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T Pritchard

Publications and source records attributed to T Pritchard.

9 recordsLinked to original sources
PubMed1998

The association between different patterns of hand symptoms and objective evidence of median nerve compression: a community-based survey.

OBJECTIVE: To examine the association between different patterns of hand symptoms and the presence of delayed nerve conduction in the general population. METHODS: We performed a 2-stage screening survey involving a questionnaire on current hand symptoms, and nerve conduction testing in samples of subjects with and without symptoms. Of 648 respondents to the symptom questionnaire, 212 reported hand symptoms. In all, 155 were tested for nerve conduction of sensory and motor median nerve latencies, including 40 who had reported no symptoms. Patterns of hand symptoms were compared with nerve conduction results and associations weighted back to the general population. RESULTS: The presence of any hand symptoms had only a 40% sensitivity for delayed nerve conduction on latency testing. The presence of typical symptoms of carpal tunnel syndrome had a much lower sensitivity. CONCLUSION: In a community setting, the distribution of hand symptoms does not usefully correlate with the presence of delayed nerve conduction in the median nerve.

Adult↗
PubMed1998

Estimating the prevalence of delayed median nerve conduction in the general population.

The objectives of this study were to determine the point prevalence of neurophysiologically defined median nerve compression and associated carpal tunnel syndrome in a random sample of the general population. The design was a two-stage screening study: (i) a cross-sectional survey to estimate the point prevalence of current hand symptoms; (ii) nerve conduction testing of the median nerve in weighted samples of the survey respondents. The target study population was a random sample of 1000 adults aged between 18 and 75 yr registered with a family practice in the UK. A mailed questionnaire enquired about hand symptoms on the day and included various demographic questions. Weighted random samples were taken based on the hand symptoms reported, and the subjects were invited to attend for motor and sensory median nerve conduction testing. A neurophysiological diagnosis of median nerve compression was made based on a number of different cut-offs using published criteria. Of those receiving a questionnaire, 79% responded. A total of 250 responders were invited to attend for nerve conduction testing, of whom 155 (62%) attended. Non-response to the questionnaire and non-attendance for nerve conduction testing may have biased the prevalence estimates. After adjustment for such biases, a prevalence estimate of between 7 and 16% was obtained, varying with the different cut-offs used to define delayed median nerve conduction. Subjects over 54 yr of age had a higher prevalence than younger participants. There was no difference in prevalence estimates between men and women. The conclusion reached was that carpal tunnel syndrome, as assessed by delayed median nerve conduction, is common in the general population.

Adolescent↗
PubMed1998

Is delayed nerve conduction associated with increased self-reported disability in individuals with hand symptoms? A population based study.

OBJECTIVE: To determine whether, in individuals in the general population with hand symptoms, there is a greater level of disability in those with objective evidence of delayed nerve conduction. METHODS: A 19 item disability schedule relevant to hand function was developed for this survey. Subjects included 71 individual respondents to a random population survey who reported pain, tingling, numbness, or loss of sensation in the hands during an interview and who agreed to have nerve conduction studies. They were divided into those with (10) and without (61) delayed median nerve conduction. RESULTS: Those with delayed conduction were more likely to report disability for 14 of the 19 items assessed. Half those with delayed conduction reported disability in 7 or more items, compared with 18% of those with normal conduction (chi-squared = 7.49, p = 0.006). Disability items that showed the greatest disparity between the 2 groups were those that relied on hand, although not specifically fine hand, movements. CONCLUSION: Individuals with hand symptoms in the general population who have objective evidence of delayed nerve conduction have a greater degree of self-reported disability than those with normal conduction.

Carpal Tunnel Syndrome↗
PubMed1995

Practice parameters for sigmoid diverticulitis. The Standards Task Force American Society of Colon and Rectal Surgeons.

It should be recognized that these guidelines should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all of the circumstances presented by the individual patient.

Acute Disease↗
PubMedDate not supplied

Limited survival of rat small bowel transplants preserved in University of Wisconsin solution for 48 hours.

We have previously shown that rat small bowel may successfully be transplanted after preservation for 24 hours. In this study, syngeneic rat small bowel transplants were studied by light microscopy and transmission electron microscopy during and after preservation in University of Wisconsin (UW) solution for 48 hours. A total of 6 transplants were carried out using a previously described, standardized technique. In most cases, the bowel appeared histologically well preserved at the end of the 48 hr storage period (prior to implantation). Upon revascularization, however, reperfusion injury was dramatic, with loss of villi and crypts and inflammatory cells in all layers. The bowel was abnormal grossly as well as microscopically. This injury was irreversible with persistently abnormal histology for up to 1 week in all but 2 cases. We conclude that UW solution alone may allow satisfactory preservation of intestinal grafts for 48 hours only in isolated cases, and is therefore not adequate for predictable, satisfactory 48 hr preservation. Attempts to prevent reperfusion injury with oxygen-free radical scavengers are in progress.

Adenosine↗
PubMedDate not supplied

Supervision in practice.

The nature of the supervising relationship is explored in relation to an intensive care unit. The relationship between clinical supervision and individual performance review is discussed. Preparation and support for the supervisor's role is identified. Peer, group and external supervision arrangements are explored.

Clinical Competence↗