54 results found
Brassett C, Cosker T, Davies DC, et al., 2020, COVID-19 and anatomy: Stimulus and initial response, Journal of Anatomy, Vol: 237, Pages: 393-403, ISSN: 0021-8782
The outbreak of COVID-19, resulting from widespread transmission of the SARS-CoV-2 virus, represents one of the foremost current challenges to societies across the globe, with few areas of life remaining untouched. Here, we detail the immediate impact that COVID-19 has had on the teaching and practice of anatomy, providing specific examples of the varied responses from several UK, Irish and German universities and medical schools. Alongside significant issues for, and suspension of, body donation programmes, the widespread closure of university campuses has led to challenges in delivering anatomy education via online methods, a particular problem for a practical, experience-based subject such as anatomy. We discuss the short-term consequences of COVID-19 for body donation programmes and anatomical education, and highlight issues and challenges that will need to be addressed in the medium to long term in order to restore anatomy education and practice throughout the world.
Leese J, Davies DC, 2020, An investigation of the anatomy of the infrapatellar fat pad and its possible involvement in anterior pain syndrome: a cadaveric study, Journal of Anatomy, Vol: 237, Pages: 20-28, ISSN: 0021-8782
The infrapatellar fat pad (IFP) is an extrasynovial, intracapsular, adipose body occupying the space in the knee joint between the inferior border of the patella, the femoral condyles, tibial plateau and patellar tendon. Little is known about the anatomy and normal function of the IFP, but it has been suggested to play a role in the aetiology of Anterior knee pain syndrome, including that associated with osteoarthritis. Forty-three knees from 11 male and 15 female embalmed cadavers (mean age 84 years; range 55-97 years) were investigated. The cadavers were donated and the study performed in compliance with the provisions of the UK Human Tissue Act (2004). The quadriceps tendon and the medial and lateral patellar retinacula were dissected from the patella, which was then reflected antero-distally. The IFP was carefully excised and details of its morphology and attachments to components of the knee joint were recorded, together with the presence of articular surface pathology on the patella and femoral condyles. The principal novel findings of the current study were that 81% of IFPs were attached to the superior border of the patella by supero-medial extensions and 65% were attached by supero-lateral extensions; the supero-medial extensions were larger than the supero-lateral extensions. The superior extensions of the IFP were always attached anteriorly to the patellar retinacula and in four individuals the extensions formed a full loop around the superior border of the patella. The volume of IFPs with attachments to the superior border of the patella was significantly greater (p = .007) than those without, and the IFP was attached to the medial meniscus in significantly (p = .009) more knees with IFP attachment to the superior border of the patella than those without. All IFPs were attached to the medial anterior horn of the meniscus and the medial Kaplan's ligament. Ninety-seven per cent were attached to the lateral anterior horn o
van Duren BH, Lebe M, Davies DC, et al., 2019, Proof-of-concept prototype drill-guide for use in medial patello-femoral ligament (MPFL) reconstruction surgery., Journal of Medical Engineering and Technology, Vol: 43, Pages: 1-7, ISSN: 0309-1902
For surgical reconstruction of the medial patello-femoral ligament (MPFL) a variety of techniques are used for fixation of the graft to the medial border of the patella. The bone bridge or V-shaped tunnel technique utilises two tunnels drilled from the medial aspect of the patella that converge centrally creating a tunnel through which the graft is threaded. This technique has advantages: it avoids hardware (bone anchors) and their associated complications, creates a broad attachment of the ligament approximating normal anatomy and the tunnel does not breach the lateral cortex of the patella reducing the risk of patella fracture. In current practice the bony tunnels are created using freehand techniques. These rely on estimation of the patella centre by the surgeon and is subject to wide variation. Additionally this technique can be inefficient, inaccurate and time consuming. To address these disadvantages a new drill-guide device was developed. A prototype drill-guide was constructed using CAD and 3D printing methods. The device was designed to allow the surgeon to