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Biomedical subjects

N R Kay

Publications and source records attributed to N R Kay.

At least 19 recordsLinked to original sources
PubMed2000

De Quervain's disease. Changing pathology or changing perception?

The basic anatomy of the first extensor compartment is presented with a review of the pathology of de Quervain's stenosing tenovaginitis. The results in 100 medicolegal cases of de Quervain's disease are analysed and reasons are sought for the poor results. A review of the known factors associated with the causation of de Quervain's disease is presented with recommendations about the management of this condition.

Adult↗
PubMed1998

Pain clinic management of medico-legal litigants.

A preliminary study was undertaken to determine the relationship between a patient's compensation claim and their management in pain clinics. Fifty consecutive patients with compensation claims and undergoing treatment in local pain clinics were selected from the senior author's medico-legal practice. An initial postal survey of UK pain clinics was undertaken to establish the percentage of patients in pain clinics with musculoskeletal pain and also what proportion of clinics enquire as to the litigation status of their patients. Medical reports available from both plaintiff and defence were reviewed together with the hospital's and general practitioner's notes. Musculo-skeletal pain contributes on average 55 per cent of the pain clinic workload and the majority of pain clinics establish the litigation status of their patients. Of the patient series, the senior author assessed 98 per cent as having exaggerated symptoms in 44 percent and 20 percent were proven to be malingering via covert video evidence. The results suggest that many patients with compensation claims seek to cloak inappropriate symptomatology with verification and medical support in pain clinics. The wisdom and expense of treating such patients in pain clinics is questioned and the need for a nationwide study on this matter identified.

Adult↗
PubMed1994

Use of the Edinburgh Postnatal Depression Scale to identify postpartum depression in a clinical setting.

The Edinburgh Postnatal Depression Scale (EPDS) is a validated instrument developed specifically to identify women experiencing postpartum depression (PPD). This study sought to determine the extent of postpartum depression in our population and the maternal characteristics associated with it and to also determine if the scale increased practitioner awareness and treatment of PPD. Two hundred eighty-seven women from the total population completing the EPDS in 1991 (n = 1,139) were randomly selected for retrospective chart review to identify relationships between maternal characteristics and elevated EPDS scores. Charts were also reviewed for outcomes related to depression for the six-month period after delivery. Statistical analysis of the data revealed that 17.4% of the total population had an EPDS score of > or = 10, indicating a potential risk of developing PPD. Eight percent scored > or = 13, suggesting that further assessment was necessary. Marital instability, lack of medical insurance and a history of depression were the factors found to correlate most significantly with elevated EPDS scores. The physicians and midwives providing service for our population were interviewed, and 83% reported that the EPDS had increased their awareness of PPD, while 92% reported having referred for treatment patients with high EPDS scores. Use of the EPDS scale can improve practitioner awareness and aid in the diagnosis of PPD. Several easily identifiable variables are associated with PPD.

Adult↗
PubMed1992

A safe, reliable method of carpal tunnel injection.

The injection of steroid preparations into the carpal canal is a recognized practice in the management of carpal tunnel syndrome. This procedure is associated with a risk of temporary or permanent damage to the median nerve. We present a new method of carpal tunnel injection based on anatomic dissections. We have used this technique successfully for more than 10 years, and there have been no cases of median nerve injury.

Carpal Tunnel Syndrome↗
PubMed1991

Segmental aponeurectomy for Dupuytren's disease: a prospective study.

A prospective study was carried out on segmental aponeurectomy for Dupuytren's contracture. 46 patients (50 hands) with primary disease were entered into the study. The procedure uses a series of C-shaped incisions to permit excision of small segments (approximately one centimetre) of diseased tissue along the affected ray. Segmental aponeurectomy achieved similar correction of deformity to limited fasciectomy. There was only one wound complication and no wound haematomas. Two patients lost flexion and one digital nerve was damaged. The incidence of recurrence at one year was no higher than with other techniques. Segmental aponeurectomy is a valuable alternative operation for Dupuytren's contracture, particularly in elderly patients.

Adult↗
PubMed1988

Mallet finger: comparison between operative and conservative management in those cases failing to be cured by splintage.

Sixty-nine patients with mallet finger who failed to be cured by a period of splintage were offered either tenodermodesis or Kirschner wire fixation of the DIP joint. Eleven (16%) accepted the offer and eight of these were significantly improved. Of those patients declining surgery, 30 were available for review after a minimum period of six months; of these 13 (43%) had undergone a significant spontaneous improvement.

Bone Wires↗
PubMed1988

The microvascular anatomy of the distal digital extensor tendon.

The circulation of six hands from four human cadavers was washed out, the hand then being injected with contrast material to provide 24 fingers for analysis under the dissecting and light microscopes. The microvascular anatomy of the distal part of the extensor tendon was outlined and is described, with particular emphasis on the fine vessels within the tendon and on the tendon surface. An area of deficient blood supply was shown within the tendon which may have implications in the aetiology and treatment of mallet finger.

Cadaver↗