Biomedical subjects

P L Pemberton

Publications and source records attributed to P L Pemberton.

3 recordsLinked to original sources

PubMed2003

The use of hypothermia as a method of neuroprotection during neurosurgical procedures and after traumatic brain injury: a survey of clinical practice in Great Britain and Ireland.

Hypothermia has been employed as a method of neuroprotection for many decades. The evidence base for its use is limited, and the balance between benefit and risk is unclear. We felt that in light of this confusion it would be interesting to canvas the opinion of the members of The Neuroanaesthesia Society of Great Britain and Ireland. A questionnaire was sent to all 274 members enquiring into their use of hypothermia during a variety of different neurosurgical procedures and in the management of the head-injured patient. A 75% response rate was achieved. The results showed that over half (58%) of those who replied attempted to cool the patient during cerebral aneurysm surgery. Forty-one per cent of respondents attempt to induce hypothermia in the head-injured patient. However, for other neurosurgical procedures most felt that the disadvantages of cooling the patient outweigh the advantages. The use of hypothermia remains a contentious issue, and as yet there is no clear answer as to whether it should be employed as a method of neuroprotection.

Adult↗

PubMed2002

A retrospective observational study of pre-operative sickle cell screening.

The aim of this study was to determine the ethnic mix of those patients being pre-operatively screened for sickle cell disease in a London teaching hospital and to determine the rate of carriage of sickle haemoglobin amongst those tested. We retrospectively studied 1879 patients undergoing surgery over a 2-month period. Two hundred and thirteen (11%) were screened for sickle cell disease and of these, 12 (5%) tested positive for sickle cell trait (HbAS). There were no patients homozygous for sickle cell disease (HbSS) or with haemoglobin SC disease (HbSC). Screening rates varied widely in different ethnic groups from 0% of the Chinese population to 85.2% of the Afro-Caribbean population. We conclude that at present there is no coherent pre-operative screening policy for sickle cell disease in our institution. Sickle cell disease poses unique anaesthetic risks and with a rapidly expanding 'mixed race' population high-risk patients are difficult to identify phenotypically. We propose a universal screening policy be implemented in high-risk areas.

Anemia, Sickle Cell↗

PubMed2002

The champagne angle.

A patient's observation led us to investigate whether drinking from a champagne flute required more cranio-cervical extension than drinking from other types of wine glasses. We measured the cranio-cervical extension required by normal volunteers to drink from four different types of glass. The mean [95% confidence intervals] extension from the neutral position required to drain each glass was: narrow flute 40 degrees [35-44]; wide flute 22 degrees [19-25]; wine glass 26 degrees [24-29]; champagne saucer 0 degree [-1-2]. Drinking from the narrow rimmed champagne flute required significantly more extension than the other types of glass (p < 0.001), and 73% of the total available cranio-cervical extension.

Adult↗