accurately and efficiently drill the required v-shaped bone tunnel. To assess the efficacy of the prototype drill guide, an experiment designed to assess a group of ten surgeons with an average of 4.2 years experience performing the task of creating a v-shaped bone tunnel using a free-hand technique and the drill-guide. To determine the accuracy of the tunnel placement, the angle between drill holes, distance from centre of the patella and the amount of over-drill were measured. Procedure duration was also compared. The results revealed that the prototype drill-guide created a more accurate bone bridge than the traditional free hand method. The root mean square error for the distance from centre was 0.50 mm vs 2.12 mm and the angle between tunnels was 2.6O vs 15.9O for the prototype and traditional methods respectively. There was a mean of 8.9 mm over-drill with the traditional metho
Davies DC, Reissis M, Reissis D, et al., 2018, A morphometric analysis of the suitability of the transverse cervical artery as a recipient artery in head and neck free flap microvascular reconstruction, Surgical and Radiologic Anatomy, Vol: 40, Pages: 891-897, ISSN: 1279-8517
PurposeGold standard recipient arteries in head and neck free flap microvascular reconstruction are currently branches of the external carotid. However, these arteries can be compromised by neck dissection or radiotherapy, resulting in ‘vessel-depleted neck’ and ‘frozen neck’ respectively. In such cases, the transverse cervical artery (TCA) may be a suitable recipient artery.MethodsThe origin, course and diameter of the TCA were determined in 46 sides of neck from 23 cadavers. The distances from the origin of the TCA to the angle of the mandible, floor of the mouth and mandibular symphysis were measured to determine the pedicle length required for free flap anastomosis.ResultsThe TCA was present bilaterally in all subjects investigated and its course across the posterior triangle of the neck was constant between individuals. The mean distances from the origin of the TCA to the angle of mandible, floor of mouth and mandibular symphysis were 10.0, 9.2 and 12.6 cm, respectively. There were no significant differences in these distances between the left and right sides of the neck (p > 0.05 for all comparisons). The distances from the TCA origin to the angle of the mandible and floor of the mouth were significantly longer in males than in females (p = 0.004) and correlated directly with the greater height of males compared to females (p = 0.0004). The mean diameter of the TCA measured 2 cm from its origin was 2.2 mm.ConclusionThe TCA is a suitable and reliable recipient artery for free flap microvascular reconstruction, when branches of the external carotid artery are unavailable.
Smith CF, Gami B, Standfield N, et al., 2018, The role of anatomy demonstrators: a surgical trainees' perspective, Clinical Anatomy, Vol: 31, Pages: 409-416, ISSN: 0897-3806
Core Surgical Trainees (CST) in the London (UK) Postgraduate School of Surgery receive clinical anatomy teaching in their first year of training, and, in their second year, give 30 sessions of anatomy teaching to medical and other students. This study set out to investigate the role of demonstrators from the perspective of the trainees. A focus group was convened to ascertain trainees' perspectives on demonstrating anatomy and to identify problems and improvement strategies to optimize their ability to enhance students' learning. A questionnaire was formulated and all second‐year CST (n = 186—from two cohorts) in the London Postgraduate School of Surgery were invited. A total of 109 out of 186 trainees completed the questionnaire. A high percentage (98%) of trainees that completed the questionnaire responded that demonstrating was an invaluable part of their training. Sixty‐two per cent responded that anatomy teaching they received in their first year of core surgical training helped them in their teaching role and 80% responded that it helped them prepare for surgical training. The study also revealed the need for improved communication between trainees and the London Postgraduate School of Surgery/Medical Schools/National Health Service Trusts to address issues such as trainees' perceived difficulty in fulfilling their teaching session requirement. The stakeholders have acknowledged and addressed the outcomes to improve the experience for both surgical trainees and students. The results indicate that anatomy demonstrating delivers important benefits to early surgical trainees, in addition to those received by the students that they teach. Clin. Anat. 31:409–416, 2018. © 2017 Wiley Periodicals, Inc.
