PubMed Health⌕ Search

Biomedical subjects

P J Radford

Publications and source records attributed to P J Radford.

At least 19 recordsLinked to original sources

A rare and serious consequence of a rat bite.

Contact with rat saliva or faeces can lead to infection with Streptobacillus moniliformis and the condition known as 'rat bite fever'. We report a case of septic arthritis of the hip due to this organism following a bite on the finger of a 14-year-old boy from a rat for sale in a pet shop. The case was successfully treated by arthrotomy, drainage and joint lavage followed by administration of penicillin. Septic arthritis of the hip due to S. moniliformis has not been previously described and this case highlights a possible danger of keeping rats as pets.

Adolescent↗

Aspiration complicating bronchopulmonary dysplasia.

The purpose of this study was to study the relationship of aspiration with ongoing respiratory difficulties in infants with bronchopulmonary dysplasia (BPD). Twelve infants with BPD were identified out of 314 children who had flexible bronchoscopy between 1987 and 1990; 11 of 12 had bronchoalveolar lavage (BAL). The lipid index (LI) was used to quantify the degree of lipid-laden macrophages in the BAL fluid as a marker of aspiration. The age range at the time of bronchoscopy was 3 months to 5 years. The LI was considered positive in 6 of 11 subjects. A pH probe study was done on seven subjects with concordant findings in five. Other findings included dynamic or structural airway abnormalities in 10 of the 12 subjects. These data suggest that aspiration frequently is associated with BPD in addition to the previously recognized dynamic and structural airway problems. The predisposition to gastroesophageal reflux and laryngeal injury probably accounts for the increased aspiration risk in children with BPD.

Bronchoalveolar Lavage Fluid↗

A prospective randomised comparison of the dynamic hip screw and the gamma locking nail.

We made a randomised prospective comparison of the Dynamic Hip Screw and the Gamma locking nail for the internal fixation of 200 petrochanteric femoral fractures in elderly patients. There was less intraoperative blood loss and a lower rate of wound complications in the patients treated by the Gamma nail. They had, however, a high incidence of femoral shaft fracture which we relate in part to implant design. We do not recommend the use of the Gamma nail for these fractures.

Aged↗

The AO dynamic condylar screw for fractures of the femur.

We report our initial experience in Nottingham of use of the AO Dynamic Condylar Screw (DCS) implant system for internal fixation of fractures of the proximal and distal femur. The implant has been used in 24 cases over a 2-year period, and with an average follow-up of 1 year the results have been as favourable as those in reports of other comparable implants, but there have been a number of technical difficulties, particularly with the fixation of osteoporotic distal femoral fractures. The DCS can be used in all situations where the 95 degrees blade plate has previously been used and technically it is easier to insert correctly. We conclude that whilst the DCS may replace the corresponding blade plates in the orthopaedic surgeon's armamentarium, it does not solve the problems of fixation of osteoporotic fractures. The indications for and difficulties of such internal fixations are discussed.

Adult↗

Longitudinal changes in bronchial hyperresponsiveness in asthmatic and previously asthmatic children.

To determine if nonspecific bronchial hyperresponsiveness is present to the same degree in previously asthmatic children compared with currently asthmatic children, a longitudinal study was conducted. On the basis of a standardized respiratory questionnaire, 139 children from asthmatic families, between the ages of 6 and 21 years, were identified. Subjects had skin tests, a serum IgE level, and a methacholine challenge test. IgE and skin tests demonstrated atopy in both the previously and currently asthmatic children, which persisted over time. Bronchial hyperresponsiveness within the asthmatic children was not significantly different between visits. Previously asthmatic children did have significantly decreased airway hyperresponsiveness over time. Age did not affect the results of the bronchial hyperresponsiveness in the currently asthmatic children. Currently asthmatic children, however, were significantly more atopic when compared with previously asthmatic children at their initial evaluation. Currently asthmatic children were also more bronchial responsive and remained so over time. Bronchial hyperresponsiveness is persistent in children with current asthma symptoms.

Adolescent↗

Torsion of a malignant undescended testis mimicking appendicitis.

Testicular maldescent is known to be associated with later development of malignancy. The maldescended testis is prone to other complications--in particular, torsion. We report an unusual coincidence of both malignancy and torsion of an intra-abdominal testis which closely simulated a ruptured appendix abscess. This case demonstrates that an intra-abdominal testis can develop acute life-threatening complications which should be considered in any patient with acute abdominal symptoms who has an 'absent' testis.

Adult↗

The Herbert screw for delayed and non-union of scaphoid fractures: a review of fifty cases.

The results of treatment using the Herbert screw in 50 consecutive patients with delayed or established non-union of the scaphoid are reported. 14% of these fractures failed to unite after operation and a further 20% required prolonged protection, uniting within six months. There were significant technical problems in 28% of operations. A bone graft was only used when there was significant collapse of the scaphoid (52%) and the cases without graft did just as well. Overall, the results do not support the view that this method of treatment is a significant advance over Russe grafting in terms of union rates, but confirm that it produces similar results without the need for prolonged immobilisation and without the need for bone grafting in almost half the cases, although there can be significant technical problems with the procedure.

Adult↗

Total hip replacement in the renal transplant recipient.

Osteonecrosis of the femoral head is a severely disabling complication of steroid immunosuppression in renal transplant patients. We report 31 total hip arthroplasties in 21 renal transplant recipients with an average follow-up of six years. There were no problems with wound healing or infection despite full immunosuppression. Four hips developed symptomatic loosening but the other results were excellent, comparing well with other methods of treatment for osteonecrosis. Ten patients died during the follow-up period. Total hip replacement is a safe and effective treatment for transplant recipients and, in view of their limited life expectancy, should be considered at an early stage in their treatment.

Aged↗

The risks of injury in public ice skating.

A prospective survey has been made of the injuries to members of the public attending a well established ice rink in a major city. Comparison is made with series in the literature reporting high levels of injuries, with corresponding demands on local hospital services, from newly established ice rinks. The main conclusion is that demands on hospital services have been markedly reduced for the well established rink, with corresponding savings in health service resources.

Adolescent↗