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Biomedical subjects

K Little

Publications and source records attributed to K Little.

At least 19 recordsLinked to original sources
PubMed2001

A radiographic analysis of the relationship between the size and shape of the intercondylar notch and anterior cruciate ligament injury.

Notch-view radiographs were obtained from 108 persons with anterior cruciate ligament (ACL) injuries (55 women, 53 men) and 186 with intact ACL (94 women, 92 men). Notch width, femur width, and notch width index were determined from each of the 294 radiographs. The notch was also categorized as either A-shaped or non-A-shaped. Intrarater and interrater reliability ranged from 0.82 to 0.99 for notch width and femur width, respectively. Reliability within and between raters for the classification of notch shape ranged from 0.80 to 1.0. Notch width was significantly influenced by a 10 degree change in knee angle when repeated radiographs were taken. Femur width was not affected by knee angle across this range. Analysis revealed a higher proportion of A-shaped notches among women than men. However, notch shape was not related to injury status. Results showed a smaller notch width and notch width index in ACL-injured patients regardless of notch shape or gender. A-shaped notches were smaller than non-A-shaped notches regardless of injury status or gender. Both notch width and notch width index were found to be significant indicators of ACL injury. Knowledge of the shape of the notch added no useful information in differentiating patients based on injury status. Thus, regardless of gender, individuals who possess smaller notch dimensions appear to be at greater risk of injury than individuals with larger notches.

Adolescent↗
PubMed2001

Tackling the problem of poor ward cleanliness.

Both the environment and equipment used in health-care facilities have been identified as sources of infection. The cleaning of any hospital environment must be carried out in a pre-planned, clearly structured and defined manner. Domestic staff need thorough basic training and regular updates.

Data Collection↗
PubMed1998

Up-regulation of fast-axonally transported proteins in retinal ganglion cells of adult rats with optic-peroneal nerve grafts.

Metabolic labeling and quantitative 2D gel fluorography were used to assess changes in the synthesis and transport of five fast-axonally transported and developmentally regulated proteins (GAP-43, SNAP-25, and proteins of 18, 22, and 23/24 kDa) after grafting of a peroneal nerve segment onto a transected optic nerve in adult rats. After optic nerve transection alone, only GAP-43 was up-regulated significantly compared to normal adult controls. The other proteins showed little change or were down-regulated following axotomy. By 4 weeks following optic nerve transection and peroneal nerve grafting, however, GAP-43, proteins 22 and 23/24 kDa showed a sustained up-regulation in synthesis and transport compared to normal controls; SNAP-25 and protein 18 kDa showed levels of expression similar to or slightly greater than normal controls. Increased expression of GAP-43 in retinal ganglion cells was also examined with immunocytochemistry. While a transient up-regulation of GAP-43 in retinal ganglion cells was observed following optic nerve transection, a sustained increase in GAP-43 immunoreactivity was present only in animals with nerve grafts. Backfilling of retinal ganglion cells from the grafts with horseradish peroxidase combined with GAP-43 immunocytochemistry revealed that all retinal ganglion cells with axons growing into the grafts were positive for GAP-43, but not all retinal ganglion cells showing GAP-43 immunoreactivity were extending axons into the grafts. We conclude that the presence of a nerve graft sustains the up-regulation of a number of proteins including GAP-43, and that this up-regulation is correlated with an increased potential for nerve growth, but other as yet unknown factors or conditions appear to play a role in determining if this growth potential will be realized.

Aging↗
PubMed1997

Atropine poisoning after drinking Indian tonic water.

Poisoning is one of the most common reasons for acute medical admission to hospital in the UK. However, certain poisons are rarely implicated. Two unusual cases involving poisoning with atropine are presented. The clinical features were classical, but the way in which the patients became poisoned by drinking contaminated Indian tonic water was most unusual.

Adult↗
PubMed1995

Plasma elastase levels and the development of the adult respiratory distress syndrome.