Iyer R, Sun K, Erridge S, et al., 2017, A qualitative analysis of near-peer teaching in an undergraduate anatomy course, AMEE 2017
Iyer R, Sun K, Erridge S, et al., 2017, Near-peer Led Anatomy Teaching Acts as a Useful Supplement to the Medical School Curriculum, ASiT Conference 2017
Sopher R, Amis A, Davies D, et al., 2016, The influence of muscle pennation angle and cross-sectional area on contact forces in the ankle joint, Journal of Strain Analysis for Engineering Design, Vol: 52, Pages: 12-23, ISSN: 0309-3247
Data about a muscle’s fibre pennation angle and physiological cross-sectional area are used in musculoskeletal modelling to estimate muscle forces, which are used to calculate joint contact forces. For the leg, muscle architecture data are derived from studies that measured pennation angle at the muscle surface, but not deep within it. Musculoskeletal models developed to estimate joint contact loads have usually been based on the mean values of pennation angle and physiological cross-sectional area.Therefore, the first aim of this study was to investigate differences between superficial and deep pennation angles within each muscle acting over the ankle and predict how differences may influence muscle forces calculated in musculoskeletal modelling. The second aim was to investigate how inter-subject variability in physiological cross-sectional area and pennation angle affects calculated ankle contact forces.Eight cadaveric legs were dissected to excise the muscles acting over the ankle. The mean surface and deep pennation angles, fibre length and physiological cross-sectional area were measured. Cluster analysis was applied to group the muscles according to their architectural characteristics. A previously validated OpenSim model was used to estimate ankle muscle forces and contact loads using architecture data from all eight limbs.The mean surface pennation angle for soleus was significantly greater (54%) than the mean deep pennation angle. Cluster analysis revealed three groups of muscles with similar architecture and function: deep plantarflexors and peroneals, superficial plantarflexors and dorsiflexors. Peak ankle contact force was predicted to occur before toe-off, with magnitude greater than five times bodyweight. Inter-specimen variability in contact force was smallest at peak force.These findings will help improve the development of experimental and computational musculoskeletal models by providing data to estimate force based on both surface and deep
Arora A, Swords C, Garas G, et al., 2016, The perception of scar cosmesis following thyroid and parathyroid surgery: A prospective cohort study, International Journal of Surgery, Vol: 25, Pages: 38-43, ISSN: 1743-9191
IntroductionVarious “scarless” approaches have been described for thyroid and parathyroid surgery. The objective of the current study was to investigate patients' perception of neck scar cosmesis, its impact on quality of life (QoL) and evaluate patient preference with regards to scar location.Methods120 patients undergoing thyroid or parathyroid surgery were followed-up over a 5-year period (2008–2013). Validated tools were used to assess scar perception and its impact on QoL. These were evaluated against sex, age, ethnicity, operation type, histopathology, time following surgery and scar length.ResultsMean follow-up was 2.6 ± 3.8 years. One of the most common post-operative problems was scar-related (n = 18). Caucasian patients and those with benign histology expressed a lower impact on QoL (p < 0.001, p = 0.038). Sex and scar length did not significantly affect patients' perception for scar cosmesis (p > 0.05). Clinicians tended to score scar cosmesis higher than patients (p = 0.02). Most participants (75%) expressed a clear preference for an extracervical “scar-less in the neck” approach.DiscussionScar-related issues are frequently reported following thyroid and parathyroid surgery. The negative impact, often underestimated by clinicians, is more apparent amongst Asian and Afro-Caribbean patients and can significantly impact on their QoL. This, combined with the lack of correlation between scar length and patient satisfaction, indicates the need to divert research from miniaturising neck scars to concealing them in extracervical sites.ConclusionPatients prefer a scar-less in the neck approach when given the option. A prospective comparative study is required to compare the cervical and extracervical approaches.
Smith CF, Finn GM, Stewart J, et al., 2016, The Anatomical Society core regional anatomy syllabus for undergraduate medicine, Journal of Anatomy, Vol: 228, Pages: 15-23, ISSN: 1469-7580
The Anatomical Society's core syllabus for anatomy (2003 and later refined in 2007) set out a series of learning outcomes that an individual medical student should achieve on graduation. The core syllabus, with 182 learning outcomes grouped in body regions, referenced in the General Medical Council's Teaching Tomorrow's Doctors, was open to criticism on the grounds that the learning outcomes were generated by a relatively small group of anatomists, albeit some of whom were clinically qualified. We have therefore used a modified Delphi technique to seek a wider consensus. A Delphi panel was constructed involving ‘experts’ (n = 39). The revised core syllabus of 156 learning outcomes presented here is applicable to all medical programmes and may be used by curriculum planners, teachers and students alike in addressing the perennial question: ‘What do I need to know ?’
