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Biomedical subjects

S Hawes

Publications and source records attributed to S Hawes.

6 recordsLinked to original sources
PubMed2000

A review of accident and emergency attendances for non-traumatic musculo-skeletal complaints.

As there have been no previous studies, we undertook a systematic review to determine the number and nature of musculo-skeletal complaints presenting to casualty departments, review the appropriateness of treatment and referrals to other departments and also to identify potential problem areas so as to address these. Over the review period of 40 non-consecutive days, the total attendance was 2863 patients of which 85 (2.97%) presented with musculo-skeletal complaints. The majority (691) were in the age group of 20-59 years. Most complaints were in the back (26), neck (11), chest (10), shoulder (8), knee (8). Main complaints were pain (78), tenderness (10), swelling (9), stiffness (9), reduced movements (8) or a combination thereof; the rest were miscellaneous, e.g. pyrexia, headache and paraesthesia. The majority had a duration of symptoms from 1 to 7 days. Investigations at the casualty department were radiographs (29), full blood count (6), biochemistry (6), erythrocyte sedimentation rate (ESR) (1), blood culture (1), electrocardiogram (ECG) (7), and joint aspiration (2). Advice was sought from orthopaedic (2), rheumatology or general medicine (0), or other departments (2). Casualty diagnoses were mainly non-inflammatory conditions. Treatment given included analgesics/non-steroidal inflammatory drugs (NSAIDs) (44), splints and slings (5), Tubigrip (6), and collars (5). Only two patients (2.4%) were admitted. We were pleasantly surprised to note very small numbers of patients with inflammatory conditions, possibly indicating previous optimal management in our locality. A surprising finding was the lack of any attendance with gout. More direct referrals to orthopaedic or rheumatology departments would be appropriate in some instances. As a result of this review, we decided to offer short courses on musculo-skeletal medicine for new casualty officers and we have also produced guidelines/algorithm for management which would be equally useful for general practitioners.

Adolescent↗
PubMed1995

High grade anal dysplasia in visually normal mucosa in homosexual men: seven cases.

BACKGROUND: Anal cancer and anal human Papillomavirus (HPV) infection are increased in homosexual men. METHODS: We screened high risk homosexual men as part of a longitudinal study examining the effect of HIV infection on the risk of development of high grade anal intraepithelial neoplasia (AIN II, III). RESULTS: We found seven men who had histological evidence of AIN II-III with visually normal findings by anoscopy. Two men were HIV-seronegative, five were HIV-seropositive, and only one of the HIV-seropositive men had a low CD4 count < 200. Abnormal cytological results seen over follow-up periods of 3 months to 2.5 yr suggest the persistence of visually inapparent anal abnormalities. Two of the men had had small internal warts at earlier examinations, and three of the seven men subsequently developed visually abnormal anal findings. All men had HPV 16 DNA detected at some point. CONCLUSIONS: We hypothesize that high grade anal neoplasia may develop deep in the glands and can be detected by cytology before visible lesions are detected even with the aid of a colposcope. However, the implications of finding high grade anal cytology are not known at this time. Natural history studies are ongoing.

Adult↗
PubMed1983

Osteomyelitis beneath pressure sores.

Twenty-eight pressure sores were evaluated prospectively. Osteomyelitis was reported histologically in nine of 28 bones and pressure-related changes were reported in 14 bones. Roentgenograms suggested the presence of osteomyelitis in four instances of histologically proved osteomyelitis. Technetium Tc 99m medronate bone scans were highly sensitive, showing increased uptake in all cases of osteomyelitis; however, increased uptake also occurred commonly in uninfected bones due to pressure-related changes or other noninfectious causes. Cultures of bone biopsy samples usually disclosed anaerobic bacteria, gram-negative bacilli, or both. The diagnosis of osteomyelitis must be considered if a pressure sore does not respond to local therapy. If the technetium Tc 99m medronate uptake is increased in the involved area, or roentgenographic findings are abnormal, the diagnosis can only be made with certainty by histologic examination of bone. Antibacterial treatment should be selected based on the results of bone culture.

Adult↗