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Biomedical subjects

P J Nichols

Publications and source records attributed to P J Nichols.

At least 19 recordsLinked to original sources
PubMed1994

Metastatic malignant melanoma: an unusual case presentation.

Secondary involvement of the genitourinary tract with malignant melanoma is a common autopsy finding, but rarely evident clinically. We report a rare case involving a previously asymptomatic patient presenting with gross hematuria and a large renal mass, which was found to be metastatic melanoma. We propose that metastatic melanoma to the kidney, although rare, be considered in the differential diagnosis of disease processes causing hematuria.

Adult↗
PubMed1986

Physiotherapy exercises for low back pain: process and clinical outcome.

This study was designed to assess whether physiotherapy exercises administered for low back pain have the physiological effects that they purport to have (increase spinal mobility and muscle strength) and whether these effects are of clinical relevance (related to changes in pain and function). Thirty-six patients were allocated to three treatment conditions, mobilizing exercises, isometric exercises or an attention-placebo control procedure. The results did not support the hypotheses concerning the effects of physiotherapy exercises, and hence challenge widely held views concerning the mechanism by which some patients suffering from low back pain improve whilst undergoing physiotherapy exercises.

Adult↗
PubMed1980

Hoists in the home: their recommendation and use.

The number of hoists recommended from Mary Marlborough Lodge has increased considerably between 1970 and 1976. This paper reports on the recommendation of hoists and slings for 233 severely disabled patients and the use made of them at follow-up by 146 patients. Electric hoists accounted for 42% of all recommendations and were more frequently used by patients in their homes than manual ones. Manual hosts were more reliable than electric ones but generated a greater number of complaints. The selection of hoists and the type of training given are considered.

Adult↗
PubMed1980

A comparison of follow-up regimes in rheumatoid arthritis.

One hundred and thirty-two patients discharged from a rheumatology unit were randomly allocated to general practitioner care, attendance at hospital outpatient clinics, or follow-up by a senior occupational therapist attached to the hospital treatment team. At the end of 1 and 2 years a number of clinical and functional tests were applied, and information was gathered about the provision and use of aids and the provision of domestic support. In addition the standard of overall care was judged by an independent assessor. Although no significant intergroup differences in disease activity or function emerged, it is clear that patients prefer continuing contact with the hospital team, and this may lead to differences appearing in the future. The financial advantages of therapist follow-up are discussed.

Arthritis, Rheumatoid↗
PubMed1979

Out-patient physiotherapy: patterns of provision.

A total of 1014 physiotherapy out-patients and their therapists were interviewed at 10 hospitals in Oxfordshire and Devonshire, including a District General Hospital, a Geriatric, and a sample of associated Community Hospitals in each of the two regions. Over 70% of these patients were suffering from long-term disabilities. The proportion of this type of patient varied between the hospital types, and this variation was similar in the two regions. The overall frequencies with which the different physiotherapy treatments were employed were, for the most part, similar in all departments regardless of hospital type or regions involved. Exercises and heat were the predominant treatments everywhere. The standard frequency of attendance was twice or three times a week. One third of the patients used hospital transport; most patients attended a hospital reasonably close to their homes.

Ambulatory Care↗
PubMed1979

Training in rehabilitation: basics needs and considerations.

Rehabilitation is an integral part of medicine. It includes physical therapy, occupational therapy, speech therapy. It involves nurses, social workers, clinical and educational psychologists. It also involves resettlement into the community and to work. Each patient, whether temporarily or permanently disabled, requires a comprehensive service to meet all his needs at the appropriate time. Although there are some multidisciplinary teams providing comprehensive rehabilitation services the needs are so wide and complex that many patients do not achieve optimum rehabilitation. Most doctors believe that the best rehabilitation stems from high standards of general medical care, but many patients require care and counselling extending into social and community aspects of their lives. The clinician must be trained to understand these needs and accept the responsibility for, at least, initiating appropriate rehabilitation and resettlement procedures and thus reducing clinical and social morbidity. Rehabilitation is more than the practice of special techniques. Most therapists can contribute considerably by the assessment of potential functional capability and by exploiting residual capability by alternative techniques of activity, or the use of aids and appliances. The behavioural aspects of response to illness or injury and the patterns of recovery thus determined need to be more clearly understood and the rehabilitation programme reappraised in the light of the knowledge.

Comprehensive Health Care↗
PubMed1979

Wheelchair user's shoulder? Shoulder pain in patients with spinal cord lesions.

A questionnaire was circulated to the 708 members of the Spinal Cord Injuries Association in 1976. The response rate was 79.5%. Over one half (51.4%) of the respondents suffered from shoulder pain, an incidence in excess of any age group in a control population derived from a general practitioner's register. The pain, which was related particularly to wheelchair usage and other attendant factors such as transfers, was in some instances clearly in the shoulder, whereas in others it was more likely to be cervical root pain. The implication of these findings are discussed.

Adolescent↗
PubMed1978

The value of flexor hinge hand splints.

Functional hand splints have been in use in a number of spinal injury units in the USA since the early 1950s. The splints are designed to provide a pinch-grip either by harnessing wrist dorsiflexion or by external power. Such devices are little used in the United Kingdom. This paper describes the results of late provision of 62 such splints in a Disabled Living Unit. A proportion of tetraplegic patients found such splints of considerable functional value. It is estimated that some 30--60 patients each year would benefit from them if appropriate facilities for early fitting were available.

Adolescent↗
PubMed1978

Mobile arm supports: an evaluation.

The results of a follow-up survey of 124 patients fitted with mobile arm supports at Mary Marlborough Lodge between 1970 and 1976 are presented. Of the patients fitted with mobile arm supports 33% are known to have used them for over one year, and 47% of those who were contacted were still using them. The reasons for non-use and the implications of the necessity for readjustments are discussed.

Adolescent↗
PubMed1977

Return to work.

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Persons with Disabilities↗