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Biomedical subjects

M Kaliszer

Publications and source records attributed to M Kaliszer.

At least 19 recordsLinked to original sources
PubMed2005

The role of hereditary hemochromatosis in aseptic loosening following primary total hip arthroplasty.

Hereditary hemochromatosis (HH) results in increased iron absorption and subsequent deposition in tissue. This condition occurs predominantly in individuals of Northern European and Celtic origin with Ireland having one of the highest allele frequencies in the world. This study examines the hypothesis that homozygosity for either the C282Y or H63D mutations in the HFE gene may be associated with aseptic loosening following total hip arthroplasty (THA). Two groups of individuals were screened for the C282Y and H63D mutations associated with HH. Group 1 were individuals who had undergone primary hip arthroplasty and group 2 were individuals who had undergone revision hip arthroplasty for aseptic loosening. Exclusion criteria included rheumatoid or other inflammatory arthropathies and revision due to causes other than aseptic loosening. Significantly more patients in the revision THA group were homozygous for the C282Y genotype (P = 0.014). Aseptic loosening occurred earlier in these patients (P = 0.009), in particular in the patients who had clinical signs of hemochromatosis. No association was seen with the H63D mutation and revision THA. The incidence of HH in the group of primary THA patients was no higher than the background incidence. Patients who require primary THA and who are homozygous for the C282Y mutation have an increased risk of developing aseptic loosening, leading to revision THA. Moreover C282Y homozygosity appears to be associated with earlier aseptic loosening than in individuals without the C282Y mutation.

Adult↗
PubMed2004

Kinematics of the toe touching test: an investigation using motion analysis.

We describe a technique for measuring dynamic motion at the low back along with the major lower limb joints during the toe touching maneuver. This type of motion analysis was carried out on eight normal volunteers. Flexion during the toe touching maneuver involves not only low back and hip movement but also ankle plantar flexion and a varying degree of knee movement. The low back and ankle movements were highly correlated within each subject to an extent that suggests a functional connection between the lower limb and low back movements. The significance of our work is two-fold. First, we emphasize that the toe touching test represents a combined movement of the low back, the hips, the knees, and the ankles and it is reasonable to suggest that abnormalities of these joints may affect the clinical relevance of the test as an indicator of back movement. Second, we point out that the guidelines of the American Medical Association in using the test to determine hip movement are incorrect as they do not take into account the effect of knee and ankle movements on the estimation of hip movement.

Adult↗
PubMed2004

Movements at the low back during normal walking.

We present a technique for measuring the kinematics of the functional low back during normal gait. We have used a similar technique previously to measure low back movement simultaneously with hip, knee, and ankle movement during the toe-touching manoeuvre. We noted that movements at the low back were biphasic. The greatest low back movements were found to occur in the transverse plane (mean = 23 degrees), whereas a mean of 17 degrees movement occurred in the coronal plane and only 5 degrees movement in the sagittal plane. These findings confirm, using a non-invasive technique, that there are significant ranges of movement at the low back during walking and lend some support to the theory that rotational movement at the low back is a major component of human locomotion.

Adult↗
PubMed2003

Outcome after acetabular fracture. Prognostic factors and their inter-relationships.

The aim of this study was to examine how commonly implicated prognostic factors are associated with late clinical outcome after reconstruction of acetabular fractures. The clinical outcomes of 180 fractures, treated by a single surgeon over a 10-year period, were assessed using the scoring system of Merle d'Aubigné and Postel. A statistical model was constructed comprising the clinical outcome and nine postulated prognostic factors. The association between these factors and sub-optimal outcome was explored by logistic regression and log linear analysis, and a model of causality was postulated. Associated fracture type, imperfect reduction (>3mm), the presence of local complications and heterotopic bone were prognostic factors independently associated with a sub-optimal outcome. The sex or age of the patient, the presence of hip dislocation, sciatic palsy, or an interval from injury to surgery of 1-18 days were factors which were not directly associated with a poor outcome. Imperfect reduction was itself affected by associated fracture type and increasing age, and it is the latter connection that may explain any apparent association between sub-optimal outcome and increasing age.

Acetabulum↗
PubMed2003

Molecular epidemiology of group B streptococci in Ireland: associations between serotype, invasive status and presence of genes encoding putative virulence factors.

