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Biomedical subjects

J H Trumpy

Publications and source records attributed to J H Trumpy.

10 recordsLinked to original sources
PubMed1987

Alterations in T-helper and T-suppressor lymphocyte populations after multiple injuries.

Fifteen patients with multiple injuries and an Injury Severity Score (ISS) ranging from 2 to 57 (median 25) were studied for variations in lymphocyte populations on the day of injury and the three following days. Nine of the patients had an ISS above 16. In all patients the total number of lymphocytes fell during the first 24 hours after the injury (P less than 0.01), mainly due to a reduction in the number of circulating T-lymphocytes from a median of 1.8 to 0.6 x 10(9) cells/l (P less than 0.01). No reduction in the T-helper/T-suppressor cell ratio could be demonstrated for the group as a whole, but in the 9 patients with an Injury Severity Score (ISS) of more than 16 a significant reduction in ratio from median 1.5 to 0.8 was found. Due to clinical observations patients with an ISS of more than 16 are considered severely injured and at risk of developing complications such as infection and septicaemia. The fall in T-helper/T-suppressor ratio indicates impaired immunity in these patients.

Adolescent↗
PubMed1987

Complement activation following multiple injuries.

Complement activation was evaluated by assay of plasma C3dg and the terminal complement complex (TCC) in 19 patients with multiple injuries. In the nine patients with thoracic involvement, statistically significant increase of plasma TCC was found at first sampling (average 90 min post-trauma), and of C3dg after 24 hours. Such increase was not found in the ten patients without thoracic involvement. Heightened granulocyte elastase activity was found in bronchial lavage fluid 90 min after the trauma in three patients with thoracic injury. Pulmonary insufficiency (pO2/FiO2 less than 16 kPa on intermittent positive-pressure ventilation) arose in four patients. All four had raised plasma levels of TCC or C3dg on arrival at the hospital. Six patients with complement activation did not show pulmonary insufficiency. Although the series was relatively small, the results indicate that thoracic injury is particularly associated with complement activation, and that complement activation alone does not suffice to produce post-traumatic pulmonary insufficiency.

Adolescent↗
PubMed1978

Extradural haematoma. Report of 132 cases.

In a consecutive unselected series of 132 cases of acute extradural haematoma among 9,600 patients who sustained a head injury and were admitted without delay to a regional neurosurgical department during the years 1964 to 1975 the overall mortality was 23 per cent. Associated intradural lesions, the relative infrequency of the lucid interval, sustained loss of consciousness from the time of admission, lack of the classical pupillary changes, and the rapid rise in intracranial pressure in some patients are factors of importance for the prognosis. It should be possible to improve the results and lower the mortality if due consideration is taken of these factors.

Adolescent↗
PubMed1977

Intracranial arteriovenous malformations: conservative or surgical treatment?

Of 89 patients with arteriovenous malformations of the brain, 47 were conservatively treated, nine of these died (19%), four with the first bleed, five of recurrent bleeding. Of 42 surgically treated patients, five died, a mortality of 12%. Four of these deaths occurred with patients in a deteriorating clinical condition caused by large intracerebral haematomas. The fifth death occurred with a recurrent bleeding where a ligation of feeding artery was the only treatment. There were no deaths in those patients in good clinical condition who underwent an excision of the malformation. Total excision of arteriovenous malformations should be performed whenever possible.

Adolescent↗