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Biomedical subjects

A Fast

Publications and source records attributed to A Fast.

At least 37 records · Page 2Linked to original sources
PubMed1989

Gluteal abscess causing sciatica in a patient with systemic lupus erythematosus.

Low back pain and sciatica may be caused by pathology remote from disc and lumbosacral vertebral segments. We report on a 59-year-old patient with systemic lupus erythematosis whose history illustrates this point. The patient was evaluated and diagnosed to have a septic arthritis of the wrist and lumbar spinal stenosis, for which she was treated. The patient's failure to respond to therapy led to further evaluation. A massive gluteal abscess was identified and drained, and with appropriate antibiotic therapy, the patient recovered. Patients with lupus have increased likelihood of infection, and their evaluation should include a search to discover unusual locations in cases that are unresponsive to standard and seemingly appropriate therapy.

Abscess↗
PubMed1989

Dermatitis-sympathetic dysfunction in carpal tunnel syndrome. A case report.

A 52-year-old woman complained of numbness affecting the thumb, index, and middle fingers of both hands. The patient was managed with night splints with partial relief of symptoms. As a house cleaner, the patient was routinely exposed to water and detergents. About a year later, the patient developed contact dermatitis in the fingertips innervated by the median nerves. Electromyographic studies confirmed the presence of bilateral carpal tunnel syndrome. The temperature of all the fingertips was measured. The median innervated fingertips were warmer than those innervated by the ulnar nerves. The median sympathetic fibers may be compromized by compression in the carpal tunnel. This caused vasodilation, increased finger temperature, and lack of sweating in the median innervated fingers. Due to regular exposure to water and detergents, the susceptible dry fingertips developed contact dermatitis. The patient was managed conservatively, and the rash and numbness disappeared.

Carpal Tunnel Syndrome↗
PubMed1988

Low back disorders: conservative management.

Painful disorders of the low back may arise from a large variety of mechanisms and there is no simple, single solution to them. They have a great social and economic cost in industrialized countries. The major syndromes of low back pain and sciatica are reviewed, including myofascial pain syndromes, disc herniations, radiculopathies, spinal stenosis and facet syndromes. Non-operative management is reviewed, including bed rest, medications, traction, manipulation, external supports, physical modalities, therapeutic exercise, trigger point injection and chemonucleolysis. Prevention should become the main goal of physicians dealing with this multifaceted problem.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1987

Disseminated intravascular coagulopathy in patients with cancer undergoing operation for pathological fractures of the hip.

Disseminated intravascular coagulopathy is a serious complication of numerous pathological conditions, particularly metastatic cancer. It is rarely encountered in orthopaedic surgery. Prompt recognition and treatment is required to prevent death. We describe two patients with pathological fractures of the proximal femur due to metastatic disease who died from disseminated intravascular coagulation after operation. A high index of suspicion, careful monitoring of the clotting mechanism and prompt treatment are required.

Aged↗
PubMed1987

Low-back pain in pregnancy.

Two hundred women were interviewed within 24-36 hours after giving birth. The patients were not examined. It was found that 56% of the patients suffered from low-back pain during pregnancy. The percentage of Caucasians was statistically higher in the back pain group. The percentage of Hispanics was statistically higher in the no pain group. Among the variables that were compared in both groups were the age, the weight gained by the mothers during pregnancy, the baby's weight, the number of previous pregnancies, number of prior children. None of the variables reached a statistically significant level. The pain group complained of pain the low-back area, which radiated in 45.5% of cases to the lower extremities. In about one-third of the patients the pain increased as the day wore on, whereas in another one-third the pain increased during the night and disturbed sleep. Standing, sitting, forward bending, lifting, and walking tended to increase the pain. Most of the patients started suffering from back pain between the fifth and seventh months of pregnancy. Several theories to explain the occurrence of backache during pregnancy are discussed.

Back Pain↗
PubMed1987

Vertebral artery damage complicating cervical manipulation.

Cervical manipulation may result in serious neurologic injury arising specifically from trauma to the vertebrobasilar system. The vertebral arteries are susceptible to trauma at three locations: in the transverse foraminae, at the atlantoaxial joint, and at the occipitoatlantal joint. Because of frequent inequality in the size of the two vertebral arteries, damage to the larger artery may lead to ischemia of the brain stem. Vertebral artery obstruction may be produced by extension with rotation, even within normal ranges of motion. Neurologic injury following manipulation requires accurate diagnosis and prompt manipulation requires accurate diagnosis and prompt anticoagulant therapy.

Adult↗
PubMed1987

Radial nerve damage as a complication of elbow arthroscopy.

Posterior interosseous nerve damage following elbow arthroscopy occurred in a 20-year-old athlete. The course of the radial nerve brings it in proximity to the puncture site when the dorsoradial approach is selected. This case emphasizes the importance of careful attention to vital structures if the complication of a posterior interosseous nerve syndrome is to be avoided.

Adult↗
PubMed1986

The simultaneous application of an interspinous compressive wire and Harrington distraction rods in the treatment of fracture-dislocation of the thoracic and lumbar spine.

