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Biomedical subjects

P Gibbons

Publications and source records attributed to P Gibbons.

At least 19 recordsLinked to original sources
PubMed2006

The stability of the femoral component of a minimal invasive total hip replacement system.

In this study, the initial stability of the femoral component of a minimal invasive total hip replacement was biomechanically evaluated during simulated normal walking and chair rising. A 20 mm diameter canal was created in the femoral necks of five fresh frozen human cadaver bones and the femoral heads were resected at the smallest cross-sectional area of the neck. The relatively short, polished, taper-shaped prostheses were cemented centrally in this canal according to a standardized procedure. A servohydraulic testing machine was used to apply dynamic loads to the prosthetic head. Radiostereophotogrammetric analysis was used to measure rotations and translations between the prosthesis and bone. In addition, the reconstructions were loaded until failure in a static, displacement-controlled test. During the dynamic experiments, the femoral necks did not fail and no macroscopical damage was detected. Maximal values were found for normal walking with a mean rotation of about 0.2 degrees and a mean translation of about 120 microm. These motions stabilized during testing. The mean static failure load was 4714 N. The results obtained in this study are promising and warrant further development of this type of minimal invasive hip prosthesis.

Arthroplasty, Replacement, Hip↗
PubMed2004

Cleft sternum: case report and literature review.

The isolated sternal cleft is a rare congenital anomaly that presents from birth to adulthood. We describe the late presentation and management in a child with this condition. The modern investigative and operative options are reviewed.

Bone Transplantation↗
PubMed2001

Patient positioning and spinal locking for lumbar spine rotation manipulation.

High velocity low amplitude (HVLA) thrust techniques are widely used by many manual therapists to treat low back pain. There is increasing evidence that spinal manipulation produces positive patient outcomes for acute low back pain. HVLA thrust techniques are associated with an audible release in the form of a pop or cracking sound that is widely accepted to represent cavitation of a spinal zygapophyseal joint. This audible release distinguishes these techniques from other manual therapy interventions. When using long lever HVLA thrust techniques spinal locking is necessary to localize forces and achieve cavitation at a specific vertebral segment. A critical factor in applying lumbar spine manipulation with minimal force is patient positioning and spinal locking. A knowledge of coupled movements of the lumbar spine aids an understanding of the patient positioning required to achieve spinal locking consistent with maximal patient comfort and cooperation. Excessive rotation can result in pain, patient resistance and failed technique. This masterclass presents a model of patient positioning for the lumbar spine that minimizes excessive use of rotation to achieve spinal locking prior to the application of the thrust.

Contraindications↗
PubMed2000

Inter-examiner and intra-examiner agreement for assessing sacroiliac anatomical landmarks using palpation and observation: pilot study.

Despite the paucity of research into the reliability of static palpation, it is still employed extensively as a diagnostic tool by manual medicine practitioners. This study tested the inter- and intra-examiner agreement of ten senior osteopathic students using static palpation on ten asymptomatic subjects. Four assessments of the posterior superior iliac spine (PSIS), sacral sulcus (SS), and the sacral inferior lateral angle (SILA) on every subject by all examiners resulted in 1200 assessments in total. Kappa (Kg) yielded intra-examiner agreement that ranged between less-than-chance to substantial for the SILA (Kg=-0.05 to 0.69; mean Kg=0.21), and slight to moderate for the PSIS (Kg=0.07 to 0.58; mean Kg=0.33) and the SS (Kg=0.02 to Kg=0.60; mean Kg=0.24), with 50% significant beyond the 0.05 level. Inter-examiner agreement was slight (PSIS Kg=0.04; SILA Kg=0.08; SS Kg=0.07) and significant at the 0.01 level. Intra-examiner agreement was greater than inter-examiner agreement, which was consistent with existing palpation reliability studies. The poor reliability of clinical tests involving palpation may be partially explained by error in landmark location.

Adolescent↗
PubMed1999

Inter-examiner and intra-examiner reliability of the standing flexion test.

