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Biomedical subjects

D Vickers

Publications and source records attributed to D Vickers.

31 records · Page 2Linked to original sources
PubMed1991

Intra-operative patient-controlled sedation. Comparison of patient-controlled propofol with anaesthetist-administered midazolam and fentanyl.

The quality of sedation and postoperative recovery have been assessed for intra-operative sedation provided by either patient-controlled sedation with propofol or a standard method using divided doses of midazolam and fentanyl, in 40 ASA 1 day surgery patients undergoing extraction of third molar teeth under local analgesia. Patient-controlled sedation with propofol produced sedation no deeper than full eyelid closure with prompt response to verbal command, but deeper levels were seen in three patients in the midazolam and fentanyl group. Patient satisfaction was higher in the patient-controlled sedation propofol group for both subjective intra-operative feelings (p less than 0.01) and willingness to have the procedure again in the same manner (p less than 0.05). Amnesia was more limited to intra-operative events (rather than extending into the postoperative period) in the patient-controlled sedation propofol group (p less than 0.05). Drug dose was correlated with duration of procedure and surgical difficulty in the patient-controlled sedation propofol group but not in the midazolam and fentanyl group. Postoperative testing included a new computerised test, the FAST index, which indicated a dose-dependent reduction in cognitive function in the midazolam and fentanyl group, which persisted until the time of discharge. Changes in cognitive function in the patient-controlled sedation propofol group in the same postoperative interval were significantly less and not related to propofol dose.

Adult↗
PubMed1987

Clinodactyly of the little finger: a simple operative technique for reversal of the growth abnormality.

The traditional approach to clinodactyly has been either to accept the deformity or to perform an osteotomy. As an alternative to osteotomy, a resection of the mid-zone of the continuous epiphysis along with the underlying physis and its replacement by a fat graft (physiolysis) is simpler and allows further growth in the phalanx. Twelve of these operations have been reviewed with a maximum follow-up of six years. Excellent functional and cosmetic results have been obtained. The renewed growth is manifest not only by an increase in length, but also by a decrease in the angular deformity and improvement of the articular surfaces. Osteotomy at maturity has only been necessary in one patient.

Diseases in Twins↗
PubMed1985

Accumulator and random-walk models of psychophysical discrimination: a counter-evaluation.

In a recent assessment of models of psychophysical discrimination, Heath criticises the accumulator model for its reliance on computer simulation and qualitative evidence, and contrasts it unfavourably with a modified random-walk model, which yields exact predictions, is susceptible to critical test, and is provided with simple parameter-estimation techniques. A counter-evaluation is presented, in which the approximations employed in the modified random-walk analysis are demonstrated to be seriously inaccurate, the resulting parameter estimates to be artefactually determined, and the proposed test not critical. It is pointed out that Heath's specific application of the model is not legitimate, his data treatment inappropriate, and his hypothesis concerning confidence inconsistent with experimental results. Evidence from adaptive performance changes is presented which shows that the necessary assumptions for quantitative analysis in terms of the modified random-walk model are not satisfied, and that the model can be reconciled with data at the qualitative level only by making it virtually indistinguishable from an accumulator process. A procedure for deriving exact predictions for an accumulator process is outlined.

Choice Behavior↗
PubMed1984

Digital avulsion injuries: the shish kebab effect of the fibrous flexor sheath.

On debriding a hand from which four fingers with all their flexor tendons had been avulsed, a sizeable quantity of 'minced' muscle was found in the palm. Further cadaver investigations showed that the avulsed flexor tendons disrupted proximal to the musculo-tendon junction, and that a significant amount of devitalized forearm muscle tissue was left in the palm as the tendons passed through the proximal fibrous flexor sheath. A case of early development of carpal tunnel syndrome following avulsion injury of the little finger is illustrated in which later surgical exploration of the palm revealed detached muscle tissue compromising the median nerve. It is suggested that exploration of the palm is indicated in all cases of proximal avulsions of the flexor tendons.

Adult↗