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Biomedical subjects

W J Gillespie

Publications and source records attributed to W J Gillespie.

At least 73 records · Page 4Linked to original sources
PubMed1986

Pyogenic spinal osteomyelitis: a review of 61 cases.

The presentation and outcome of 61 cases of nontuberculous spinal osteomyelitis were reviewed. Although the commonest presentation was subacute, with back pain predominating, 10% had septicaemia and 7% paraperesis or paraplegia. Most infections were caudal to the fourth thoracic vertebra. One third were associated with preceding urinary, respiratory, dental or abdominal sepsis. Staphylococcus aureus was the infecting organism in 85% of isolates. Delay in diagnosis was frequent. There were four deaths, and seven individuals remained severely disabled: outcome was otherwise satisfactory. An algorithm for the investigation and management of this uncommon but serious condition is proposed.

Acute Disease↗
PubMed1986

Physiological changes in hemostasis associated with acute exercise.

Acute exercise enhances fibrinolytic (FA), factor VIII coagulant and factor VIII ristocetin cofactor activities, and increases the concentration of factor VIII-related antigen. Little is known concerning the mechanisms of these changes. To investigate possible relationships between exercise-induced changes in blood lactate, 2,3-diphosphoglycerate (DPG), and the hemostatic variables, a branching multistage treadmill protocol was used to exercise male volunteers to a maximum effort. Blood samples were drawn before, immediately post-, and 8 min postexercise. All hemostatic variables were significantly (P less than 0.05) increased postexercise. Highest values for factor VIII coagulant, factor VIII-related antigens and factor VIII ristocetin cofactor were observed at 8 min postexercise. Significant (P less than 0.001) correlations were found postexercise for lactate with factor VIII coagulant (r = 0.64), while no association between pre-, post-, or 8 min postexercise. Postexercise lactate demonstrated a significant correlation (r = +0.81), which was strengthened by including the preexercise high-density lipoprotein (HDL) concentrations (r = +0.87). Consequently, the expected postexercise FA may be calculated from the observed values for postexercise lactate and preexercise HDL. The correlations of lactate with postexercise FA and with postexercise factor VIII coagulant may reflect a common stimulus for these exercise-induced changes.

Adult↗
PubMed1986

Subacute pyogenic osteomyelitis.

Records of 110 cases of subacute osteomyelitis were reviewed. Twenty percent of the cases with a subacute clinical course had diffuse radiological changes more characteristic of an acute disease. Classic metaphyseal (Brodie) abscesses were most common. Diaphyseal lesions, of which over half were in adults, had a significantly higher rate of recurrence. The distribution by site and age of metaphyseal lesions resembled that of acute osteomyelitis. Staphylococcus aureus was the most common isolate, but 10% of lesions grew S. epidermidis. A modification of current classification is suggested which offers a basis for management and studies of outcome.

Acute Disease↗
PubMed1985

Multiple level injuries of the cervical spine.

In a group of 105 patients admitted to hospital with injuries of the cervical spine, the incidence of injuries at multiple levels was 24 per cent. Multi-level injuries occurred in 17 out of 54 patients (31 per cent) sustaining a noteworthy neurological injury and in 8 out of 51 when such an injury was absent. This incidence is higher than previously reported, probably due to increasingly elaborate investigations. In the majority of cases, treatment of the dominant injury was unchanged by the demonstration of injuries at other levels, but in a small number, serious errors in treatment arose or could have arisen. Careful multi-level assessment, including assessment of the cervicothoracic junction, is indicated before selecting management. While conventional or computerized axial tomography may occasionally be necessary to achieve this, good conventional radiography remains the most important investigation. Computerized axial tomography is particularly useful in establishing the anatomy of complex injuries in the upper cervical spine.

Adolescent↗
PubMed1985

The epidemiology of acute haematogenous osteomyelitis of childhood.

Hospital morbidity data from New Zealand, Western Australia, England and Wales and Scotland are reviewed. The incidence of osteomyelitis in childhood is greater in males than females, greater in European children in Australia and New Zealand than in Great Britain, and much greater in Aboriginal and New Zealand Maori children than in European children. A seasonal peak is present in late summer and autumn in both hemispheres. The reported incidence is generally declining, except in Western Australia. Local variations in incidence within New Zealand correlate with mean annual vapour pressure. The male/female sex ratio increases with age. Discussion centres on possible inferences from the data.

