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Jones HW, Bates J, Harrison WJ. The Use of Over-Penetrated Radiographs for Assessment of Chronic Osteomyelitis in Children. Ann R Coll Surg Engl 2007. [DOI: 10.1308/rcsann.2007.89.8.821] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Mphande ANG, Killowe C, Phalira S, Jones HW, Harrison WJ. Effects of honey and sugar dressings on wound healing. J Wound Care 2007; 16:317-9. [PMID: 17708384 DOI: 10.12968/jowc.2007.16.7.27053] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To investigate whether there is a difference between the efficacy of honey and sugar as wound dressings. METHOD Patients with open or infected wounds were randomised to receive either honey or sugar dressings. Bacterial colonisation, wound size, wound ASEPSIS score and pain were assessed at the start of treatment and at weekly intervals until full healing occurred. RESULTS Forty patients were enrolled; 18 received sugar dressings and 22 honey dressings. In the honey group, 55% of patients had positive wound cultures at the start of treatment and 23% at one week, compared with 52% and 39% respectively in the sugar group.The median rate of healing in the first two weeks of treatment was 3.8cm2/week for the honey group and 2.2cm2/week for the sugar group. After three weeks of treatment 86% of patients treated with honey had no pain during dressing changes, compared with 72% treated with sugar. CONCLUSION Honey appears to be more effective than sugar in reducing bacterial contamination and promoting wound healing, and slightly less painful than sugar during dressing changes and motion.
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Norrish AR, Lewis CP, Harrison WJ. Pin-track infection in HIV-positive and HIV-negative patients with open fractures treated by external fixation. ACTA ACUST UNITED AC 2007; 89:790-3. [PMID: 17613506 DOI: 10.1302/0301-620x.89b6.18854] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Patients infected with HIV presenting with an open fracture of a long bone are difficult to manage. There is an unacceptably high rate of post-operative infection after internal fixation. There are no published data on the use of external fixation in such patients. We compared the rates of pin-track infection in HIV-positive and HIV-negative patients presenting with an open fracture. There were 47 patients with 50 external fixators, 13 of whom were HIV-positive (15 fixators). There were significantly more pin-track infections requiring pharmaceutical or surgical intervention (Checketts grade 2 or greater) in the HIV-positive group (t-test, p = 0.001). The overall rate of severe pin-track infection in the HIV-positive patients requiring removal of the external-fixator pins was 7%. This contrasts with other published data which have shown higher rates of wound infection if open fractures are treated by internal fixation. We recommend the use of external fixation for the treatment of open fractures in HIV-positive patients.
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Lavy CBD, Mkandawire N, Harrison WJ. Orthopaedic training in developing countries. THE JOURNAL OF BONE AND JOINT SURGERY. BRITISH VOLUME 2005; 87:10-1. [PMID: 15686229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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Harrison WJ, Lewis CP, Lavy CBD. Open fractures of the tibia in HIV positive patients: a prospective controlled single-blind study. Injury 2004; 35:852-6. [PMID: 15302236 DOI: 10.1016/j.injury.2004.01.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Twenty-seven patients with severe open fractures were studied prospectively analysing infection and union as outcome measures. A standard treatment regime was applied. Seven patients were HIV positive, and 20 patients HIV negative. Wound infection and delayed union were more common in HIV positive patients. The difference in rate of infection was statistically significant (P = 0.020), while that in union did not quite reach significance (P = 0.059). The authors have developed an algorithm for treatment of these injuries in areas of high seroprevalence of HIV infection.
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Harrison WJ, Lavy CBD, Lewis CP. One-year follow-up of orthopaedic implants in HIV-positive patients. INTERNATIONAL ORTHOPAEDICS 2004; 28:329-32. [PMID: 15338205 PMCID: PMC3456908 DOI: 10.1007/s00264-004-0592-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2004] [Accepted: 07/26/2004] [Indexed: 11/26/2022]
Abstract
We followed prospectively 38 orthopaedic implants in 36 HIV-positive patients. X-rays and clinical examination were used to assess union, and observation was made for early and late wound sepsis for 12 months from the time of surgery. Two patients died of causes unrelated to the implantation, two patients had implants removed for reasons other than infection and eight cases were lost to follow-up. Of the 26 cases that were reviewed at 1 year, no late sepsis was identified. All of the fractures, non-unions, osteotomies and arthrodeses united. The literature indicates that late sepsis following arthroplasty occurs more frequently in haemophiliacs who are HIV positive than their HIV-negative counterparts. It is still not certain whether or not such a risk also applies to HIV-positive patients who are not haemophiliacs and have undergone internal fixation of fractures or non-unions. This study increases the confidence that fixation in immune-compromised patients with intact skin is safe, at least for the time period that the implant is required. Further studies are required to know whether or not fixation implants should be removed.
