Comparison of hydrocellular foam and calcium alginate in the healing and comfort of split-thickness skin-graft donor sites.

This is a comparative study of a hydrocellular foam (Allevyn, Smith and Nephew) and a calcium alginate (Kaltostat, ConvaTec) in dressing split-thickness skin-graft donor sites. The dressing materials were used in equal halves of each donor site in 20 patients undergoing skin-graft harvest. The donor sites dressed with Allevyn showed a tendency to earlier healing, but this was not confirmed statistically.

Treatment of upper eyelid retraction associated with thyroid eye disease with subconjunctival botulinum toxin injection.

Objective: To study the effectiveness of botulinum toxin injections, via a subconjunctival approach, in the management of upper eyelid retraction associated with thyroid eye disease.

Design: Prospective, non-comparative, interventional case series.

Participants: Eleven patients with upper scleral exposure associated with thyroid eye disease who declined conservative or conventional surgical management.

Lateral digital photography with computer-aided goniometry versus standard goniometry for recording finger joint angles.

This study compares the accuracy of computer-aided goniometry with standard goniometry. 109 finger joint angles at the extremes of flexion and extension were measured by a senior hand therapist using standard goniometry. Lateral digital photographs were then taken of the hands and the same angles were read from these by computer.

Pterygial derived fibroblasts express functionally active histamine and epidermal growth factor receptors.

Pterygia are characterised by a fleshy outgrowth of altered conjunctival tissue over the cornea and are most common in tropical regions. Pterygial fibroblasts are characteristically distinct from normal conjunctival fibroblasts, and therefore the aim of this study was to determine the presence and functional significance of histamine and epidermal growth factor (EGF) receptors in these cells. Pterygial specimens were cultured in vitro and cellular outgrowths were phenotypically characterised as fibroblasts using vimentin and cytokeratin staining.

Basophils in chronic urticaria.

Blood basophils are reduced in chronic urticaria and respond less well to immunologic stimuli. Active recruitment of basophils from peripheral blood into lesional skin may be important in wheal pathogenesis.

Palmar segmental aponeurectomy for Dupuytren's disease with metacarpophalangeal flexion contracture.

Eighty palmar segmental aponeurectomies were performed between 1993 and 1999 for well-localized palmar cords with metacarpophalangeal flexion contracture. A retrospective patient review with a minimum follow-up of 1-year demonstrated a 6% rate of recurrent metacarpophalangeal flexion and two minor complications. Segmental aponeurectomy rather than limited fasciectomy is recommended for this type of disease.

Intraocular pressure and pulsatile ocular blood flow after retrobulbar and peribulbar anaesthesia.

Aims: This study investigated the effect of peribulbar and retrobulbar local anaesthesia on intraocular pressure (IOP) and pulsatile ocular blood flow (POBF), as such anaesthetic techniques may adversely affect these parameters.

Methods: 20 eyes of 20 patients who were to undergo phacoemulsification cataract surgery were prospectively randomised to receive peribulbar or retrobulbar anaesthesia. The OBF tonometer (OBF Labs, Wiltshire, UK) was used to simultaneously measure IOP and POBF before anaesthesia and 1 minute and 10 minutes after anaesthesia.

Management and diagnostic guidelines for urticaria and angio-oedema.

These guidelines for management of urticaria and angio-oedema have been prepared for dermatologists on behalf of the British Association of Dermatologists. They present evidence-based guidance for treatment, with identification of the strength of evidence available at the time of preparation of the guidelines, and a brief overview of aetiology, diagnosis and investigation.

Phacoemulsification cataract surgery: is routine review necessary on the first post-operative day?

Purpose: To determine the value of routine review on the first post-operative day following phacoemulsification cataract surgery.

Methods: A prospective study was performed of 238 consecutive patients who underwent phacoemulsification cataract surgery. Local anaesthesia was used for 97% of patients and surgery was performed as a day-case procedure for 93% of patients.

Can blood taken from intraosseous cannulations be used for blood analysis?

Intraosseous infusion is increasingly finding application for venous access to infuse drugs and fluids in paediatric resuscitation including burns. The aim of this study was to determine the feasibility of using blood samples taken from the bone marrow cavity for routine blood analysis. In paediatric resuscitation where alternative venous access is not available this could prove valuable.

Randomized double-blind study of cyclosporin in chronic 'idiopathic' urticaria.

Background: Histamine-releasing activity (HRA) is detectable in up to 50% of patients with chronic ordinary urticaria.

Objectives: To determine the effect of cyclosporin on clinical features and HRA in patients with chronic urticaria.

