Biomedical subjects

H O Fredin

Publications and source records attributed to H O Fredin.

11 recordsLinked to original sources

PubMed1991

Elderly patients' responses to preoperative autologous blood collection.

OBJECTIVE: To follow the haematological response in elderly patients to preoperative autologous blood collection. DESIGN: A prospective, randomised study. SETTING: Malmö General Hospital, Sweden. PATIENTS: Sixty patients with a mean age of 71 years (range, 60-82 years) who were to undergo total hip replacement were randomly divided into four groups of 15. One group served as control. Three units of blood were collected from patients in the other three groups, the first unit at least 30 days before the planned operation, with an average interval of 10 days between collections. Iron supplementation was given to one group as a substitution remedy, another group was given iron and folic acid and the third group was without supplementation during the collection period. MAIN OUTCOME MEASURES: Haematological and biochemical tests were performed on blood samples taken at the time of each collection, on the morning of the hip replacement operation, and ten days after and six weeks after the operation. RESULTS: No major complication was encountered with blood collection. The patients tolerated the procedure very well including the substitution remedies. Haematological and biochemical parameters remained within the normal range during the collection period and after the operation. No patient in the autologous groups needed homologous blood during the operation; three units of homologous blood were used after the operation in these patients. CONCLUSION: Preoperative blood collection from the elderly is safe and well tolerated. The procedure should be encouraged in elective orthopaedic operations regardless of age.

Aged↗

PubMed1991

Lower-limb vasospasm and renal failure during postoperative thromboprophylaxis. Case report.

In a 73-year-old woman with trimalleolar fracture, secondary acute ischemia of the limb and renal failure developed in association with heparin-dihydroergotamine thromboprophylaxis. Earlier cases of thromboprophylaxis-related angiospasm are briefly reviewed. The condition is infrequent, but trauma of extremities and shock are risk factors. Renal failure is rare.

Acute Kidney Injury↗

PubMed1988

Fate of bone grafts in acetabular roof reconstructions assessed by roentgenography and scintigraphy.

Autogeneic bone grafts--26 femoral heads, four femoral and two iliac bone grafts--were used in 32 total hip arthroplasties, mainly on patients with complete dislocation of the hip, to reconstruct deficiencies of the acetabular roof by a standardized procedure. At the follow-up examination after 24 to 101 months (median, 52 months), roentgenography demonstrated lateral resorption of the graft in 20 of 32 hips, but resorption involved bone support of the socket in only three of the hips. Analysis of serial roentgenograms showed that resorption was not a function of time. Complete incorporation of the grafts was observed in 27 hips; partial incorporation was shown in three. Roentgenographically, two grafts were not incorporated. None of three grafts of a cortical nature was incorporated. Graft uptake of radioactive tracer was found by 99mTc-diphosphonate emission scintigraphy in 16 of 21 hips, but did not correlate with progressive bone resorption, nonunion, or loss of bone structure. High quality serial roentgenograms showing good bone detail provided the best information about the integrity of the acetabular roof reconstructions.

Acetabulum↗

PubMed1987

Femoral fracture following hip arthroplasty.

In 1,961 primary total hip arthroplasties performed during a 14-year period, 11 proximal ipsilateral femoral fractures occurred postoperatively. Seven were located distally to the tip of the femoral stem; none was a comminuted fracture. Six of the fractures were primarily revised with a long-stem prosthesis. The results after 5(1-8) years were good.

Aged↗

PubMed1985

Scintigraphy and chest radiography in the screening of pulmonary embolism after total hip replacement.

210 patients were screened for pulmonary embolism after total hip replacement with chest radiography and perfusion-ventilation scintigraphy using a new, dry 99mTc-microaerosol and a detailed system for coding scintigraphic abnormalities. Chest radiography did not contribute significantly to the diagnosis of pulmonary embolism. In spite of careful evaluation, false-negative and false-positive scintigraphic diagnoses of PE are still possible.

Evaluation Studies as Topic↗

PubMed1984

On thrombo-embolism after total hip replacement in epidural analgesia: a controlled study of dextran 70 and low-dose heparin combined with dihydroergotamine.

