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Biomedical subjects

J Older

Publications and source records attributed to J Older.

At least 19 recordsLinked to original sources
PubMed1989

A controlled trial of sip-feed supplements in elderly orthopaedic patients.

The potential nutritional and clinical benefits of sip-feed supplements were investigated by means of a controlled trial in elderly female patients admitted for orthopaedic surgery. A nutritional risk assessment procedure (Nutritional Risk Questionnaire, NRQ) was used to identify patients who might benefit from supplementation. Patients identified as high risk who did not receive supplements showed significant losses in triceps skinfold thickness (TSF) and mid-upper arm muscle circumference (MUAMC) measurements during hospitalization. Such changes were not observed in high-risk supplemented patients, but significant losses of MUAMC were also recorded in a group of patients who failed to comply with the supplement. No differences in biochemical parameters, muscle function, or clinical outcome were observed between supplemented and unsupplemented and non-compliant patients. The problems of poor compliance to sip-feed supplements and failure to observe clinical benefit in supplemented patients are discussed.

Aged↗
PubMed1988

Cytological assessment of knee effusions.

Effusion fluid from 80 knee joints was obtained from patients prior to arthroscopy and arthroscopic surgery and submitted to independent physicochemical analysis and cytological examination. The majority of the effusions were secondary to osteoarthrosis and traumatic mechanical derangement. These two conditions gave nonspecific findings on physicochemical analysis and cytology, and the cytologist diagnosed on 13% of these correctly. Cytological examination of fluid from rheumatoid knees revealed ragocytes in just over half the cases, and on this basis, the cytologist was able to correctly diagnose rheumatoid arthritis. Contrary to other reports, we conclude that physicochemical analysis and cytological examination of joint fluid is of little value in the assessment of knees presenting to the orthopaedic surgeon.

Adolescent↗
PubMed1988

The first four years' experience of day case orthopaedic surgery in a district general hospital.

Clinical data were obtained for 2838 consecutive patients admitted to a new day case unit in a district general hospital by four consultant surgeons between 1 October 1981 and 30 September 1985. Surgical procedures under general anaesthesia: on 2581 patients were analysed in detail. Intra-articular arthroscopic surgery was performed on 60% of knees. A fifth of patients had manipulation and intra-articular infection of a joint. Surgical operations involving the hands and forearm were required by 17%. Toe surgery was performed on 11% of patients of whom 21% had a distal metatarsal osteotomy. Overnight admission was necessary for 6% of patients because of postanaesthetic difficulties, the operation occurring too late in the day or proving more extensive. The use of day case facilities was an economic saving, pleased 98% of patients and reduced waiting list time significantly, except for patients with serious chronic joint disorders. The waiting list for total hip and knee replacements increased in the four year period.

Adult↗
PubMed1986

Seven at one.

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Adolescent↗
PubMed1986

Low-friction arthroplasty of the hip. A 10-12-year follow-up study.

The data from a series of patients operated upon by Charnley and reviewed after ten to 12 years shows that low-frictional torque arthroplasty remains a sound concept of design. If done with precision, it is still the best operation for patients with discomfort and disability from coxarthrosis. The development of a sound interface is controlled not only by the initial strength of the interlock achieved by the surgeon, but also by the loads applied to it by the patients. The total hip arthroplasty may be a miracle of modern medicine, but it can never be superior to normal articulation; this should encourage the surgeon to steer the patient away from unreasonable expectations. In this review, 217 arthroplasties were performed in 184 patients; 58 died, leaving 153 arthroplasties in 126 patients. Eighty-eight percent were more than satisfactory; 6% required revision. This was due to aseptic loosening in only two percent.

Adult↗
PubMed1984

Teaching touch at medical school.

The association between touch and healing is ancient and worldwide. Skilled hands are among the physician's most important diagnostic and therapeutic tools. Yet a survey of medical schools in the English-speaking world revealed that most offer no touch training in their curricula. Of 169 medical schools, only 12 give any formal instruction in the uses and meaning of therapeutic touch in medicine. The teaching modes of these 12 schools are discussed, and the program of the most touch-conscious school, the University of Otago, is described.

Behavioral Sciences↗
PubMed1984

Optimizing the oral examination in medical education.

The oral examination, or viva, is a testing procedure well-suited to psychiatry and the behavioural sciences, but it is a procedure which tests the skill of examiners nearly as much as it does students. Guidelines are suggested to maximize the efficacy of the viva and to minimize its potential weaknesses. The guidelines include: relaxing students, clear thinking, open-ended questions, active probing, calibrating questions to the appropriate level of sophistication, looking for strengths, and encouraging creativity.

Education, Medical↗
PubMed1984

Preparing the conference paper.

Presentations at many psychology and psychiatry conferences are ponderous monologues overfilled with information in a format designed for readers, not listeners. Seven ways are suggested to improve the conference paper, and in doing so, to improve the chances of survival (or at least the quality of life) of those who attend them.

Congresses as Topic↗
PubMed1983

First year's experience of day-case arthroscopy in diagnosis and management of disorders of the knee joint.

Clinical data and questionnaires were obtained for 130 patients with knee disorders admitted to a new day-case unit in a district general hospital in the year from Oct 1, 1981, under the care of one surgeon. A third of the 148 knees investigated had more than one pathological lesion, and in 18% the arthroscopic diagnosis differed from the preoperative diagnosis. Intra-articular arthroscopic surgery was carried out on 59% of knees; only 12% of operations took more than 60 min. The time before return to normal everyday activities, work, and sport was much shorter than after arthrotomy. Postanaesthetic sickness or poor communication with staff were the only causes of discontent, and 93% of the patients were pleased with day-case treatment. With the day-case facilities the number of patients admitted for arthroscopic investigation and treatment of knee disorders has trebled and the waiting-list time has been halved.

Adolescent↗
PubMed1983

Touching and birthing.

Although humans are mammals, experts have often acted as though we were not, especially in the realm of our need for touch. Psychologists, surgeons and maternity hospitals are among those who have sought to discourage this basic mammalian form of contact and comfort. Yet there is ample evidence that touch is needed in a number of ways at the time of birth, for the months that precede it and for the years that follow. Even those who criticize touch-advocates for overstating the scientific evidence for their case, share their conclusion about the importance of touch at the time of birth.

Animals↗
PubMed1982

Bad language.

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Communication↗