Methods: Thirty patients with severe unremitting disease, responding poorly to antihistamines and showing a positive autologous serum skin test (ASST) as a marker of HRA, were randomized to 4 mg kg-1 daily of cyclosporin (Sandimmun, n = 20) or placebo (n = 10) for 4 weeks.

Thomas Bateman MD FLS 1778-1821.

Thomas Bateman was a physician to the Carey Street Public Dispensary with Robert Willan in the first decade of the nineteenth century when the latter was developing the classification that would act as a foundation for modern dermatology. Following Willan's death with his work still incomplete, Bateman published a book, as an abstract of Willan's full concept, which was probably the most influential dermatology text of the nineteenth century. This was the first classification of dermatology that precisely defined the terms used and fitted individual diseases into a single class, rather than considering different stages of the same disease as maladies that belonged in different classes.

The phacoemulsification learning curve: per-operative complications in the first 3000 cases of an experienced surgeon.

Purpose: To assess the per-operative complications occurring during the first 3000 phacoemulsification cases performed by an experienced consultant surgeon.

Methods: A prospective analysis of 3000 consecutive cases performed without supervision between November 1992 and November 1998 was carried out. Data recorded for each case included details of per-operative complications, pre-operative best corrected visual acuity, nuclear density, history of previous pars plana vitrectomy, and whether phacoemulsification was performed as part of a phacotrabeculectomy procedure.

Does preservative-free lignocaine 1% for hydrodissection reduce pain during phacoemulsification?

Purpose: To compare preservative-free 1% lignocaine with balanced salt solution (BSS) in alleviating pain during hydrodissection in phacoemulsification cataract surgery.

Setting: West Norwich Hospital, Norfolk, United Kingdom.

Methods: This prospective double-masked trial comprised 68 patients having day-case phacoemulsification cataract surgery.

An independent assessment of a supraregional pain management programme and comparison of patients' and general practitioners' perceptions of the effects.

This study was designed to evaluate the therapeutic response, as perceived by patients and their general practitioners, to a supraregional residential pain management programme (INPUT). Twenty patients who completed the INPUT programme and their general practitioners, were sent locally designed questionnaires. Eighteen patients and 16 general practitioners responded.

Dermofasciectomy in the management of Dupuytren's disease.

Dupuytren's disease may present with well-defined subcutaneous cords or as more diffuse disease with involvement of the skin. Fasciectomy is the procedure commonly carried out for the full range of disease, but is associated with rates of recurrence of up to 66%. We reviewed 143 rays in 103 patients undergoing dermofasciectomy for diffuse disease with involvement of the skin.

Primary vitrectomy for pseudophakic and aphakic retinal detachments.

Purpose: To evaluate primary vitrectomy for the treatment of pseudophakic and aphakic retinal detachments. Primary vitrectomy may enable better identification of retinal breaks than scleral buckling procedures.

Methods: A prospective study was performed of primary vitrectomy for the treatment of 25 consecutive cases of pseudophakic and aphakic retinal detachment.

Visual experience during phacoemulsification cataract surgery under topical anaesthesia.

Background/aims: Visual awareness during phacoemulsification cataract surgery is an important determinant of patient satisfaction with any anaesthetic technique. Topical anaesthesia could be associated with significant visual awareness because it does not affect optic nerve function.

Methods: The visual experience during phacoemulsification cataract surgery under topical anaesthesia (without sedation) was assessed for 106 consecutive unselected patients.

Phacotrabeculectomy without peripheral iridectomy.

Background And Objective: Peripheral iridectomy has been a long established part of glaucoma drainage surgery. This series examines the potential to dispense with iridectomy when trabeculectomy is combined with modern small-incision cataract surgery.

Patients And Methods: Twenty-five unselected consecutive patients underwent a standardized phacotrabeculectomy by a single surgeon.

A local anaesthetic technique for endoscopic carpal tunnel release.

A local anaesthetic technique for endoscopic carpal tunnel release is described. This accurately and rapidly blocks median and ulnar nerves in the distal forearm. It avoids the infiltration of local anaesthetic solution at the operation site, a technique which may render the endoscopic view unsatisfactory.

A comparison of the patient and surgeon opinion on the long-term aesthetic outcome of reduction mammaplasty.

The aim of this study was to assess the difference in opinion between patients and surgeons regarding the aesthetic outcome of reduction mammaplasty. A total of 34 women, who were more than 1 year post surgery, attended an outpatient clinic to assess their opinion of the aesthetic outcome of their breast reduction. A questionnaire was used to standardise their responses.