperative venography. A risk factor for postoperative deep venous thrombosis in hip arthroplasty patients?

The incidence of postoperative deep venous thrombosis was compared between patients who had or had not received a preoperative screening venogram. No statistically significant difference in the deep venous thrombosis rate was noted postoperatively. Thirty percent of patients who received a preoperative venogram developed postoperative deep venous thrombosis, and 28% of those who did not have a preoperative venogram developed postoperative deep venous thrombosis. These results suggest that an orthopaedic surgeon may order a preoperative venogram for a patient at potential high risk of thromboembolic complications without predisposing the patient to an increased risk of postoperative deep venous thrombosis.

Causality↗
PubMed1990

Structure and conformations of two cycloisomeric hexapeptides: cyclo(L-Leu-L-Phe-Gly-D-Phe-L-Leu-Gly-) trihydrate and cyclo(L-Phe-L-Leu-Gly-D-Leu-L-Phe-Gly-) trihydrate.

cyclo(L-Leucyl-L-phenylalanyl-glycyl-D-phenylalanyl-L-leucyl-glycyl-) trihydrate (IV), C34H46N6O6.-3H2O, Mr = 688.8, monoclinic, P2(1), a = 11.720 (2), b = 36.354 (4), c = 8.888 (1) A, beta = 103.88 (1) degree, V = 3676.3 A3, Z = 4, Dx = 1.244 g cm-3, lambda (Cu K alpha) = 1.54178 A, mu = 7.6 cm-1, F(000) = 1480, T = 138 K, final R = 0.052 for 7661 unique reflections. cyclo(L-Phenylalanyl-L-leucyl-glycyl-D-leucyl-L-phenylalanyl-glycyl-) trihydrate (V), C34H46N6O6.-3H2O, Mr = 688.8, triclinic, P1, a = 101.54 (2), b = 19.111 (5), c = 8.527 (1) A, alpha = 101.54 (2), beta = 93.42 (2), gamma = 94.27 (2) degree, V = 1852.4 A3, Z = 2, Dx = 1.235 g cm-3, lambda (Cu K alpha) = 1.54178 A, mu = 7.5 cm-1, F(000) = 740, T = 138 K, final R = 0.063 for 7574 unique reflections. Peptides IV and V both have two independent conformers (molecules A and B). The peptide ring in each case contains one beta (I) turn and one beta (II') turn. A molecules in both structures have two transannular N--H...O hydrogen bonds, while B molecules form only one strong transannular hydrogen bond. The conformational differences between the two independent molecules (A and B) are much larger than the differences between the corresponding molecules of the two structures (A and A, and B and B). The crystal structures of the two peptides are very similar and consist of parallel bands of hydrophobic side chains and polar peptide regions. In each structure, molecules are stacked one over another with the hexapeptide ring lying perpendicular to the axis of the stack. The water molecules form well delimited solvent channels sandwiched between the layers of peptide molecules, and bridge the peptides through extensive hydrogen bonding.

Peptides, Cyclic↗
PubMed1990

Neurons of the lateral entorhinal cortex of the rhesus monkey: a Golgi, histochemical, and immunocytochemical characterization.

This study identifies the neuronal types of the rhesus monkey lateral entorhinal cortex (LEC) and discusses the importance of these data in the context of the connectional patterns of the LEC and the possible role of these cells in neurodegenerative diseases. These neuronal types were characterized with the aid of Golgi impregnation techniques. These characterizations were based upon their spine densities, dendritic arrays, and, where possible, axonal arborizations. The cells could be segregated into only spinous and sparsely spinous types. The most numerous spinous types were pyramidal neurons. Other spinous types included multipolar, vertical bipolar and bitufted, and vertical tripolar neurons. The sparsely spinous neuronal types consisted of multipolar, horizontal bipolar and bitufted, and neurogliaform cells. These cells were further classified with the aid of histochemical stains and immunocytochemical markers. Nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) histochemistry stained multipolar, bipolar, and bitufted neurons. Stain for cytochrome oxidase (CO) was found in pyramidal and nonpyramidal cell types. Immunocytochemical techniques revealed several nonpyramidal neurons that contain somatostatin (Som) or substance P (SP). This study complements previous analyses of the neuronal components described in the LEC and adds further information about the distribution of selected neurochemicals within this cortex.

