PubMed Health⌕ Search

Biomedical subjects

W J Harrison

Publications and source records attributed to W J Harrison.

18 recordsLinked to original sources
PubMed2004

One-year follow-up of orthopaedic implants in HIV-positive patients.

We followed prospectively 38 orthopaedic implants in 36 HIV-positive patients. X-rays and clinical examination were used to assess union, and observation was made for early and late wound sepsis for 12 months from the time of surgery. Two patients died of causes unrelated to the implantation, two patients had implants removed for reasons other than infection and eight cases were lost to follow-up. Of the 26 cases that were reviewed at 1 year, no late sepsis was identified. All of the fractures, non-unions, osteotomies and arthrodeses united. The literature indicates that late sepsis following arthroplasty occurs more frequently in haemophiliacs who are HIV positive than their HIV-negative counterparts. It is still not certain whether or not such a risk also applies to HIV-positive patients who are not haemophiliacs and have undergone internal fixation of fractures or non-unions. This study increases the confidence that fixation in immune-compromised patients with intact skin is safe, at least for the time period that the implant is required. Further studies are required to know whether or not fixation implants should be removed.

Adult↗
PubMed2004

Open fractures of the tibia in HIV positive patients: a prospective controlled single-blind study.

Twenty-seven patients with severe open fractures were studied prospectively analysing infection and union as outcome measures. A standard treatment regime was applied. Seven patients were HIV positive, and 20 patients HIV negative. Wound infection and delayed union were more common in HIV positive patients. The difference in rate of infection was statistically significant (P = 0.020), while that in union did not quite reach significance (P = 0.059). The authors have developed an algorithm for treatment of these injuries in areas of high seroprevalence of HIV infection.

Adult↗
PubMed2002

Delay in skeletal maturity in Malawian children.

The atlas of Greulich and Pyle for skeletal maturity and epiphyseal closure is widely used in many countries to assess skeletal age and to plan orthopaedic surgery. The data used to compile the atlas were collected from institutionalised American children in the 1950s. In order to determine whether the atlas was relevant to subSaharan Africa, we compared skeletal age, according to the atlas, with chronological age in 139 skeletally immature Malawian children and young adults with an age range from 1 year 11 months to 28 years 5 months. The height and weight of each patient were also measured in order to calculate the body mass index. The skeletal age of 119 patients (85.6%) was lower than the chronological age. The mean difference was 20.0+/-24.1 months (t-test, p = 0.0049), and the greatest difference 100 months. The atlas is thus inaccurate for this group of children. The body mass index in 131 patients was below the normal range of 20 to 25 kg/m2. The reasons for the low skeletal age in this group of children are discussed. Poor nutrition and chronic diseases such as malaria and diarrhoea which are endemic in Malawi are likely to be contributing factors. We did not find any correlation between the reduction in body mass index in our patients and the degree of retardation of skeletal age.

Adolescent↗
PubMed2002

Wound healing after implant surgery in HIV-positive patients.

We performed a prospective, blind, controlled study on wound infection after implant surgery involving 41 procedures in patients infected with the human immunodeficiency virus (HIV) and 141 in HIV-negative patients. The patients were staged clinically and the CD4 cell count determined. Wound infection was assessed using the asepsis wound score. A risk category was allocated to account for presurgical contamination. In HIV-positive patients, with no preoperative contamination, the incidence of wound infection (3.5%) was comparable with that of the HIV-negative group (5%; p = 0.396). The CD4 cell count did not affect the incidence of infection (r = 0.16). When there was preoperative contamination, the incidence of infection in HIV-positive patients increased markedly (42%) compared with that in HIV-negative patients (11%; p = 0.084). Our results show that when no contamination has occurred implant surgery may be undertaken safely in HIV-positive patients.

Adolescent↗
PubMed2000

Audit of deep wound infection following hip fracture surgery.

