Biomedical subjects
Publications and source records attributed to M Madden.
Biostereometry is the measurement of living things (especially the human body) in 3 dimensions. Moire topography provides a simple, one-step method for mapping contours of the face, or other parts of the body--a method which has potential value for the plastic surgeon. A prospective study of the value and the uses of this method is now under way at our institution.
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A multicenter clinical study assessed the ability of an acellular allograft dermal matrix to function as a permanent dermal transplant in full-thickness and deep partial-thickness burns. The study consisted of a pilot phase (24 patients) to identify the optimum protocol and a study phase (43 patients) to evaluate graft performance. Each patient had both a test and a mirror-image or contiguous control site. At the test site, the dermal matrix was grafted to the excised wound base and a split-thickness autograft was simultaneously applied over it. The control site was grafted with a split-thickness autograft alone. Fourteen-day take rates of the dermal matrix were statistically equivalent to the control autografts. Histology of the dermal matrix showed fibroblast infiltration, neovascularization, and neoepithelialization without evidence of rejection. Wound assessment over time showed that thin split-thickness autografts plus allograft dermal matrix were equivalent to thicker split-thickness autografts.
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Moire topography, a form of biostereometrics, is a technique that provides one-step contour maps. Facial measurements so obtained may be useful in reconstructive surgery.
Fifty-one children with an average age of 27 months and who had sustained a burn injury were tested at 1, 6, and 12 months postinjury to determine their physical, functional, and developmental outcomes. Most parents were either African-American or Hispanic, lived on public assistance, and had a high school education or less. Most children had normal range of motion and were appropriate for their age in self-care skills. On the basis of the Home Screening Questionnaire, 48% of the children came from suspect home environments. Developmental delays were noted in language acquisition that persisted over the first year postburn. Although the outcomes of these burn injuries were good in physical and functional areas, the developmental findings raised concerns. The results alert clinicians to screen for potential developmental problems during the burned child's recovery phase and to include appropriate developmental activities and parental guidance in the treatment plan.
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BACKGROUND: A survey of public health doctors was undertaken in the South Thames region to support coordination of continuing professional development (CPD) and to guide appropriate provision of educational activities for those working in the specialty. METHODS: A postal survey of 130 public health doctors in service, academic and military posts in the South Thames region of the UK. RESULTS: The response rate was 79% with good representation of grades and geographical areas. Public health doctors preferred personal and small group learning particularly focused on problem solving. Epidemiology as a basic discipline was rated highly by respondents, but senior doctors also showed preferences for topics beyond the textbooks. Respondents demonstrated that they had acquired such knowledge and skills, which could be shared in CPD sessions with colleagues. There was support for learning with and from non-medical colleagues. In the service posts structural change was ongoing, expectations of performance by management were high, and appropriate CPD was an expressed need, although time was seriously limited for this activity. CONCLUSIONS: Appropriate CPD could support the effectiveness of public health physicians in challenging circumstances. However, a critical evaluation of the relevance of CPD programmes to public health practice is essential if CPD is to support doctors in delivering the public health agenda in the changing structures within which they work.