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Biomedical subjects

J D Vinen

Publications and source records attributed to J D Vinen.

4 recordsLinked to original sources
PubMed1998

Biochemical markers of acute myocardial infarction: strategies for improving their clinical usefulness.

We investigated the early diagnostic utility, including incremental value, of the serum cardiac markers creatine kinase (CK), CK-MB (mass and activity measurements), cardiac troponin T, and myoglobin in the diagnosis of acute myocardial infarction (AMI) in patients presenting to a major teaching hospital with chest pain and non-diagnostic electrocardiographs (ECG). The reference diagnosis of acute myocardial infarction was made by a single, independent cardiologist using World Health Organization criteria. CK and CK-MB mass were the only significant predictors of AMI at presentation to the Emergency Department. Logistic regression analysis revealed that CK did not significantly predict (P = 0.23) myocardial infarction once CK-MB mass was in the model. Using test results on follow up, in addition to presentation CK-MB mass, change in CK-MB mass was the only other significant independent predictor of AMI. Likelihood ratios for various levels of the significant markers in the logistic regression are given. In conclusion, CK-MB mass measurement was the only useful serum cardiac marker for the diagnosis of AMI in patients presenting with chest pain with non-diagnostic ECGs.

Biomarkers↗
PubMedDate not supplied

Acute spinal epidural hematoma.

A 17-year-old female presented to the Emergency Department with a history of recent onset of severe upper thoracic back pain, urinary retention, weakness and paraesthesia in the lower limbs. Magnetic Resonance Imaging (MRI) Scan demonstrated a spinal epidural hematoma at the C7-T2 level. This report highlights a rare, but eminently treatable condition; the use of MRI Scan as a specific diagnostic tool; and the need for urgent surgical decompression to ensure good recovery of function.

Acute Disease↗
PubMedDate not supplied

An aid to blind nasal intubation.

Blind nasal intubation remains an important technique in the management of the difficult airway. Many aids to this technique have been described, but unfortunately, these often require additional expense, training, and equipment. Methods that involve listening at the end of the endotracheal tube and observing moisture condensation in the tube are relatively insensitive and may expose the operator to the patient's bodily fluids. Our aim was to devise an aid to blind nasal intubation that was effective, inexpensive, simple to learn, and easy to assemble. It is essential that breath sounds can be monitored through the endotracheal tube, as it is felt that this helps to minimize retropharyngeal perforation caused by the tube abutting the posterior pharyngeal wall. We describe the use of an endotracheal tube stethoscope in conjunction with either 'inline' or 'sidestream' capnometry and present a case of successful nasotracheal intubation using this device. The total cost of this aid is less than $10 Australian.

Accidents, Traffic↗