Screening for Patients at Risk of Diabetic Foot Ulceration in a General Diabetic Outpatient Clinic

An examination of the reproducibility of three tests for identifying patients at risk of diabetic foot complications is reported. One thousand and one patients attending a general diabetic outpatient clinic at the Royal Liverpool University Hospital underwent screening using the Semmes-Weinstein monofilaments, the biothesiometer, and palpation of pedal pulses. Two hundred and fifty-nine patients who were found to have a deficit on at least one of these tests were given a second appointment where the tests were repeated. Two hundred and twenty-nine patients attended for their second appointment. The expected range of variation in readings for the biothesiometer was 5 log hertz, sufficient variation to make the biothesiometer unacceptable as a screening instrument. The range of reproducibility for the four pedal pulses was from 68 % to 81 %, also an unacceptable level of variation. Over 85 % of the results for the Semmes–Weinstein monofilaments were the same on the first and second measurement. Of the three instruments examined in this study, only the Semmes–Weinstein monofilaments have sufficient reproducibility in the clinical setting for them to be recommended for general use as a screening test for risk of diabetic foot complications.     

Effective anthropometry in the evaluation of weight loss

Evaluation of some of the physical variables recorded during an intake of patients into the Macquarie University Weight Control Program is reported. Measures from 43 females aged between 19 and 66 years were taken prior to therapy and 15 weeks later. All subjects lost weight, the range being from 1 to 19 kg, and significant reductions on 14 anthropometric recordings were found. Factor analysis on the reductions suggested that five factors accounted for the variance. These were called general weight loss, torso, limbs, skinfold, and thigh factors. Suggestions are made to reduce the amount of anthropometry in future sessons in the interests of economy of time.     

Haemangioma of the digital nerve: a case report

An intra-neural haemangioma of the digital nerve of the left index finger is described, the first report of such a lesion in a digit. Treatment consisted of excision of the tumour and the affected portion of the nerve, followed by direct coaptation of the nerve ends.     

The effects of antishock trouser inflation during hypothermic cardiovascular depression in the canine model

The purpose of this study was to investigate the value and to identify any deleterious effects of antishock trouser use during hypothermic cardiovascular depression. Thirteen mongrels were made hypotensive by cooling to a core temperature of approximately 27 degrees C. Eight dogs had antishock trousers inflated for one hour and five dogs served as controls. Metabolic and hemodynamic variables were measured at regular intervals during cooling, during trouser inflation, and after trouser deflation. No study animal experienced ventricular fibrillation. Neither central temperature, pH, or serum potassium nor mean arterial BP or systemic vascular resistance were significantly affected by trouser inflation or deflation. Antishock trouser use during the early phase of hypothermia before rewarming does not appear to result in a central bolus of cold, acidotic, hyperkalemic blood or the precipitation of ventricular fibrillation. There appears to be no significant hemodynamic benefit of antishock trouser use early in the management of hypotension caused by moderate hypothermia.     

Needle localization of mammographically detected lesions in perspective

Needle localization of mammographically detected lesions has been shown to detect early breast cancer. One hundred seven patients who underwent needle localized biopsy from June 1977 to September 1985 were reviewed. Eighty percent of the biopsies were benign and 20 percent were cancers (22 patients). In patients undergoing modified radical mastectomy, 80 percent of the axillary specimens were node-negative. During the same 8 year period, 570 breast cancers were diagnosed. Needle localization was responsible for only 4 percent of all cancers found. Though needle localization represents an advance in the detection of early breast cancer, the majority of cancers are found by physical examination. The importance of routine examination by a physician and self-breast examination remains paramount.     

Dental materials: 1979 literature review Part II

This paper, which is presented in two parts, reviews the work on dental materials published in 1979. Included in Part II are sections on impression materials, model, die and investment materials, waxes, acrylic resins, denture base polymers, soft lining materials and tissue conditioners, cast and wrought dental alloys, ceramics, implants and, finally, corrosion. Part I included sections on dental biomechanics, fissure sealants, cements, amalgam, composite filling materials, endodontic materials and microleakage.