A randomised study of "wet wraps" versus conventional treatment for atopic eczema.

Aims: To compare two treatments in common usage for children with atopic eczema: "wet wrap" bandages versus conventional topically applied ointments.

Methods: A total of 50 children (age 4-27 months) with moderate to severe eczema were randomised to one or other treatment. Two research nurses supervised the study.

Routine symptom screening for postnatal urinary and anal incontinence in new mothers from a district.

Parous middle-aged women present with urinary and faecal incontinence and childbirth trauma is thought to be a causal factor. Both symptoms are common after childbirth but usually go under-reported. It has been suggested that new mothers are likely to benefit from routine symptom screening because by actively identifying symptomatic women they could then be helped to access continence services.

Lisfranc fracture--dislocation: an easily overlooked injury in the emergency department.

Lisfranc fracture-dislocations are rare, and their correct diagnosis is important. Misdiagnosis is common and can lead to chronic disability. Two cases of Lisfranc fracture-dislocations are presented and emphasis is made on the diagnosis in the Emergency Department.

Selective surgicel packing for the treatment of posterior epistaxis.

Rod lens endoscopes provide residents in otolaryngology a means of more accurately identifying the site of bleeding and, when possible, cauterizing the bleeding vessel. Identification of a posterior bleeding point is often difficult and sometimes impossible. Intranasal manipulation for electrocautery is painful, may require general anesthesia, and is associated with complications.

A new biomechanical model for the functional assessment of knee osteoarthritis.

The severity of symptoms in osteoarthritis (OA) of the knee can be difficult to assess. A new method for assessing medial compartment OA of the knee is proposed. The purpose of this study was to determine if a relationship exists between the severity of OA and single limb stance knee adduction moment (SSKAM).

Organ donation: what can we learn from North America?

The aim of this qualitative case study was to investigate how organ donation is promoted and managed in North America aimed specifically at patients and relatives. A 4-week study to Boston and Baltimore in America was undertaken to observe and learn how organ donation is promoted and managed within a critical care environment. The study tour was undertaken specifically to examine the policy and procedures that enhance the procurement of organ donation in specific centres in the USA.

Unusual cause of infective discitis in an adolescent.

The first case of infective discitis caused by Eikenella corrodens in an adolescent is presented. The need for anaerobic cultures when dealing with infective pathology in the spine is stressed. A 14 year old boy presented with acute exacerbation of back pain, which showed characteristics of infective discitis after magnetic resonance imaging.

Pharmacological treatment of acute coronary syndromes.

Many trials have examined the efficacy of medications used in acute coronary syndromes. This paper reviews those now recommended in patients with unstable angina and non-ST-segment elevation myocardial infarction. There are currently seven groups of drugs that are used in the management of such patients.

Device for accurately siting the acetabular component during total hip replacement.

Introduction: In this paper we describe a device which allows consistent acetabular cup placement to reduce post-arthroplasty dislocation.

Patients And Methods: The development of this surgical appliance is traced from the initial concept to the construction of a device suitable for clinical trials. The system of use is explained.

Acute cerebellar ataxia associated with chickenpox.

A case of a child with acute cerebellar ataxia associated with chickenpox virus infection is described. Acute cerebellar ataxia associated with chickenpox is a well-recognised complication and the pertinent features of this condition are discussed.

Diagnosis of Down's syndrome in neonates.

The results of karyotyping for Down's syndrome in neonates were surveyed. From local data 36%, and from a national questionnaire, 32% of such samples were negative for Down's syndrome. To examine this, a subset of notes was reviewed for documentation of clinical signs of Down's syndrome.

Amyloidosis of Waldeyer's ring and larynx.

Amyloidosis of the upper aerodigestive tract is relatively rare. A case of localized amyloidosis involving all components of Waldeyer's ring with added laryngeal involvement is described. This has not been previously reported.

Retropharyngeal abscess: an unusual complication of tracheal intubation.

A 42-year-old man presented as an emergency to the ENT department with sore throat and complete dysphagia, having undergone an umbilical hernia repair under general anaesthesia with tracheal intubation 3 weeks previously at another institution. One course of antibiotics from his general practitioner improved the symptoms but, on discontinuation of the antibiotics, symptoms flared up leading to complete dysphagia. Indirect laryngoscopy showed a bulging of the retropharyngeal wall, which was confirmed as a widening of the retropharyngeal space on a lateral soft-tissue X-ray film of the neck.

A clinical evaluation of the effectiveness of including fluoride into an orthodontic bonding adhesive.

A clinical trial was undertaken to assess the value of incorporating fluoride released from a commercially available bonding adhesive (Rely-a-Bond) to determine the extent of any protection provided against enamel decalcification. Fifty patients undergoing fixed appliance therapy were included in the trial. Contralateral quadrants were used as controls where no fluoride was present in the adhesive.

Oesophageal intramural pseudodiverticulosis: a cause of dysphagia in a 10-year-old boy.

We report a 10-year-old boy who presented with a piece of chicken stuck in his throat. He had similar episodes in the past that resolved spontaneously. The foreign body was removed and oesophagoscopy revealed no abnormality.

Prader-Willi syndrome--a case report of the multidisciplinary management of the orofacial problems.

A 24-year-old man with Prader-Willi syndrome presented with a class III malocclusion, featuring maxillary hypoplasia and severe enamel deficiency. Treatment involved orthodontic alignment, surgical advancement of the maxilla and restorative treatment to augment vertical facial height, improve the final occlusion and increase short clinical dental crown heights. The principal features of the syndrome and the management of this case are discussed.

The Nd:YAG laser in caries removal.

This paper shows how a laser can be used in the various stages of caries removal prior to the placement of a glass-ionomer restoration. In the future the laser may prove to be a valuable tool in enabling the dentist to perform surgical procedures with maximum comfort to the patient.

Enamel sealants: a clinical evaluation of their value during fixed appliance therapy.

A clinical trial was undertaken to evaluate the effectiveness of two new enamel sealing systems in the prevention of enamel decalcification following bracket bonding. Eighty patients undergoing fixed appliance therapy were included. Of these, 40 were treated with a viscous chemically-cured sealant and bonding system (Maximum Cure), while 40 patients were treated using a non-viscous visible light-cured sealant and bonding agent (Transbond resin).

An assessment of dental anxiety in children.

The aims of this study were to assess child behaviour in a dental surgery and to isolate the variables most closely associated with lack of cooperation by means of a questionnaire/interview. Sixty-five children aged 6-18 years, who had been referred to one dentist because of poor cooperation, formed the study group. Forty-two children of similar age, treated by the same dentist, but referred for reasons other than lack of cooperation, acted as the control.