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Harrison WJ, Lewis CP, Lavy CBD. Wound healing after implant surgery in HIV-positive patients. THE JOURNAL OF BONE AND JOINT SURGERY. BRITISH VOLUME 2002; 84:802-6. [PMID: 12211668 DOI: 10.1302/0301-620x.84b6.12641] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We performed a prospective, blind, controlled study on wound infection after implant surgery involving 41 procedures in patients infected with the human immunodeficiency virus (HIV) and 141 in HIV-negative patients. The patients were staged clinically and the CD4 cell count determined. Wound infection was assessed using the asepsis wound score. A risk category was allocated to account for presurgical contamination. In HIV-positive patients, with no preoperative contamination, the incidence of wound infection (3.5%) was comparable with that of the HIV-negative group (5%; p = 0.396). The CD4 cell count did not affect the incidence of infection (r = 0.16). When there was preoperative contamination, the incidence of infection in HIV-positive patients increased markedly (42%) compared with that in HIV-negative patients (11%; p = 0.084). Our results show that when no contamination has occurred implant surgery may be undertaken safely in HIV-positive patients.
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Lewis CP, Lavy CBD, Harrison WJ. Delay in skeletal maturity in Malawian children. THE JOURNAL OF BONE AND JOINT SURGERY. BRITISH VOLUME 2002; 84:732-4. [PMID: 12188494 DOI: 10.1302/0301-620x.84b5.12642] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The atlas of Greulich and Pyle for skeletal maturity and epiphyseal closure is widely used in many countries to assess skeletal age and to plan orthopaedic surgery. The data used to compile the atlas were collected from institutionalised American children in the 1950s. In order to determine whether the atlas was relevant to subSaharan Africa, we compared skeletal age, according to the atlas, with chronological age in 139 skeletally immature Malawian children and young adults with an age range from 1 year 11 months to 28 years 5 months. The height and weight of each patient were also measured in order to calculate the body mass index. The skeletal age of 119 patients (85.6%) was lower than the chronological age. The mean difference was 20.0+/-24.1 months (t-test, p = 0.0049), and the greatest difference 100 months. The atlas is thus inaccurate for this group of children. The body mass index in 131 patients was below the normal range of 20 to 25 kg/m2. The reasons for the low skeletal age in this group of children are discussed. Poor nutrition and chronic diseases such as malaria and diarrhoea which are endemic in Malawi are likely to be contributing factors. We did not find any correlation between the reduction in body mass index in our patients and the degree of retardation of skeletal age.
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Harrison WJ, Lewis CP, Lavy C. External fixation in HIV-positive patients with open fractures. Malawi Med J 2001; 13:36. [PMID: 27528902 PMCID: PMC3345402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
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Lewis CP, Lavy C, Harrison WJ. How safe is internal fixation in the immune compromised patient? Malawi Med J 2001; 13:39. [PMID: 27528904 PMCID: PMC3345391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
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Mackay DC, Harrison WJ, Bates JH, Dickenson D. Audit of deep wound infection following hip fracture surgery. JOURNAL OF THE ROYAL COLLEGE OF SURGEONS OF EDINBURGH 2000; 45:56-9. [PMID: 10815382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
An audit of 171 consecutive hip fractures treated surgically showed a deep wound infection rate of 3.6%. Several shortcomings in the implementation of the infection policy were identified and recommendations to eliminate them introduced. Review of the subsequent 186 patients gave a deep infection rate of 1.1%. Attention to detail and good practice are essential to maintain low wound infection rates.
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Harrison WJ, Rankin KC. Osteogenesis imperfecta in Zimbabwe: a comparison between treatment with intramedullary rods of fixed-length and self-expanding rods. JOURNAL OF THE ROYAL COLLEGE OF SURGEONS OF EDINBURGH 1998; 43:328-32. [PMID: 9803105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The results of surgical treatment of 15 children with osteogenesis imperfecta in Bulawayo, Zimbabwe are reviewed. A total of 23 self-expanding and 27 fixed-length rods were used. Outcome was measured in terms of mobility status, growth, incidence of refracture, need for reoperation, and complications. Eight of the children improved their mobility status over the course of treatment. Self-expanding rods appeared to confer more benefit to growth than fixed-length rods. Refracture was more common in bones splinted with fixed-length rods and more often necessitated revision surgery in these bones. The complication rate was high in all cases, but the complications associated with outgrown fixed-length rods were a particular problem. The 15 children benefited from surgical treatment. The self-expanding rods performed better than fixed-length rods in reducing the number of surgical interventions. They also appear to facilitate growth. The self-expanding rods may be used to good effect in appropriate centres in the developing world.