Animals↗
PubMed1990

Structure and absolute configuration of pyrophen, a novel pryrone derivative of L-phenylalanine from Aspergillus niger.

Pyrophen, a novel 4-methoxy-2-pyrone derivative of L-phenylalanine isolated from cultures of Aspergillus niger, crystallizes in the orthorhombic space group P2(1)2(1)2(1), with a = 8.918(1), b = 9.199(3), and c = 18.092(4) A. The structure was solved by direct methods and the absolute configuration assigned by the Bijvoet method. Refinement gave R = 0.045 and S = 1.78 for 1677 reflections with I greater than 3 sigma (I). Though numerous other pyrone natural products are known, including other products of A. niger, this is the first report of an amino acid-pyrone derivative.

Aspergillus niger↗
PubMed1990

The preoperative prevalence and postoperative incidence of thromboembolism in patients with hip fractures treated with dextran prophylaxis.

A prospective preoperative and postoperative venographic study of hip fracture patients has documented a significant preoperative prevalence and postoperative incidence of thromboembolic disease. A statistically higher incidence of deep-venous thrombosis is observed in patients with femoral neck fractures compared to patients with intertrochanteric fractures. A 9% (15 of 176) preoperative prevalence and an 11% (12 of 108) incidence of new postoperative thromboembolic disease were detected. There was a predilection for deep-venous thrombosis in the injured extremity compared to the noninjured extremity both preoperatively and postoperatively.

Adult↗
PubMed1989

Low dose dextran 40 in reconstructive hip surgery patients.

Preoperative and postoperative bilateral lower extremity venography was used to evaluate the efficacy of low dose dextran 40 in prophylaxis of deep venous thrombosis in reconstructive hip surgery patients. Patients were given dextran 40 at 50 cc/hr, with 250 cc given perioperatively and 500 cc given on postoperative days two and four. Five of 227 patients had positive venograms preoperatively. Of these 227 patients, 179 met protocol requirements and had venography postoperatively. Venous thrombosis occurred in 33 (18%) of those studied postoperatively. Of these, 11 were calf clots without extension to the popliteal region. Therefore, there were 22 patients (12%) with femoral or popliteal involvement overall. There were two deaths, neither of which was secondary to pulmonary embolus or a complication of dextran. There were two wound complications. These results suggest that low dose dextran 40 administered as indicated is a safe and efficacious means of deep venous thrombosis prophylaxis in reconstructive hip surgery patients.

Arthroplasty↗
PubMed1989

Perioperative asymptomatic venous thrombosis: role of duplex scanning versus venography.

We compared combined B-mode/Doppler (duplex ultrasonic scanning and venography in routine preoperative and postoperative screening for major proximal deep vein thrombosis in 78 patients undergoing total hip or knee arthroplasty. Of 309 extremity examinations, duplex scanning had an overall sensitivity of 85.7% (12/14) and a specificity of 97.3% (287/295). The preoperative prevalence and postoperative incidence of major deep vein thrombosis were 2.5% and 14.1% of patients, respectively, despite intensive mechanical and pharmacologic prophylaxis. In addition, venography documented a preoperative prevalence and postoperative incidence of isolated calf deep vein thrombosis in 2.5% and 16.7% of patients, respectively. Whereas such disease extended proximally even in the absence of anticoagulation in only 18% of patients studied by serial duplex scans, calf deep vein thrombosis accounted for the only two instances of pulmonary embolism in this study. There were no deaths related to pulmonary embolism. This study suggests that duplex scanning is useful in screening for perioperative deep vein thrombosis in patients undergoing total hip or knee arthroplasty, which carries a significant risk of venous thromboembolism despite routine prophylaxis.

Adult↗
PubMed1989

Soft-tissue reconstruction in severe lower extremity trauma. A review.

The reconstruction of soft tissues is a difficult aspect of limb salvage after severe lower extremity injury. Newer techniques such as free-tissue transfer can expedite wound care, decrease morbidity and hospital costs, and spare some limbs from amputation. It is important to know the mechanism of injury and the resultant zone of soft-tissue trauma. This is best defined by serial debridements over several days. The final defect size and composition will determine the type of soft-tissue flap used. Soft-tissue coverage may be accomplished with muscle, with muscle and skin transposition, or with free transfer. Microvascular transfers offer the advantage of one procedure that provides coverage for donor and recipient sites with early patient mobilization.

Fractures, Bone↗