UK trial of the Osseointegrated Prosthesis for the Rehabilitation for Amputees: 1995-2018.

Background:: Amputation of a limb impacts on patients' self-perception and quality of life. Prostheses directly anchored to the skeleton are being investigated, aiming to avoid soft tissue complications.

Objectives:: We report outcome data for the UK trial of the Osseointegrated Prosthesis for the Rehabilitation of Amputees Implant System with a minimum of 9-year follow-up.

High-resolution ultrasound findings in the symptomatic residual limbs of amputees.

Introduction: Amputations are increasingly prevalent because of medical complications associated with diabetes, meningitis, peripheral vascular disease, and neoplasms as well as road traffic accidents and war. The use of ultrasound (U/S) to diagnose the cause of pain in the residual limb of amputees is presented together with a review of the literature.

Patients And Methods: 133 civilian patients with one or more amputations were included in the study.

Functional dyspepsia pathogenesis and therapeutic options--implications for management.

Functional dyspepsia is far more common than dyspepsia due to organic disease, both in the community and general practice. Proposed aetiopathogenic factors include gastric acid, Helicobacter pylori infection, delayed emptying, hypersensitivity or impaired accommodation of the stomach, dysfunction of the duodenum or brain-gut axis, psychosocial morbidity and post-infective mucosal damage. More effective therapy will depend on the development of drugs targeted at these putative pathophysiological mechanisms.

Comparative reproducibility of three methods of radiographic assessment of alveolar bone grafting.

The aims of this study were to compare the reproducibility of three radiographic methods of assessing the quality of alveolar bone grafts, namely the Bergland, Kindelan and Chelsea Scales, and evaluate their application in the mixed and permanent dentitions. Additionally the use of occlusal versus periapical radiographs was assessed. Three examiners applied each scale on two occasions to the radiographs of 48 cleft lip and palate patients who had received alveolar bone grafts in 59 sites (11 had bilateral clefts).

Natural head posture--considerations of reproducibility.

This three-part study investigated the reproducibility of natural head posture (NHP) using radiographs and photographs. In part 1, reproducibility of cephalograms 1 year after the introduction of NHP was investigated and found to be less favourable (Dahlberg coefficient of 2.99 degrees) than most other previous investigations.

Magnetic resonance imaging of lung water content and distribution in term and preterm infants.

An increase in lung liquid may contribute to respiratory disease in preterm infants. Uneven distribution of lung liquid may cause heterogeneity in the lung disease seen in these infants. We used magnetic resonance imaging to investigate lung water content and distribution in 16 preterm (24-31 weeks) and 9 term infants in the first week of life.

Belle Maudsley Lecture 2001. Risk management in orthodontics--making clinical practice safer.

Facing a civil claim for negligence or prosecution for breach of Health and Safety law is something that any sensible clinician wishes to avoid. This review discusses the main areas of risk in clinical practice and how such risks can be minimized when acting as a clinician and as an employer. Although orthodontic examples are used to highlight particular points, this paper is also relevant to general dental practice.

Congenital atresia of the orifice of the submandibular duct: a report of 2 cases and review.

Two infants presented with unilateral cystic swellings in the floor of the mouth as a result of imperforate submandibular ducts. This is thought to result from a congenital failure of canalization of the terminal end of the duct. Both cases responded to simple incision and decompression of the fluid-filled duct.

Clinical and radiological evidence to support superficial parotidectomy as the treatment of choice for chronic parotid sialadenitis: a retrospective study.

We present a retrospective series of 23 consecutive parotidectomies, over a 10-year period (1989-1999) for 22 patients with chronic sialadenitis unresponsive to conservative measures. There were 10 male and 12 female patients. Mean age was 52 years (range 12-72), and mean duration of symptoms 4.

The use of vacuum-formed splints for temporary intermaxillary fixation in the management of unilateral condylar fractures.

We report a simple, effective method of managing displaced unilateral condylar fractures with occlusal disruption using vacuum-formed thermoplastic foil splints with bonded wire cleats. The cleats enable intermaxillary fixation in the form of orthodontic elastics to be used, which guide then maintain the occlusion in centric relation. A case is presented in which this technique was used successfully.

Background considerations to facial aesthetics.

This paper examines the nature of our objectives in attempting to improve facial appearance. Questions are addressed concerning the basis for any collective agreement on "improvement" and the nature of an agreed "ideal", including an exploration of the reasons for its existence. The discussion focuses on the concept of "averageness", as well as supplementary hypotheses.

