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Biomedical subjects

Helen Young

Publications and source records attributed to Helen Young.

7 recordsLinked to original sources

Complications associated with the use of a titanium tibial nail.

Intramedullary nailing is the treatment of choice for unstable or displaced tibial fractures. Titanium nails have been advocated for their improved biocompatibility and biomechanical properties but concerns are held about increased complications. We present results of 225 tibial fractures in 221 patients (90% follow-up) treated with the ACE titanium tibial nail (DePuy International Limited, Leeds, UK) inserted between 1995 and 2003 in one hospital department, which show no increased complications compared with the published literature. Eighty-two percent of the patients were male with a median age of 33 years. The mechanism of injury was RTA (52%), Sport (22%) and other (26%). Forty-one percent of the fractures were open. The general complication rate represents the published literature whereas only 32% patients developed knee pain compared with the 40-57% previously reported. Median union time was unaffected by open injury, reaming or age. Ninety (43.3%) patients required re-operation of which 23 (11%) had a second re-operation. In total 43 (20.7%) nails were removed, without any complication as previously reported for this nail.

Adolescent↗

Quantitative contrast-enhanced computed tomography: is there a need for system calibration?

The purpose of the study was to perform phantom studies to assess the impact of computed tomography (CT) system variability on quantitative measurements of contrast enhancement. A phantom containing tubes of contrast material at dilutions of 120, 1:35, 1:50, 1:100 and 1:200 arranged in air or water was imaged using 11 CT systems at 9 institutions. All systems had undergone routine calibration against air and water in accordance with the manufacturers' recommendations. For a given tube voltage, the relationship between the iodine concentration and CT attenuation value on a single system varied by 17 to 24% over 46-48 weeks. The coefficients of variance for iodine calibration factors across different CT systems were 8.9% in air and 5.1% in water. Calibration of individual CT systems for iodine response is required to allow comparison of quantitative measurements of contrast enhancement across different institutions. Using the iodine calibration factor to express contrast enhancement as iodine concentration would facilitate the universal application of diagnostic enhancement thresholds, especially if the necessary calculations were performed by software installed on the CT console.

Calibration↗

Helen Young.

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History, 21st Century↗

Evidence for common genetic control in pathways of inflammation for Crohn's disease and psoriatic arthritis.

OBJECTIVE: Clinical, pharmacologic, and epidemiologic evidence supports the hypothesis that common genetic pathways may underlie inflammatory diseases. In a previous study, a Crohn's disease gene, CARD15, was demonstrated to be associated with psoriatic arthritis (PsA). Recently, a functional haplotype of 2 single-nucleotide polymorphisms (SNPs) mapping to the organic cation transporter (OCTN) genes, SLC22A4 and SLC22A5, was identified as a second Crohn's disease susceptibility locus. The SLC22A4 gene has also been associated with rheumatoid arthritis. This study was undertaken to further elucidate associations of PsA with Crohn's disease susceptibility genes. METHODS: Association with CARD15 and OCTN was investigated in UK Caucasian patients with PsA (n = 472) and population controls (n = 594), using 5' allelic discrimination assays (TaqMan). Two SNPs in OCTN, forming a haplotype previously associated with Crohn's disease, were also tested in patients with psoriasis (n = 218) and patients with early undifferentiated inflammatory arthritis (n = 386). Allele and estimated haplotype frequencies were compared between patients and controls. RESULTS: No association of PsA with CARD15 was detected. In contrast, a functional SNP mapping to the promoter region of SLC22A5 (rs2631367) was associated with PsA (for CC versus GG, odds ratio 1.65, 95% confidence interval 1.13-2.41, uncorrected P = 0.005). In addition, the haplotype associated with Crohn's disease was also associated with PsA (P = 0.001). No association was detected in the cohort with psoriasis alone or in the cohort with undifferentiated inflammatory arthritis. CONCLUSION: The OCTN haplotype previously associated with Crohn's disease is also associated with PsA, suggesting that these 2 diseases may share some common genetic control in pathways of inflammation.

Adolescent↗

Linking rights and standards: the process of developing "rights-based" minimum standards on food security, nutrition and food aid.

This article examines the recent revision of the Sphere Minimum Standards in disaster response relating to food security, nutrition and food aid. It describes how the revision attempted to incorporate the principles of the Humanitarian Charter, as well as relevant human rights principles and values into the Sphere Minimum Standards. The initial aim of the revision was to ensure that the Sphere Minimum Standards better reflected the principles embodied in the Humanitarian Charter. This was later broadened to ensure that key legal standards and principles from human rights and humanitarian law were considered and also incorporated, in part to fill the "protection gap" within the existing standards. In relation to the food security, nutrition and food aid standards, it was agreed by participants in the process that the human right to adequate food and freedom from hunger should be incorporated. In relation to more general principles underlying the Humanitarian Charter, itself drawn largely from human rights and humanitarian law, it was agreed that there was a need to strengthen "protection" elements within the standards and a need to incorporate the basic principles of the right to life with dignity, non-discrimination, impartiality and participation, as well as to explore the relevance of the concept of the progressive realisation of the right to food. The questions raised in linking rights to operational standards required thought, on the one hand, about whether the technical standards reflected a deep understanding of the values expressed within the legal instruments, and whether the existing standards were adequate in relation to those legal rights. On the other hand, it also required reflection on how operational standards like Sphere could give concrete content to human rights, such as the right to food and the right to be free from hunger. However, there remain challenges in examining what a rights-based approach will mean in terms of the role of humanitarian agencies as duty-bearers of rights, given that the primary responsibility rests with state governments. It will also require reflection on the modes and mechanisms of accountability that are brought to bear in ensuring the implementation of the Minimum Standards.

Altruism↗

Neurofibromatosis 1: clinical review and exceptions to the rules.

Neurofibromatosis 1 is an autosomal dominant, multisystem disorder with myriad clinical manifestations. Between 1991 and 1998, 495 adults and children were diagnosed with neurofibromatosis 1 at a specialized neurogenetics clinic in Sydney, Australia. This review establishes the prevalence of the clinical manifestations of neurofibromatosis 1 in these patients and provides guidelines for assessment and management. In addition, we review in detail patients who had unusual presentations and who represent important "exceptions to the rules" of clinical practice.

Adolescent↗

Public nutrition in complex emergencies.

Public nutrition is a broad-based, problem-solving approach to addressing malnutrition in complex emergencies that combines analysis of nutritional risk and vulnerability with action-oriented strategies, including policies, programmes, and capacity development. This paper focuses on six broad areas: nutritional assessment, distribution of a general food ration, prevention and treatment of moderate malnutrition, treatment of severe malnutrition in children and adults, prevention and treatment of micronutrient deficiency diseases, and nutritional support for at-risk groups, including infants, pregnant and lactating women, elderly people, and people living with HIV. Learning and documenting good practice from previous emergencies, the promotion of good practice in current emergencies, and adherence to international standards and guidelines have contributed to establishing the field of public nutrition. However, many practical challenges reduce the effectiveness of nutritional interventions in complex emergencies, and important research and programmatic questions remain.

Africa↗