A prospective study of thrombo-embolism after total hip replacement in epidural analgesia was carried out in 116 patients, randomly allocated to dextran 70 or low-dose heparin combined with dihydroergotamine (HDHE). Amounts of blood loss and transfused bank blood did not differ significantly between dextran 70 and HDHE prophylaxis. There was a lower incidence of femoral deep vein thromboses in patients given dextran prophylaxis as compared with those on HDHE (P less than 0.05). However, the total frequency of DVT and the frequency of pulmonary embolism did not differ between the two groups. There was no case of fatal pulmonary embolism. The side effects were major bleeding complications in 7 per cent of the HDHE group as compared to none in the dextran group. No anaphylactic reaction was noted from dextran 70 using hapten-dextran prophylaxis.

Aged↗

PubMed1984

Width of the normal ankle joint.

An investigation of the talocrural joint was performed in 160 normal adults, 80 males and 80 females. The joint space was measured on films at six locations, three in the antero-posterior and three in the lateral view of the ankle. The average joint space in men was 3.4 mm and in women 2.9 mm, which is a significant difference (p less than 0.001). The joint space was wider in the medial part when evaluating the antero-posterior view, but did not change with age.

Adolescent↗

PubMed1983

Screening and treatment of pulmonary embolism after total hip replacement.

The effect of anticoagulative treatment of pulmonary embolism was studied in 63 patients out of 348 operated on with total hip replacement. Screening diagnosis of pulmonary embolism was obtained from 99mTc perfusion scintigraphy in combination with 99mTc-microaerosol ventilation scintigraphy and chest radiogram. The administration of heparin and warfarin was associated with hemorrhagic side effects in 7 per cent. The final outcome of surgery, however, was not interfered with. Fatal pulmonary embolism occurred in one patient (0.3 per cent) in whom the diagnosis had been missed.

Aged↗

PubMed1982

Fatal pulmonary embolism after total hip replacement.

A retrospective study of fatal pulmonary embolism (FPE) was carried out in 1,324 cases of total hip replacement (THR), performed during 1969 to 1978. Dextran 70 (Macrodex 6 per cent in saline. Pharmacia AB, Sweden) was given as thromboembolic prophylaxis. Sixteen patients died within 3 months. Autopsy was performed in 14 cases. Nine died from embolism, which makes an incidence of 0.7 per cent. Autopsy was performed in 8 of these cases. Seven patients died during the second and third week. Five patients had complained of acute chest pain and 4 of them had chest radiograms taken, which were normal. Only one patient had clinical symptoms of deep vein thromboses. Perfusion lung scan was performed as a screening procedure in 3 cases, all of them showing defects typical of pulmonary embolism. Four patients died from FPE, despite heparin therapy for 3-5 days. A comparison between patients with FPE and a control group showed that premonitory attacks of acute chest pain and previous operations for orthopaedic reasons were significantly more common in patients with FPE (P less than 0.001 and P less than 0.05), respectively). No difference could be found between the groups concerning blood loss, amount of transfusion, sex, operated side, type of prosthesis and weight.

Aged↗

PubMed1982

Prophylaxis of deep vein thrombosis in patients with fracture of the femoral neck: a prospective comparison between dextran and a sulphated polysaccharide.

A prospective and randomized study of 100 patients with fracture of the femoral neck was carried out. The aim was to compare the thromboembolic prophylactic effect of dextran 70 and a sulphated polysaccharide, PZ 68. Deep vein thrombosis was diagnosed using the 125I-fibrinogen test and phlebography, and pulmonary embolism with a perfusion and ventilation scan. The number of thromboses and emboli did not differ significantly between the two groups. However, there was a general tendency for predominance of thrombosis on the operated side. Six patients were excluded in the PZ 68 group because of major haemorrhage.

Aged↗

PubMed1980

Total hip replacement in congenital dislocation of the hip.

Twenty cases of congenital dislocation of the hip were treated with total hip replacement. The hips were completely dislocated with the femoral head supported by a nearthrosis proximal to the original acetabulum. The concept was to reconstruct the hip with an acetabular cup at the site of the original acetabulum even if a portion of the proximal end of the femur had to be sacrificed in the process. The Harris prosthesis appears, in most instances, to be the most suitable type of prosthesis but it was concluded that the surgeon needs a selection or prostheses for this procedure. Nine-tenths of the patients were improved by the procedure and the complications could mostly be successfully dealt with. This type of surgery is justified in cases with special indications.

Adult↗