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Marchese B, McDonald A, McGowan H. The bifurcation and topography of the posterior tibial artery within the tarsal tunnel. Surg Radiol Anat 2023; 45:611-622. [PMID: 36912942 PMCID: PMC10130123 DOI: 10.1007/s00276-023-03115-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/16/2023] [Indexed: 03/14/2023]
Abstract
PURPOSE The tarsal tunnel (TT) is a fibro-osseous anatomical space coursing from the medial ankle to the medial midfoot. This tunnel acts as a passage for both tendinous and neurovascular structures, including the neurovascular bundle containing the posterior tibial artery (PTA), posterior tibial veins (PTVs) and tibial nerve (TN). Tarsal tunnel syndrome (TTS) is the entrapment neuropathy that describes the compression and irritation of the TN within this space. Iatrogenic injury to the PTA plays a significant role in both the onset and exacerbation of TTS symptoms. The current study aims to produce a method to allow clinicians and surgeons to easily and accurately predict the bifurcation of the PTA, to avoid iatrogenic injury during treatment of TTS. METHODS Fifteen embalmed cadaveric lower limbs were dissected at the medial ankle region to expose the TT. Various measurements regarding the location of the PTA within the TT were recorded and multiple linear regression analysis performed using RStudio. RESULTS Analysis provided a clear correlation (p < 0.05) between the length of the foot (MH), length of hind-foot (MC) and location of bifurcation of the PTA (MB). Using these measurements, this study developed an equation (MB = 0.3*MH + 0.37*MC - 28.24 mm) to predict the location of bifurcation of the PTA within a 23° arc inferior to the medial malleolus. CONCLUSIONS This study successfully developed a method whereby clinicians and surgeons can easily and accurately predict the bifurcation of the PTA, to avoid iatrogenic injury that would previously lead to an exacerbation of TTS symptoms.
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Affiliation(s)
- B Marchese
- Department of Microbiology, Anatomy, Physiology and Pharmacology, La Trobe University, Bundoora, VIC, 3086, Australia
| | - A McDonald
- Department of Microbiology, Anatomy, Physiology and Pharmacology, La Trobe University, Bundoora, VIC, 3086, Australia.
| | - H McGowan
- Department of Microbiology, Anatomy, Physiology and Pharmacology, La Trobe University, Bundoora, VIC, 3086, Australia
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Marx S, May JH, Cohen T, Kamber B, McGowan H, Petherick L. Dust emissions from Kati Thanda-Lake Eyre: a review. T ROY SOC SOUTH AUST 2022. [DOI: 10.1080/03721426.2022.2054918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- S.K. Marx
- GeoQuEST Research Centre - School of Earth, Atmospheric and Life Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - J-H May
- School of Geography, University of Melbourne, Melbourne, Victoria, Australia
| | - T. Cohen
- GeoQuEST Research Centre - School of Earth, Atmospheric and Life Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- ARC Centre of Excellence for Australian Biodiversity and Heritage, University of Wollongong, Wollongong, New South Wales, Australia
| | - B.S. Kamber
- School of Earth and Atmospheric Sciences, Queensland University of Technology, Wellington, Queensland, Australia
| | - H.A. McGowan
- School of Earth and Environmental Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - L. Petherick
- School of Geography, Environment and Earth Sciences, Victoria University of Wellington, Wellington, New Zealand
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McGowan H, Gopeesingh K, O’Kelly P, Gilligan P. Emergency Department Overcrowding And The Full Capacity Protocol Cross Over Study: What Patients Who Have Experienced Both Think About Being An Extra Patient In The Emergency Department Or On A Ward. Ir Med J 2018; 111:788. [PMID: 30520615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Hospital overcrowding is evidenced by Emergency Department (ED) overcrowding. The Full Capacity Protocol (FCP) is activated to move patients to temporary extra beds placed in the inpatient wards. This research aims to establish patient preferences when waiting for a ward bed in an Irish Hospital. The FCP in Beaumont Hospital was updated in the context of national guidelines. Patients’ attitudes towards boarding in the ED as opposed to being in extra beds on the wards were assessed using a questionnaire based structured interview. Ninety nine patients took part in the study. Eighty three patients (83.83%) preferred being an additional patient on the ward, 12 (12.12%) had no preference and four (4.04%) preferred being boarded in the ED. Moving patients from the ED into extra beds on the wards creates space, facilitating safer care delivery. The vast majority of patients who have experienced both, prefer being boarded in the ward rather than in the ED.
