No abstract

Regular exposure to hand-transmitted vibration can result in symptoms and signs of peripheral vascular, neurological and other disorders collectively known as the hand-arm vibration syndrome (HAVS). A significant proportion of workers can suffer from HAVS after using vibrating power tools. HAVS is a chronic and progressive disorder. Early recognition and prevention is the key to managing vibrating tool exposures and health effects. This article gives a broad overview of the condition with a detailed account of its pathogenesis, identification and management.

No abstract

Avotermin 500 ng per 100 µl per linear cm of wound margin given once is well tolerated and significantly improves scar appearance.

Ann R Coll Surg Engl 2008; 90: 386-388 386Acute rupture of an abdominal aortic aneurysm (AAA) accounts for 2% of mortality in over 60-year-old men. 1 Emergency AAA repair at the time of rupture has a mortality of approximately 75% and elective AAA repair before rupture has a mortality of approximately 5%. 2Screening programmes attempt to detect asymptomatic AAAs in order to repair them electively before rupture occurs.Age and sex are the only AAA risk factors that are currently used to select a population to be invited for screening. It has been shown that a history of an inguinal hernia repair is a risk factor for AAA and that selectively screening over 65-year-old men with inguinal hernias pre-operatively may detect more AAAs than conventional screening programmes. This study aimed to confirm whether pre-operative screening of male patients over the age of 65 years, who have an inguinal hernia, detected a significantly increased prevalence of AAA compared with the results of screening programmes using only age and sex to select their populations. Patients and MethodsThis study was calculated to require n = 70 to be able to achieve a power of 86% if the expected prevalence = 12% and the control prevalence = 3% (alpha = 0.05, one-tailed, exact method).Seventy consecutive male patients aged 65 years and older who were referred to the out-patient clinic of a single vascular surgeon with an inguinal hernia between June 2004 and March 2007 underwent ultrasound examination of the abdominal aorta in the supine position. The variety of ultrasound machines (one Siemens Sonoline Antares, two Hitachi EUB 8500 and two EUB 5500) and ultrasonographers was not limited for this study. ResultsThe age range of the study population was 65-88 years (mean, 74 years; mode, 66 years; median, 73 years; 95% confidence interval [CI],[73][74][75]. Ultrasound scan results were <2 .5 cm in any transverse section in 64 cases (91%), ectatic (2.5-3 cm in any transverse section) in 3 cases (4%), aneurysmal (≥ 3c m in any transverse section or dilated ≥ 50% than the proximal aorta) in two cases that measured 3.8 cm and 6.0 cm (3%) and occluded in one case (1.4%). This gives an AAA prevalence of 3% (normal 95% CI, -1 to 7%, exact 95% CI, 0-10%).

No abstract

This study shows that there is a marked underestimate of vascular workload when comparing central recorded data with that obtained from local audit. Marked variation is seen in the accuracy of data submitted from different hospitals.

No abstract