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Biomedical subjects

D Patel

Publications and source records attributed to D Patel.

241 records · Page 14Linked to original sources
PubMedDate not supplied

Proximal approaches to arthroscopic surgery of the knee.

Arthroscopic surgery of the knee has become more popular recently because of better optics and instrumentation. The currently available techniques and approaches for doing surgery as well as their drawbacks are summarized. The author's new technique is described. The anterior and lateral compartments and popliteal tunnel could not be adequately visualized with the existing techniques. Distortion of image, magnification, crowding, and collision were found in the distal approaches during surgery. Injuries to the anterior compartment of the knee as the instruments come blindly in and out can also cause damage to the fat pad and the menisci. By inserting the arthroscope proximally (midpatellar lateral, midpatellar medial) and using inferomedial and inferolateral portals for instruments, the surgery and the above problems have been minimized. The drawbacks of this technique are initial confusion in orientation and poorer placement of the arthroscope. The posterior cruciate ligament cannot been seen using this technique. The posterolateral portion of the lateral meniscus and to some extent the posteromedial portion of the medial meniscus are, in inexperienced hand, somewhat difficult to see. The technique of menisectomy is described.

Arthroscopes↗
PubMedDate not supplied

Pulsed holmium:yttrium-aluminum-garnet (Ho:YAG) laser ablation of fibrocartilage and articular cartilage.

A new, near-infrared, pulsed holmium laser (wavelength, 2.1 microns; pulse duration, 400 microseconds) was used to ablate bovine articular cartilage and meniscal fibrocartilage. Microscopic examination revealed zones of thermal damage extending 550 microns from ablation sites. Ablation rates were measured with a mass loss technique. Above threshold, mass removal rates were proportional to laser radiant exposure. Threshold radiant exposure for ablation was 50 J/cm2 for articular cartilage and 11 J/cm2 for meniscal fibrocartilage. Because the holmium laser can precisely and rapidly resect cartilaginous tissues with only moderate necrosis, function in a saline environment in direct contact with tissue, and be transmitted through conventional optical fibers, it has the potential to become a useful tool for the precise arthroscopic removal of intraarticular tissue.

Animals↗
PubMedDate not supplied

Medical repatriation of British diplomats resident overseas.

BACKGROUND: The aim of this study was to analyse medical evacuations and short tours (collectively known as medevacs) in British Foreign and Commonwealth Office (FCO) staff and dependents residing overseas. Further aims were to look for groups with a disproportionate number of medical evacuations/short tours, and to identify events which may have been predictable in retrospect. For the purposes of this study, a medical evacuation was defined as a journey to the UK or an appropriate regional referral center for medical treatment or review, and a medical short tour was an early termination of posting for medical reasons. METHOD: The medical records of all staff and dependents who had been medically evacuated/short toured in 1995 were retrospectively analysed. Information collected included demographic details, whether the medevac was an emergency or a predicted necessity, why the medevac was required, the diagnosis, and the time from medical clearance to medevac. RESULTS: In 1995, 160 medevacs involving 137 individuals were authorized. This represented 3.08% of individuals overseas, with only 0.4% of individuals posted overseas being evacuated with new medical events within 1 year of medical clearance. The proportion of medevacs for staff was significantly higher than for dependents (spouses and children), and staff in their 20s and fast-stream diplomats (young "high-flyers" with a university education) were over-represented in the evacuee group. Non-physical problems were predominant in the latter groups. The main reason for evacuation (70%) was that medical facilities were considered unsuitable, and just over half of the medevacs (51%) were considered by the investigating team to have been unpredictable. CONCLUSIONS: Only a small percent of individuals posted overseas required medevac. The likelihood of evacuation was significantly higher in staff when compared to dependents, and certain grades/age groups appeared to be over-represented in the evacuee group. These groups are possibly more vulnerable, particularly to non-physical problems, and this is a potential area for future research. A prospective study of medical events overseas is proposed to see if these results are reproduced. If these findings are confirmed, medical clearance and FCO posting procedures may need to be altered for groups which are identified as being vulnerable.

Adolescent↗
PubMedDate not supplied

Transient headache and impaired vision after intravenous thyrotropin-releasing hormone in a patient with pituitary macroadenoma.

We report a case of transient headache and impaired vision following administration of intravenous thyrotropin-releasing hormone (TRH) to a woman with a non-functioning pituitary macroadenoma, visual field defect, and elevated thyroid-stimulating hormone (TSH). The symptoms lasted for two hours and then resolved without known sequelae. There are a few other reported cases of similar adverse reactions to neuroendocrine manipulation in patients with pituitary macroadenomas. This is the second reported case of such adverse reactions to TRH alone and the first in which the patient had prior elevation of TSH.

Adenoma↗
PubMedDate not supplied

Urinary tract infections in cocaine-exposed infants.

Infants prenatally exposed to cocaine are reported to have an increased incidence of genitourinary tract abnormalities. Because children with genitourinary tract anomalies have a higher incidence of urinary tract infections, a prospective study was performed to investigate the incidence of urinary tract infections in cocaine-exposed infants. The urine culture results were positive in 14% of 110 cocaine-exposed infants studied. This is significantly higher than the 4% infection rate in our control group and higher than the previously reported incidence of 0.1% to 3% urinary tract infections in newborns. Although the incidence of abnormal results from renal ultrasonography was high (16%), abnormal results did not correlate with the development of a urinary tract infection. Other laboratory tests also did not predict urine culture abnormalities. Urine culture screening is recommended for all cocaine-exposed infants.

Case-Control Studies↗
PubMedDate not supplied

Maternal and paternal risk factors and adverse neonatal outcomes among Hispanic subgroups in Illinois (1989 through 1993).

OBJECTIVES: The study purposes were to examine maternal and paternal high-risk factors and note associated differences in birth outcomes among Hispanic subgroups compared with white and black populations in Illinois. STUDY DESIGN: Computerized birth certificate data of 131,768 Hispanic singleton neonates (14.1% of all Illinois births from 1989 through 1993) were compared among five Hispanic subgroups. Matched infant birth-death computerized files were obtained for neonatal and postneonatal mortality (1989 through 1992 birth cohorts) and separate fetal mortality tables were also examined. RESULTS: Whereas Puerto Rican mothers had higher prevalence rates for various maternal risk factors and higher infant morbidity rates among the five Hispanic groups, infants of Cuban mothers had significantly higher fetal and infant mortality rates. CONCLUSIONS: Our study identified substantial differences during the prenatal period and in birth outcomes among the five Hispanic subgroups. Those differences may help us develop innovative targeted interventions.

Adult↗