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Biomedical subjects

D L Scott

Publications and source records attributed to D L Scott.

At least 289 records · Page 16Linked to original sources
PubMed1975

Sedation for local analgesia. Distraction and diazepam.

An approach to the patient is described that is of value when operations are performed under local analgesia during intravenous sedation with diazepam. The technique involves maintained distraction of the patient with some phantasy of his own choice. All mention of the different stages of the procedure is deliberately avoided.

Anesthesia, Local↗
PubMedDate not supplied

Use of disablement resettlement officers by patients with musculoskeletal disorders.

OBJECTIVE: to define the use of disablement resettlement officers (DRO) by patients with locomotor disorders. DESIGN: questionnaire for patients with locomotor disorders potentially handicapping them from obtaining work. SETTING: outpatient clinics. PATIENTS: 52 patients, capable of work, aged 55 years or less, with a locomotor disorder; 19 had chronic arthritis and 18 back disorders. QUESTIONNAIRE: obtained details of diagnosis, work status, contact with DRO and results of referral. RESULTS: 21 had seen the DRO and three of these were dissatisfied; 15 were referred to the DRO and only three were placed in employment; 16 did not want referral to the DRO; overall 60% were unemployed. CONCLUSIONS: Many patients are reluctant to see the DRO. Only a minority either attend or find work on referral. A modified system is needed to improve the employment prospects of patients with locomotor disorders.

Adult↗
PubMedDate not supplied

Early developments in combination therapy.

The concept of combination therapy implies the concurrent use of two or more slow-acting antirheumatic drugs to treat rheumatoid arthritis. This review places such combination therapy into an historical context and evaluates studies carried out before 1990. There were no published studies before 1980 of combination therapy, and between 1980 and 1990 there were 11 published studies. Three were conventional randomised controlled trials, three were non-randomised studies of parallel group design, four were observational open studies, and one was a retrospective review. Altogether 486 patients were studied with the numbers of cases in each study varying between 12 and 101. The main combinations used were penicillamine + hydroxychloroquine or chloroquine, gold + hydroxychloroquine, and sulphasalzine + penicillamine. Six studies concluded that combination therapy helped patients, three suggested possible benefits, and two gave essentially negative findings. These two negative studies were randomised controlled trials. Most studies indicated an increase in adverse events with combination therapy. The average erythrocyte sedimentation rate on combination therapy fell by 21.4%. A majority of patients remained on the therapy for 6-12 months. The balance of evidence in 1990 suggested that combination therapy had a modest advantage. However, the trials were too small to detect its true value, and the combinations used were not ideal. In particular, combining gold or penicillamine with other drugs appeared to give too much toxicity. The future development of the field would depend on identifying more effective combinations of drugs and undertaking larger and better-designed trials.

Antirheumatic Agents↗
PubMedDate not supplied

A comparative study of outcome in myositis and other musculoskeletal disorders assessed using the Nottingham health profile.

OBJECTIVE: This study evaluated the comparative impact of myositis and other musculoskeletal disorders on general health using the Nottingham health profile (NHP) as a generic measure of health status. METHODS: A prospective observational study of 113 females with myositis, 142 females with rheumatoid arthritis, 45 females with spinal osteoporosis and 96 females with knee osteoarthritis. RESULTS: All mean NHP section scores were higher in myositis and other musculoskeletal disorders compared to population mean values. Section scores for energy and social isolation were high in myositis compared to all other disorders. Scores for physical disability in myositis were similar to RA. Pain scores were higher in RA and OA compared to myositis. Backwards linear regression models explained 26-42% of the variation in energy and social isolation scores. Emotion and physical section scores were the major determinants and the pattern was similar in all disorders. Disease duration and age had little effect. CONCLUSIONS: Myositis is not simply a disease with physical problems but has wide ranging effects on social and emotional well being. Until disease-specific instruments are available, a generic measure like the NHP can be used to assess problems other than muscle pain and loss of strength.

Activities of Daily Living↗