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Biomedical subjects

R Dalziel

Publications and source records attributed to R Dalziel.

10 recordsLinked to original sources
PubMed2005

Measurement of scapula upward rotation: a reliable clinical procedure.

BACKGROUND: It is important to deal with the scapula when developing rehabilitation strategies for the shoulder complex. This requires clinical measurement tools that are readily available and easy to apply and which provide a reliable evaluation of scapula motion. AIM: To determine the reliability of the Plurimeter-V gravity inclinometer for the measurement of scapular upward rotation positions during humeral elevation in coronal abduction in a group of patients with shoulder pathology. METHOD: Twenty six patients were assessed in two repeat tests within a single testing session. Patients exhibiting a wide spectrum of shoulder pathology were selected. The angle of scapular upward rotation was measured during total shoulder abduction. The measurement protocol was performed twice during a single testing session by a single tester. Results of the two tests were compared and the reliability assessed by intraclass correlation coefficients (ICCs). RESULTS: There was no significant difference in the scapula measurements taken during the two tests at each testing position. Overall, there was very good intrarater reliability (ICC = 0.88). The ICC ranged from 0.81 (at 135 degrees) to 0.94 (at both resting and end of total shoulder abduction range). CONCLUSION: The Plurimeter-V gravity inclinometer can be used effectively and reliably for measuring upward rotation of the scapula in all ranges of shoulder abduction in the coronal plane.

Adult↗
PubMed2005

Post-thrombotic syndrome after total hip or knee arthroplasty: incidence in patients with asymptomatic deep venous thrombosis.

PURPOSE: To measure the risk of developing signs of post-thrombotic syndrome 15 to 24 months after total hip or knee arthroplasty in patients with asymptomatic deep venous thrombosis (DVT). METHODS: A total of 85 total knee arthroplasty patients and 47 total hip arthroplasty patients were postoperatively screened for asymptomatic DVT using colour duplex ultrasound. RESULTS: The rate of asymptomatic DVT was 37.6% (n = 32) in knee patients and 34.0% (n = 16) in hip patients. All 32 DVT cases in the knee group had thrombi located below the knee, whereas 6 of the 16 DVT cases in the hip group had thrombi located above the knee, the remaining 10 were below the knee. Patients with proximal thrombi were treated with warfarin for 3 months, whereas patients with distal DVT received 300 mg aspirin daily for the same period. All DVT cases were monitored for up to 12 weeks using repeated colour duplex scans. Signs of thrombus resolution were present at around 6 weeks (range, 4-12 weeks). Clot propagation was observed in 3 cases. In a mean of postoperative 18 months (range, 15-24 months), 28 of the 32 knee patients with asymptomatic DVT were available for follow-up: 11 had transient calf and ankle swelling, 6 had persistent oedema, and the remaining 11 were symptom free. 14 of the 16 hip patients with asymptomatic DVT were available for follow-up: 6 had transient calf and ankle swelling, 4 had persistent oedema, and 4 remained symptom free. 17 patients reported ongoing problems and were re-examined. Signs of mild-to-moderate post-thrombotic syndrome were recorded in 4 knee patients and 3 hip patients. CONCLUSIONS: Patients with above-knee DVT were much more likely to have post-thrombotic syndrome. Despite thromboprophylaxis with low-molecular-weight heparin, asymptomatic DVT is common after total joint arthroplasty and is responsible for the development of post-thrombotic venous insufficiency and post-thrombotic syndrome in a considerable proportion of patients. Once symptomatic or asymptomatic DVT is established, treatment appears incapable of preventing the occurrence of post-thrombotic syndrome, especially in cases of above-knee DVT. Efforts should hence concentrate on combating DVT propagation and improving DVT prevention.

Age Distribution↗
PubMed2005

Early results of primary Birmingham hip resurfacings. An independent prospective study of the first 230 hips.

We describe the experience with the first consecutive 230 Birmingham hip resurfacings at our centre. At a mean follow-up of three years (25 to 52 months) survivorship was 99.14% with revision in one patient for a loose acetabular component and one death from unrelated causes. One patient developed a fracture of the femoral neck at six weeks which united unremarkably after a period of non-weight-bearing. The Harris hip score improved from a mean of 62.54 (8 to 92) to 97.74 (61 to 100). The mean flexion improved from 91.52 degrees (25 to 140) to 110.41 degrees (80 to 145). Most patients (97%) considered the outcome to be good or excellent. Our preliminary experience with this implant is encouraging and the results are superior to the earlier generation of resurfacings for the same length of follow-up.

Adolescent↗
PubMed2004

National survey for Salmonella in pigs, cattle and sheep at slaughter in Great Britain (1999-2000).