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Affiliation(s)
| | - K Gopeesingh
- Royal College of Surgeons in Ireland, St. Stephens Green, Dublin 2
| | - P O’Kelly
- Beaumont Hospital, Beaumont Rd, Dublin 9
| | - P Gilligan
- Emergency Department, Beaumont Hospital, Beaumont Rd, Dublin 9
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McGowan H, Gopeesingh K, Gilligan P, O'Kelly P. FCP AND THE ED: SAVING LIVES THROUGH ORGANISING CARE. Arch Emerg Med 2016. [DOI: 10.1136/emermed-2016-206402.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sahgal A, Somani S, Xu W, Krema H, Heydarian M, Michaels H, McGowan H, Payne D, Simpson R, Laperriere N. 21 SIGNIFICANT LATE TOXICITIES ASSOCIATED WITH STEREOTACTIC RADIOTHERAPY FOR JUXTAPAPILLARY CHOROIDAL MELANOMA. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)72408-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Krema H, Somani S, Sahgal A, Xu W, Heydarian M, Payne D, McGowan H, Michaels H, Simpson ER, Laperriere N. Stereotactic radiotherapy for treatment of juxtapapillary choroidal melanoma: 3-year follow-up. Br J Ophthalmol 2009; 93:1172-6. [DOI: 10.1136/bjo.2008.153429] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pedrazzini AE, McGowan H, Lucking L, Johanson RJ. 'The trouble with sex - it always gets in the way': an evaluation of a peer-produced teenage pregnancy video. Br J Fam Plann 2000; 26:131-5. [PMID: 10920287 DOI: 10.1783/147118900101194544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This paper describes the development and pilot evaluation of a peer-produced video, produced for use as part of North Staffordshire's Personal and Social Education school programme. A number of studies carried out in the area, including a recent audit into post-coital contraception in the under 20s, have shown that young people need to know how to access contraceptive services. Background surveys also suggest that young people need to be aware of the wider issues implicit in contraception. The impetus for the video came from the Advice Centres for the under Twenties (ACT) Working Party, who produced the video together with Staffordshire University's Media Studies Department and a local high school drama group. The video was intended for use in schools, and was designed to be complimentary to an updated and standardised teaching pack, which was already in preparation. The pilot study showed the video to be beneficial as a stand-alone intervention, principally to promote active discussion on topics that might otherwise be difficult to approach. A comparison of responses before and after the educational session demonstrated an improvement in knowledge in most areas. Further objective evaluation of the combined video and teaching pack is now necessary.
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Affiliation(s)
- A E Pedrazzini
- Academic Department of Obstetrics and Gynaecology, North Staffordshire Hospital NHS Trust, Stoke on Trent, UK
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Dubinsky I, McGowan H. Case report: retinal tear as a consequence of air bag inflation. Can Fam Physician 1997; 43:1576-7. [PMID: 9303236 PMCID: PMC2255344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- I Dubinsky
- Department of Emergency Medicine, Toronto Hospital
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Vandongen R, McGowan H, Anderson H, Barden A. Renal prostanoids after unclipping the denervated one-kidney, one-clip hypertensive rat. Am J Physiol 1985; 249:F542-5. [PMID: 3863493 DOI: 10.1152/ajprenal.1985.249.4.f542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The contribution of the renal nerves in maintaining blood pressure and modulating renal prostanoid synthesis was examined in established (less than 8 wk in duration) one-kidney, one-clip (1K,1C) hypertension in the rat. Systolic blood pressure was measured for 7 days after renal denervation, at which time the renal artery clip was removed. Twenty-four-hour urinary excretion of PGE2 and 6-keto-PGF1 alpha (stable degradation product of PGI2) was determined before and after denervation and unclipping. Compared with sham-denervated rats, denervation (n = 15) resulted in a small but significant fall in blood pressure (from 216 +/- 4 to 182 +/- 4 mmHg after 48 h) and an increase in urinary 6-keto-PGF1 alpha (from 31 +/- 4 to 43 +/- 5 ng/24 h after 24 h). There was no change in PGE2 excretion. Seven days after surgery, blood pressures were similar in denervated (202 +/- 4 mmHg) and sham-denervated (211 +/- 5 mmHg) rats and fell to a similar extent 24 h after unclipping (142 +/- 3 and 147 +/- 4 mmHg, respectively). Urinary 6-keto-PGF1 alpha increased from 25 +/- 5 to 74 +/- 11 in denervated and 21 +/- 2 to 72 +/- 9 ng/24 h in sham-denervated rats in the 24 h after unclipping. PGE2 excretion increased approximately twofold over this period. These findings indicate that the renal nerves have only a minor role in established hypertension in the 1K,1C rat and that the reversal of hypertension and stimulation of renal prostanoid synthesis following unclipping is not dependent on neural mechanisms.
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McGowan H, Anderson H, Barden A, Vandongen R. Increased renal prostanoid synthesis after unclipping the one-kidney, one-clip hypertensive rat: effect of renal denervation. Clin Exp Pharmacol Physiol 1985; 12:253-6. [PMID: 4028513 DOI: 10.1111/j.1440-1681.1985.tb02642.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Renal denervation of hypertensive one-kidney, one-clip (1K, 1C) rats resulted in a minor fall in blood pressure (216, s.e.m. = 4, to 182, s.e.m. = 4, mmHg) 24 h later, which returned to predenervation levels with 1 week. Subsequent unclipping led to a similar fall in blood pressure in denervated (202, s.e.m. = 4 to 142, s.e.m. = 3) and sham-denervated (211, s.e.m. = 5 to 147, s.e.m. = 4) rats. Unclipping also resulted in a marked rise in urinary PGE2 and 6-keto PFG1 alpha in both denervated and sham-denervated animals. It appears that 1K, 1C hypertension, 8 weeks after clipping, is only slightly dependent on renal nerves. Unclipping results in increased renal synthesis of PGE2 and PGI2 which is not dependent on intact renal innervation.
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Cherry PM, Kraft S, McGowan H, Ghosh M, Shenken E. Corneal and conjunctival deposits in monoclonal gammopathy. Can J Ophthalmol 1983; 18:143-9. [PMID: 6409389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
An IgG kappa monoclonal gammaglobulinopathy was discovered during investigation of long-standing corneal deposits. The deposits were located between the basal epithelial cells, in the anterior layer of Bowman's membrane and in keratocytes. This is the third reported case of corneal deposits associated with Bence Jones proteinuria and the fifth case of corneal deposits associated with crystalline inclusions within plasma cells of the bone marrow. A biopsy of the buccal mucosa showed intraepithelial inclusions. Immunoelectrophoresis of the tears revealed a small amount of secretory IgA and a moderate amount of IgG, practically all kappa light chains.
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