Consider 'hyperviscosity syndrome' in unexplained breathlessness.

A 58-year-old man presenting with increasing shortness of breath over several months is reported here. All investigations were repeatedly normal until he suddenly and rapidly deteriorated, warranting admission, and a diagnosis was made of early multiple myeloma associated with the hyperviscosity syndrome. The plasma viscosity was extremely high compared to the low concentration of paraprotein present, and the possible mechanisms are discussed.

Tuberculosis of the breast presenting as carcinoma.

Breast infections caused by Mycobacterium tuberculosis, although rare in western countries, should not be forgotten as a cause of a breast lump presenting clinically and radiologically as a carcinoma in the older patient who gives a history of previous tuberculosis. We report the case of an 84-year-old woman with a breast lump showing noncaseating granulomas on histology who developed a sinus track after excision biopsy of the lump. The patient responded to empiric treatment with anti-tuberculosis drugs and remains well 2 years after presentation.

The development of a long, dual-platform triaxial walkway for the measurement of forces and temporal-spatial data in the clinical assessment of gait.

Force-plate measurement of the ground reaction force (GRF) has, for many years, been considered a vital component of the comprehensive assessment of human gait in the clinical context. For example, the data can be used in the adjustment of prostheses and orthoses and in identifying the mechanisms underlying a gait dysfunction. However, commercial force plates are usually only capable of measuring GRF data from one step in a single traverse.

Cannula related suppurative thrombophlebitis in the burned patient.

Suppurative thrombophlebitis is a well recognised and potentially fatal complication of intravenous cannulation in burns patients. We report a case of an Afro-Caribbean patient with noninsulin-dependent diabetes who developed signs of systemic sepsis two weeks after a 14% total body surface area flame burn. Despite an initial paucity of clinical signs at the cannulation site, exploratory venotomy revealed frank suppuration within the long saphenous vein from the ankle to the groin.

Unusual multiple pilomatrixomata: case report and review of the literature.

Pilomatrixomata are rare, benign, calcifying cutaneous tumours of the hair matrix cells. They usually present in childhood with a pre-surgical diagnosis of sebaceous cyst, because of their size and appearance. The usual sites of occurrence are the scalp, head and neck.

Pharmacokinetics of antibiotics in burn patients.

Drug pharmacokinetics are significantly altered in the burned patient but the interplay of a large number of variables is involved in deciding how an individual will deal with a drug. Consequently the burn patient population shows significant inter- and intrapatient variation. In 1976 altered aminoglycoside pharmacokinetics and the need for increased dosage in burn patients was reported but, despite this early study, a review of the currently available literature shows that for many drugs there is a paucity of information to support current dosage recommendations.

Squamous carcinoma of the tongue: review.

Carcinoma of the tongue is a common condition treated by oral and maxillofacial surgeons. The tongue is a complex anatomical site at the entrance of the oropharynx, bounded by the floor of mouth and lingual mandibular cortex; its form and mobility are crucial for efficient swallowing; speech, and the appreciation of taste. Single and multiple treatments have been used, but the tongue remains a difficult area to assess and treat.

Multiple pilomatrixomata and myotonic dystrophy: a familial association.

The association of pilomatrixoma and myotonic dystrophy has been described in the past in 13 publications in the English literature. The association seems to involve the development of pilomatrixomata before signs of myotonic dystrophy. Myotonic dystrophy is the commonest adult dystrophy and is an autosomaldominant disease with a variable phenotypic penetrance.

Effect of providing fortified meals and between-meal snacks on energy and protein intake of hospital patients.

This study aimed to evaluate whether food fortification and snacks could increase the energy and protein intakes of hospital patients. The control group of 82 consecutive admissions on medical, elderly care and orthopaedic wards ate freely from the hospital menu. Subsequently, an intervention group of 62 patients were offered fortified food and snacks, providing an extra 22.

The outcome of contact tracing for gonorrhoea in the United Kingdom.

Tracing and treating contacts (partner notification, PN) is a crucial part of the control of sexually transmitted infections but few studies have quantified its outcome. A retrospective national study obtained information from 155 clinics on 1308 patients with gonorrhoea, 59% of all UK patients attending in January to March 1995. These gave 1887 contacts (1:1.