Search results for: P. Pemberton

Authors: Suvorov Vasyl, Filipchuk Viktor

Abstract:

Developmental Dysplasia of the Hip (DDH) is a frequent pathology in pediatric orthopedist’s practice. Neglected or residual cases of DDH in walking patients are usually treated using pelvic osteotomies. Plastic changes take place in hinge points due to acetabulum reorientation during surgery. Classically described hinge points and a traditional division of pelvic osteotomies on reshaping and reorientation are currently debated. The purpose of this article was to evaluate biomechanical changes during the most commonly used pelvic osteotomies (Salter, Dega, Pemberton) for DDH treatment in pediatric patients. Methods: virtual pelvic models of 2- and 6-years old patients were created, material properties were assigned, pelvic osteotomies were simulated and biomechanical changes were evaluated using finite element analysis (FEA). Results: it was revealed that the patient's age has an impact on pelvic bones and cartilages density (in younger patients the pelvic elements are more pliable - p<0.05). Stress distribution after each of the abovementioned pelvic osteotomy was assessed in 2- and 6-years old patients’ pelvic models; hinge points were evaluated. The new term "restriction point" was introduced, which means a place where restriction of acetabular deformity correction occurs. Pelvic ligaments attachment points were mainly these restriction points. Conclusions: it was found out that there are no purely reshaping and reorientation pelvic osteotomies as previously believed; the pelvic ring acts as a unit in carrying out the applied load. Biomechanical overload of triradiate cartilage during Salter osteotomy in 2-years old patient and in 2- and 6-years old patients during Pemberton osteotomy was revealed; overload of the posterior cortical layer in the greater sciatic notch in 2-years old patient during Dega osteotomy was revealed. Level of Evidence – Level IV, prognostic.

Keywords: developmental dysplasia of the hip, pelvic osteotomy, finite element analysis, hinge point, biomechanics

Procedia PDF Downloads 61

Authors: D. Tohlob, E. Abo Hashem, N. Ghareeb, M. Ghanem, R. Elfarahaty, S. A. Roberts, P. Pemberton, L. Mohiyiddeen, W. G. Newman

Abstract:

Gonadotropin stimulation is used in females undergoing assisted reproductive treatment for ovulation induction, but ovarian response is variable and unpredictable in these women. More effective protocols and individualization of treatment are needed to increase the success rate of IVF/ICSI cycles. We genotyped seven variants reported in previous studies to be associated with ovarian response (number of ova retrieved and total gonadotropin dose) in women undergoing IVF treatment including FSHR variants Asn 680 Ser (c.2039 A > G), Thr 307 Ala (c. 919 > A), -29 G > A, HRG c.610 C > T gene, BMP15 -9 C > G, AMH Ile 49 Ser (c.146 G > T), and AMHR -489A˃G in 118 Egyptian females attending Mansoura Integrated Fertility Center in Egypt, these females were undergoing their first cycle of controlled ovarian hyper stimulation for IVF/ICSI treatment. They were analyzed by TaqMan allelic discrimination assay in Manchester Center of Genomic Medicine. We found no evidence of any significant difference (p value < 0.05) in the number of eggs retrieved or the gonadotropin dose used between individuals in all genotypes except for HRG c.610 C > T gene polymorphism where regression analysis gives a p value of 0.04 with a fewer eggs number in TT genotyped females. These results indicate that these variants do not provide sufficient clinically relevant data to individualize the treatment protocols.

Keywords: controlled ovarian hyperstimulation, gene variants, ovarian response, assisted reproduction

Procedia PDF Downloads 292

Authors: Barbara Pemberton

Abstract:

Now that people of all faiths are experiencing suffering due to many global issues, shared narratives may provide common ground in which true understanding of each other may take root. This paper will consider the all too common problem of suffering and address how adherents of the three great monotheistic religions seek understanding and the appropriate believer’s response from the same story found within their respective sacred texts. Most scholars from each of these three traditions—Judaism, Christianity, and Islam— consider the writings of the Tanakh/Old Testament to at least contain divine revelation. While they may not agree on the extent of the revelation or the method of its delivery, they do share stories as well as a common desire to glean God’s message for God’s people from the pages of the text. One such shared story is that of Job, the servant of Yahweh--called Ayyub, the prophet of Allah, in the Qur’an. Job is described as a pious, righteous man who loses everything—family, possessions, and health—when his faith is tested. Three friends come to console him. Through it, all Job remains faithful to his God who rewards him by restoring all that was lost. All three hermeneutic communities consider Job to be an archetype of human response to suffering, regarding Job’s response to his situation as exemplary. The story of Job addresses more than the distribution of the evil problem. At stake in the story is Job’s very relationship to his God. Some exegetes believe that Job was adapted into the Jewish milieu by a gifted redactor who used the original ancient tale as the “frame” for the biblical account (chapters 1, 2, and 4:7-17) and then enlarged the story with the complex center section of poetic dialogues creating a complex work with numerous possible interpretations. Within the poetic center, Job goes so far as to question God, a response to which Jews relate, finding strength in dialogue—even in wrestling with God. Muslims only embrace the Job of the biblical narrative frame, as further identified through the Qur’an and the prophetic traditions, considering the center section an errant human addition not representative of a true prophet of Islam. The Qur’anic injunction against questioning God also renders the center theologically suspect. Christians also draw various responses from the story of Job. While many believers may agree with the Islamic perspective of God’s ultimate sovereignty, others would join their Jewish neighbors in questioning God, not anticipating answers but rather an awareness of his presence—peace and hope becoming a reality experienced through the indwelling presence of God’s Holy Spirit. Related questions are as endless as the possible responses. This paper will consider a few of the many Jewish, Christian, and Islamic insights from the ancient story, in hopes adherents within each tradition will use it to better understand the other faiths’ approach to suffering.

Keywords: suffering, Job, Qur'an, tanakh

Procedia PDF Downloads 151