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Biomedical subjects

R Fricker

Publications and source records attributed to R Fricker.

33 records · Page 2Linked to original sources
PubMed1995

Skier's thumb. Treatment, prevention and recommendations.

Skier's thumb is an injury to the ulnar collateral ligament (UCL) of the thumb metacarpophalangeal joint (MCPJ) which has a serious risk of disabling chronic instability if not treated adequately. The lesion most often occurs in skiers when the ski pole forces the thumb to deviate radially. Strapless poles do not decrease the incidence of skier's thumb, but if skiers are trained to discard the pole during a fall the risk might be reduced. Clinical and anatomical findings and the understanding of the injury mechanism show that stability testing (performed with the joint in full flexion) and additional standard radiographs remain the keystones in decision making in all MCPJ sprains. Protective splinting is advocated in stable, undisplaced avulsion fractures and incomplete ligamentous lesions of the UCL. However, surgery should not be delayed where there are displaced bony avulsion fractures, and where a complete ligamentous rupture is suspected because of a more than 30 degrees stressed radial deviation and more than 20 degrees difference compared with the uninjured side. Controlled active range of motion exercises can usually be started 3 to 4 weeks after the injury or open surgical repair, respectively. Protective splinting is continued until the sixth week and unrestricted use allowed 12 weeks following injury.

Athletic Injuries↗
PubMed1995

Randomized comparison of gastric pH control with intermittent and continuous intravenous infusion of famotidine in ICU patients.

OBJECTIVE: To compare gastric pH control using intravenous famotidine as a primed, continuous infusion versus intermittent infusion. METHODS: In a prospective, double-blind study, 40 ICU patients at risk for stress ulceration were randomly assigned to receive either famotidine 20 mg intravenous bolus followed by 1.67 mg/h infusion or famotidine 20 mg intravenously every 12 h. Intraluminal gastric pH was recorded at baseline and every 4 h using a glass electrode. Clinical outcome indicators were also monitored. Subjects were studied for a minimum of 24 h and a maximum of 6 days. Continuous variables were analyzed by ANOVA and nominal variables by Fisher's exact test (alpha = 0.05). RESULTS: Nineteen patients were randomized to the continuous infusion group, and 21 were randomized to the intermittent group. Using gastric pH greater than 4.0 as an endpoint, the continuous group exhibited better pH control, both in terms of percentage of total measurements (83% versus 63%, p < 0.001) and time spent above pH 4.0 (91% versus 76%, p < 0.01). Similar results were found at pH greater than 5.0 (78% versus 56% for all measurements for the continuous and bolus groups, respectively (p < 0.001), and 88% versus 72% for the time spent above pH 5.0 (p < 0.01). Clinical outcomes, including evidence for gastrointestinal bleeding and hospital mortality, did not differ significantly between groups. CONCLUSION: Famotidine infusion at 1.67 mg/h, when preceded by a bolus dose of 20 mg, provides a greater and more sustained increase in gastric pH than intermittent administration of famotidine 20 mg every 12 h.

Aged↗
PubMed1995

[Functional and morphological results of transplantation of vascularized knee joints in a dog model--a preliminary report].

Functional and morphological results of transplantation (n = 3) and replantation (n = 4) of vascularised total knee joints were compared in a canine model. Follow up time was 6 months. All vascular anastomoses remained patent and all osteotomies healed. Replanted animals displayed normal static weight bearing in contrast to the transplant recipients, which showed reduced weight bearing after 6 months compared to preoperative values. Mild to moderate signs of chronic allograft rejection were detected in all transplanted animals. Functional results were correlated with morphological outcome demonstrating the relevance of adequate control of rejection.

Animals↗
PubMed1994

Lateral flexion/extension radiographs: still recommended following cervical spinal injury.

We present the case of a patient who sustained a cervical spinal injury and subsequent transient quadriplegia with full recovery from the spinal cord concussion. Initial plain X-ray films and magnetic resonance imaging did not show any pathological findings, but lateral radiographs in flexion and extension performed 10 days later revealed a fracture of the C4 spinous process without ligamentous instability, confirming significant injury to the cervical spine.

Cervical Vertebrae↗
PubMed1994

[Surgical technique in vascularized auto- and allotransplantation of the knee joint in a dog model].

Experimental transplantation of vascularized canine knee joints has so far been associated with high complication rates in both auto- and allografts. We have now compared 4 autografts and 4 allografts that were successfully performed at our institution. This report details our surgical technique. Stable internal fixation enabling immediate postoperative weight bearing, microsurgical end-to-end anastomoses of popliteal artery and vein and postoperative control of immunosuppression in transplanted animals are crucial. Thus, an interdisciplinary approach of experts in microsurgery, orthopedic and trauma surgery and immunologists appears to be a prerequisite for successful joint transplantation.

Animals↗
PubMed1988

Absorption of protein in the early postoperative period in chronic conscious dogs.

Postoperative alterations in amino acid exchange across the intestinal tract and in the capacity for protein absorption were investigated in a chronic canine model. Changes in postoperative splanchnic amino acid exchange consisted of a temporary decrease of total splanchnic amino acid release, including a significant reduction in alanine production, and an increase in glutamine consumption. Contrary to results under stable metabolic conditions, branched chain amino acids were also taken up by the intestine in the early postoperative period. The changes in postoperative amino acid exchange were not, however, reflected by a corresponding alteration in protein transport capacity. The absorptive capacity for a protein hydrolysate remained stable during the early postoperative period.

Amino Acids↗
PubMed1978

Effect of hospitalization on weight of psychiatric patients.

The hypothesis that patients hospitalized for long periods and receiving psychotrophic drugs increase in weight is tested, and it was discovered that women patients were somewhat heavier than their 'standard' weights. This, however, was not due to hospitalization or drug effects. Contrary to expectation, the ratio of observed/'standard' weight frequently observed in affective disorder patients, we discovered puzzling higher mean ratios in men with this illness. This paper shows that small research projects can be carried out by nurses who are actively involved in patient care. It also demonstrates that small scale investigations, replicating locally some other research, testing its validity in a different setting are eminently worthwhile.

Adult↗