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Biomedical subjects

A Frank

Publications and source records attributed to A Frank.

At least 289 records · Page 16Linked to original sources
PubMedDate not supplied

Relationship of interleukin-1 beta and beta 2-microglobulin with neuropeptides in cerebrospinal fluid of patients with dementia of the Alzheimer type.

We studied interleukin-1 beta (IL-1 beta), beta 2-microglobulin (beta 2-m), beta-endorphin, substance P, neuropeptide Y and somatostatin concentrations in the cerebrospinal fluid of 13 patients with dementia of the Alzheimer type (DAT), 13 patients with multi-infarct dementia (MID) and 15 age-matched control subjects. Substance P was significantly lower in DAT than in controls (P < 0.05), as well as somatostatin in DAT as compared to both controls (P < 0.01) and MID (P < 0.05), whereas beta 2-m was higher in DAT than in controls (P < 0.01). Neuropeptide Y, beta-endorphin and IL-1 beta showed similar concentrations in the three groups studied. A significantly positive correlation was observed between IL-1 beta and substance P (r = 0.79, P < 0.01) and somatostatin (r = 0.75, P < 0.05) in DAT, which was not observed in MID. In addition, beta 2-m showed a negative correlation with IL-1 beta (r = -0.73, P < 0.05) in DAT, and age correlated negatively with IL-1 beta in controls and MID, but positively in DAT. Therefore, these results support the idea that an altered relationship may exist in Alzheimer's disease between the nervous and immune system.

Aged↗
PubMedDate not supplied

Arthroscopic release of the glenohumeral joint in shoulder stiffness: a review of 26 cases. French Society for Arthroscopy.

The purpose of this multicenter retrospective study of arthroscopic release of the glenohumeral joint was to evaluate the technical feasibility, the results, and the potential correlations between results and cause of the stiffness. Twenty-six shoulders in 25 patients (19 women and six men) were re-evaluated 3 to 72 months (mean, 21 months) after arthroscopic release of the glenohumeral joint. Diagnoses were primary frozen shoulder in 13 cases, bipolar stiffness (rotator cuff tear plus capsular contraction) in 3 cases, and postinjury or postsurgery stiffness in 10 cases. Results were evaluated on passive range of motion, Constant's score, and subjective assessment. Anterior or anterior inferior capsular release was done at the anterior rim of the glenoid fossa. Posterior capsule release was not performed in this series. There were no intraoperative complications. Mean range of motion gains were 86 degrees for forward elevation, 72 degrees for abduction, 34 degrees for external rotation, and 6 spinal processes for internal rotation. Constant's range of motion score increased from 12.9 out of 40 to 32 out of 40 points. Thirteen patients were very satisfied, 5 satisfied, 5 improved, and 3 unchanged. Range of motion gains were independent from the cause of shoulder stiffness, but global results were better in the primary frozen shoulder group in terms of pain and strength. Arthroscopic release of the glenohumeral joint is feasible and safe. For primary frozen shoulders, in case of failure of the functional treatment, arthroscopic release is a less traumatic alternative to manipulation under general anesthesia. For bipolar stiffness, arthroscopy provides the opportunity for treating concomitant lesions. For postsurgical stiffness, arthroscopic release improves range of motion, but the shoulder often remains painful.

Adult↗
PubMedDate not supplied

A multicenter study of 210 rotator cuff tears treated by arthroscopic acromioplasty.

