Is herniography useful and safe?

117 consecutive herniograms were reviewed for patients who had symptoms suggestive of hernia but with no evidence or inconclusive findings on physical examination. The traditional approach has been to explore patients with suspected occult hernias. The aim of this study was to assess the impact of herniography in minimizing needless groin exploration and to evaluate its safety.

Eye injuries in sport.

Most ocular injuries involve only the external eye. However, in approximately one-third of cases the intraocular structures are damaged with potentially sight threatening consequences. A small number of sports, such as soccer, rugby, hockey and the racquet sports are responsible for most injuries.

Head injury.

Head injury is one of the commonest injuries in sport. Most are mild but some can have serious outcomes. Sports medicine doctors should be able to recognise the clinical features and evaluate athletes with head injury.

Sport and exercise medicine--the state of play.

The delivery of clinical services and the organisation and teaching of Sport and Exercise Medicine in the UK were developed in concept as long ago as 1912. It accelerated, particularly over the last 36 years, until the Faculty of Sport and Exercise Medicine of the Royal Medical Colleges of the United Kingdom was established at the Royal College of Surgeons of Edinburgh. From the concept of a hobby for doctors interested in sport to its coming of age as a medical speciality Sports Medicine has a long and fragmented history.

Scapula winging in a sports injury clinic.

Scapula winging is an uncommon condition but one which may be underdiagnosed. Four patients with scapula winging referred to a sports injury clinic are presented. None of the patients was aware of any trauma and a traction injury to the long thoracic nerve is proposed as the aetiology of this condition.

Audit of knee injuries seen in a sports medicine clinic.

In order to assess the management of knee injuries in a sports medicine clinic, an audit was performed of all new patients who attended the clinic over a 12-month period. Of the 167 new patients seen, 76 (46%) had sustained knee injuries. Of these, 43 (57%) were treated in the sports medicine clinic and 33 (43%) were referred for arthroscopic assessment.

Acute pancreatitis and pancreatic fistula formation.

The cause, management and outcome of 23 patients with a pancreatic fistula following acute pancreatitis are reviewed. Nineteen patients developed an external fistula following necrosectomy or drainage of a pancreatic abscess or pseudocyst; four of these patients died. In the 15 survivors spontaneous closure occurred in 11 cases with low output fistulae; operative intervention was needed in the four cases with high output fistulae.

Soft tissue trauma: a randomised controlled trial of the topical application of felbinac, a new NSAID.

Two hundred and thirty-one patients with acute soft tissue injuries were treated in a double-blind placebo-controlled study of felbinac (biphenylacetic acid) gel applied three times daily to the injured site. Those treated with felbinac had significantly greater improvement at Day 4 (p less than 0.001) and Day 7 (p less than 0.

Clinical neurological examination, neuropsychology, electroencephalography and computed tomographic head scanning in active amateur boxers.

Twenty active amateur boxers were studied seeking evidence of neurological dysfunction and, if present, the best method for detecting it. Seven of these boxers had an abnormal clinical neurological examination, eight an abnormal EEG and nine of 15 examined had abnormal neuropsychometry. The CT scan was abnormal in only one.

Survival of surgical patients with carcinoma, lymphoma and carcinoid tumours of the small bowel.

We have analysed the effects of 'curative' and palliative surgery and adjuvant therapy on actuarial 5 and 10 year survival in 97 local patients with primary small bowel malignancies presenting to five Glasgow teaching hospitals over a 15 year period. The 5 year survival rates in 18 patients with lymphoma undergoing 'curative' surgery was 48 per cent while in patients whose surgery was considered palliative the figure was 12 per cent (P less than 0.001).

Smoking habits in professional football.

In a questionnaire study of 1,559 English professional footballers, the incidence of cigarette smoking was found to be much lower than the national average. Of those surveyed only 5% admitted to cigarette smoking. Smoking was much lower in First Division Clubs (3.

Timentin in the treatment of post-operative infections.

In an open study 50 patients were treated for a variety of infections with 3.2 g Timentin 6, 8- or 12-hourly for a mean period of six days. Timentin was clinically successful in 87% of patients assessed at the end of treatment of whom 95% remained cured or improved at a later follow-up.

Variable schedules of ibuprofen for ankle sprains.

In a study of 144 patients, with Grade 1 and 2 inversion injuries to the ankle sustained in sport, treatment with a non-steroidal anti-inflammatory was considerably superior to placebo with respect to joint tenderness, level of training and injury severity. No difference in efficacy could be determined between ibuprofen 2400 mg given in two or four equally divided daily doses. Ten patients withdrew from the study because of side effects, five from ibuprofen twice daily, three from ibuprofen four times daily and two from the placebo group.

The use of endoscopic retrograde choledocho pancreatography (ERCP) in the diagnosis of internal fistulae complicating severe acute pancreatitis.

Three patients are presented in whom internal pancreatic fistulae were accurately demonstrated by ERCP. It is recommended that this procedure be considered in the investigation of patients with continuing acute pancreatitis who are not settling on standard conservative treatment and in whom internal fistula formation is suspected. The procedure should also be considered in patients who present with unusual respiratory symptoms or with amylase-rich effusions.

Clinical examination as a screening method for breast cancer.

A five-year experience of a breast cancer screening clinic in a Scottish urban area is reported. During this period 28 per cent of the female population aged 25 to 70 years was screened by clinical examination alone. The pick-up rate for cancers was 7.

Karate and karate injuries.

The origins of karate and its evolution as a sport are described. Karate injuries tend to occur in three main areas: the head and neck, the viscera, and the limbs. Effective legislation controlling karate, which could help prevent injuries, is lacking at the moment and should be established.