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Biomedical subjects

N Wilson

Publications and source records attributed to N Wilson.

At least 19 recordsLinked to original sources
PubMed2006

Volar lunate dislocation associated with a Salter-Harris Type III fracture of the distal radial epiphysis in an 8 year-old child.

Carpal fracture-dislocations in children are extremely rare injuries and are easily missed or misdiagnosed. An 8 year-old boy who presented with a volar lunate dislocation associated with a Salter Harris Type III injury of the distal radial epiphysis is reported. Open reduction without internal fixation followed by plaster immobilisation achieved good short-term results.

Casts, Surgical↗
PubMed2006

Dosimetric and treatment planning considerations for radiotherapy of the chest wall.

Radiotherapy treatment planning calculations of the chest wall are complex due to missing tissue, the thin chest wall and the presence of lung. The accuracy of calculated dose is dependent on the type of algorithm employed. This work evaluates a collapsed cone (CC) and a pencil beam (PB) convolution model for radiotherapy planning of the chest wall. Various irradiation geometries simulating the chest wall have been examined and calculations were compared with measurements with an ionization chamber in epoxy resin water substitute and in low-density lung substitute blocks. A retrospective treatment planning study comprising 6 patients was carried out to evaluate the differences in the dose distributions and monitor units predicted by the two algorithms. The calculated dose in unit density medium was within +/-1% for the CC model and up to +/-2% for PB. In low density medium and under full scatter conditions, CC overestimated the dose by 1% whereas PB overestimated the dose by 9%. In the tangential irradiation geometry with water and lung media, the PB overestimated dose to the isocentre by up to 10%, whereas the dose from CC was within 3%. From the treatment planning study calculated monitor units (MU) and doses were consistent with the experimental findings. The CC model is more accurate for radiotherapy treatment planning of the chest wall and especially when there is significant involvement of lung tissue.

Algorithms↗
PubMed2005

Risk factors for mold in housing: a national survey.

UNLABELLED: A national random telephone survey was undertaken to determine the prevalence of reported mold in New Zealand houses and the risk factors for it. A total of 613 households provided responses. Mold in one or more rooms was reported by 35.1% of respondents in the sample. House design and construction factors that were independently associated with reported mold in the multivariate analysis included: poorer house condition, older house age (>22 years), relative lack of sun exposure, and having no insulation (e.g. for poorer house condition: odds ratio=1.97, 95% CI=1.25, 3.11). Univariate analyses also showed increased risk associated with high locality rainfall, and living in the most northern part of the country. The number of residents was significantly associated with reported mold in the multivariate analysis as were various behaviors in the univariate analysis (i.e. frequency of baths, showering and clothes washing). The high prevalence of unflued gas heating (32.9%) found in this sample is of potential concern given the potential respiratory hazards. Although this survey has a number of limitations, it does suggest that there are a number of potentially modifiable risk factors for mold that could be reduced by a range of policy responses. PRACTICAL IMPLICATIONS: While further research is desirable, the available evidence associated with the health and other adverse impacts of both mold and dampness would favor additional policy responses by government. These could include changes to regulations around housing design including house position, access to sunlight, and level of insulation. The extension of low interest loans for insulation or subsidized installation can help to increase its level of use. Restrictions on the sales of unflued gas heaters could also be considered. A mass media campaign could also be used to inform the population of the readily modifiable risk factors for mold growth and dampness.

Adolescent↗
PubMed2005

Deaths from international terrorism compared with road crash deaths in OECD countries.

OBJECTIVE: To estimate the relative number of deaths in member countries of the Organisation for Economic Co-operation and Development (OECD) from international terrorism and road crashes. METHODS: Data on deaths from international terrorism (US State Department database) were collated (1994-2003) and compared to the road injury deaths (year 2000 and 2001 data) from the OECD International Road Transport Accident Database. RESULTS: In the 29 OECD countries for which comparable data were available, the annual average death rate from road injury was approximately 390 times that from international terrorism. The ratio of annual road to international terrorism deaths (averaged over 10 years) was lowest for the United States at 142 times. In 2001, road crash deaths in the US were equal to those from a September 11 attack every 26 days. CONCLUSIONS: There is a large difference in the magnitude of these two causes of deaths from injury. Policy makers need to be aware of this when allocating resources to preventing these two avoidable causes of mortality.

Accidents, Traffic↗
PubMed2005

The effectiveness of television advertising campaigns on generating calls to a national Quitline by Māori.