Davies D, 2015, The Anatomical Society core regional anatomy syllabus for undergraduate medicine, Journal of Anatomy, ISSN: 1469-7580
Arora A, Kotecha J, Acharya A, et al., 2015, Determination of biometric measures to evaluate patient suitability for transoral robotic surgery, HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, Vol: 37, Pages: 1254-1260, ISSN: 1043-3074
Meththananda I, Auld B, Bellringer J, et al., 2015, Cadaveric dissection for modern obstetrics and gynaecology training - a means of mastering the pelvis? The role of anatomy cadaveric dissection in obstetrics and gynaecology training, BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Vol: 122, Pages: 243-243, ISSN: 1470-0328
Berdugo-Vega G, Arias-Gil G, Rodriguez-Niedenfuehr M, et al., 2014, GFAP immunoreactivity within the rat nucleus ambiguus after laryngeal nerve injury, JOURNAL OF ANATOMY, Vol: 225, Pages: 492-501, ISSN: 0021-8782
Brooks HF, Moss RF, Davies NA, et al., 2014, Caecal ligation and puncture induced sepsis in the rat results in increased brain water content and perimicrovessel oedema, METABOLIC BRAIN DISEASE, Vol: 29, Pages: 837-843, ISSN: 0885-7490
Benjamin P, Davies DC, 2011, Investigation of the size and axonal content of the anterior commissure of the Japanese Quail, JOURNAL OF ANATOMY, Vol: 218, Pages: 356-356, ISSN: 0021-8782
Ahmed K, Rowland S, Patel VM, et al., 2011, Specialist anatomy: Is the structure of teaching adequate?, Surgeon, Vol: 9, Pages: 312-317, ISSN: 1479-666X
BACKGROUND: A knowledge and understanding of specialist anatomy, which includes radiological, laparoscopic, endoscopic and endovascular anatomy is essential for interpretation of imaging and development of procedural skills. METHODS AND MATERIALS: Medical students, specialist trainees and specialists from the London (England, UK) area were surveyed to investigate individual experiences and recommendations for: (1) timing of the introduction of specialist anatomy teaching, and (2) pedagogical methods used. Opinions relating to radiological, laparoscopic, endoscopic and endovascular anatomy were collected. Non-parametric tests were used to investigate differences in recommendations between specialist trainees and specialists. RESULTS: Two hundred and twenty-eight (53%) individuals responded to the survey. Imaging was most commonly used to learn radiological anatomy (94.5%). Procedural observation was most commonly used to learn laparoscopic (89.0%), endoscopic (87.3%) and endovascular anatomy (66.2%). Imaging was the most recommended method to learn radiological anatomy (92.1%). Procedural observation was the most recommended method for learning laparoscopic (80.0%), endoscopic (81.2%) and endovascular anatomy (42.5%). Specialist trainees and specialists recommended introduction of specialist anatomy during undergraduate training. CONCLUSION: Although the methods for specialist anatomy learning are in practice, there is no consensus on timing and structure within the anatomy curriculum. Recommendations from trainees and specialists should be considered so that the existing curriculum can be refined to maximise learning outcomes.
Rowland S, Ahmed K, Davies DC, et al., 2011, Assessment of anatomical knowledge for clinical practice: perceptions of clinicians and students, Surg Radiol Anat, Vol: 33, Pages: 263-269, ISSN: 0930-1038
PURPOSE: In anatomy education, assessment may be done by written, practical or oral methods. These are used to varying degrees in UK medical schools with no consensus on the preferred approach. The purpose of this article is to highlight changes to methods of anatomical knowledge assessment utilised in medical schools since the early 1990s and to present recommended methods of assessment according to the level of medical training. METHODS: Medical students, trainees and specialists in the London (UK) area were surveyed to: (1) identify methods experienced in anatomy education at medical school and (2) gather recommendations. Medical student, trainee and specialist responses were compared using non-parametric tests. RESULTS: Two hundred and twenty-eight individuals responded to the survey giving a response rate of 53%. Subjects who graduated before 2005 were assessed significantly more frequently by practical (94.2 vs. 33.3%) and oral (84.5 vs. 13.1%) methods than those whose graduation year was 2005 or later. Subjects whose graduation year was 2005 or later were assessed significantly more frequently by written methods, such as EMQs than those whose graduation was before 2005 (68.7 vs. 25.2%). Practical examination was identified as the most recommended method of assessment in anatomy education by medical students (59.1%), trainees (all stages combined; 54.2%) and specialists (51.7%). CONCLUSION: Practical assessment is recommended over written and oral methods for the assessment of anatomical knowledge. A formal evaluation of the relative benefits and limitations of available assessment tools is required.
