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Biomedical subjects

R Farrell

Publications and source records attributed to R Farrell.

26 records · Page 2Linked to original sources
PubMed1977

Muscle-protein catabolism after injury in man, as measured by urinary excretion of 3-methylhistidine.

1. Urinary excretion of 3-methylhistidine, an index of the rate of muscle breakdown, has been measured during the first 7 days in patients after elective surgery or accidental injury. 2. There was no major difference between the mean daily excretion after skin grafting or total hip replacement, or in injured patients who were hyperketonaemic for the first 24 h after admission. 3. The group of injured patients who did not develop hyperketonaemia had a mean urinary 3-methylhistidine excretion which was twice that of the other groups. 4. It is concluded that increased breakdown of muscle protein makes a major contribution to the greater urinary nitrogen excretion in the normoketonaemic group of injured patients.

Adolescent↗
PubMed1976

Branched-chain amino acids, nitrogen excretion and injury in man.

1. Venous blood concentrations of the branched-chain amino acids, valine, leucine and isoleucine, and urinary nitrogen excretion have been measured in sixteen adult males, from 2 h to 7 days after injury, and in four adults after elective skin grafts. 2. In the injured group the concentrations of these amino acids rose significantly 24 h after injury and had doubled at 4 days and remained high; in contrast the skin-graft patients showed no significant change. 3. In those injured patients with initial hyperketonaemia, defined as more than 0-2 mmo1/1, the increase in concentrations of branched-chain amino acids at the fourth and seventh days after injury was significantly less than in those with normoketonaemia, and was accompanied by lower urinary nitrogen excretion throughout the whole period. 4. It is suggested that the changes in the concentration of branched-chain amino acids after injury indicate decreased uptake by muscle or excessive release due to an imbalance between protein synthesis and protein catabolism in this tissue.

Adolescent↗
PubMed1976

Colonoscopy associated bacteremia.

Fifty-two patients undergoing uneventful diagnostic colonoscopy with or without polypectomy and biopsy were evaluated for evidence of bacteremia during and after the procedure. In only two instances was bacteremia noted. Positive findings were noted in patients with carcinomatosis and severe liver involvement. These data suggest that routine prophylactic antibiotic coverage is unnecessary in uncompromised patients. Further studies are warranted when patients have either severe liver involvement or impairment of normal host defense mechanisms.

Adult↗
PubMed1976

Experience with the use of the Carboflator for establishing pneumoperitoneum.

Safe and adequate pneumoperitoneum is dependent upon intraperitoneal pressure and not upon the number of liters of gas insufflated. Volume of gas delivered depends upon the size of the patient and whether there is any possible leakage. The Carboflator is a useful instrument for establishing controlled insufflation of gas and fail-safe intraperitoneal pressure.

Laparoscopes↗
PubMedDate not supplied

The effects of dilute epinephrine saline irrigation on the need for tourniquet use in routine arthroscopic knee surgery.

A prospective, randomized, double-blinded study was performed to determine whether dilute epinephrine saline irrigation (1 mg/l) delivered by gravity flow would significantly reduce the need for tourniquet use during routine arthroscopic surgery. One hundred five patients requiring straightforward arthroscopic knee surgery were randomly assigned to either an epinephrine group that received dilute epinephrine irrigation by gravity flow or to a placebo group that received normal saline irrigation by gravity flow. The need for tourniquet use and the tourniquet time, total operative time, and volume of irrigation fluid used were documented and compared between the two groups. A tourniquet was required 50% less often in the epinephrine group than in the placebo group. This difference was found to be statistically significant using the Student's t-test (P < 0.008, alpha < or = 0.05). If a tourniquet was required, the presence of dilute epinephrine in the irrigation fluid did not affect the overall tourniquet time or the ratio of tourniquet time to total operative time. We believe this study proved that dilute epinephrine irrigation is effective in decreasing the need for tourniquet use during routine arthroscopic knee surgery.

Adult↗