Inflammatory cells, particularly neutrophil granulocytes, have been implicated in the pathogenesis of the adult respiratory distress syndrome (ARDS). In this study, we investigated whether a relationship exists between neutrophil elastase in the plasma of multiple-trauma patients on initial hospital presentation and the subsequent development of lung injury and ARDS. Sixty-one multiple-trauma patients were enrolled prospectively. Neutrophil elastase was measured by a specific radioimmunoassay, and analysis was performed by nonparametric statistical methods. A highly significantly elevated plasma elastase level was found in patients who progressed to ARDS (median 217 ng/ml, range 127 to 480) (n = 8) compared with those who did not (median 117 ng/ml, range 21.4 to 685) (n = 53) (p = 0.009). Significant correlation was found between initial elastase values and subsequent requirement for mechanical ventilation (p = 0.01), lowest arterial oxygen saturation/oxygen supplementation recorded (p = 0.003), and organ failure score (p = 0.006). This study shows that within minutes of the initiating trauma event, there is evidence of enhanced neutrophil degranulation as manifested by elevated levels of immunoreactive neutrophil elastase in the peripheral blood. The level of this enzyme correlates with the degree of subsequent lung injury and ARDS. These findings reinforce the importance of neutrophils and their secretory products in early ARDS disease pathogenesis.

Adolescent↗
PubMed1992

Flying squad response to out-of-hospital cardiac arrest--a decade of experience.

The Flying Squad (MEDIC I) based at the Royal Infirmary, Edinburgh, commenced operation in 1980. The MEDIC I response to out of hospital non-traumatic cardiac arrest over the past decade is reported. On-scene resuscitation was attempted in 384 patients. A total of 149 (39%) patients were successfully resuscitated and transferred to hospital. Thirty-six (9.4%) patients survived to discharge from hospital. Patients receiving basic life support prior to the arrival of MEDIC I and in ventricular fibrillation had a survival rate of 14.5% (25/174). During 1988-89, 21 patients were initially attended by ambulance crews equipped with semi-automatic external defibrillators and eight (38%) of these patients survived. The response of a hospital-based flying squad to support trained ambulance crews, especially when equipped with a defibrillator may provide an economically and operationally feasible alternative to training all first responders in the full range of paramedic skills.

Adolescent↗
PubMed1990

Non-traumatic chest pain in young adults: a medical audit.

Four hundred consecutive young patients who attended an accident and emergency department with non-traumatic chest pain as their primary complaint were reviewed. They represented 0.7% of total new attendances. Most were self-referrals, but ambulance transport was requested for over 25%. The majority of investigations (mainly chest radiography and electrocardiography) performed in this group of patients were normal; however, almost one in six investigations was judged to be abnormal. Although this group of patients is at low risk for serious cardiorespiratory disease, a small but significant number of underlying (mainly non-cardiac) disorders was found and 22.5% (90) required in-patient admission. In contrast, almost one-fifth of patients received no specific diagnosis, while almost 40% were deemed to require no follow-up.

Adolescent↗
PubMed1990

An objective analysis of an accident flying squad.

An objective evaluation of an accident flying squad, in relation to trauma call-outs during a six month period, was performed using the Injury Severity Score and the recently described Revised TRISS methodology. We have demonstrated improvement in patient survival for those trauma cases treated at the scene. This has not been previously documented. Objective evaluation of these squads in relation to medical emergencies is even more difficult. The profile of these call-outs is described. (11.1%) of those treated at the scene for cardiac arrest survived to leave hospital. Ventricular fibrillation was the primary arrhythmia recorded in this group of survivors. This supports the vogue for extended ambulance personnel training.

Emergency Medical Services↗
PubMed1989

Measuring subacute mood changes using the profile of mood states and visual analogue scales.

Mood lability and mixtures of moods are important clinical features that may contribute to diagnostic formulation and treatment response. Attempts at quantifying such lability and mixtures have been limited. In this preliminary study both the Profile of Mood States (POMS) and comparable Visual Analogue Scales were assessed for their feasibility and relative performance over a 3- to 5-day period in two groups of inpatients. Both demonstrated concurrent validity and feasibility. The performance of the POMS appeared somewhat superior. A major concern remains regression to the mean after multiple sampling. The authors suggest continued exploration of the relationships between POMS change scores and diagnosis, biological markers, and treatment outcome.

Affect↗
PubMed1989

The impact of alcohol on the acute hospital service: patient presentation, admission and the perception of alcohol use in such groups.

Patients presenting to an Emergency Department were assessed by a standard questionnaire and clinical examination as to the contribution that alcohol made to their presentation and the perception of their alcohol use. Patients under the influence of alcohol are more than twice as likely not to fill in simple questionnaires and not to perceive their alcohol consumption as different from non-drinking fellows. Emergency Departments are not the optimal site for the education and motivation of drinking patients to alter their future habits.

Alcohol Drinking↗