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Biomedical subjects

F Blake

Publications and source records attributed to F Blake.

8 recordsLinked to original sources
PubMed2005

Intraoperative imaging of zygomaticomaxillary complex fractures using a 3D C-arm system.

After preclinical studies and evaluation of radiation exposures, intraoperative three-dimensional (3D) C-arm based imaging is now available for the facial skeleton. Fourteen patients admitted for surgical treatment of zygomaticomaxillary complex (ZMC) fractures were included in the study. Preoperative diagnostics and surgical treatment were performed as usual. Intraoperatively, after open reduction, a cone-beam computed tomography (CBCT) dataset was generated using the SIREMOBIL Iso-C3D (Siemens Medical Solutions, Erlangen, Germany). After DICOM-import in eFilm Workstation axial, coronal and sagittal reconstructions were evaluated by five examiners with the help of six defined criteria. In our study, secondary reconstructions were available after 6 min, excluding the time needed for the evaluation of the images. Especially the positioning of the isocentre of the SIREMOBIL Iso-C3D proved to be uncomplicated. Because of the size of the datasets, assessment of the symmetry of the malar projection proved difficult. Best scoring results were found regarding the visualization of the fragment position, bony anchorage of the screws and the fitting of the plates. Remarkable was the low level of metal artefacts in primary and secondary reconstructions. In conclusion, our results demonstrate intraoperative CBCT using the SIREMOBIL Iso-C3D suitable for assessment of postoperative results following ZMC reduction.

Adult↗
PubMed2002

Clinical and histological results of sensory recovery after radial foreann flap transfer.

The necessity of nerve anastomosis in an attempt to regain dermal sensitivity following pedicled or free-flap transfer has been the basis of many discussions. In our study, we investigated the degree of sensory recovery with emphasis on the different nerval qualities, on the radial forearm flap and correlated it to the histological and immunohistological findings. Nineteen patients with radial forearm free flap--five of whom underwent nerve anastomosis--were examined. The follow-up interval was 20.3 months (average) after surgical intervention. Histological examinations were performed on 13 of the 19 patients, in eight cases on one occasion and in five on more than one occasion. Seventeen patients experienced sensory recovery, whereby the degree and quality of dermal innervation varied. In comparison, the nerval reconstruction did not lead to any significant improvement. Based on our clinical results, we regard the nerve reconstruction during the radial forearm free flap transfer as unnecessary. To what extent this can be said for other flaps demands further investigation.

Adolescent↗
PubMed1998

Cognitive therapy for premenstrual syndrome: a controlled trial.

The aim of this study was to evaluate the effectiveness of cognitive therapy (CT) as a psychological treatment for premenstrual syndrome (PMS), by comparison with a waitlist control group. Women meeting selection criteria for PMS were randomly allocated to one of two treatment groups: (i) an immediate treatment group, who received 12 weekly sessions of individual CT; or (ii) a waiting list group who recorded symptoms of PMS for a length of time equivalent to the duration of an individual treatment in the immediate treatment group. General practitioners and gynecologists referred women who were complaining of distressing and disabling emotional and physical symptoms in the second half of the menstrual cycle, as verified by 2 months of prospective diary recording. Assessments of the women's psychological and social functioning were made on entry to the study, 2 months later, and at the end of the treatment period. This design allows evaluation of the efficacy of CT relative to any spontaneous remission that may have occurred as a consequence of the passage of time, the keeping of menstrual diaries, interview, and self-rated assessments. Results indicated that CT was significantly more effective than assignment to the waitlist group. Diary measures and self-report questionnaires indicated an almost complete remission of psychological and somatic symptoms and of impairment of functioning. It is concluded that CT for PMS is associated with substantial improvements that cannot be attributed to the passage of time or the completion of the diary and other assessments.

Adult↗
PubMed1997

Free flap transfer and the prevention of endothelial damage.

