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Biomedical subjects

J Templeton

Publications and source records attributed to J Templeton.

At least 19 recordsLinked to original sources
PubMed1992

Os calcis fractures: a randomized trial comparing conservative treatment with impulse compression of the foot.

Published data suggest that soft tissue involvement plays a role in the aetiology of residual symptoms following fractures of the os calcis. This randomized study involved 23 patients with 24 intra-articular fractures of the calcaneum. It was designed to evaluate the efficacy of a pneumatic plantar impulse device in reducing pain, associated morbidity and convalescent time. The results show a significant improvement in subtalar range of movement in the pumped group at 3 months, with pain significantly reduced at 6 months and at 1 year. There was no difference in weight bearing or walking distance between the pumped and control groups. The time from date of injury to return to work was significantly reduced in the pumped group by an average of 3 months.

Adult↗
PubMed1991

Intraosseous infusion of fluids in the initial management of hypovolemic shock in young subjects.

Immediate aggressive fluid resuscitation of a child with life-threatening hemorrhagic shock provides the difference between life and death. Obtaining venous access in the hypovolemic child sometimes is difficult and time consuming. In order to evaluate the benefit of prehospital administration of intraosseous fluids into the tibial bone marrow as a method of gaining quick access to the systemic circulation and in resuscitating victims from severe hypovolemic shock, 13 puppies weighing 4.6 to 10 kg were subjected to progressive, controlled exsanguination until their mean arterial pressure (MAP) was 20% or less of their baseline MAP for 5 minutes (maxishock). Then an 18-gauge intraosseous needle was inserted into the tibial bone marrow and lactated Ringer's solution was infused at 300 mm Hg of pressure until a volume three times the blood loss had been administered. The MAP, central venous pressure, arterial blood gases, hematocrit, serum lactate, and urine output were recorded at 10, 20, 30, 45, 60, 90, and 120 minutes after the onset of maxishock. At the end of the experiment the left lung of each animal was sent to the pathology department to investigate the possibility of bone marrow emboli. The results were compared with a group of control dogs with maxishock and no treatment, and a group of dogs with maxishock treated with a canine military antishock trousers inflated to 50 to 55 mm Hg and no fluids. The average needle insertion time was 16 seconds; the rate of infusion of fluids varied from a maximum of 25.7 mL/min to a minimum of 4.5 mL/min, with a mean of 10.6 mL/min.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Trauma centres.

Explore the source record for details and available documents.

Adult↗
PubMed1988

Major blunt abdominal trauma due to child abuse.

We reviewed 15 years' experience with childhood trauma at two hospitals in different cities, one a city hospital, the other a children's hospital, to learn the extent, circumstances, presentations, and consequences of major blunt abdominal trauma due to child abuse. Some 10,000 children admitted to these hospitals for treatment of injuries from 1972 through 1986 provided the basis for the study; the incidence and severity of pediatric trauma at the two hospitals was similar, in that 13% of the visits to both hospitals' emergency rooms were for trauma, of which 5% resulted in admission. Major blunt abdominal trauma due to child abuse accounted for 22 of these cases, six at the former, 16 at the latter, and represented less than 0.50% of all abused children seen at both institutions. The average age was 24 mo; 14 were boys and eight were girls. In only two instances was the family unit intact; in both, the child was abused by the babysitter. Otherwise, the father, or the mother's "boyfriend," was responsible. Overall mortality was 45%, and was related both to type of injury and presenting signs. Of one who presented with an epigastric mass due to a pancreatic hematoma, none died; the pseudocyst which subsequently developed resolved on bowel rest and TPN. Of three who presented with bilious vomiting due to duodenal hematoma, none died; one required operative evacuation. Of five who presented with peritonitis due to duodenojejunal rupture, one died; this child presented greater than 24 hr following injury in profound septic shock. Of three who presented with hypovolemia due to moderate hemorrhage, none died; the former two were managed conservatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdominal Injuries↗
PubMed1987

An animal model for the study of hemorrhagic shock from abdominal trauma in children.

Trauma is the most frequent cause of death in children over one year of age, and liver laceration secondary to blunt abdominal injury is frequently the major cause of hemorrhagic shock. In the current study, we have developed an animal model for the study of hemorrhagic liver lacerations in childhood. Using puppies six to 12 weeks of age, and three to nine kilograms in weight, we have been able to reliably produce shock (89%) without an excessive initial mortality rate (11%). The animals experienced a decrease in mean arterial pressure to 50% of the baseline level within 1.3 to eight minutes after the injury. This model will permit the study of various methods of resuscitation from blunt abdominal trauma in future experiments.

Animals↗
PubMed1987

External fixation in contemporary fracture management.

Important advances have been made within the last two decades in the field of fracture management. The development of the AO internal fixation system and the advances in cast bracing techniques are but two of the improvements worthy of mention. It is, however, in the field of external fixation of fractures that the greatest advances have been made. This paper traces the history of external fixation up to the present day and discusses, with examples, the application of external fixation in the management of complex limb fractures.

