Biomedical subjects
Publications and source records attributed to Stephen Blair.
Tibial nail length can be estimated pre-operatively by several methods, but this usually requires an intact contralateral tibia. The purpose of this study is to describe an alternative method using the forearm as a reference. A simple clinical method using a forearm measurement is described. This method gives an accurate estimation of the likely range of nail length's that may be required using a simple formula.
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BACKGROUND: Because a patient's migraines often differ in duration, intensity, and accompanying symptoms, as well as the conditions and circumstances at the time of the headache, the mode for treatment also may change. OBJECTIVE: The goal of this study was to determine whether migraine management is improved by providing 3 formulations of sumatriptan succinate to patients, together with education to assist them in selecting the most appropriate formulation for specific attacks. METHODS: This was an open-label study conducted in 3 family practice settings. Patients were recruited who had at least a 1-year history of migraine meeting International Headache Society criteria and experienced 2 to 6 attacks per month within the previous 3 months. Patients received instructions on oral, intranasal, and subcutaneous (SC) sumatriptan and were provided with all 3 formulations to treat 6 headaches. Migraine features, formulation used, reason for selecting specific formulation, migraine symptom relief, and use of follow-up doses were recorded in diaries. At follow-up, patients completed a questionnaire assessing satisfaction with access to multiple formulations. RESULTS: Of the 33 enrolled patients (26 women, 7 men; mean age, 38.5 years [range, 23-54 years]), 25 (75.8%) completed all visits. Of 149 headaches treated, 39 (26.2%) were mild at onset, 70 (47.0%) were moderate, and 40 (26.8%) were severe. Eighty (53.7%) headaches were treated with tablets, 35 (23.5%) with nasal spray, and 34 (22.8%) with SC injection. Primary reasons for selecting specific formulations included "fewer side effects" for tablets, "convenience" for nasal spray, and "quick onset of action" for SC injection. Twenty-one (84.0%) patients reported being either very satisfied or satisfied with their ability to manage their headaches. Physicians reported that 18 of 24 (75.0%) patients had an improved attitude toward managing their headaches. All formulations were well tolerated. Eight (32.0%) patients reported adverse events, the 2 most common being chest pressure and fatigue. CONCLUSION: The patients in this study reported greater satisfaction with migraine management when given access to multiple sumatriptan formulations and education regarding their appropriate use.
The purpose of this study is to assess the effect of the commonly used below elbow plaster casts on driving ability. The position of the Driver and Vehicle Licensing Agency and five motor insurance companies is established. The study aims to help doctors decide whether or not a patient is fit to drive with a plaster cast. Three types of cast were tested using one driver. A score was given for several driving abilities. The right Colles cast was found to have no effect on ability to drive. Scaphoid and Bennett's casts were found to have significant affects on driving ability. The DVLA has no specific guidelines regarding driving with a plaster cast and the position of insurance companies is variable, but will usually depend upon medical advice.