Group B streptococcal isolates (n = 159) from the three Dublin maternity hospitals, were serotyped and analysed for the bac, bca, hylB, pepB, and rib genes. The serotype distribution of the isolates was Ia, 19.5%; Ib, 18.9%; II, 10.7%; III, 29.5%; IV, 1.9%; V, 15.1%; non-typeable, 4.4%. There was a statistically significant association between the serotype and invasive status (carriage or infection) of isolates (P < 0.005), but no significant association between serotype and degree of invasiveness was demonstrated. The presence or absence of each analysed gene was not associated with the invasive status of isolates. Statistically significant associations were revealed between bca and hylB (IS1548) (P = 0.0004) and between bac and bca (P=0.014). The bac, bca, hylB (IS1548) and rib genes and the numbers of tandem repeats in the bca gene showed significant associations with serotype. Almost 50% of serotype III isolates possessed at least one of the bac and bca genes and 55-65% of strains of serotypes Ia, Ib and II possessed the rib gene. Most serotype III isolates had IS1548 in their hylB genes. Serotype Ib was the only serotype in which more than half of the strains contained more tandem repeats in the bca gene than the overall mean for the GBS population studied of 7.4 repeats. These findings indicate that some previously reported associations between putative virulence factors and GBS disease require further study and clarification.

Chi-Square Distribution↗
PubMed2002

Absenteeism among nursing students - fact or fiction?

This study explores absenteeism patterns and trends among a group of third-year student nurses. A questionnaire was used to elicit information about absence behaviour from 110 students at two hospital sites. Retrospective analysis of attendance records of 70 of these students, covering a period of 123 weeks, was also performed to determine absenteeism trends. The findings of the study reveal that 1567 days were lost because of absenteeism during this period on 1027 episodes. This represents a time lost index, which is the amount of days lost expressed as a percentage of total days available, of 4% among the group. Most absenteeism episodes lasted 3 days or less, with 73% of episodes lasting only 1 day. Absenteeism commencing either on Mondays or Fridays accounted for more than half of the absenteeism episodes in the group. Voluntary absence was a reported feature of this group, which occurred more frequently from lectures than wards. The main reasons cited for absence from both lectures and ward duties were personal and social commitments and stress. Students' views on nursing as a career and responses to factors that may cause stress were examined and revealed an association with reported absence behaviour.

Absenteeism↗
PubMed2002

Aspects of nurse education programmes that frequently cause stress to nursing students -- fact-finding sample survey.

This study examined reported stress in 12 areas commonly reported to cause stress to nursing students. A questionnaire was distributed to 110 third-year nursing students, and the results indicate that stress exists for students in both the clinical and academic aspects of the programme. Financial constraints and academic-related concerns emerged as the most stressful areas for the students. A third of the students reported that relationships with teachers and staff on the ward cause some degree of stress. Factor analysis revealed that five factors emerged as sources of stress. Firstly, 'academic' stress factors. The second and third components concern relationships, the former involving teaching-related staff, and the latter involving the clinical experience. The last two components suggest that finance and death of patients are independent sources of stress. Major restructuring is about to take place in nurse education in Ireland, with the introduction of degree preparation for all nursing students in 2002. It is imperative that those involved with nursing students, both in the clinical area and in education settings, take cognisance of the stress that current students face. Recommendations for educators include adequate support structures for clinical areas, preceptorship programmes and the availability of student counselling services.

Attitude of Health Personnel↗
PubMed2002

Comparison between clinical and radiologic outcome measures after reconstruction of acetabular fractures.

OBJECTIVES: To compare clinical and radiologic outcome measures in patients after reconstruction of acetabular fractures and to investigate whether an objective radiologic outcome could be used as a proxy for a clinical outcome. DESIGN: Follow-up survey with retrospective analysis of consecutive case records. PATIENTS AND INTERVENTION: Over a ten-year period, 201 consecutive patients had open reduction and internal fixation of acetabular fractures performed by a single surgeon. The outcome measures on 166 fractures were available for analysis when the twenty-six patients who were lost to follow-up and the fourteen patients who had salvage total hip replacement were excluded. MAIN OUTCOME MEASUREMENTS: The assessment of patients was performed by one of two independent assessors, who used the Merle d'Aubigné (1954) clinical outcome score and a radiologic score of degenerative hip disease (Matta, 1994). RESULTS: Although the overall correlation between the clinical and radiologic outcome grades was good (r = 0.63, p < 0.001), their agreement (i.e., the prediction of a specific clinical outcome by a corresponding radiologic one) was poor (Kappa = 0.24). The authors found that the clinical scoring system was difficult to apply specifically to acetabular trauma in 29 percent of fractures because of complications related to associated injuries. When the individual Merle d'Aubigné scores for pain, range of motion, and walking were correlated with the radiologic score, it was found that the walking score had a significant association with the radiologic score and the pain and range of movement scores. CONCLUSIONS: The Merle d'Aubigné score has shortcomings as an outcome measure for acetabular fractures. Our aim to use a radiologic outcome as a proxy for this clinical grading system was not realized, but we propose that the patient's walking ability could be used as an objective local outcome measurement.

Acetabulum↗
PubMed2001

Surface topography, Cobb angles, and cosmetic change in scoliosis.