Prolonged ischemia is thought to have detrimental effects on the most vulnerable structure of a free flap, the intima. We investigated experimentally and clinically the effects of ischemia on microvascular flaps, with emphasis on the endothelial cell lining and the efficacy of cold storage solutions in preventing endothelial damage. Experimentally, we investigated three cold storage solutions--the Eurocollins solution, Bretschneider's solution, and the University of Wisconsin solution-histologically, submicroscopically, and functionally regarding their ability to protect the intima. The University of Wisconsin solution proved superior to the Eurocollins and Bretschneider's solutions. Our preliminary results on the clinical free flaps confirm a relationship between the duration of ischemia and the secretion of prostacyclin. We therefore recommend that operating teams be organized to allow immediate reanastomosis following free flap elevation. If immediate reanastomosis is not possible, our results indicate that perfusion with the University of Wisconsin solution provides optimal endothelial protection and increases flap viability.

Animals↗
PubMed1997

Psychological effects of continuation versus discontinuation of hormone replacement therapy by estrogen implants: a placebo-controlled study.

There is conflicting evidence regarding the effects of hormone replacement therapy (HRT) with estrogens on psychological and psychiatric symptoms of menopause. Forty women already attending a menopause clinic for continuing HRT by estrogen implants were studied in a randomized, double-blind, placebo-controlled study of estrogen reimplantation versus implantation of a placebo preparation. Assessment included self rating with visual analog scales, standardized psychological and menopause rating scales (Hospital Anxiety and Depression Scale, Self-Concept Questionnaire, Cognitive Failures Questionnaire, Greene Menopause Index), and interview with the Present State Examination. No difference in outcome with regard to either psychological or psychiatric symptoms was found 2 months after entry to the study between the women who received an active implant and those who received a placebo implant, in spite of the former group having a significant rise in estradiol levels. The only effect of HRT on physical symptoms was a nonsignificant reduction in flushes. Psychiatric morbidity of the study population was high with nearly half being "psychiatric cases" according to the Present State Examination at both initial assessment and follow-up. At entry to the study nearly all the women had levels of estradiol in the premenopausal range and four had supraphysiological levels. It appears likely that women were returning requesting a new implant because of symptoms related to nonhormonal factors. Women receiving continuing HRT for menopausal symptoms should be reassessed both for hormonal status and current psychosocial factors when they present with recurrent symptoms, especially those of a psychological or psychiatric nature.

Adult↗
PubMed1995

Psychological and sexual symptoms associated with the menopause and the effects of hormone replacement therapy.

BACKGROUND: There is considerable inconsistency in the results of studies of the psychological and sexual sequelae of the menopause and their treatment. METHOD: A search of the literature on Medline was made of studies of psychological symptoms in women who were either naturally or surgically menopausal or who were receiving hormone replacement therapy for menopausal symptoms. RESULTS: There is evidence of a small increase in psychological morbidity (not usually amounting to psychiatric disorder) preceding the natural menopause and following the surgical menopause. Psychosocial as well as hormonal factors are relevant. While the response of psychosocial symptoms to hormone replacement therapy with oestrogens is variable and most marked in the surgical menopause, in some studies the effect is little greater than that for placebo. Where sexual symptoms are present, there is more consistent evidence that hormone replacement therapy is effective. CONCLUSIONS: In the light of the available evidence, the current use of hormone replacement therapy to treat psychological symptoms detected at the time of (but not necessarily therefore due to) the natural menopause must be questioned. It does appear that oestrogen therapy ameliorates psychological symptoms after surgical menopause.

Adaptation, Psychological↗
PubMed1990

Daylight saving time in psychiatric illness.

It has been reported that the change in photoperiod induced by the occurrence of daylight saving time has an effect on psychiatric presentation. We therefore investigated the impact of daylight saving time in three conditions: (1) parasuicide presentations; (2) psychiatric outpatient contacts, and inpatient admissions; (3) registered suicides. Results indicate that neither the change in photoperiod nor the effect of a small change in circadian rhythm associated with daylight saving time has an effect on 'cases' in any of the three conditions.

Circadian Rhythm↗