Biomedical subjects

Max Bulsara

Publications and source records attributed to Max Bulsara.

23 records · Page 2Linked to original sources

PubMed2003

Suction technique to improve cement penetration under the tibial component in total knee arthroplasty.

Improving the longevity and reliability of cemented total knee arthroplasty remains an important part of orthopaedic research. This paper examines the recently described method of preparation of the cancellous surface of the tibia using suction cannulae in the proximal tibia and stem recess during pulsatile lavage and component fixation. The technique provides a surface clear of debris, fat, blood and marrow, and prevents backflow of blood. A retrospective analysis of post-operative radiographs shows significant improvement in the penetration of cement into the tibial plateau, and improved cement profile towards the periphery. Techniques of stem cementation are also compared, and it is recommended that for this particular design implant, cement should be applied into the cut stem recess in the tibia rather than to the stem of the implant itself. This technique of preparation of the cut surface of the tibia is a simple and, to-date, complication-free method of reliably providing satisfactory cement penetration during total knee arthroplasty.

Aged↗

PubMed2003

Impact of lead transport on children's blood and environmental lead levels.

INTRODUCTION: A lead monitoring project was established in 1996 to monitor the environmental and health effects of lead being transported through a remote town in tarpaulin-covered trucks. METHODS: Dust samples from sites on the transport route were collected at 3-6 monthly intervals between 1996 and 1999. Annual blood lead testing clinics, offering voluntary testing to children, were conducted from 1997 to 1999. RESULTS: Of the 55 dust samples analysed, only nine contained particles of lead concentrate and these were present at very low levels. During the project 167 children were tested. The geometic mean of blood lead levels in 1997, 1998 and 1999 were 4.5 micro g/dL, 5.0 micro g/dL and 5.1 micro g/dL, respectively (all within the normal range). Residence on the transport route was not associated with higher lead levels (P > 0.05). CONCLUSIONS: Lead transport was not associated with any detectable environmental contamination or increase in children's blood lead levels.

Age Distribution↗

PubMed2003

Validation of the FibroTest biochemical markers score in assessing liver fibrosis in hepatitis C patients.

BACKGROUND: Determining the stage of fibrosis by liver biopsy is important in managing patients with hepatitis C virus infection. We investigated the predictive value of the proprietary FibroTest score to accurately identify significant fibrosis in Australian hepatitis C patients. METHODS: Serum obtained from 125 confirmed hepatitis C patients before antiviral therapy was analyzed for haptoglobin, alpha(2)-macroglobulin, apolipoprotein A1, bilirubin, and gamma-glutamyltransferase activity, and the FibroTest score was computed. Liver fibrosis pathology was staged according to a defined system on a scale of F0 to F4. We used predictive values and a ROC curve to assess the accuracy of FibroTest scores. RESULTS: The prevalence of significant fibrosis defined by liver biopsy was 0.38. The most useful single test for predicting significant fibrosis was serum alpha(2)-macroglobulin (cutoff value, 2.52 g/L; sensitivity, 75%; specificity, 67%). The negative predictive value of a FibroTest score <0.1 was 85%, and the positive predictive value of a score >0.6 was 78%. Although 33 of the 125 patients had FibroTest scores <0.1 and were therefore deemed unlikely to have fibrosis, 6 (18%) had significant fibrosis. Conversely, of the 24 patients with scores >0.6 who were likely to have significant fibrosis, 5 (21%) had mild fibrosis. Of the 125 patients in the cohort, 57 (46%) could have avoided liver biopsy, but discrepant results were recorded in 11 of those 57 (19%). CONCLUSION: The FibroTest score could not accurately predict the presence or absence of significant liver fibrosis.

Adult↗

PubMed2002

Licit psychostimulant consumption in Australia, 1984-2000: international and jurisdictional comparison.

OBJECTIVES: To examine trends in the licit consumption of the psychostimulants dexamphetamine and methylphenidate in Australia and nine other countries from 1994 to 2000 and in each State and Territory of Australia from 1984 to 2000. DESIGN: Annual rates of consumption of psychostimulants were compared using Poisson regression models. All drug consumption was standardised to defined daily doses per 1000 population per day. MAIN OUTCOME MEASURES: Rates of consumption of each psychostimulant in each country and in each Australian State and Territory. RESULTS: For the 10 countries from 1994 to 2000, total psychostimulant consumption increased by an average 12% per year, with the highest increase from 1998 to 2000. Australia and New Zealand ranked third in total psychostimulant use after the United States and Canada. Australia consumed significantly more than the United Kingdom, Sweden, Spain, the Netherlands, France or Denmark. In Australia, from 1984 to 2000, the rate of consumption of licit psychostimulants increased by 26% per year, with an 8.46-fold increase from 1994 to 2000. Western Australia ranked first, with nearly twice the consumption rate of total psychostimulants as New South Wales, which ranked second. Methylphenidate is the main psychostimulant consumed in the US and Canada, and dexamphetamine in Australia. CONCLUSIONS: The consumption of psychostimulants in Australia is high internationally and varies significantly between States and Territories. The results imply varied jurisdictional prescribing determinants and supply processes throughout Australia, which may require new national prescribing standards and access to online patient data for prescribers and dispensers.

Australia↗

PubMedDate not supplied

Telemedicine-friendly, portable tonometers: an evaluation for intraocular pressure screening.

PURPOSE: To evaluate the intraocular pressure (IOP) readings from two portable, telemedicine-friendly tonometers for suitability in glaucoma screening. METHODS: 213 eyes of 107 consenting patients attending an eye clinic were tested with an I-care tonometer and a Pulsair-Easy Eye puff-air tonometer. Gold standard IOP was measured with a Goldmann applanation tonometer (GAT). Effect of central corneal thickness, anterior chamber depth and refractive errors on IOP measurements were also analysed. RESULTS: The mean difference of IOP by GAT and both the portable tonometers was +/- 2.2 mmHg. The analysis indicates minimal difference between IOP readings of both the portable tonometers. The mean difference between two consecutive readings by I-care was 0.01 mmHg. Using 21 mmHg as a threshold for suspected glaucoma, both the portable digital tonometers reported a sensitivity of 38% and specificity of >95%. In the subjects studied, central corneal thickness had statistically significant influence on IOP measurements while refractive errors and anterior chamber depth had no significant influence on IOP measurements with any tonometry. CONCLUSION: The IOP readings by both portable tonometers are comparable and were within clinically acceptable range from GAT. These portable tonometers are useful tools for IOP screening.

Adult↗