An audit of 171 consecutive hip fractures treated surgically showed a deep wound infection rate of 3.6%. Several shortcomings in the implementation of the infection policy were identified and recommendations to eliminate them introduced. Review of the subsequent 186 patients gave a deep infection rate of 1.1%. Attention to detail and good practice are essential to maintain low wound infection rates.

Aged↗
PubMed1998

Osteogenesis imperfecta in Zimbabwe: a comparison between treatment with intramedullary rods of fixed-length and self-expanding rods.

The results of surgical treatment of 15 children with osteogenesis imperfecta in Bulawayo, Zimbabwe are reviewed. A total of 23 self-expanding and 27 fixed-length rods were used. Outcome was measured in terms of mobility status, growth, incidence of refracture, need for reoperation, and complications. Eight of the children improved their mobility status over the course of treatment. Self-expanding rods appeared to confer more benefit to growth than fixed-length rods. Refracture was more common in bones splinted with fixed-length rods and more often necessitated revision surgery in these bones. The complication rate was high in all cases, but the complications associated with outgrown fixed-length rods were a particular problem. The 15 children benefited from surgical treatment. The self-expanding rods performed better than fixed-length rods in reducing the number of surgical interventions. They also appear to facilitate growth. The self-expanding rods may be used to good effect in appropriate centres in the developing world.

Adolescent↗
PubMed1990

Increased tau messenger RNA in Alzheimer's disease hippocampus.

The microtubule-associated protein tau is present in the pathologic hallmarks of Alzheimer's disease and its production and deposition have been implicated in the pathogenesis of the disease. We detected tau mRNA using in situ hybridization histochemistry in the hippocampus, visual cortex, and cerebellum, and compared its level in Alzheimer's disease with controls. The amount of tau mRNA also was determined as a ratio of total polyadenylated mRNA in each area. A significant and gene-specific increase in tau mRNA hybridization was found in hippocampal fields CA4 and CA3, with a similar trend in the dentate gyrus. In contrast, no change was found in the visual cortex or cerebellum in Alzheimer's disease. Increased hippocampal expression of tau mRNA also was present in cases of non-Alzheimer's dementia. Enhanced tau mRNA may be a marker of attempted plasticity involving the cytoskeleton in neuronal populations affected by various neurodegenerative disorders.

Aged↗
PubMed1986

Non-Hodgkin's lymphoma: a survey from a district general hospital.

We report a retrospective survey of 167 patients with non-Hodgkin's lymphoma (NHL) seen at a district general hospital between 1 August 1971 and 1 August 1983. Details of their clinical presentation, histology, therapy, response rates and survival are presented. The patient population reported is generally older than that seen at specialist centres and has a greater proportion of tumours with low-grade histology. Whereas specialist centres see a pre-selected population of patients, our data may be from a more representative group and this gives a truer incidence of this disease in the general population. The remission rates and overall survival of our patients are comparable to those achieved at specialist centres. We conclude that it is both feasible and desirable for patients with NHL to be assessed and treated in a district general hospital with a radiotherapy department.

Adolescent↗
PubMed1970

Inflammatory bowel disease in ankylosing spondylitis.

Routine detailed gastroenterological investigations were performed in a series of 47 ankylosing spondylitics. Evidence of chronic inflammatory bowel disease was found in eight patients, a prevalence of 17%. Unsuspected bowel disease was found in the absence of symptoms in three of these patients.

Adult↗
PubMedDate not supplied

The so-called intravascular bronchioloalveolar tumour of lung (low grade sclerosing angiosarcoma): presentation with extrapulmonary deposits.

Two further cases of the so-called intravascular bronchioloalveolar tumour of lung are reported. Electron microscopic demonstration of Weibel-Palade bodies and immunocytochemical demonstration of factor VIII in the cytoplasm of the tumour cells indicate the vascular nature of these lesions. One patient presented with an enlarged liver and the tumour was found to be involving the liver and parietal pleura as well as the lung. The characteristic micropolypoid structure was not seen in the pleural or hepatic deposits and it is evident that this feature is a consequence of the alveolar architecture of the lung and is not an inherent property of the tumour.

Factor VIII↗