RESUMO
This prospective study of 1000 femoral neck fractures (476 intertrochanteric and 524 subcapital) found the pre-injury mobility to be the most significant determinant for post-operative survival. The intrahospital mortality of the 975 surgically treated fractures was 11.3 per cent. Non-operatively treated fractures had a mortality of 60 per cent. The best predictors of morbidity and discharge mobility were age and pre-injury mobility. Delay was significant in the development of morbidity but only after 30 h from admission. Internal fixation produced a lower mortality than uncemented hemiarthroplasty. The use of acrylic cement was associated with an increased morbidity and mortality rate in hemiarthroplasties. Neither the grade nor the experience of the operating surgeon had an effect on mortality or morbidity.
Assuntos
Atividades Cotidianas , Competência Clínica , Fraturas do Colo Femoral/cirurgia , Fixação de Fratura/mortalidade , Fraturas do Quadril/cirurgia , Fatores Etários , Artroplastia/mortalidade , Inglaterra/epidemiologia , Feminino , Fraturas do Colo Femoral/mortalidade , Fraturas do Quadril/mortalidade , Humanos , Masculino , Estudos Prospectivos , Resultado do Tratamento , População UrbanaRESUMO
The ability of Escherichia coli K-12(K88ab) to adhere to immobilized porcine small intestine mucus was examined. E. coli K-12(K88ab) but not the isogenic E. coli K-12 strain was found to adhere readily to immobilized crude mucus but not to bovine serum albumin. The adhesion of E. coli K-12(K88ab) was inhibited in a specific fashion by anti-K88 antiserum. Adhesion was also inhibited by pretreatment of receptor-containing crude mucus preparations with sodium metaperiodate or proteolytic enzymes. Removal of glycolipids from crude mucus by chloroform-methanol extraction did not affect the ability of E. coli K-12(K88ab) to bind to mucus preparations. Adsorption of crude mucus preparations with K88ab fimbriae but not type 1 fimbriae resulted in the removal of K88-specific receptors. Analysis of the pelleted fimbriae-receptor complex by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, together with gel filtration chromatography of crude mucus preparations, suggest that the K88-specific receptor present in porcine small intestine mucus is a 40- to 42-kDa glycoprotein.
Assuntos
Aderência Bacteriana , Proteínas da Membrana Bacteriana Externa/metabolismo , Proteínas de Bactérias/análise , Intestino Delgado/química , Receptores Imunológicos/análise , Adesinas de Escherichia coli , Animais , Cromatografia em Gel , Endopeptidases/farmacologia , Escherichia coli , Glicolipídeos/metabolismo , Mucosa Intestinal/química , Mucosa Intestinal/microbiologia , Intestino Delgado/microbiologia , Ácido Periódico/farmacologia , Coelhos , SuínosRESUMO
This paper reports the results in a prospective series of recent fractures of both the femur and tibia treated by the Grosse and Kempf locking system of intramedullary nailing. Although the technique requires some attention to detail, it has been possible to treat a wide range of relatively severe injuries with a short hospital stay and rapid rehabilitation, with benefit to both the patient and hospital services.
Assuntos
Fraturas do Fêmur/cirurgia , Fixação Intramedular de Fraturas , Fraturas da Tíbia/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Pinos Ortopédicos , Feminino , Fraturas do Fêmur/diagnóstico por imagem , Fraturas do Fêmur/reabilitação , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Radiografia , Fraturas da Tíbia/diagnóstico por imagem , Fraturas da Tíbia/reabilitaçãoRESUMO
Secondary tumors in the hand are very uncommon. Of the reported cases the majority arise from primary bronchial carcinoma, with multiple secondary deposits into bone. A case is reported of bony metastasis to the middle phalanx of the small finger in a patient who had a resection of a colonic adenocarcinoma 2 years previously.
