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J D Yelland

Publications and source records attributed to J D Yelland.

12 recordsLinked to original sources

Head injuries to children riding bicycles.

This article examines the characteristics of 150 children who were admitted to Brisbane hospitals with head injuries that were caused by bicycle riding. These children constitute over 20% of all the children with head injuries who were admitted to hospital; accidents involving bicycle riding are the second largest single cause of head injury in these children, after falls. There was one death in the group, and three children were moderately disabled nine months after the injury. These four children all had Glasgow coma scores of less than 9 on their admission to hospital. Only two of the 150 children wore helmets. A survey of a random subgroup of children who had sustained head injuries confirmed our opinion that many children owned helmets but did not wear them for fear of peer derision. It is suggested that this refusal can be overcome by a combination of legislative enforcement, helmet design and promotion.

Australia↗

Phenytoin impairs the bioavailability of dexamethasone in neurological and neurosurgical patients.

Plasma concentration-time data after oral and intravenous administration of dexamethasone have been subjected to pharmacokinetic analysis in six neurological or neurosurgical patients taking the steroid with phenytoin, and in nine patients (one studied twice) taking dexamethasone without phenytoin. An additional patient was studied before and during phenytoin intake. Apparent volume of distribution was similar in the two groups, but the group treated with phenytoin had an almost statistically significantly shorter dexamethasone mean terminal half-life, an approximately trebled mean plasma clearance, and a mean oral bioavailability of the steroid of only 33%, compared with a mean 84% oral bioavailability in those not receiving phenytoin. To achieve a given plasma dexamethasone concentration, patients treated with the steroid and phenytoin may need oral dexamethasone doses several times those required by patients not receiving phenytoin.

Adult↗

Severe head injury managed without intracranial pressure monitoring.

A prospective series of 100 consecutive severe head injuries is presented. There were 34 deaths. Intracranial pressure (ICP) was not monitored in this series, and it is suggested that the outcome compares favorably with series in which ICP monitoring was performed. Early evacuation of life-threatening intracranial hematoma and airway control remain essentials of treatment of severe head injury.

Adolescent↗

Craniostenosis.

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Adolescent↗