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Biomedical subjects

A H Roberts

Publications and source records attributed to A H Roberts.

At least 55 records · Page 3Linked to original sources
PubMed1989

Cytomegalovirus infection in gastrointestinal tracts of patients infected with HIV-1 or AIDS.

All gastrointestinal tract biopsy specimens from 190 patients positive for HIV-1 or with AIDS were reviewed to assess the prevalence of cytomegalovirus (CMV) infection, morphology of infected cells, and the associated histopathological features. Eighteen patients (10 (7.7%) of 129 HIV antibody positive and eight (13.1%) of 61 with AIDS) had CMV identified in 35 biopsy specimens from the following sites: oesophagus (n = 3); stomach (n = 6); small intestine (n = 4); colorectum (n = 18) and perianal area (n = 4). Eleven patients had CMV alone as the potential cause of symptoms and in seven there were coexistent pathogens or Kaposi's sarcoma. The appearance and type of infected cells at different sites was highly variable. Immunocytochemical techniques and electron microscopic examination were performed to confirm the presence of CMV antigen and CMV virus particles and to exclude the possibility of an adenovirus producing similar cytopathic changes. It is important to recognise the different morphological forms of infected cells, and the use of immunocytochemical techniques is recommended in patients at risk for CMV or in whom CMV infection is suspected.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Fasciocutaneous flaps for burn reconstruction: a report of 57 flaps.

We have used 57 fasciocutaneous flaps in 24 patients to correct burn contractures. There were six complications, four of which healed with dressings alone. The flaps were used either locally (22 patients) or as a cross-leg flap (2 patients). The local flaps have clearly shown that grafted areas can be raised as flaps provided that the fascia is included in the flap, and that the flap can also be based distally. Fasciocutaneous flaps have several advantages over the technique of cross-cutting the contracture, followed by split skin grafting. Firstly, there is no skin graft, which may result in further contracture. Secondly, if a patient does not have a skin graft on the secondary defect (83% in this series), the patient has the advantage of a shorter hospital stay. The techniques of the design and raising of fasciocutaneous flaps for burn reconstruction are discussed.

Burns↗
PubMed1988

The use of tonometry in the assessment of upper extremity lymphoedema.

The use of a specially designed tissue tonometer in 17 lymphoedema patients, who were treated with multiple lymphaticovenous anastomoses, with a follow-up period of up to 18 months, gives a quantitative measurement of "softness" and correlates well with their subjective feeling. It would appear to complement limb volume and circumferential limb measurements.

Anastomosis, Surgical↗
PubMed1988

Tangential excision of scalp burns: experience from the Bradford fire disaster.

Tangential excision of deep dermal scalp burns does not appear to be widely practised. During the Bradford Football fire victims sustained mixed depth scalp burns. These were mainly as a result of radiant heat, although falling molten bitumen was the cause of injury in a few patients. Deep dermal or full thickness burns of the scalp were tangentially excised and skin grafted. One patient did not have a graft applied after tangential excision. The early results of graft take were satisfactory. Subsequently, however, 56 per cent required further grafting; the reasons for this are discussed. Ten months after the incident there is no difference in appearance between areas of primary grafting and areas of secondary healing.

Adult↗
PubMed1988

Paraplegia in an electrical burn: a case report.

Electrical burns constitute a significant component of burn injuries worldwide. Cason (1981) reported about 150 deaths occurring every year from electrical injuries in the UK. However, spinal cord involvement is a relatively uncommon sequel of electrical injury. A case of paraplegia mainly with motor involvement, following electrical injury, and near complete recovery is reported.

Adolescent↗
PubMed1987

Hypospadias repair: the seagull meatoplasty.

An operation is described which has been used in six cases to produce a single stream of urine in patients who were spraying following hypospadias repair. It has also been used in four patients to advance the meatus terminally.

Adolescent↗
PubMed1987

The complications of fasciocutaneous flaps.

We analyzed the complications in a series of 126 fasciocutaneous flaps. The overall complication rate was 40%, which included both early and late complications. The early complications were divided into major and minor groups. The main avoidable causes of major complications were poor design; the presence of orthopedic metal in the wound; and late referral of infected wounds, particularly of the lower leg. In all the cases in which partial necrosis occurred, the fascia had an adequate blood supply, either to allow the wound to heal with dressings or, if the necrosis was more extensive, to provide a good bed for a split-skin graft.