The practice of musculoskeletal medicine requires the use of a wide variety of clinical examination procedures to establish a diagnosis, plan treatment, and monitor patient progress. Many of these examination procedures constitute a significant part of daily practice. Despite their extensive use, the reliability and validity of many of these assessment procedures remains questionable. The aim of this study was to determine the inter- and intra-examiner reliability of palpatory findings for the standing flexion test; one test for sacroiliac joint (SIJ) dysfunction. Nine examiners performed the standing flexion test on nine asymptomatic subjects. Inter-examiner reliability data, with a mean percentage agreement of 42% and a kappa coefficient of 0.052, demonstrated statistically insignificant reliability. Intra-examiner reliability data demonstrated a mean percentage agreement of 68% and a kappa coefficient of 0.46 indicating moderate reliability. These results suggest that the reliability of the standing flexion test as an indicator of SIJ dysfunction still remains questionable. Before this test can be relied upon as an accurate indicator of SIJ dysfunction it must undergo further research. This research must not only further standardize the procedure, but also ascertain reliability and validity.

Adult↗
PubMed1997

Guilty but insane: the insanity defence in Ireland, 1850-1995.

BACKGROUND: This is a retrospective study describing sociodemographic and clinical characteristics of an almost complete sample of insanity acquittees in Ireland between 1850-1995. METHOD: Case records and legal files were examined for each of the 437 patients admitted to the Central Mental Hospital under guilty but insane criteria, and a profile of sociodemographic, forensic and clinical data completed in each. RESULTS: The number of insanity acquittees has fallen five-fold since the 19th century. Acquittees were usually single males from rural areas, aged in their 30s, who had committed a violent crime while suffering from a major psychiatric illness. Female insanity acquittees were relatively few in number and were equally likely to have been charged with violent crime, especially against their own children. The mean length of detention was 14.5 years. CONCLUSIONS: The insanity defence is rarely used in Ireland, is largely confined to serious offences (especially homicide), and generally results in prolonged detention.

Crime↗
PubMed1997

A study of aggression among referrals to a community-based psychiatry of old age service.

OBJECTIVE: The aims of the study were to examine the prevalence of aggressive behaviour in a non-selected community-based population, to identify clinical and sociodemographic variables associated with aggression and to examine the relationship between aggression and outcome at 2-year follow-up. DESIGN: Case series, using the Ryden Aggression Scale as a retrospective measure of aggression. SETTING: A community-based specialist psychiatry of old age service. PARTICIPANTS: All referrals to the service over a 3-month period. RESULTS: Of the 42 subjects included in the study, 25-patients had a diagnosis of dementia. Aggressive behaviour was reported in 18 patients, this being verbal only in nine cases and both verbal and physical in nine cases. Sexual aggression and self-injurious behaviour were each reported in one case only. Aggression was found to be positively associated with a diagnosis of dementia and high physical dependency but was not found to be associated with age, sex, physical illness or the use of psychotropic medication. At 2-year follow-up, aggressive patients were found to have a higher rate of admission to psychiatric inpatient or residential care and tended to have a higher use of neuroleptic drugs. CONCLUSIONS: These findings suggest that aggression is a significant problem for community-based elderly people and their carers, may increase the likelihood of admission into long-term care and that a reliable instrument to measure aggression would be useful in the clinical assessment of this population.

Adult↗
PubMed1994

Five-year follow-up study of the fat clearance technique in colorectal carcinoma.

PURPOSE: The aim of our study was to determine the five-year survival of patients with colorectal carcinoma whose Dukes classification had changed following fat clearance of the mesocolon or mesorectum. METHODS: One hundred three patients with colorectal carcinoma were followed up at a special clinic for at least five years after surgery. The tumors from these patients had previously been given a Dukes classification before and after fat clearance. RESULTS: Four of the five patients whose Dukes status changed from B to C as a result of fat clearance died of malignant disease during the five-year follow-up period. After fat clearance it was apparent that Dukes B patients survived, on average, 11 months longer than Dukes C patients. A significantly increased mean number of positive nodes was found after fat clearance in Dukes C cases, both in those who were alive at five years and those who died of their malignant disease. CONCLUSIONS: The fat clearance technique is a useful aid to improving the accuracy of the Dukes classification and has prognostic significance. It should be used in specimens of colorectal carcinoma, which on initial examination appear to be Dukes B cases.

Colorectal Neoplasms↗
PubMed1994

Mechanisms of recovery of swallow after supraglottic laryngectomy.