We followed 210 cases of rotator cuff tears treated in four French centers by arthroscopic acromioplasty in 195 cases and by a tenotomy of the Long Head of Biceps (LHB) in 15 cases. All patients were evaluated by means of the Constant score (CS) and radiographic imaging. The mean age was 61 years and the mean follow-up period was 26.6 months (range, 12 to 93 months). The preoperative CS was 38.2 points; 41% were supraspinatus tears, 40.2% were supra and infraspinatus tears, 10.5% were three-tendon tears, and 8.1% were supraspinatus and subscapularis tears. The LHB was altered or disrupted in 77% of cases, dislocated or subluxated in 44% of cases. Acromioplasty was associated to tear debridement in 183 cases (88%) and to a tenotomy of the LHB in 38 cases (19%) of which 15 did not benefit from an associated acromioplasty. Global objective results shown by the corrected CS reached 79.7% and were satisfying in 73% of cases. Poor clinical factors were preoperative shoulder stiffness, postoperative painful crises, worker compensation, a preoperative history longer than 4 years, and young age. The poor anatomic factors were osteoarthritis, a lesion of the acromioclavicular joint or of the LHB tendon. An isolated supraspinatus tear will produce much better results than a triple-tendon tear. The persistence of an aggressive acromion was a prejudicial factor. The benefits of LHB tenotomy were evident and could be isolated in case of massive rotator tears. It seems that LHB tenotomy was particularly effective for massive tears of two or more tendons. Arthroscopic acromioplasty is an excellent indication for elderly patients without professional activity, functionally less demanding that a younger patient.

Acromion↗
PubMedDate not supplied

Arthroscopic treatment of osteochondral lesions of the talar dome: a retrospective study of 48 cases.

We treated 48 symptomatic osteochondral lesions of the talar dome arthroscopically. Of these, 18 patients had an osteochondral fracture with a loose fragment located in every case on the anteriolateral side of the talus. Treatment consisted of removal (16 cases) or fixation (2 cases) of the bone fragment. Thirty patients had chronic lesions (27 subchondral necrosis with a sequestrum and 3 extensive cysts). The lesion was posteromedial in 27 cases and the treatment consisted of removal of the sequestrum with curettage of the subchondral bone necrosis (27 cases) or transchondral drilling if the cartilage surface was intact (3 cases). All the patients were clinically and radiogically reviewed with a mean follow-up of 5 years (7 months to 11 years). Patients treated for an osteochondral fracture obtained significant better results (16 excellent or good results out of 18 cases) than those treated for chronic lesions (20 excellent or good results out of 30 cases). On radiographic examination, we noticed that, even at the longest follow-up, the bone healing was usually incomplete and the bone defect persisted indefinitely in case of extensive subchondral bone necrosis. The articular surface could be seen in 11 cases (8 computed arthrotomographies, 1 magnetic resonance imaging, and 2 second-look arthroscopies). The fibrous cartilaginous surface was apparently regular in 6 cases without any clear correlation with our clinical results. This study suggests that we must make a distinction between osteochondral fractures (recent or not healed) located in the anterolateral part of the talar dome, which carry a good prognosis, and necrotic lesions located medially, which are less likely to have a favorable outcome.

Adolescent↗
PubMedDate not supplied

[Functional and socioeconomic outcome of inpatient rehabilitation of patients with complex hand injuries].

PURPOSE: Evaluation of functional outcome and socio-economic results of patients with complex hand injuries after inpatient rehabilitation. PATIENTS AND METHODS: In a prospective investigation 36 patients with complex hand injuries received an intensive therapy regime under inpatient conditions. In all patients functional parameters of the hand (total active range of motion, palm to palm distance, spread between thumb and index finger, spread between thumb and little finger) and the score of Buck-Gramcko were registered initially and at the end of inpatient rehabilitation. Socio-economic data (kind of discharge, job reintegration, further treatment) were documented as well. RESULTS: The total active range of motion could be improved from 36% to 69%, spread D1-D5 from 18.5 to 20.7 cm and spread D1-D2 from 13.9 to 15.6 cm. The palp to palm distance of all fingers was reduced from 4.6 cm to 2.3 cm. The Buck-Gramcko score of all injured fingers improved from 4.2 points (poor) at admission, to 11.8 points (good) at discharge, At the end of inpatient rehabilitation 18 patients could return to their job either gradually or on full-time. CONCLUSION: Even patients with complex hand injuries, good functional results could be achieved by an intensive inpatient rehabilitation characterised by close medical supervision and guidance and tight clinical controls.

