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Biomedical subjects

J Hoskinson

Publications and source records attributed to J Hoskinson.

11 recordsLinked to original sources
PubMed2003

Prospective double-blind randomized study of the effects of four intravenous fluids on platelet function and hemostasis in elective hip surgery.

A prospective randomized double-blind study was performed to determine the effects of three colloids, Haemaccel, Gelofusine and albumin, and also saline on platelet activation, platelet aggregation (induced by adenosine diphosphate (ADP), epinephrine, collagen) platelet agglutination by ristocetin and other hemostatic variables in 55 patients undergoing primary unilateral total hip replacement. The fluids were administered according to normal clinical practice and assessments were made immediately before, at the end, and 2 h after the end of surgery. Surgery was accompanied by thrombin generation (increases in thrombin/antithrombin III complex, prothrombin F1 +2 fragment) platelet activation (betaTG) and compromised coagulation. Generally, the platelet activation appeared to result in platelet desensitization and brought about a persistent reduction in platelet aggregation to ADP and epinephrine, irrespective of the fluid used. Additionally, Haemaccel and Gelofusine inhibited ristocetin-induced platelet agglutination and albumin inhibited collagen-induced platelet aggregation. Gross inhibitory effects of Haemaccel that had been predicted from an earlier in vitro study did not occur. Particular fluids had selective additional effects on the hemostatic system. Albumin infusion served to maintain plasma albumin at normal concentrations postsurgery. The two gelatin preparations, Haemaccel and Gelofusine, maintained plasma viscosity. All three colloids led to a transient increase in activated partial thromboplastin time postsurgery and also a transient fall in the concentration of factor VIII, which were accompanied by a transient increase in bleeding time, but there was no measurable increase in blood loss. Inhibition of platelet aggregation by certain colloids may provide additional protection against the increased thrombotic risk in patients following major surgery.

Adenosine Diphosphate↗
PubMed1993

Abdominal pain associated with an umbilical abscess in a llama.

A 3-month-old llama with a presenting complaint of lethargy, anorexia, and a painful, distended abdomen was evaluated. The llama had intermittently strained to defecate during the 3 days prior to admission. Physical examination results, hematologic data and lateral abdominal radiographs were used to diagnose a large umbilical abscess, which was causing a partial obstruction of the gastrointestinal tract. Under general anesthesia, 3 liters of purulent exudate were drained from the abscess. The abscess cavity was then lavaged with saline solution and its capsule was marsupialized to the skin. Cultures of the abscess content yielded Proteus sp, Streptococcus equisimilis, and Clostridium septicum. Two days after surgery, the llama was drinking, eating, and passing feces. The abscess was lavaged daily for a total of 11 days. Six months after surgery, the llama was the same size as other llamas of the same age, and the owners were pleased with the cosmetic appearance of the ventral abdomen. Umbilical abscesses can vary in size and clinical presentation; they should be recognized as a possible cause of abdominal pain with a potential for causing intestinal obstruction in llamas.

Abdominal Pain↗
PubMed1991

Coccydynia. Aetiology and treatment.

A five-year prospective trial involving 120 patients was undertaken to investigate the aetiology and treatment of coccydynia. The cause lies in some localised musculoskeletal abnormality in the coccygeal region. Lumbosacral disc prolapse is not a significant factor. The condition is genuine and distressing and we found no evidence of neurosis in our patients. Physiotherapy was of little help in treatment but 60% of patients responded to local injections of corticosteroid and local anaesthesia. Manipulation and injection was even more successful and cured about 85%. Coccygectomy was required in almost 20% and had a success rate of over 90%.

Adolescent↗
PubMed1988

Avulsion fracture of the index metacarpal base: three case reports.

Three cases of an avulsion fracture of the base of the index metacarpal by the tendon of Extensor Carpi Radialis Longus are reported. There are two previous reports of this injury which were both treated operatively. These cases were treated conservatively with satisfactory results. The relevant anatomy, mechanism of injury and incidence are discussed.

Adult↗
PubMed1987

Management of severely displaced medial epicondyle fractures.

The role of surgical fixation of the displaced medial epicondyle fracture remains controversial. We reviewed 20 patients with displaced (mean 10 mm) fractures, all associated with elbow dislocation. All elbows were therefore unstable, and all were managed nonoperatively. Although all fractures healed by fibrous union, the functional results were good. Clinical and radiological tests were used to assess the static stability of the ulnar collateral ligament. All patients had demonstrable ulnar collateral ligament laxity, but only one patient had slight impairment of elbow function. None had late-onset ulnar neuritis. We have shown that even the severe forms of this injury can be managed without internal fixation.

Adolescent↗
PubMed1978

Bone density and the carpal tunnel syndrome.

Bone density was studied in ten patients before and after release of an idiopathic carpal tunnel syndrome. A corticomedullary ratio was measured at the mid-point of the metacarpals and proximal phalanges of both hands. There was a significant increase in the mean bone density over the period of observation in the thumb and middle finger metacarpals and in the index, middle, and ring finger proximal phalanges of the operated hand. There was no significant increase in the density of either metacarpal or proximal phalanx on the non-operated side. Release of the carpal tunnel syndrome provides not only symptomatic relief but also leads to increased bone density.

Adult↗
PubMed1975

Thompson prosthesis for fractured neck of femur. A comparison of surgical approaches.

The records of 243 patients with Thompson prostheses for displaced femoral neck fractures have been studied. One hundred and seven prostheses were inserted through an anterior approach and 136 by a posterior approach. The short-term results and complications in these otherwise comparable groups are discussed. The infection rate of 18.5 percent in the group operated upon by the posterior approach was thrice that after operations by the anterior route (6.5 per cent infected). Drained wounds had significantly less infection (6.3 per cent) compared with the undrained group (28 per cent infected). Other factors influencing the infection rate are discussed. The anterior approach offered greater stability. Of the twenty dislocations in the series, nineteen followed operations by the posterior approach. The mortality rate six weeks after operation was 6.5 per cent after the anterior approach and 20.6 per cent after the posterior approach. Statistical analysis significantly favours the anterior approach.

Aged↗