This study examines oropharyngeal swallow disorders and measures of pharyngeal and laryngeal movement during deglutition from videofluorographic studies of oropharyngeal swallow in 9 patients who had undergone supraglottic laryngectomy and 9 age-matched normal subjects. The swallows of surgical patients were examined at 2 weeks and 3 months postoperatively. Two critical factors in recovery of swallowing were identified: (a) airway closure at the laryngeal entrance, that is, the space between the arytenoid cartilage and the base of the tongue, and (b) the movement of the tongue base to make complete contact with the posterior pharyngeal wall. When patients achieved these two functions, they returned to normal swallowing. The duration of tongue base contact to the posterior pharyngeal wall and extent of anterior movement of the arytenoid increased significantly from 2 weeks to 3 months in the surgical patients. At 2 weeks postsurgery, patients who had undergone supraglottic laryngectomy exhibited significantly shorter airway closure and tongue base to pharyngeal wall contact, reduced laryngeal elevation, increased width of cricopharyngeal (CP) opening, and later onset of airway closure and tongue base movement than normal subjects. These significant differences remained at 3 months postoperatively, although swallow measures were moving toward normal in the patients who had undergone supraglottic laryngectomy. Comparison of patients not eating at 2 weeks with patients at the time of first eating revealed significantly longer duration of tongue base contact to the pharyngeal wall, longer duration of airway closure, and greater movement of the arytenoid in patients who were eating. Results indicate that the focus of swallowing therapy after supraglottic laryngectomy should be on improvement of posterior movement of the tongue base and anterior tilting of the arytenoid to close the airway entrance and improve bolus propulsion (in the case of the tongue base).

Barium Sulfate↗
PubMed1992

Food intake by maneuver; an extreme compensation for impaired swallowing.

We report two young patients able to exist on exclusively oral intake despite an absent pharyngeal swallow response. Videofluoroscopic swallowing studies showed that both patients used a sequence of devised maneuvers rather than a coordinated pharyngeal swallow to move the bolus, protect the airway, and open the upper esophageal sphincter during bolus ingestion. We conclude that it is possible for young, highly motivated individuals to maintain oral intake despite ablation of neurologic elements crucial for the normal swallow response.

Adolescent↗
PubMed1992

Committal procedures in Ireland.

The study aims to describe current committal practice in an Irish public psychiatric service and to establish the role of 'dangerousness' in determining practice. A six month retrospective review was undertaken using casenotes and original temporary forms of all patients committed to St Brendan's Hospital, Dublin within a six month period in 1990. A total of 136 cases were examined. In 65% of cases the application for detention was initiated by a spouse or relative. The recommending physician was identified as a General Practitioner in 80% of cases, although most were locum GP's. The number of male and female patients were almost equal. There was a wide age range with the largest group (42%) in the range 26-40 years. Previous contact with the psychiatric service was found in 89% of cases. There was a wide range of diagnoses with the largest category (56%) suffering from schizophrenia. Of those not admitted with alcohol or drug related illness 66% showed evidence of acute psychotic symptoms. Length of admission was relatively short with 84% of patients being discharged within three months. A total of 43% showed evidence of being a danger to themselves or others. Significant differences were found between these patients and the non-dangerous group, the latter being more likely to be older and to suffer from a major psychotic illness. These findings indicate that a committal law based purely on 'dangerousness' criteria would be likely to significantly affect committal practice in Ireland. These findings are discussed in relation to proposed changes in mental health legislation in Ireland.

Adolescent↗
PubMed1989

Chemotaxis to chitin oligosaccharides by Vibrio furnissii, a chitinivorous marine bacterium.

We have reported that Vibrio furnissii, a chitinivorous marine bacterium, expresses a complex apparatus for adhesion/deadhesion to chitin analogues (1). In the present studies, we show that this organism exhibits a chemotactic response (swarming) to chitin oligosaccharides at concentrations as low as 10 microM. In contrast, V. furnissii exhibits slight to no chemotaxis to other utilizable compounds (glycerol, lactate, amino acids), with the exception of L-glutamic acid. V. furnissii may lack the tar (aspartate) receptor of Escherichia coli.

Acetylglucosamine↗
PubMed1989

Colopleural fistula due to strangulated Bochdalek hernia in an adult.

An elderly patient presented with a right sided pneumothorax due to strangulation of part of the colon through a congenital Bochdalek hernia. Congenital posterolateral diaphragmatic hernia of Bochdalek is rare in an adult and strangulation with pneumothorax has not been reported before.

Aged↗