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Harrison WJ, Willis RG, Neal DE. Adverse reactions to tiaprofenic acid mimicking interstitial cystitis. BMJ (CLINICAL RESEARCH ED.) 1994; 309:574. [PMID: 8086944 PMCID: PMC2541417 DOI: 10.1136/bmj.309.6954.574] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Barton AJ, Harrison PJ, Najlerahim A, Heffernan J, McDonald B, Robinson JR, Davies DC, Harrison WJ, Mitra P, Hardy JA. Increased tau messenger RNA in Alzheimer's disease hippocampus. THE AMERICAN JOURNAL OF PATHOLOGY 1990; 137:497-502. [PMID: 2119143 PMCID: PMC1877517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The microtubule-associated protein tau is present in the pathologic hallmarks of Alzheimer's disease and its production and deposition have been implicated in the pathogenesis of the disease. We detected tau mRNA using in situ hybridization histochemistry in the hippocampus, visual cortex, and cerebellum, and compared its level in Alzheimer's disease with controls. The amount of tau mRNA also was determined as a ratio of total polyadenylated mRNA in each area. A significant and gene-specific increase in tau mRNA hybridization was found in hippocampal fields CA4 and CA3, with a similar trend in the dentate gyrus. In contrast, no change was found in the visual cortex or cerebellum in Alzheimer's disease. Increased hippocampal expression of tau mRNA also was present in cases of non-Alzheimer's dementia. Enhanced tau mRNA may be a marker of attempted plasticity involving the cytoskeleton in neuronal populations affected by various neurodegenerative disorders.
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Abstract
Geological processes of fluid transport and chemical reaction in sedimentary basins have formed many of the earth's energy and mineral resources. These processes can be analyzed on natural time and distance scales with the use of supercomputers. Numerical experiments are presented that give insights to the factors controlling subsurface pressures, temperatures, and reactions; the origin of ores; and the distribution and quality of hydrocarbon reservoirs. The results show that numerical analysis combined with stratigraphic, sea level, and plate tectonic histories provides a powerful tool for studying the evolution of sedimentary basins over geologic time.
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Mehta AB, Evans JP, Kumaran TO, Yin JA, Jarvis KJ, Harrison WJ, Matthews EM, Marsh GW. Non-Hodgkin's lymphoma: a survey from a district general hospital. Clin Radiol 1986; 37:183-6. [PMID: 3698506 DOI: 10.1016/s0009-9260(86)80396-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
We report a retrospective survey of 167 patients with non-Hodgkin's lymphoma (NHL) seen at a district general hospital between 1 August 1971 and 1 August 1983. Details of their clinical presentation, histology, therapy, response rates and survival are presented. The patient population reported is generally older than that seen at specialist centres and has a greater proportion of tumours with low-grade histology. Whereas specialist centres see a pre-selected population of patients, our data may be from a more representative group and this gives a truer incidence of this disease in the general population. The remission rates and overall survival of our patients are comparable to those achieved at specialist centres. We conclude that it is both feasible and desirable for patients with NHL to be assessed and treated in a district general hospital with a radiotherapy department.
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Corrin B, Harrison WJ, Wright DH. The so-called intravascular bronchioloalveolar tumour of lung (low grade sclerosing angiosarcoma): presentation with extrapulmonary deposits. DIAGNOSTIC HISTOPATHOLOGY 1983; 6:229-37. [PMID: 6426909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Two further cases of the so-called intravascular bronchioloalveolar tumour of lung are reported. Electron microscopic demonstration of Weibel-Palade bodies and immunocytochemical demonstration of factor VIII in the cytoplasm of the tumour cells indicate the vascular nature of these lesions. One patient presented with an enlarged liver and the tumour was found to be involving the liver and parietal pleura as well as the lung. The characteristic micropolypoid structure was not seen in the pleural or hepatic deposits and it is evident that this feature is a consequence of the alveolar architecture of the lung and is not an inherent property of the tumour.
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Harrison WJ. New consultant contract. West J Med 1978. [DOI: 10.1136/bmj.2.6131.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Thorley CM, McC Calder HA, Harrison WJ. Recognition in Great Britain of Bacteroides nodosus in foot lesions of cattle. Vet Rec 1977; 100:387. [PMID: 878236 DOI: 10.1136/vr.100.18.387] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Abstract
Routine detailed gastroenterological investigations were performed in a series of 47 ankylosing spondylitics. Evidence of chronic inflammatory bowel disease was found in eight patients, a prevalence of 17%. Unsuspected bowel disease was found in the absence of symptoms in three of these patients.
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Jones JV, Harrison WJ. Depression of delayed hypersensitivity: a new hypothesis. Arch Dis Child 1969; 44:545. [PMID: 5803658 PMCID: PMC2020134 DOI: 10.1136/adc.44.236.545-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Harrison WJ. Out-of-focus images; some properties, uses, and a geometrical explanation. APPLIED OPTICS 1967; 6:1559-1561. [PMID: 20062259 DOI: 10.1364/ao.6.001559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Out-of-focus images tend to move and split when obstructions are passed through or near the nodal planes of the image forming lens, while in-focus images do not show such effects. Geometrical optics is used to produce a qualitative explanation of these effects with the object of utilizing them for automatic focusing and rangefinding devices. Several problems in such devices are briefly discussed and a proposed automatic rangefinder is described.
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Brzechwa-Ajdukiewicz A, McCarthy CF, Austad W, Cornes J, Harrison WJ, Read AE. Carcinoma, villous atrophy, and steatorrhoea. Gut 1966; 7:572-7. [PMID: 5957507 PMCID: PMC1552634 DOI: 10.1136/gut.7.6.572] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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50
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Harrison WJ. Complete Stapes thrown off during Chronic Suppurative Otitis Media, ? Tuberculosis. Proc R Soc Med 1934; 27:899-900. [PMID: 20914199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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