Adult↗
PubMedDate not supplied

Acupuncture in alcoholism treatment: a randomized out-patient study.

Seventy-two alcoholics were treated with acupuncture to the ear in a randomized single-blind controlled design over 10 weeks. Orthodox points and incorrect points 3-5 mm from orthodox points were used. No initial differences were found regarding social characteristics, the responses to the Swedish version of the Alcohol Use Inventory and the Three-dimensional Personality Questionnaire, indicating a successful randomization. There were non-significant tendencies towards gender differential response after acupuncture treatment (P = 0.07). There was no difference in the number of drinking days or level of craving between treatment and control patients. Among females, those in the treatment group reported reduction of anxiety after 1 month, more often than those in the control group (P < 0.05). Response to acupuncture was not related to personality or drinking pattern. Patients' experience of needle placement was similar in the study and control groups. The effects of acupuncture were less pronounced than those previously reported.

Acupuncture Therapy↗
PubMedDate not supplied

[Atypical neuroradiologic manifestation of systemic lupus erythematosus].

The most frequent neurological lesions found on Cranial Computerized Tomography (CT scan) in patients with Systemic Lupus Erythematosus (SLE) are cortical atrophy (psychosis, although in general atrophy is not associated with a particular clinical presentation), infarcts and haemorraghes (strokes). We describe a patient diagnosed of SLE who developed a psychotic clinical picture followed by generalized epileptic seizures within a context of diffuse lupus encephalopathy. On the neurological examination, she presented cortical blindness, generalized piramidalism and extrapiramidal rigidity. Various electroencephalographic recordings showed signs of diffuse cerebral involvement predominantly in posterior regions. Cerebrospinal fluid analysis showed a slight increase of IgG without oligoclonal bands and a positive anti-DNA antibody with an homogeneous pattern. Sequential CT images were carried out demonstrating hypodense areas initially in the occipital regions that extended progressively to the temporal, parietal and finally to the frontal lobes, with a moderate mass effect on the lateral ventricles and with no contrast enhancement. The images of the lesions on the CT disappeared completely with the adequate treatment as the symptomatology resolved. A MRI and cerebral angiography were performed when the patient recovered. Both MRI and angiography showed no alterations. We consider that this neuroradiological finding is exceptional, because of its total resolution. Nevertheless, more observations will be necessary to determine the exact meaning of these abnormalities.

Adult↗
PubMedDate not supplied

The Job Corps experience with health problems among disadvantaged youth.

Health problems in a disadvantaged group of young people were studied by analysis of Job Corps screening and medical termination data obtained during fiscal year 1975. The Job Corps is a federally funded, residential vocational training program. During fiscal year 1975, the program was conducted in 60 centers throughout the United States. Corpsmembers (ages 16-21) come from poverty backgrounds; in 1975, 55 percent were black. Approximately 1 percent of applicants with serious health problems are screened out by a nonprofessional procedure. Comprehensive health services are provided to corpsmembers; however, limited funds and interference with training prevent continuing care for pregnancies and some serious illness and injuries. Corpsmembers with these conditions are terminated from the Job Corps, and arrangements are made for care in their communities. Less than 2 percent of the corpsmembers were terminated for medical reasons during fiscal year 1975. Pregnancy accounted for 359 terminations. Of 44,390 corpsmembers, 457 were terminated for illness or injury. The majority of these terminations were for mental health problems; trauma was the next largest category. During fiscal year 1975, 22 deaths occurred; 21 were from accidents or suicide. The low medical termination rate among these socioeconomically disadvantaged young people suggests that maintenance of relatively good health is possible over a short period through provision of basic health care and health education, which can be provided largely by allied health personnel under professional supervision.

Adolescent↗