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Biomedical subjects

M F Pilcher

Publications and source records attributed to M F Pilcher.

9 recordsLinked to original sources

Identifying scoliosis in the adolescent with thermography: a preliminary study.

Early diagnosis of adolescent idiopathic scoliosis is essential to prevent severe deformity. The accuracy of thermographic examination of the spine in the detection of minor degrees of curvature has been assessed in 125 asymptomatic young persons mean age 13.4 +/- 0.8 years who were also examined clinically and by spinal X-ray. Assessment of thermograms selected at random from the group of 154 young subjects showed that thermography has a sensitivity of 98.2% and a specificity of 91.0% in the identification of scoliosis when compared with radiography. Thermographic examination of the spine is simple, noninvasive and provides a permanent recording which is easily interpreted. It may provide an ideal method for use in large-scale prospective surveys. The criteria used to detect the thermographic abnormality associated with idiopathic scoliosis was derived from the spinal thermograms of 29 patients, mean age 10.25 +/- 4.65 years with known scoliosis, mean angle of curve 27 degrees +/- 12 degrees. In contrast to the thermal symmetry of the normal spine, all the thermograms of these patients show asymmetry, characteristically an increase in thermal emission on the concave aspect of the curve. Eight of the 16 patients with scoliosis with minor curves and a characteristic thermogram were not detected clinically. There were 25 asymmetrical thermograms in the asymptomatic group. Three of these patients had a simple postural defect, 5 had dorsal kyphosis and 16 had idiopathic scoliosis. Postural defects and kyphosis were readily recognized on clinical examination and did not produce the characteristic scoliotic thermogram.

Adolescent↗

Intravenous lignocaine in prevention of deep venous thrombosis after elective hip surgery.

Intravenous lignocaine is a possible means of preventing deep venous thrombosis (D.V.T.) after elective hip surgery. In 14 control patients the total incidence of D.V.T. was 78%, with a 57% incidence of thigh-vein thrombosis. In 14 patients treated at random with intravenous lignocaine during the first 6 postoperative days, there were only 2 calf-vein thrombi (14%; P less than 0-005). In a further 14 cases treated consecutively there were 4 unilateral calf-vein thrombi. No thrombi originated in the thigh veins (P less than 0-001). After intravenous lignocaine was stopped the total incidence of D.V.T. in the 28 patients rose to 53% with a 21% incidence of thigh-vein thrombi between the 7th and 14th postoperative days. There was no significant difference in postoperative coagulation and fibrinolytic activity between control and treated patients, and blood loss and transfusion requirements were similar. Immediate or delayed hypersensitivity reactions to lignocaine were not observed. The results support the view that damage to the vessel wall may be the initial event in the formation of a venous thrombus.

Adult↗

Failure of orally administered hydroxychloroquine sulphate to prevent venous thromboembolism following elective hip operations.

In a double-blind, randomized trial of orally administered hydroxychloroquine sulphate in the prevention of venous thromboembolism after elective surgery on the hip, the drug or a placebo was given to fifty consecutive patients. Therapy was commenced on the day before the operation and continued for fourteen days. The diagnosis of deep venous thrombosis was made by daily thermographic scanning of the legs and confirmed by phlebography. The diagnosis of pulmonary embolism was made by perfusion lung scanning. No significant difference in the incidence of thromboembolism was found between treated and control groups. The results provide evidence that substances which reduce the incidence of thromboembolism in general surgery may not be effective in operations on the hip.

Administration, Oral↗

Serum fibrin(ogen) degradation products in diagnosis of deep-vein thrombosis and pulmonary embolism after hip surgery.

Levels of fibrin(ogen) degradation products (F.D.P.) have been measured by radioimmunoassay for degradation product E (FgE) and by tanned-red-cell haemagglutination-inhibition immunoassay (T.R.C.H.I.I.) in the serum of thirty-three patients undergoing total hip replacement. Levels of F.D.P. did not correlate with thermographic evidence of deep-venous thrombosis. However, in 34 patients with pulmonary embolism, levels of F.D.P. measured by the T.R.C.H.I.I. were transiently raised at the time of embolus, and FgE concentrations were increased for up to 5 days preceding the embolus. Since the measurments of FgE is simple, convenient, and cheap, this estimation might constitute a valuable screening test for major thromboembolic episodes in the postoperative period.

Aged↗

The surgical isolator.

A plastic film isolator has been developed which is intermediate between a half-suit and an arm isolator. Used for orthopaedic surgery in an aseptic environment few operating difficulties have been found, and an extended trial of its use should be carried out to assess its effect on the incidence of postoperative wound infection.

Air Microbiology↗

Thermography in diagnosis of deep venous thrombosis.

The possibility that subclinical increased heat of the limb may be an early and reliable sign in the diagnosis of deep venous thrombosis is being investigated using thermography. Of the 35 cases studied 17 have had early deep venous thrombosis confirmed on phlebography. Of these, 16 cases have been previously diagnosed using thermography.

Body Temperature↗