OBJECTIVE: To examine the effectiveness of four mass media campaigns on calls to a national Quitline by Māori (the indigenous people of New Zealand). METHODS: Monthly Quitline call data and calls within one hour of a television commercial (TVC) being shown were analysed for the 2002-2003 period. Data on target audience rating points (TARPs) and expenditure on TVCs were also used (n = 2319 TVC placements). RESULTS: Māori were found to register with the Quitline at higher rates during the most intense six campaign months (15% more registrations compared to less intense months). The most effective campaign generated 115 calls per 100 TARPs by Māori callers within one hour of TVC airing (the "Every cigarette" campaign). A more Māori orientated campaign with both health and cultural themes generated 91 calls per 100 TARPs from Māori callers. For these two campaigns combined, the advertising cost per new registration with the Quitline by a Māori caller was NZD 30-48. Two second hand smoke campaigns that did not show the Quitline number were much less effective at 25 and 45 calls per 100 TARPs. CONCLUSIONS: These television advertising campaigns were effective and cost effective in generating calls to a national Quitline by Māori. Health authorities should continue to explore the use of both "threat appeal" style media campaigns and culturally appropriate campaigns to support Quitline use by indigenous peoples.

Adult↗
PubMed2005

Random urine calcium/osmolality in the assessment of calciuria in children with decreased muscle mass.

BACKGROUND: Random urine Ca/creatinine (UCa/Cr) is used to estimate 24-hour Ca excretion. However, due to decreased urine creatinine excretion in children with decreased muscle mass (DMM), UCa/Cr overestimates their Ca excretion. OBJECTIVE: To evaluate whether in children with DMM random urine Ca/osmolality (UCa/Osm) can accurately predict hypercalciuria (24-hour urine Ca > 4.0 mg/kg) and at which "cutoff" value. METHODS: 19 children with DMM and 29 with normal muscle mass (NMM), ages 6 - 17 years, were studied. DMM was diagnosed based on clinical findings and decreased serum creatinine, and confirmed by low urine creatinine excretion. Over 24 hours, subjects collected each void separately. After each sample was analyzed, samples of each participant were combined to form a 24-hour specimen from which an aliquot (AL) was obtained; 24-hour urine Ca was first correlated with the corresponding AL Ca/Cr and Ca/Osm. As an internal control, a similar assessment ofproteinuria was conducted. In the next step, AL data were compared with individual urine samples to identify the time of day when a random sample best correlates with AL. RESULTS: The correlation coefficient between 24-hour Ca and AL Ca/Cr in all children was 0.61, in NMM 0.96, and in DMM 0.69 (in all p < 0.001). The correlation coefficient between 24-hour urine Ca and AL Ca/Osm in all children was 0.90, in NMM 0.90, and in DMM 0.91 (in all p < 0.001). In children with DMM, the correlation coefficient of 24-hour protein with AL protein/Cr was 0.75, and with protein/Osm 0.98 (both p < 0.001). Receiver operating characteristic curves showed UCa/Cr as a better predictor of 24-hour Ca > 4.0 mg/kg in NMM, whereas UCa/Osm was a better predictor of hypercalciuria in DMM patients. In NMM, UCa/Cr ratio > 0.20 had sensitivity of 88% and specificity of 96% in detecting 24-hour Ca > 4.0 mg/kg, whereas in those with DMM UCa/Osm (x 10) ratio of > 0.25 had sensitivity of 100% and specificity of 93% in detecting hypercalciuria. It was further found that random urine specimens collected between 9:00 a.m. and 2:00 p.m. best represented 24-hour urine data. CONCLUSION: In children with DMM, UCa/Osm can successfully replace UCa/Cr as a screening tool for hypercalciuria.

Adolescent↗
PubMed2004

How much downside? Quantifying the relative harm from tobacco taxation.

OBJECTIVE: To estimate the loss of life expectancy attributable to tobacco taxation (via financial hardship and flow-on health effect) in New Zealand. DESIGN: Data were used on the gradients in life expectancy and smoking by neighbourhood socioeconomic deprivation and survey data on tobacco expenditure. Three estimates were modelled of the percentage of the crude association of neighbourhood deprivation with life expectancy that might be mediated via financial hardship: 100%, 50%, and 25% (best estimate). From this information the impact of tobacco taxation on life expectancy was estimated. MAIN RESULTS: For the total population, the estimated loss of life expectancy due to tobacco tax ranged from 0.005 years to 0.027 years. For people living in the most deprived 30% of neighbourhoods, the range was 0.009 to 0.044 years (that is, 3 to 16 days of lost life expectancy). For the total population the loss of life expectancy attributable to tobacco tax ranged from 119 to 460 times less than that attributable to deprivation. The loss of life expectancy attributable to tobacco tax was 42 to 257 times less than that attributable to smoking. CONCLUSIONS: The estimated harm to life expectancy from tobacco taxation (via financial hardship) is orders of magnitude smaller than the harm from smoking. Although the analyses involve a number of simplistic assumptions, this conclusion is likely to be robust. Policy makers should be reassured that tobacco taxation is likely to be achieving far more benefit than harm in the general population and in socioeconomically deprived populations.