STUDY DESIGN: Preliminary analysis of the clinical value of surface topography in a spinal deformity clinic. OBJECTIVES: The Cobb angle is the gold standard for the monitoring of scoliosis. This study was designed to determine whether surface topography would reflect Cobb angle status with sufficient reliability to permit its safe use as an alternative means of documentation in some circumstances. SUMMARY OF BACKGROUND DATA: Surface topography offers the possibility of describing spinal deformity more fully than radiographic measures alone. To be useful, it must ignore changes due to varying posture and reliably detect differences that are clinically significant, while broadening the ability to assess deformity. METHODS: Surface topography using Quantec () was obtained routinely in all patients attending a spinal deformity unit. Intrasubject variation was reduced by taking the mean for each parameter of four repositioned scans, which gives a smallest detectable change on all measures of approximately 10 U. Fifty-nine patients with two sets of radiographs and topography scans were studied to determine the ability of the different measurements to detect significant change. RESULTS: There was a significant correlation between Cobb angle and Quantec spinal angle. A significant change in Cobb angle could be identified by associated change in at least one topographic measure in a significant proportion of cases. CONCLUSIONS: It is unlikely that topography will supplant radiography for the ascertainment of Cobb angles, because the error margins of both are wide, and the two are not measuring the same aspect of the deformity. The Quantec system is useful in patient monitoring as an alternative to radiography, without diminishing the standard of care.

Anthropometry↗
PubMed1995

First admission incidence study of mania, 1975-1981.

BACKGROUND: A previous cross-national epidemiological study of first admission rates in London and in Aarhus, Denmark, found that the incidence of mania was virtually identical for both centres. This study sought to examine the corresponding rate for a defined catchment area in Dublin, Ireland, and to establish whether the impression of a higher rate could be validated. METHOD: The study combined a six-year retrospective review and one-year prospective collection of first-admission cases of mania from a defined catchment area. Diagnosis was according to ICD criteria and the Syndrome Check List of the Present State Examination (PSE). Cross-national comparisons were made using standardised incidence rate ratios (SIRs). RESULTS: The crude incidence rate for Dublin in the age range 18-60 years was established at 4.5 per 100,000 per year. A comparison of SIRs for the three centres showed the Dublin rate to be higher than expected (P < 0.02). Age-specific analysis indicated that this increase came mainly from the age range 18-29 (chi 2 = 9.08, P = 0.01). CONCLUSIONS: The study confirmed the impression that the local incidence of mania in Dublin is higher than that reported from two other North European centres. A variation in rates from contrasting socioeconomic districts within the catchment area points to some caution in the interpretation of the results and suggests further study from wider catchment areas.

Adolescent↗
PubMed1989

Setting the baseline parameters for clinical assessment of foot to ground contact using the Musgrave pressure plate system.

The Musgrave Pressure Plate System for the measurement of foot contact patterns comprises two fixed pressure plates constructed from arrays of load cells, interfaced to a BBC computer. Its main advantage is the ability to measure and analyse spatial distributions of contact pressures and their time dynamics, and to do this relatively inexpensively in a clinical setting. Its main potential disadvantage is that it can disrupt the natural gait pattern by the discipline in enforces on the foot placement. The eventual aim of the project of which this study forms the pilot phase, is to develop formal decision rules based on the analysis of a large number of normal subjects for the diagnosis of abnormal foot pathology and the evaluation of therapy, using data collected by a Musgrave system. The objective of this study is to set baseline norms, and to evaluate the system. The analysis is based on 100 normal subjects using selected parameters on foot contact pressure, contact area and time, available from the system. Several stages of the foot contact process are described in terms of the selected parameters. The results show clearly that even with a relatively small subset of the available recorded data on each foot plant, a wide range of descriptive information can be accumulated. Statistically significant differences were found between the right and left feet on most of the parameters considered. However, these differences were based on a large sample and are not large in absolute terms in many instances. Therefore the observed differences may be small compared to differences between normal and abnormal cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Anthropometry↗
PubMedDate not supplied

Sexually transmitted diseases as seen by general practitioners in Ireland: use of a telephone survey.

A telephone survey of one of every five general practitioners in the Republic of Ireland was carried out in July 1978 for the purpose of establishing the frequency of diagnosis of venereal diseases during the preceding year. In addition, information was obtained on the subsequent management of the diseases. This type of survey was found to be economical and quick, and the response rate (98.6%) was excellent. The national frequency of diagnosis (per 100,000 population) was estimated from the sample to be 7.7 for syphilis, 97 for gonorrhea, and 2,000 for nonspecific venereal diseases. The rates of reporting of these diseases were less than or equal to 24.3%, 9.8%, and 3.1%, respectively, of the estimated frequencies. Sixty-nine percent of the general practitioners treated the patients themselves; 51% treated on the basis of clinical diagnosis alone.

Family Practice↗