AIMS: The objective of these surveys was to estimate the prevalence of faecal carriage of Salmonella in healthy pigs, cattle and sheep at slaughter, and of pig carcase contamination with Salmonella. These data can be used as a baseline against which future change in Salmonella prevalence in these species at slaughter can be monitored. METHODS AND RESULTS: In this first randomized National Survey for faecal carriage of Salmonella in slaughter pigs, cattle and sheep in Great Britain, 2509 pigs, 891 cattle and 973 sheep were sampled in 34 pig abattoirs and 117 red meat abattoirs in England, Scotland and Wales. Carriage of Salmonella in 25 g caecal contents was identified in 578 (23.0% pigs) but in only 134 (5.3%) of carcase swabs. The predominant Salmonella serovars found in both types of sample were S. Typhimurium (11.1% caeca, 2.1% carcases) and S. Derby (6.3% caeca, 1.6% carcases). The main definitive phage types (DT) of S. Typhimurium found were DT104 (21.9% of caecal S. Typhimurium isolates), DT193 (18.7%), untypable strains (17.6%), DT208 (13.3%) and U302 (13.3%). Three isolates of S. Enteritidis (PTs 13A and 4) and one enrofloxacin-resistant S. Choleraesuis were also isolated. A positive 'meat-juice ELISA' was obtained from 15.2% of pigs at 40% optical density (O.D.) cut-off level and 35.7% at 10% cut-off. There was poor correlation between positive ELISA results or carcase contamination and the caecal carriage of Salmonella. The ratio of carcase contamination to caecal carriage rates was highest in abattoirs from the midland region of England and in smaller abattoirs. In cattle and sheep 1 g samples of rectal faeces were tested. Two isolates (i.e. 0.2%) were recovered from cattle, one each of S. Typhimurium, DT193 and DT12. One sheep sample (0.1%) contained a Salmonella, S. Typhimurium DT41. In a small subsidiary validation exercise using 25 g of rectal faeces from 174 cattle samples, three (1.7%) isolates of Salmonella (S. Typhimurium DT104, S. Agama, S. Derby) were found. CONCLUSIONS: The carriage rate of Salmonella in prime slaughter cattle and sheep in Great Britain was very low compared with pigs. This suggests that future control measures should be focused on reduction of Salmonella infection on pig farms and minimizing contamination of carcases at slaughter. SIGNIFICANCE AND IMPACT OF THE STUDY: This work has set baseline figures for Salmonella carriage in these species slaughtered for human consumption in Great Britain. These figures were collected in a representative way, which enables them to be used for monitoring trends and setting control targets.

Abattoirs↗
PubMed1991

Tennis injuries.

An unfit tennis player is more likely to suffer an injury. The tennis player should be well prepared physically and possess a sound technique. Attention should be paid to playing gear to minimise the possibility of injury.

Biomechanical Phenomena↗
PubMedDate not supplied

Frozen shoulder: a 12-month clinical outcome trial.

A prospective study was undertaken of 73 patients with frozen shoulder syndrome who were treated with an arthroscopic capsulotomy. All of the patients were assessed for pain, function, and range of motion before surgery and were monitored through to 1-year follow up. Improvement in all parameters was achieved, with pain taking an average of 2.24 weeks to diminish and range of motion improving to within 10% of the other side at an average of 5.5 weeks after surgery. Patients were discharged with a full range of motion and without pain at an average of 8.9 weeks. There was, however, some mild reaggravation of most patients' pain within the postoperative period (mean 4.5 weeks). This pain usually settled with appropriate massage within a 2-week period. In 37% of cases, however, an injection of corticosteroid was required as part of the postoperative management. These cases were usually in that subgroup of patients who still had significant night pain and were in stage 2 or 3 of the disease process at the time of surgery. The postoperative results continued to the 12-month follow-up, with 11% of patients having a recurrence of pain or stiffness. This study has demonstrated that arthroscopic capsulotomy is an effective technique in the management of the frozen shoulder. It also has enabled the authors to document postoperative recovery times, which has given prospective patients realistic time frames of functional expectation in their postoperative recovery.

Adult↗
PubMedDate not supplied

Total hip and total knee arthroplasty in juvenile rheumatoid arthritis.

Total hip arthroplasty (THA) or total knee arthroplasty (TKA) is indicated for patients with juvenile rheumatoid arthritis (JRA) when marked joint destruction is present and pain or deformity compromises function despite optimal medical therapy. Relief of pain, reduction of the deformity, and dramatic improvement in functional status and quality of life can be achieved in most patients. Functional impairment and deformity rather than pain are usually the primary indications for THA or TKA. When there is both hip and knee involvement, hip arthroplasty should probably be done first. Regional anesthetic appears to be the anesthetic of choice. Careful preoperative planning and the availability of custom and minisized components are essential. Small bone size, osteoporosis, and severe soft tissue disease make the surgery technically demanding. Skeletal immaturity may not contraindicate surgery if the patient is otherwise bedridden with progressive deformity. In the hip trochanteric osteotomy is often necessary for adequate exposure, with the possible exception being a patient with juvenile ankylosing spondylitis who is subject to heterotopic bone formation. Although complete capsulectomy and psoas tenotomy may be necessary to relieve a hip flexion contracture, a soft tissue release that produces leg lengthening may lead to nerve palsy. In the hip component loosening has been less common in patients with JRA than in other young patients who have undergone THA, but it is still the most frequent cause of failure. In the knee preoperative and postoperative serial casts can aid in the correction of severe flexion contracture. Secondary patellar pain has been the most common cause of late failure. Patellar resurfacing should probably be performed at the time of the original knee arthroplasty in all patients with JRA.

Adolescent↗