Acute Disease↗
PubMed1985

Problem drinking in orthopaedic patients.

Problem drinking was found to be likely in 21% of inpatients in a general orthopaedic and fracture service, and in 42% of outpatients attending the fracture clinics. The questionnaire showed that the problem was most common among young men, particularly among outpatients. Previous hospital admissions were more frequent in this group. Many of the health problems associated with the chronic abuse of alcohol are directly relevant to orthopaedic practice. Early intervention may be highly successful, and it is recommended that screening for problem drinking be considered in orthopaedic and fracture services.

Adolescent↗
PubMed1984

Physiologic profiles of female professional ballerinas.

The prospect of the application of scientific techniques of physiology and movement science to dance promises to enhance not only the performance but also the safety of ballet dancing. The scientific analysis of nutrition, strength, and cardiovascular and movement demands of elite athletes in a great variety of competitive sports has increased our understanding of the stresses placed upon the body in these sports and in so doing has improved training techniques, enhanced performance, and helped to decrease the incidence of injuries. The application of these scientific analysis techniques to dance may reap similar benefits. Although the classical ballet teacher may, at first glance, be horrified by a computer analogue analysis of a grand jete, the information obtained from such studies may help him or her to decide when a young dancer is ready for such a technique or demonstrate a technical deficiency in the performance of such a technique. Similarly, the often debated question of when a young dancer should attempt pointe may become less subject to a teacher's intuition or parental pressure if research on the strength of muscles, bones, and ligaments teaches us the specific levels needed before this technique should be attempted.

Adult↗
PubMed1982

Rehabilitation.

Explore the source record for details and available documents.

Education, Medical, Undergraduate↗
PubMed1981

Isolated fractures of the shaft of the tibia.

We have reviewed 106 fractures of the tibia with an intact fibula. Most patients were treated in above-knee plaster casts and allowed to walk. Only 2 fractures failed to unite and there were 4 refractures. In 27 patients (25 per cent) the fracture healed with more than 5 degrees of varus angulation. The cause of this deformity and its prevention are discussed.

Adolescent↗
PubMed1981

The management of acute haematogenous osteomyelitis in the antibiotic era: a study of the outcome.

The outcome of primary management of acute osteomyelitis in 655 children treated in New Zealand between 1947 and 1976 is examined. Failure occurred in 20 per cent of children, in four-fifths of whom it was manifest by one year, and half of whom experienced one recurrence only. Lower failure rates were associated with use of bactericidal antibiotics, certain favourable sites, and age over 16 years. Surgical intervention was associated with significantly higher failure rates. The place of surgical intervention and the optimal duration of antibiotic treatment can only be determined by prospective clinical trials.

Acute Disease↗
PubMed1979

Racial and environmental factors in acute haematogenous osteomyelitis in New Zealand.

Data on the hospital incidence of acute haematogenous osteomyelitis in New Zealand children between 1965 and 1973 are presented. The incidence in Maori children is four times that in European children. The condition is more common in the North Island than the South Island, but this difference is mainly due to the distribution of the Maori people. Admissions to hospital are common in late summer and autumn. The relationship of osteomyelitis to skin and ear sepsis and some possible reasons for ethnic difference, are discussed.

Adolescent↗
PubMed1979

Haematogenous osteomyelitis of the metatarsal sesamoid.

A case of haematogenous osteomyelitis of the medical first metatarsal sesamoid is presented and the differential diagnosis discussed. Review of the literature suggests that the condition is rarely seen and tends to present in childhood and adolescence. This contrasts with metatarsal sesamoid osteomyelitis due to direct spread of infection, which occurs in the elderly as an important complication of the diabetic foot.

Adolescent↗
PubMed1979

Hypercalcaemia in Paget's disease of bone.

Albright in 1944 described a syndrome of hypercalcaemia in patients immobilized following fractures through bones affected with Paget's disease. This paper reports a further two cases in which this syndrome was considered the cause of hypercalcaemia with fatal outcome. Both patients had parathyroid adenomata. The literature is reviewed, and it is argued that no firm evidence for the existence of this syndrome has ever been put forward. The finding of hypercalcaemia in Paget's disease of bone should prompt an exhaustive search for its cause.

Adenoma↗