During open reduction of thoracolumbar fracture-dislocation, the normal constraints to distraction and lengthening may be ruptured and allow instrumentation to exert deleterious traction of the spinal cord. An interspinous wire across the unstable segment together with a Harrington rod may be used to prevent potential overdistribution of the spinal cord. Thirty-six patients with fracture-dislocation of the thoracolumbar spine were treated by open reduction with Harrington rods and interspinous wiring. Of 15 patients with a partial cord lesion, four made complete recovery, and nine of the remaining 11 became ambulators. Six patients with a complete paraplegia did not improve; 15 patients remained neurologically intact following the procedure. The compressive wire and Harrington rods act in concert and enable correction of kyphosis and restoration of vertebral and discal height while protecting the cord against traction. The technique is safe and does not add to operative time.

Adolescent↗
PubMed1986

Spine fractures in ankylosing spondylitis.

Patients with ankylosing spondylitis are susceptible to spine fracture, usually in the cervical spine. Less frequently, the thoracic and lumbar spine is affected. The fracture line may involve anterior and posterior elements. Frequently, it extends through the entire width of the spine. As a result the fracture tends to be unstable and may cause neurologic damage. Prompt immobilization and reduction of the dislocated spine followed by stabilization may prevent neurologic damage. We report a 45-year-old man who fell and sustained a fracture dislocation of L2 vertebra. The patient was operated and stabilized with Harrington rods. A deep wound infection developed, which did not respond to antibiotic therapy and led to removal of the rods. In spite of bed immobilization with a body jacket the fracture remained unstable and dislocated. As a result the patient sustained severe neurologic damage. Many fractures in patients with ankylosing spondylitis occur following minor trauma. We feel that a very important aspect of ankylosing spondylitis management is prevention of these fractures. Alerting patients of their spine fragility and teaching then how to evade situations leading to spinal trauma may help in avoiding this situation.

Fractures, Bone↗
PubMed1985

Surgical treatment of lumbar spinal stenosis in the elderly.

Unrelenting sciatica or intermittent neurogenic claudication in the elderly may be caused by degenerative lumbar spinal stenosis. This rather common condition is produced by advanced multilevel disc degeneration leading to facet hypertrophy, infolding of ligamentum flavum, descent of the pedicles, and occasional disc herniation. The symptoms of lumbar spinal stenosis usually do not improve with time. Despite the advanced age of some patients, surgical decompression may offer significant relief. Of 19 patients who underwent lumbar decompressive laminectomy, 18 showed sufficient improvement to return to normal daily activities.

Aged↗
PubMed1984

Protrusio acetabuli in Marfan's syndrome: report on two patients.

Marfan's syndrome is a hereditary disorder of connective tissue, involving the ophthalmic, cardiovascular and musculoskeletal systems. Two cases are described in which protrusio acetabuli was a major problem. Otto pelvis should be considered as one of the musculoskeletal manifestations of Marfan's syndrome.

Acetabulum↗
PubMed1984

Osseous involvement in de Quervain's disease.

Osseous involvement is usually not appreciated in de Quervain's stenosing tenosynovitis. A case of stenosing tenosynovitis accompanied by significant local osteoporosis in the radial styloid area and a corresponding positive area on a technetium-99m polyphosphonate bone scan provoked the authors' interest in this entity. In seven consecutive patients with de Quervain's disease, six had evidence of osseous involvement of the radial styloid as demonstrated by roentgenographic studies and/or technetium bone scanning. In the process of differential diagnosis of a lytic lesion in the radial styloid area, de Quervain's tenosynovitis should be included.

Adult↗
PubMed1983

Electrically elicited blink reflex in children.

Blink reflex was studied in 12 neurologically intact infants and children aged 2 weeks to 3 years. A coaxial needle electrode inserted in the outer lower quadrant of the orbicularis oculi muscle was used for recording. Responses were elicited by a 50-100V current delivered through a stimulating electrode placed on the supraorbital groove. Absence of contralateral R2 response was a consistent finding. Ipsilateral R2 responses were elicited in 50% of the cases. R1 response was present in all instances and showed latency values similar to adults. The amplitudes of both R1 and R2 were lower than reported in adult population. The blink reflex may be an indication of the degree of myelination of the brain stem, facial and trigeminal pathways in children.

Age Factors↗
PubMed1983

Control of massive retroperitoneal bleeding associated with pelvic fractures by angiographic embolization.

Continuous retroperitoneal bleeding may be an immediate life-threatening complication of pelvic fractures. While surgical control of the bleeding vessels has been advocated in these cases, today angiographic embolization of the branches of the internal iliac arteries is proving to be the treatment of choice. This is a relatively simple, safe, prompt and effective method of controlling the hemorrhage. It avoids the disadvantages of surgery, general anesthesia, loss of the tamponade effect of the retroperitoneum when opened, and the not uncommon difficulty of identifying and ligating the bleeding vessels. Two cases in which massive retroperitoneal bleeding associated with pelvic fractures was controlled by angiographic embolization are described, illustrating the importance of early angiography.

Angiography↗