Biomedical subjects
J Llewelyn
Publications and source records attributed to J Llewelyn.
Lag screws in sagittal split osteotomies: should they be removed?
The use of stainless steel lag screws to provide rigid internal fixation for sagittal split osteotomies was first described more than 17 years ago. It was shown that the need for intermaxillary fixation could be eliminated and that lower relapse rates could be produced. However a decade later, removal of the screws was still being advocated. In this study, 48 patients had a total of 259 screws inserted over a 5 year period. Twenty six screws were removed 10 months following insertion. Most of these were removed in the absence of any symptoms although a few were palpable or tender to touch. None of the screws removed were loose nor was there any evidence of infection or corrosion associated with them. The long term consequences of screw retention are discussed and it is suggested that they do not need to be removed routinely.
Orbital lymphoma: blindness as a presenting symptom.
A case of isolated orbital lymphoma presenting as blindness is reported. An unusual feature of bone erosion is highlighted and the difficulty in the histological interpretation is discussed.
Complications of use of carbon fibre in the temporomandibular joint: a case report.
The aetiology of recurrent temporomandibular joint dislocation is numerous. A case is described of frequent dislocation which was finally treated using a carbon fibre sling. However this was removed 3 years later due to the presence of a radiolucency in the head of the condyle. Radiographic and photographic appearances of this carbon fibre induced radiolucency are shown.
Neurilemmoma of the mandible. Report of a case.
A case of neurilemmoma is described recurring 15 years after a previous excision.
Acquired hemophilia and diabetes mellitus.
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A photographic method for the assessment of examiner accuracy and variability for the scoring criteria of the debris index.
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Use of chlorhexidine gluconate and povidone iodine mouthwashes in the treatment of acute ulcerative gingivitis.
A trial was conducted to compare the effectiveness of povidone iodine and chlorhexidine gluconate with buffered peroxyborate in the treatment of acute ulcerative gingivitis. After 20 patients had entered the trial and 11 had required additional therapy with metronidazole to control their symptoms, the study was terminated. Those patients receiving peroxyborate all showed a satisfactory improvement in clinical signs and symptoms. One patient each receiving povidone iodine or chlorhexidine reported a symptomatic improvement, although gingival ulceration was still apparent at 1 week. The remaining patients all required metronidazole therapy to control their symptoms. Povidone iodine and chlorhexidine gluconate therefore cannot be recommended for the treatment of acute ulcerative gingivitis.
A five-year demonstration project associated with improvement in physician health maintenance behavior.
The purpose of this demonstration project was to evaluate the effect of a sustained preventive medicine emphasis in a community hospital based family practice residency. A simplified, visually tolerable, and prominent "health maintenance guide" served as the cornerstone of the overall residency educational effort. Screening interventions and intervals were based on the major published recommendations at the initiation of the project. An audit of 100 random adult patient charts was done at baseline and yearly for five years. Physicians received both group and individual feedback regarding screening compliance on a regular basis. Overall physician compliance with screening for six basic parameters improved from 71% to 85% (P less than .0005). Physicians behavior improved significantly in recording or recommending blood pressure, physician breast exam, personal life change, tetanus/diphtheria immunization, mammography, breast self-examination, testicular self-examination, and a prudent diet. Physician use of the guide as a recording device steadily increased.