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Biomedical subjects

P Nicholson

Publications and source records attributed to P Nicholson.

At least 19 recordsLinked to original sources
PubMed2002

Percutaneous screw fixation for fractures of the sesamoid bones of the hallux.

Over a period of one year we treated nine fractures ofhe sesamoid bones of the hallux, five of which were in the medial sesamoid. All patients had symptoms on exercise, but only one had a recent history of injury. The mean age of the patients was 27 years (17 to 45) and there were six men. The mean duration of symptoms was nine months (1.5 to 48). The diagnosis was based on clinical and radiological investigations. We describe a new surgical technique for percutaneous screw fixation for these fractures using a Barouk screw. All the patients were assessed before and after surgery using the American Orthopaedic Foot and Ankle Society Hallux Score (AOFAS). There was a statistically significant improvement in the mean score from 46.9 to 80.7 (p = 0.0003) after fixation of the fracture with a rapid resolution of symptoms. All patients returned to their previous level of activity by three months. We believe that this relatively simple technique is an excellent method of treatment in appropriately selected patients.

Adolescent↗
PubMed2001

Trochanteric union in revision hip arthroplasty.

A total of 69 patients undergoing revision hip arthroplasty using a transtrochanteric approach who all had at least 1 previous transtrochanteric surgical approach. In 6 patients, it was the third time the trochanter was taken down, and in 2 patients, it was the fourth time. We believe this is the first review of trochanteric union in such a subgroup of patients. The mean age was 66 years (range, 46-82 years). Before revision, 49 of 69 patients (71%) had a united trochanter, whereas 20 of 69 (29%) had a pseudarthrosis. The overall pseudarthrosis rate decreased from 20 patients (29%) to 10 patients (14%) after revision surgery. The mean Harris hip score was 86 (range, 29-100). Repeated transtrochanteric osteotomy was not associated with any significant morbidity and did not affect the clinical outcome.

Aged↗
PubMed2000

Quantification of facial contamination with blood during orthopaedic procedures.

Operative surgery exposes the surgeon to possible blood-borne infections. Risks include pen-etrating injuries and conjunctival contact with infected blood. Visor masks worn during orthopaedic trauma procedures were assessed for blood contamination using computer analysis. This was found to be present on 86% of masks, of which only 15% was recognized by the surgeon intraoperatively. Of the blood splashes 80% were less than 0.6mm in diameter. We conclude that power instrumentation produces a blood particulate mist causing considerable microscopic, facial contamination which is a significant risk to the surgeon.

Blood-Borne Pathogens↗
PubMed1999

Epidemiology of multiple myeloma in parts of England, 1984-1993.

This paper presents a new analysis of aspects of the descriptive epidemiology of multiple myeloma (MM) for parts of the U.K., 1984-1993. It provides no indication for geographical heterogeneity, nor is there evidence of a decline in rates over the decade. There is, however, evidence that cancer registration inflates MM rates in the elderly.

Adolescent↗
PubMed1999

Three-dimensional spiral CT scanning in children with acute torticollis.

Three-dimensional spiral CT scanning is now becoming a common investigation in children who have a history of acute torticollis. In the last year, 21 consecutive children who came to our unit with a history of acute torticollis were assessed using standard plain radiographs and a 3-dimensional spiral CT scan. Ten patients had a history of recent trauma. Spiral CT scanning revealed that 13 children had atlanto-axial rotatory subluxation (AARS). Plain radiographs had only a sensitivity of 33% and specificity of 71% in detecting AARS. Sixteen children were treated using a Halter traction. Four failed to resolve clinically and were put on a halo traction after 3-dimensional CT scanning again confirmed residual AARS. Two children remained symptomatic after halo traction, with persisting rotatory and anterior subluxation on repeat spiral CT. They both underwent a posterior in-situ fusion, with no attempt at open reduction. Plain radiography is limited in investigating acute torticollis in children. Spiral 3-dimensional CT reconstruction has an important role to play in both the investigation and management of children who present with acute torticollis.

Acute Disease↗
PubMed1999

The unstable distal radial fracture one year post Kapandji intrafocal pinning.

Kapandji pinning has been proposed as the treatment of choice for unstable Colles' fractures. The aim of this paper is to evaluate our experience treating unstable Colles' type fractures using this technique. Over a nine month period, 36 patients with Colles' type fractures were treated operatively at St. Vincent's Hospital. 22 of these fractures were deemed unstable and were treated using percutaneous intrafocal Kapandji pinning. 20 of these patients were recalled for review at a mean of 11.3 month post injury. At this stage the wrist was examined clinically and radiologically. Initial satisfactory correction of deformity was achieved by this technique. Between the time of wire removal and final review, however, there was significant recurrence of dorsal angulation (P < 0.05), but no significant radial shortening on radiographs. The patients had a satisfactory clinical result in spite of these radiological parameters.

Adult↗
PubMed1999

Trauma on rural roads: the role of a peripheral hospital.

