Assessment of the impact of social deprivation, distance to hospital and time to diagnosis on survival in idiopathic pulmonary fibrosis.

Background: Idiopathic pulmonary fibrosis (IPF) is a progressive condition associated with a variable prognosis. The relationship between socioeconomic status or distance travelled to respiratory clinics and prognosis is unclear.

Research Question: To determine whether socioeconomic status, distance to hospital and time to referral affects survival in patients with IPF.

Pulmonary Langerhans cell histiocytosis (PLCH): a new UK register.

Pulmonary Langerhans cell histiocytosis (PLCH) is a rare interstitial lung disease of unknown aetiology. We aimed to characterise a UK-wide cohort of patients with PLCH and compare diagnostic and management methods in specialist and non-specialist centres. 106 cases (53 hospitals) identified.

Assessment of treatment outcomes in patients with overactive bladder: importance of objective and subjective measures.

Overactive bladder (OAB) is a highly prevalent symptom syndrome that negatively affects health-related quality of life (HRQL). In clinical practice, the diagnosis and treatment of OAB are largely driven by a patient's reporting of symptoms, often in combination with objective assessment. Thus, OAB provides the opportunity to examine the relations between objective (eg, urodynamic studies, bladder diary variables) and subjective (eg, symptom bother, HRQL) outcomes.

Femoral cementing techniques: current trends in the UK.

Introduction: The results of a survey conducted amongst hip surgeons in Great Britain on the use of bone cement and femoral cementing techniques are reported.

Materials And Methods: A postal questionnaire was sent out to the members of the British Orthopaedic Association for their opinion on cement usage and femoral cementing techniques in primary hip arthroplasty.

Results: A majority of surgeons use high viscosity cement (82%) and cement containing antibiotics (77%).

Safety and tolerability of tolterodine for the treatment of overactive bladder in men with bladder outlet obstruction.

Purpose: Antimuscarinic therapy for men with OAB and BOO is perceived as a potential risk for urinary retention. Using pressure flow urodynamics, we evaluated the safety of tolterodine vs placebo in men with OAB and BOO.

Materials And Methods: Men (older than 40 years) with BOO and confirmed detrusor overactivity were randomized to tolterodine (2 mg twice daily in 149) or placebo (in 72) for 12 weeks.

Development and early results of a new patellofemoral arthroplasty.

Unlabelled: A new patellofemoral arthroplasty is described, based on a previous design of total knee arthroplasty. The indications are for patients with specific isolated patellofemoral disease with advanced chondral or arthritic damage. The design and technique of insertion is detailed.

Factors affecting employment after whiplash injury.

Of 586 employed patients with a whiplash injury 40 (7%) did not return to work. The risk was increased by three times in heavy manual workers, two and a half times in patients with prior psychological symptoms and doubled for each increase of grade of disability. The length of time off work doubled in patients with a psychological history and trebled for each increase in grade of disability.

Urodynamic effects of doxazosin in men with lower urinary tract symptoms and benign prostatic obstruction. Results from three double-blind placebo-controlled studies.

Objectives: Urodynamic investigations provide an objective, quantitative evaluation of urinary function in patients with benign prostatic obstruction (BPO). The effects of doxazosin, a selective alpha 1-adrenoceptor antagonist, on urodynamic measurements were investigated in three double-blind, placebo-controlled clinical studies of the treatment of BPO.

Methods: 302 normotensive and mildly hypertensive men with BPO were evaluated.

A simple technique to improve access to the adult palate.

A simple method to facilitate good access to the palate of the adult patient using the Dingman gag is described.

A combined urodynamic and continence unit--a review of the first 19 years.

We have completed a 19-year audit of all patients referred to the urodynamic/continence unit since its inception in 1972 and their subsequent clinical management; a total of 20,437 patients were referred, increasing from 51 in the first year to 1564 in 1990. Although the annual number of referrals has remained constant for the last 8 years, the need for more complex urodynamic assessment such as video-cystourethrography has increased from 5% (56/1164) in 1981 to 25% (385/1564) in 1990. The number of out-patient attendances to medical, physiotherapy and continence clinics has also increased over that period.

Do psychiatric patients know what is good for them?

The paper reports the findings of a medical audit exercise which monitored 192 consecutive psychiatric admissions. Approximately two-thirds of patients, consultants and referrers provided information on admission objectives and the degree to which they were attained. One-third of the patients furnished information on social problems and satisfaction with treatment.

Intra-oral carcinoma simulating benign oral disease.

Intra-oral carcinoma can present in a variety of ways. Whilst carcinoma classically presents as an irregular, indurated, painless mass or ulcer, it is also recognised as being a great 'mimic' of benign lesions. A series of four cases of intra-oral squamous cell carcinoma is presented in which the initial presentation suggested a lesion of benign or dental origin.

Surgical treatment and complications of urinary incontinence.

Numerous surgical approaches to the management of incontinence, particularly genuine stress incontinence, have been reported. No single operation is a panacea for the condition, and many factors must be taken into account before deciding which procedure is best tailored to an individual's needs. The procedures vary in their results, morbidity, and associated complications.

Magnetic resonance imaging of meniscal and cruciate injuries of the knee.

We investigated 133 knees with suspected meniscal or cruciate injuries by magnetic resonance imaging, and compared the findings with those at arthroscopy. MRI was found to be highly sensitive, specific and accurate in the evaluation of the menisci and the anterior cruciate ligament.

Routine examination in the neonatal period.

Objective: To assess the value of the second neonatal examination as a medical surveillance procedure.

Design: Prospective survey of routine neonatal examinations and the abnormalities identified during 8 March-30 June 1988.

Setting: Maternity unit with an annual birth rate of 5700.

Late lengthening of the fibula for malaligned ankle fractures.

We describe a technique of lengthening osteotomy of the fibula for the late treatment of symptomatic malaligned or malunited fractures of the ankle. Good results at two to three years were achieved in five of six cases despite delays of up to four years from the original injury. The method can prevent progressive instability and degenerative arthritis.

Correction of hypernatraemia with continuous arteriovenous haemodiafiltration.

Continuous arteriovenous haemodiafiltration was used successfully to achieve controlled correction of hypernatraemia in the presence of renal failure, when peritoneal dialysis was contraindicated, in a 4 year old girl.