Fracture Fixation↗
PubMed1985

Progesterone derivatives that bind to the digitalis receptor: effects on Na+,K+-ATPase and isolated tissues.

The steroid nature of the cardiac glycosides (CG) suggests that an endogenous steroid (or steroids) may be the natural ligand for the specific receptor site, i.e., Na+,K+-ATPase. Derivatives of progesterone (PROG) that compete in a [3H]ouabain radioreceptor binding assay (RRA) are characterized by 17 alpha-acetylation and modifications in the B ring. Chlormadinone acetate (CMA) is the most potent analog identified thus far, having about one-twentieth the RRA potency of ouabain. CMA interacts at the ouabain site on Na+,K+-ATPase, inhibits the enzyme in the same rank order of species sensitivity as do the CG, and inhibits the sodium pump in vitro in guinea pig atrium and perfused heart, cardiac myocytes, rat diaphragm, and red blood cells. CMA does not cross-react with digoxin antiserum, which indicates that CG antibodies are not necessarily directed at molecular determinants of biological activity. By crystallographic analysis, the 20-carbonyl moiety in CMA is seen spatially oriented so as to be equivalent to the lactone 23-oxygen atom in the CG. CMA exerts primarily cardiodepressant effects, in accordance with the often-reported similar action of PROG. Negative inotropy may be mediated other than by Na+,K+-ATPase because PROG itself has no significant CG-like actions. Positive inotropy by CG, cardiodepression by CMA and PROG or low concentrations of CG, occasional transient enhancement of contractility by CMA, and pump stimulation by low concentrations of CMA or CG may reflect different affinities of the compounds for sites that mediate Na+,K+-ATPase/pump inhibition, positive inotropy, and negative inotropy. Thus, PROG derivatives related to CMA appear to be likely candidates for endogenous digitalis-like hormones. Body tissues possess the enzymes for conversion of PROG to derivatives related even more closely than the semisynthetic CMA to the CG configuration.

Animals↗
PubMed1977

Improved survival after coronary bypass surgery in patients with poor left ventricular function: role of intraaortic balloon counterpulsation.

The operative mortality rate of aortocoronary bypass surgery in 23 patients with poor left ventricular function (ejection fraction 0.30 or less) operated on in 1973-74 was 34.7 percent. The incidence rate of operative myocardial infarction was 30.4 percent. In an attempt to improve survival, intraaortic balloon counterpulsation was used therafter in 25 similar patients. Counterpulsation was instituted preoperatively and continued intra- and postoperatively for 2 to 5 days. Preoperative studies revealed an "unloading" effect of the left ventricle, with significant reductions of systolic arterial blood pressure, end-diastolic pulmonary arterial pressure and end-diastolic left ventricular volume and pressure. Metabolic improvement was demonstrated by the lesser production of myocardial lactate after pacing-induced tachycardia when the ventricle was balloon-assisted. Intraoperatively, blood flow through the vein graft was found to increase with counterpulsation. The rate of operative myocardial infarction was reduced to 4 percent and the mortality rate to 8 percent. In patients who have sustained a significant loss of functioning myocardium, the beneficial hemodynamic and metabolic effects of intraaortic balloon counterpulsation appear to prevent furhter, possibly critical, myocardial damage in the perioperative period.

Assisted Circulation↗
PubMed1977

Femoral neuropathy associated with anticoagulant therapy.

The English literature concerning femoral neuropathy associated with anticoagulant therapy is reviewed. Anatomical dissections were carried out in order to determine how the neuropathy might be produced. It is postulated that hemorrhage occurs within the iliacus muscle and that a pressure neuropathy of the femoral nerve ensues. Conservative management is recommended. The condition is probably more prevalent than previously thought, as evidenced by the fact that two cases were diagnosed in as many years by one orthopedic surgeon in a 300-bed general hospital.

Anticoagulants↗
PubMed1977

Hip fracture in the patient with Parkinson's disease.

Although treatment of the parkinsonian with hip fracture has progressed because of more effective operative intervention, the prognosis is not nearly as good as for the patient without parkinsonism. The patient's personal physician needs to be aware of possible complications, and the family should be made aware of the seriousness of the problem.

Hip Fractures↗
PubMed1976

Vertical fracture dislocation of the tarsal navicular.

An isolated vertical fracture dislocation of the left tarsal navicular with some comminution was successfully treated with open reduction and internal fixation with a screw. The surgical treatment is described, and early mobilization strongly recommended.

Adult↗
PubMed1975

A study of the human metabolism of secbutobarbitone.

The urinary excretion of secbutobarbitone (I) and its metabolites has been studied quantitatively using combined gas chromatography-mass spectrometry. After a single oral dose was given to healthy male volunteers, unchanged drug (5-9%), 2'-hydroxysecbutobarbitone (II, 1.7-3.2%), 2'-oxosecbutobarbitone (III, less than 1%), and the carboxylic acid (IV, 24-34%) were found. The kinetics of the excretion process were studied.

Barbiturates↗