Biomedical subjects

S A W Pickering

Publications and source records attributed to S A W Pickering.

4 recordsLinked to original sources

PubMed2004

Work practices and histopathological changes in the tenosynovium in carpal tunnel syndrome in men.

The aim of this prospective study was to assess whether the fibrous thickening of the carpal tunnel tenosynovium is influenced by working practices. We did this by investigating 50 men (58 hands) with idiopathic carpal tunnel syndrome, who were undergoing carpal tunnel decompression. Occupational history, including vibration tool exposure, and presence of callosities and/or ingrained dirt on hands was recorded at the time of surgery. The flexor tenosynovium was biopsied, and assessed histologically by an observer blinded to occupational history. Occupational group, age, weight and smoking showed no significant association with fibrous tenosynovial thickening. There was also no significant association between fibrous tenosynovial thickening and the presence of hand callosities/in-grained dirt or regular use of vibration tools. Thus no association was found between heavy occupational hand usage and the development of fibrous tenosynovial thickening around tendons within the carpal tunnel.

Adult↗

PubMed2003

Bier's block using prilocaine: safe, cheap and well tolerated.

OBJECTIVES: To examine the safety of prilocaine Bier's block performed for Colles fracture manipulation, and assess patient satisfaction. METHOD: Fifteen-year retrospective review of all patients undergoing Colles fracture manipulation with a prilocaine Bier's block looking for the incidence of significant neurological or cardiovascular events. A confidential questionnaire was administered to 50 consecutive patients to assess patient satisfaction with the method of anaesthesia. RESULTS: 1504 males with mean age 48 years and 5906 females with mean age 66 years received a prilocaine Bier's block for distal radial fracture manipulation. There were no documented incidences of anaphylaxis, arrhythmia, convulsions or collapse. Of 50 consecutive patients, all but two were satisfied with this form of anaesthesia. The pressure cuff inflation was considered the worst part of the procedure. CONCLUSION: Bier's block performed with prilocaine is at least as safe as other commonly used methods of anaesthesia for distal radial fracture reduction with high patient satisfaction. The procedure can be safely carried out by a single medical practitioner with appropriate patient monitoring and assistance from trained nursing staff.

Aged↗

PubMed2003

Electromagnetic augmentation of antibiotic efficacy in infection of orthopaedic implants.

Infection of orthopaedic implants is a significant problem, with increased antibiotic resistance of adherent 'biofilm' bacteria causing difficulties in treatment. We have investigated the in vitro effect of a pulsed electromagnetic field (PEMF) on the efficacy of antibiotics in the treatment of infection of implants. Five-day biofilms of Staphylococcus epidermidis were grown on the tips of stainless-steel pegs. They were exposed for 12 hours to varying concentrations of gentamicin or vancomycin in microtitre trays at 37 degrees C and 5% CO2. The test group were exposed to a PEMF. The control tray was not exposed to a PEMF. After exposure to antibiotic the pegs were incubated overnight, before standard plating onto blood agar for colony counting. Exposure to a PEMF increased the effectiveness of gentamicin against the five-day biofilms of Staphylococcus epidermidis. In three of five experiments there was reduction of at least 50% in the minimum biofilm inhibitory concentration. In a fourth experiment there was a two-log difference in colony count at 160 mg/l of gentamicin. Analysis of variance (ANOVA) confirmed an effect by a PEMF on the efficacy of gentamicin which was significant at p < 0.05. There was no significant effect with vancomycin.

Analysis of Variance↗

PubMed2002

Electromagnetic fields for bone healing.

Electrical stimulation has been applied in a number of different ways to influence tissue healing. Most of the early work was carried out by orthopedic surgeons looking for new ways of enhancing fracture healing, particularly those fractures that had developed into nonunions. Electrical energy can be supplied to a fracture by direct application of electrodes or inducing current by use of pulsed electromagnetic field or capacitive coupling. Many of these techniques have not been standardized, so interpretation of the literature can be difficult and misleading. Despite this, there have been a few good laboratory and clinical studies to investigate the effect of electrical stimulation on fracture healing, which are reviewed. These do not permit recommendation or rejection of the technique per se; however, there is some room for optimism. The authors present some of the guidelines for using this treatment modality but suggest that all treatment should be carried out as part of a clinical trial in order to generate reliable data.

Journal Article↗