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Biomedical subjects

R D Alexander

Publications and source records attributed to R D Alexander.

5 recordsLinked to original sources
PubMed1997

The effect of knee immobilization on degree of hip flexion: a clinical correlation with posterior wall acetabular fractures.

The purpose of this investigation was to determine whether maintaining the knee in extension substantially limits hip flexion. The dominant lower extremity in 22 male subjects was goniometrically evaluated to determine hip flexion both when the knee was allowed to flex and when the knee was held in extension. Pelvic rotation values were subtracted from thigh rotation values to show true flexion of the femur in relation to the pelvis. Hip flexion averaged 49.25 degrees +/- 9.08 degrees in the straight-leg raise test and 94.14 degrees +/- 4.94 degrees in the flexed-knee raise test. This study shows that using a knee immobilizer in the postoperative treatment of posterior wall acetabular fractures should serve to protect the fracture site while still affording early ambulation.

Acetabulum↗
PubMed1978

Contrast media-induced oliguric renal failure.

Seven patients had acute oliguric renal failure after intravenous urography (2), celiac arteriography (2), or cardiac angiography (3). Diatrizoate meglumine was the contrast media used in all of the cases. These patients had an average age of 63 years and six were 55 years of age or older. Diabetes mellitus, negative fluid balance before the procedure, underlying renal insufficiency, and hypertension were common, being present in three, four, five, and six of the patients respectively . Anuria or oliguria occurred within 24 hours of the procedure and persisted from 36 to 96 hours (72 hours average). The serum creatinine level rose significantly in all of the patients and reached a peak in two to seven days after the procedure. In six patients, recovery was complete by two to three weeks. The seventh patient experienced only partial recovery. These cases taken together with a mounting number of recent reports suggest that contrast media-induced oliguric renal failure is more common than generally believed. Diabetes mellitus, older age, and underlying renal insufficiency seem to be important predisposing factors.

Acute Kidney Injury↗
PubMedDate not supplied

Using quality and efficiency evaluations of physicians.

Most physicians have long felt that there must be a better way to address the need for improving the cost effectiveness of medical care other than the process-heavy, invasive tactics of traditional UR. The QE strategy of replacing case-by-case pretreatment authorizations and certifications with a more thorough retrospective analysis of medical practice patterns appears to have the potential to dramatically improve managed care results while minimizing many of the more irritating aspects of traditional UR. The QE managed care strategy has much to offer the manager of a medical group practice who has come to realize the importance of demonstrating superior quality and efficiency as a way out of the "price discounting" game.

Efficiency↗
PubMedDate not supplied

Wrist arthrodesis in children with cerebral palsy.

Wrist arthrodesis was performed on 19 upper extremities in 18 children with cerebral palsy to correct volar flexion and ulnar deviation deformities. Mean age at the time of surgery was 15.8 years, and mean follow-up was 4.7 years. Review of medical records and radiographs and follow-up clinical examination, including standardized functional testing and a child/parent questionnaire, were performed to assess outcome in technical, functional, and satisfaction domains. Technical domain outcomes were best when arthrodesis was performed by proximal row carpectomy with plate fixation. Functional improvement, as documented by the House scale, averaged 1.8 levels, with 14 children (83.3%) showing improvement. Child/parent satisfaction with cosmetic, hygienic, and functional outcomes was high, ranging from 72 to 94%. Wrist arthrodesis, when combined with appropriate procedures for the forearm, fingers, and thumb, provided excellent technical, functional, and satisfaction domain outcomes for children with cerebral palsy, particularly those with more severe upper extremity involvement, dyskinetic type cerebral palsy, or poor motivation for rehabilitation.

Adolescent↗