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Biomedical subjects

H R Champion

Publications and source records attributed to H R Champion.

14 recordsLinked to original sources
PubMed1992

Associated aortic rupture-pelvic fracture: an alert for orthopedic and general surgeons.

Blunt trauma patients with pelvic fractures have been shown to have a two-fold to five-fold increased risk of aortic rupture compared with the overall blunt trauma population. A retrospective review was performed to determine whether the relationship between aortic rupture and pelvic fracture could be further delineated using a pelvic fracture classification based on mechanism of injury. Of 4,157 consecutive blunt trauma patients, 371 (8.9%) had pelvic fractures, 34 (0.8%) had ruptured thoracic aortas and 12 had both injuries. When pelvic fractures were classified according to vector of force, 10 of 12 (83%) aortic ruptures occurred in patients with an anterior-posterior compression fracture pattern, an incidence of aortic rupture eight times greater than that of the overall blunt trauma population. There was no increased incidence of aortic rupture among patients with any other pelvic fracture pattern. We conclude that the previously reported association between aortic rupture and pelvic fracture can be further specified to include, predominantly, those patients with an anterior-posterior compression fracture pattern.

Adolescent↗
PubMed1976

Post-traumatic hepatic dysfunction as a major etiology in post-traumatic jaundice.

Thirty-eight patients who had sustained acute trauma, profound hemorrhagic shock, and massive transfusion were studied prospectively to determine the predominant etiologic factors in the development of post-traumatic jaundice. An analysis of clinical and biochemical factors occurring in association with each bilirubin peak in the postoperative course found the jaundice related to transfusion and surgery in 11 instances, to sepsis and septicemia in 15 instances, and to hepatic dysfunction in 23 instances. Results indicated that admission estimates of SGOT and LDH levels, the height of the bilirubin peak and the postoperative day on which it occurs, and the white cell count and GGT at the time of the peak may be of use in the differential diagnosis. Four case reports were used to emphasize the fluctuating pattern of jaundice and the different etiologic factors that may predominate. Light and electron microscopy from three patients illustrated the structural alterations that accompany the biochemical impairment of liver function and enable a more precise appreciation of this syndrome. Hepatic dysfunction appears to be implicated in a high proportion of patients who develop post-traumatic jaundice, which frequently occurs as part of a spectrum of multiple organ failure.

Adolescent↗
PubMed1976

A clinicopathologic study of hepatic dysfunction following shock.

Nineteen patients who had profound hypotensive shock were studied to correlate the light and electron microscopic appearances of the liver with the clinical and biochemical evidence of hepatic dysfunction. Despite the multiple etiologic factors that can result in jaundice in these patients, a fluctuating pattern occurs which enables the correlation of a bilirubin peak with the predominating etiologic factor. Immediately after shock, there was enzymatic and light and electron microscopic evidence of hepatocellular damage, resulting in a jaundice peak on the eighth to tenth day after the shock episode. This was followed by repair and regeneration of the liver as well as an increase in cholestatic enzyme levels. Later, bilirubin peaks occurred when hepatocellular function was further decreased or overloaded against this background of dysfunction related to the episode of shock. Recovery of hepatic function could continue or be delayed by intercurrent disease, particularly systemic infection. Support of hepatic function, similar to that available for pulmonary and renal failure may, in the future, be used to effect the prognosis of these patients.

Bilirubin↗
PubMed1975

Alcohol intoxication and serum osmolality.

The relation between serum osmolality and blood-alcohol was studied prospectively in 565 acute trauma patients. The two measurements were closely correlated. It is therefore possible to estimate the blood-alcohol from serum osmolality to assist in the clinical management of acutely injured patients.

Accidents↗
PubMed1975

Abdominal lavage in blunt trauma.

A technique for abdominal lavage is described and was used to evaluate the abdomen of 671 multiple trauma victims. In 44 per cent (299 cases) there was a bloodstained return and these were regarded as positive. Patients with a positive result underwent exploratory laparotomy which revealed that 89 per cent had significant intra-abdominal trauma requiring a surgical procedure, 8 per cent had trauma which did not require any active surgical correction and 3 per cent had no abdnormal findings. Of all the lavages performed, there were 0-11 per cent false positive and 0-03 per cent false negative results. The value of the test in the context of multiple trauma is emphasized.

Abdominal Injuries↗
PubMed1975

Urinary aetiocholanolone in patients with early breast cancer from South East Scotland and South Wales.

Urinary aetiocholanolone levels have been measured in 417 women aged between 20 and 70 years. The women were drawn from South East Scotland and South Wales and consisted of patients with either benign or malignant disease of the breast and control patients suffering from no detectable breast disorder. The pattern of aetiocholanolone excretion with respect to age and menopausal status has been defined in each group of patients. No significant differences in urinary levels have been detected between patients with breast disease, whether benign or malignant, and control patients. More detailed examination of the 201 women with early cancer of the breast has also shown that there is no consistent correlation between pre-operative aetiocholanolone levels and factors of prognostic significance detectable at the time of primary treatment-tumour size, grade, round cell infiltration, histological involvement of nodes by tumour and the clinical palpability of lymph nodes. It would seem, therefore, that the prognostic value of pre-operative aetiocholanolone measurements is somewhat limited in patients with early breast cancer. It is noted, however, that low levels of aetiocholanolone are associated with post-menopausal patients, a group in which the prognosis is generally poorer than that in pre-menopausal women.

Adenofibroma↗