Road accident trauma is a leading cause of death and serious morbidity among healthy young adults in the developed world. The Irish Republic has the third worst road safety record in the EU. In studying the unique demographics of rural road accidents, our aim was to provide information essential to the future development of trauma care in Ireland. Our figures highlight the inadequacies of data received by the National Roads Authority, illustrate the resource impact of road trauma on a peripheral hospital, and demonstrate the need for similar studies in the rationalisation of trauma care as we approach the next millennium.

Accidents, Traffic↗
PubMed1999

FDG-PET in the staging work-up of patients with suspected intracranial metastatic tumors.

OBJECTIVE: To evaluate the role of positron emission tomography with 2-[18F] fluoro-2-deoxy-D-glucose (FDG-PET) in 31 patients with evidence of intracranial metastatic disease. MATERIALS AND METHODS: PET was used to evaluate the intracranial lesions for glucose hypermetabolism to suggest malignancy, mutiplicity of intracranial lesions, and extracranial foci or sources of disease. Patients with proven malignant intracranial lesions subsequently underwent further corroborative radiologic tests and histologic examination to confirm staging and primary location. RESULTS: PET identified focal hypermetabolic abnormalities in 19 of 22 intracranial metastases, 2 hypometabolic lesions, and 1 renal cell tumor embolism that hemorrhaged (hypometabolic lesion). It also identified 82% of extracranial primary tumor sites, of which 55% were found only on PET and not on conventional diagnostic tests. CONCLUSION: FDG-PET may prove valuable in the initial work-up of patients with suspected intracranial metastases.

Aged↗
PubMed1999

Development and use of a reverse transcription-PCR assay to study expression of Tri5 by Fusarium species in vitro and in planta.

The Tri5 gene encodes trichodiene synthase, which catalyzes the first reaction in the trichothecene biosynthetic pathway. In vitro, a direct relationship was observed between Tri5 expression and the increase in deoxynivalenol production over time. We developed a reverse transcription (RT)-PCR assay to quantify Tri5 gene expression in trichothecene-producing strains of Fusarium species. We observed an increase in Tri5 expression following treatment of Fusarium culmorum with fungicides, and we also observed an inverse relationship between Tri5 expression and biomass, as measured by beta-D-glucuronidase activity, during colonization of wheat (cv. Avalon) seedlings by F. culmorum. RT-PCR analysis also showed that for ears of wheat cv. Avalon inoculated with F. culmorum, there were different levels of Tri5 expression in grain and chaff at later growth stages. We used the Tri5-specific primers to develop a PCR assay to detect trichothecene-producing Fusarium species in infected plant material.

Antifungal Agents↗
PubMed1997

Age-associated decline in human femoral neck cortical and trabecular content of insulin-like growth factor I: potential implications for age-related (type II) osteoporotic fracture occurrence.

Recent evidence suggests that regulatory peptides such as insulin-like growth factor-I (IGF-I) are released locally from bone during resorption, and may then act in a sequential manner to regulate the cellular events required for the coupling of bone formation to resorption. Among other factors, a decrease in bone-associated IGF-I levels could therefore result in remodeling imbalance and contribute to the gradual loss of bone that occurs with age. As the femoral neck region is of primary concern for the clinical manifestations of osteoporosis, the current study was intended to assess the IGF-I contents in femoral neck cortical and trabecular bone from aging individuals. Bone samples from the neck region were obtained at postmortem from 39 females and 35 males, aged 23-92 years. Concentrations of IGF-I and osteocalcin were measured by radioimmunoassay in the supernatants obtained after EDTA and guanidine hydrochloride extraction. The total amount of protein present in the extracts was determined by spectrophotometry. IGF-I levels were significantly lower in trabecular compared with cortical bone. Though femoral neck total protein did not vary with donor age, both IGF-I and osteocalcin were found to decline markedly. Between the ages of 23 and 92 years, average yearly rates of loss of 0.30 and 0.21 ng IGF-I/mg protein were observed in cortical and trabecular bone, respectively, corresponding with net losses of nearly 35% of the cortical skeletal content of IGF-I and 41% of the trabecular skeletal content of IGF-I. These changes in bone-associated IGF-I paralleled those of osteocalcin, consistent with an overall decrease in osteoblast function with aging. In women, the rate of decline was significantly faster for trabecular than for cortical IGF-I, however in men, age-dependent changes in cortical and trabecular IGF-I were similar. These findings support the hypothesis that changes in the local IGF regulatory system over time could be a pathophysiologic component of the age-related (type II) femoral neck osteoporotic syndrome.

Adult↗
PubMed1997

Enzyme exposure, smoking and lung function in employees in the detergent industry over 20 years. Medical Subcommittee of the UK Soap and Detergent Industry Association.

This study was undertaken to examine the long term relationship between lung function, smoking and exposure to enzymes in the detergent industry. A total of 731 male workers from five locations in the United Kingdom were subject to respiratory health surveillance including lung function testing over a period of 4-20 years. Exposure groups were defined by job history. Significantly different rates of fall in FEV1 and FVC with time were found by geographical location and by smoking habit, but there were no consistent trends with enzyme exposure.

Adult↗