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Biomedical subjects

W Regan

Publications and source records attributed to W Regan.

At least 19 recordsLinked to original sources

Classification and treatment of coronoid process fractures.

Fractures of the coronoid process are rare as isolated injuries and usually are associated with significant, sometimes devastating trauma to the elbow. The classification system based on the degree of involvement has proven helpful to estimate prognosis and to help guide treatment. Severe fractures are generally associated with instability and portend a poor prognosis. Treatment by distraction, external fixation, and early motion has been encouraging.

Adolescent

A study of elastic tissue and actinic radiation in "aging," temporal arteritis, polymyalgia rheumatica, and atherosclerosis. The actinic storm in the modern world.

Solar radiation provokes a lifelong series of destructive changes in the supporting elastic tissues of "exposed" skin. Called actinic elastosis/lysis (or actinic "aging"), the sequence begins in early life as simple elastic hyperplasia, converts in middle life to progressive actinic elastotic degeneration, and, in late life, typically ends with a stage of resorption (elastolysis) and atrophy ("aged" skin). Superficial "exposed" arteries such as the temporal artery participate in the same sequence of degenerative elastotic changes, which, as in the skin, may provoke granulomatous responses in a few of the many subjects affected. In the case of the temporal artery, a contingent outcome may be giant cell (temporal) arteritis and its recognized systemic vascular expression, polymyalgia rheumatica. Actinic commotion at the surface of the body is often massive in degree and extent and may be expected to exert a deleterious autoimmune impact on the essential elastic tissues of the arterial system. For this reason, solar radiation should be recognized as a risk factor for other elastic-related vascular diseases, including atherosclerosis and aneurysms. Man-made radiations may be exacerbating the effects of predominant solar radiation. Of the many radiant bands that make up the actinic (electromagnetic) spectrum, little is known for certain about the identity of those that cause these prevalent disorders of elastic tissue. Until this void is filled, more care should be taken with solar and the other "safe" radiations.

Arteriosclerosis

Acne keloidalis.

Explore the source record for details and available documents.

Acne Keloid

Fractures of the coronoid process of the ulna.

A review of thirty-five patients who had a fracture of the coronoid process of the ulna revealed three types of fracture: Type I--avulsion of the tip of the process; Type II--a fragment involving 50 per cent of the process, or less; and Type III--a fragment involving more than 50 per cent of the process. A concurrent dislocation or associated fracture was present in 14, 56, and 80 per cent of these patients, respectively. The outcome correlated well with the type of fracture. According to an objective elbow-performance index used to assess the results for the thirty-two patients who had at least one year of follow-up (mean, fifty months), 92 per cent of the patients who had a Type-I fracture, 73 per cent who had a Type-II fracture, and 20 per cent who had a Type-III fracture had a satisfactory result. Residual stiffness of the joint was most often present in patients who had a Type-III fracture. We recommend early motion within three weeks after injury for patients who have a Type-I or Type-II fracture. Reduction and fixation, followed by early motion when possible, may be the preferred treatment for patients who have a Type-III fracture.

Adolescent

Some observations on psychiatric research.

Principles of sound research design are too often incompletely applied in scientific investigations. Physicians may fail to evaluate journal articles for quality of research, comparability among studies, and clinical relevance. For many investigators quick publishable experiments take precedence over those with rigorous methods. Clinicians and researchers are becoming more aware of these concerns. Students should be taught the skills necessary to interpret scientific reading. Greater attention should be given to correct research design, and authors should fully explain both the procedures of a study, and its relevance. Fewer published articles and more review papers or commentaries might also stimulate better research quality.

Forecasting

On making clinical research count.

Principles of sound research design are inconstantly applied to scientific investigations. Quality research depends on good study design. Many research groups appear to favor quick publishable experiments over more rigorously controlled ones. Clinicians seem inadequately prepared to critically evaluate journal articles for quality of research, clinical relevance, and comparability of reports. Clinicians and researchers alike are increasingly aware of these problems, and are calling for greater attention to research design in scientific work. Authors should explain their procedures and the study's relevance to clinical practice. Educators are encouraged to increase teaching of research design and interpretation of scientific writing.

Research Design