Aged↗
PubMed2004

The decline of smoking in British portraiture.

OBJECTIVE: To examine time trends in the portrayal of smoking in a national collection of portraiture and to compare this with the similar trends for television and film. METHODS: A compact disc produced by the National Portrait Gallery in London, UK, was systematically searched for artworks produced in the years 1950 to 1999. A "smoking portrayal" in an artwork was defined as having a cigarette, cigar or pipe in the mouth or hand of a named individual. RESULTS: Out of 1063 artworks included in the analysis, 53 portrayed smoking by identifiable individuals (5.0%). The rate of portrayal was highest in the 1950s (10%) and 1960s (11%) and then declined sharply thereafter (p value for trend < 0.00001). Smoking virtually disappeared from portraiture in the 1990s (at 0.6%). The median age of the smokers portrayed was significantly higher in the 1970 to 1999 period when compared to the 1950 to 1969 period. CONCLUSIONS: The decline of smoking in this collection of portraiture is consistent with the decline in smoking in the UK over these decades, but contrasts with trends for increasing smoking portrayal described elsewhere for film and television.

Art↗
PubMed2003

High incidence of Haemophilus influenzae type b infection in children in Pacific island countries.

The Haemophilus influenzae type b (Hib) disease burden among children <5 years old in 4 Pacific island countries (PICs) was estimated. The incidence of confirmed Hib meningitis was calculated using the numbers of culture-confirmed isolates. In addition, the World Health Organization (WHO) Hib Rapid Assessment Tool (RAT) was used to estimate the true Hib meningitis incidence and the number of Hib meningitis and pneumonia cases, as well as the number of deaths due to Hib meningitis and pneumonia. The Hib meningitis annual incidence in 3 PICs was 70-84 cases per 100,000 children <5 years old. For PICs, the RAT is likely to overestimate the Hib pneumonia burden, as it assumes a 5 : 1 ratio of Hib pneumonia to Hib meningitis. The true ratio is likely to be 1 : 1. The high Hib disease burden and the relative cost-effectiveness of Hib vaccine make the introduction of Hib vaccine a good investment for PICs, costing US1000 dollars-US10,000 dollars for each death prevented--a number that ignores savings from reductions in the cost of treatment.

Bacterial Capsules↗
PubMed2003

Fractured neck of femur in the mobile independent elderly patient: should we treat with total hip replacement?

PURPOSE: To report the outcome of displaced sub-capital neck of femur fractures in the independent elderly (>70 years) managed with total hip arthroplasty through a modified Hardinge approach. METHODS: Between 1998 and 2000, a surgeon performed a cemented hip replacement using a modified lateral approach in 36 consecutive patients in the Hawke's Bay Regional Hospital, Hastings. Medical charts and out-patient follow-up clinic records were reviewed with respect to outcomes, with particular reference to complications. Independent review of functional outcome was completed at one year postsurgery using a questionnaire. RESULTS: At an average follow-up of 1.8 years (range, 1-3 years), no patient needed further surgery. One patient had died, giving a mortality rate at one year of 2.9%. All other medical complications were successfully treated. The overall prevalence of early medical complications was 43%. There were no dislocations, and 80% of patients had a good clinical outcome at their first follow-up. CONCLUSION: The modified lateral approach of Hardinge minimises the incidence of postoperative dislocation. However, there was a high incidence of medical complications and aggressive treatment of such complications was necessary, both preoperatively and postoperatively. The number of pre-existing medical conditions was a significant factor influencing patient morbidity.

Activities of Daily Living↗
PubMed2003

Health seeking behaviour of tuberculosis patients--role of the private practitioner.

India accounts for nearly 30% of the global tuberculosis burden. The goal of the Revised National TB Control Programme (RNTCP) is to cure at least 85% of new smear positive cases of TB and detect at least 75% of such patients. There are many reasons for patient delaying seeking healthcare. A Private Practitioner plays a major role in combating the disease but unfortunately the doctor-delay is more than patient-delay. Still patients seem to prefer Private Practitioners and they are often the first point of contact for a significant number of patients with TB.

Communicable Disease Control↗
PubMed2002

Fatal Kawasaki disease caused by early occlusive coronary artery disease.

In Kawasaki disease severe coronary artery narrowing may develop at an early stage despite treatment with gammaglobulin and in the absence of prominent aneurysm formation or thrombosis. Vaso-occlusive disease may not be clinically or echocardiographically apparent until very severe.

Child, Preschool↗