Wright G, Soper R, Brooks HF, et al., 2010, Role of aquaporin-4 in the development of brain oedema in liver failure, JOURNAL OF HEPATOLOGY, Vol: 53, Pages: 91-97, ISSN: 0168-8278
Ahmed K, Rowland S, Patel V, et al., 2010, Is the structure of anatomy curriculum adequate for safe medical practice?, Surgeon, Vol: 8, Pages: 318-324, ISSN: 1479-666X
INTRODUCTION: Anatomy has been considered a core subject within the medical education curriculum. In the current setting of ever-changing diagnostic and treatment modalities, the opinion of both students and trainers is crucial for the design of an anatomy curriculum which fulfils the criteria required for safe medical practice. METHODS: Medical students, trainees and specialist trainee doctors and specialists from the London (England) area were surveyed to investigate the how curriculum changes have affected the relevance of anatomical knowledge to clinical practice and to identify recommendations for optimum teaching methods. The survey employed 5-point Likert scales and multiple-choice questions. Where the effect of training level was statistically significant (p < 0.05), post-hoc analysis was carried out using Mann-Whitney U tests. Significance levels were modified according to the Bonferroni method. RESULTS: Two hundred and twenty-eight individuals completed the survey giving a response rate of 53%. Medical students, trainees and specialists all agreed (mean Likert score 4.51, 4.79, 4.69 respectively) that knowledge of anatomy is important for medical practice. Most of the trainees (88.4%) and specialists (81.3%) used dissection to learn anatomy, but only 61.4% of medical students used this approach. Dissection was the most commonly recommended approach for learning anatomy across all the groups (41.7%-69.3%). CONCLUSIONS: Knowledge of anatomy is perceived to be important for safe clinical practice. Anatomy should be taught with other relevant system or clinical modules. Newer tools for anatomy teaching need further validation before incorporation into the curriculum.
Wilson CA, Dakin CL, Rico JA, et al., 2009, The Anti-Dopaminergic Agent, Haloperidol, Antagonises the Feminising Effect of Neonatal Serotonin on Sexually Dimorphic Hypothalamic Nuclei and Tyrosine Hydroxylase Immunoreactive Neurones, JOURNAL OF NEUROENDOCRINOLOGY, Vol: 21, Pages: 648-656, ISSN: 0953-8194
Davies NA, Wright G, Ytrebo LM, et al., 2009, L-Ornithine and Phenylacetate Synergistically Produce Sustained Reduction in Ammonia and Brain Water in Cirrhotic Rats, HEPATOLOGY, Vol: 50, Pages: 155-164, ISSN: 0270-9139
Saint-Dizier H, Constantin P, Davies DC, et al., 2009, Subdivisions of the arcopallium/posterior pallial amygdala complex are differentially involved in the control of fear behaviour in the Japanese quail, BRAIN RESEARCH BULLETIN, Vol: 79, Pages: 288-295, ISSN: 0361-9230
Davies DC, Bradley EM, Szewczy KA, et al., 2009, Sepsis induces pathological changes in the spinal cord, FASEB JOURNAL, Vol: 23, ISSN: 0892-6638
Saadoun S, Tait MJ, Reza A, et al., 2009, AQP4 gene deletion in mice does not alter blood-brain barrier integrity or brain morphology., Neuroscience, Vol: 161, Pages: 764-772
Barton DJP, Davies DC, Mahadevan V, et al., 2009, Dissection of soft-preserved cadavers in the training of gynaecological oncologists: report of the first UK workshop, Gynecologic Oncology, Vol: 113, Pages: 352-346
Pearce CJ, Sexton SA, Davies DC, et al., 2008, The transverse acetabular ligament may be used to align the acetabular cup in total hip arthroplasty., Hip International, Vol: 18, Pages: 7-10
Dakin CL, Wilson CA, Kallo I, et al., 2008, Neonatal stimulation of 5HT2 reeptors reduces androgen receptor expression in the rat anteroventral periventricular nucleus and sexually dimorphic preoptic area, European Journal of Neuroscience, Vol: 27, Pages: 2473-2480
Barton DPG, Davies DC, Dennis L, 2008, Re: Spackman R, Wrigley B, Roberts A, Quinn M. 2007. The inferior hypogastric plexus: a different view. Journal of Obstetrics and Gyanaecology 27:130-133., Journal of Obstetrics and Gynaecology, Vol: 28, Pages: 141-142
Brooks HF, Osabutey CK, Moss RF, et al., 2007, Caecal ligation and puncture in the rat mimics the pathophysiological changes in human sepsis and causes multi-organ dysfunction, 4th International Hannover Conference on Hepatic Encephalopathy, Publisher: SPRINGER/PLENUM PUBLISHERS, Pages: 353-373, ISSN: 0885-7490
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