PubMed Health⌕ Search

Biomedical subjects

R Luff

Publications and source records attributed to R Luff.

5 recordsLinked to original sources
PubMed1989

Rehabilitation after lower limb amputation: a comparative study of above-knee, through-knee and Gritti-Stokes amputations.

A study of 169 unilateral amputees under three Disablement Services Centres was performed. The study comprised 88 above-knee, 54 through-knee and 27 Gritti-Stokes amputations. Satisfactory rehabilitation occurred in 33 per cent of above-knee, 62 per cent of through-knee and 44 per cent of Gritti-Stokes patients (56 per cent overall). The better rehabilitation of through-knee versus above-knee amputees (P less than 0.02) was also found in a group of patients matched for comparable age and duration of amputation as well as in a group of age-matched vascular amputees. Through-knee amputees relied significantly less on wheelchairs than above-knee (P = 0.016) and Gritti-Stokes (P = 0.05) amputees. The prosthesis used for the through-knee and Gritti-Stokes amputations was considered unsightly in 50 per cent of cases (versus 31 per cent for the above-knee prosthesis). The superior rehabilitation with through-knee amputations should prompt us to improve both our technique for this amputation and the prostheses currently available. A through-knee amputation should be performed in preference to an above-knee amputation in the case where either is surgically possible, and a below-knee amputation not feasible.

Adult↗
PubMed1989

A five-year review of referrals for prosthetic treatment in England, Wales and Northern Ireland, 1981-85.

Patients undergoing amputation and who are considered to be suitable for an artificial leg are referred to the Disablement Services Centres (formerly called the Artificial Limb and Appliance Centres). This article reviews the referrals to the 23 centres in England, Wales and Northern Ireland over the five-year period 1981-85. The results show that there has been a decrease in the number of both upper and lower limb referrals and a 4% increase in the primary cause of amputation, arteriosclerosis. Centres that are the busiest, those seeing the greatest and fewest number of arteriosclerosis and diabetic referrals and those being referred the largest numbers of above, below and knee level amputations are identified.

Amputation, Surgical↗
PubMed1981

Fetal growth retardation induced by dietary imbalance of threonine and dispensable amino acids, with adequate energy and protein-equivalent intakes, in pregnant rats.

Whether fetal growth retardation could be induced by diets apparently adequate in protein and energy sources, but imbalanced relative to a single amino acid, was investigated. Pregnant rats were fed one of three diets: either a basal (B) 6% casein diet supplemented by L-methionine (L-Met) and a 5% mixture of essential plus 4.5% small neutral non-essential amino acids, which provided 4 kcal and 0.16 g protein-equivalent/g diet and was complete in other essential nutrients; an experimental (E) diet [same, except 0.4% L-threonine (L-Thr) supplement omitted]; or a control (C) diet, life B, but containing 20% casein. A total of 343 fetuses and their placentas were delivered by Caesarean section usually on day 21 of pregnancy but occasionally on day 20 or 22. Food consumption was similar in all groups (kcal/100 g rat/day); however, protein intake of the B and E rats was bout half that of the C group. Net maternal weight gain (excluding uterus + contents) was +8% in C. )% in B and -12% in E group dams. Body weight, length, volume, brain weight and placental weight, adjusted by multiple regression analysis to standardize for maternal prepregnant weight, length, litter size, net weight gain and duration of gestation, were significantly reduced in 155E greater than 156 B greater than 32C fetuses. Protein restriction accounted for 30-59% of the total observed variance in birth measures of the B versus C group fetuses; and the Thr-limiting amino acid imbalance for 36% of the total variance between the E and B groups. Imbalanced diets containing excess dispensable amino acids with adequate net protein and caloric intakes during pregnancy induce fetal growth retardation (F GR), which is increased by limiting threonine. Net maternal weight loss does not prevent F GR in rats under these conditions.

Amino Acids↗
PubMedDate not supplied

Platelet counts during rapid massive transfusion.

The effect of rapid massive transfusion upon platelet counts has been studied retrospectively in 24 patients treated for severe trauma. Multiple linear regression analysis showed that a platelet dilution model with an exponential form described the quantitative relationship between the pre- and posttransfusion platelet counts and the volumes of blood products administered. Intravenous salt solutions had very little effect upon the platelet count even when large volumes were infused. Red blood cell transfusions decreased the platelet count to an extent two and one-half times greater than that of colloid infusions. The differences in the magnitudes of the dilution effects are attributable to the different physiologic volumes of distribution of the various classes of infusates. If only red blood cells (RBC) and fresh frozen plasma (FFP) are transfused, two useful equations obtain. First, the current platelet count (Pt) can be predicted knowing the initial platelet count (Po) and the number (#) of units of RBC and FFP administered: Pt = Po (0.634) e-0.046 [#RBC + #FFP/8]. Second, the point during massive transfusion when platelet transfusions will be necessary can be predicted knowing the initial platelet count.

Colloids↗