Adolescent↗
PubMed1987

Breast reconstruction by tissue expansion.

The techniques of tissue expansion for use in breast reconstruction is described, together with the results of its use in 33 patients. The advantages and disadvantages of tissue expansion in relation to other currently favoured techniques are discussed. It is concluded that tissue expansion represents a major advance in the field of breast reconstruction.

Adolescent↗
PubMed1986

Fascio-cutaneous cross-arm flaps in hand reconstruction.

Experience is reported in the use of eight fascio-cutaneous cross-arm and forearm flaps in three patients. This has proved to be a reliable and satisfactory means of providing skin cover in reconstruction of the hand, giving flaps of a length to breadth ratio of at least two to one. The method was particularly useful where multiple defects were encountered, although in one case where a single defect required reconstruction, the ability to tube the pedicle of the flap allowed full mobility of the injured hand. Primary wound healing was achieved in all cases, and the patients have progressed to a satisfactory functional result. The advantages and disadvantages of this flap are discussed and compared with other established methods of reconstruction.

Adolescent↗
PubMed1986

The correction of scalp hair defects by tissue expansion.

This paper presents the results and complications in the correction of partial scalp alopecia in ten patients using the technique of 'tissue expansion'. The average size of defect that was covered by expanded hair bearing scalp was 45.9 cms2, and the largest defect covered measured 11 X 6 cm. This series indicates that tissue expansion is now one of the most promising methods available for dealing with the difficult problems of partial alopecia which can present to surgeons and physicians in a wide range of specialties.

Adolescent↗
PubMed1985

Treatment of burns casualties after fire at Bradford City football ground.

On 11 May 1985 the main stand of Bradford City Football Club caught fire. Within four minutes the stand was alight from end to end. Fifty three people were burnt to death and about 250 injured; 83 required admission to hospital, and 55 of these were treated by primary excision of their burns and skin grafting. In such disasters the help of staff from other hospitals and areas is essential. Patients should be assessed to see whether they have burns that will ultimately be fatal; if they have they should not be sent to regional burns units, where they would take up beds that could be used for patients with treatable burns. All districts should ensure that their plans for accidents in which burns injuries predominate are adequate.

Adult↗
PubMed1985

Hand injuries in the textile industry.

This paper is a review of the hand injuries occurring in the Yorkshire Wool Industry and referred to the Regional Plastic Surgery Unit for skin replacement, or other treatment, during the years 1965-1984. A total of forty-one cases has been seen, and although the number employed in the industry has fallen about fivefold, the injuries referred yearly have remained approximately constant. An analysis of the types of injury has been made and the improvement in the results is shown with changes in the method of acute treatment. The case for early referral, active initial treatment and early mobilisation is very obvious from the results.

Accidents, Occupational↗
PubMed1985

A prospective trial of prophylactic povidone iodine in lacerations of the hand.

A series of 418 patients with lacerations of the hands were allocated randomly to a control group or to a group where the injury was treated with povidone iodine before suture. The incidence of infected and imperfectly healed wounds was determined seven days later. As well as the effect of povidone iodine on infection, thirteen other factors were also analysed. The overall infection rate of 5.0% and the 38.5% imperfect healing rate were not significantly affected by povidone iodine treatment, although both were reduced. The figures of four other trials were combined with this trial and this showed a significant effect of povidone iodine treatment. There were no adverse reactions to povidone iodine. It is therefore recommended that hand lacerations should be treated with povidone iodine prior to suture. Other factors found to be significantly important in wound infection or imperfect healing were the condition of the dressing, the part of the hand injured and pain. Patients should be strongly advised to keep their dressing clean and dry.

Adolescent↗
PubMed1984

Subungual melanoma following a single injury.

Subungual melanoma is an uncommon disease. This paper presents eight cases where a subungual melanoma followed a single injury to the digit after an interval of between nine months and seven years (average 2.9 years). Although most injuries to the nail bed have no long term problems and subungual melanomata do arise in apparently normal nail beds, it is felt that there is increasing evidence that a direct causal relationship between the injury and the melanoma exists in some cases. This evidence includes case histories, statistical studies, the incidence of melanoma in coloured races and the distribution between the various digits.

Black People↗