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Biomedical subjects

Albert J Aboulafia

Publications and source records attributed to Albert J Aboulafia.

12 recordsLinked to original sources
PubMed2005

Palliative care and orthopedics: what is on the horizon?

Patient-centered palliative care involves effective and empathetic communication between the physician and patient, with the ultimate goal of providing improved quality of life for individuals who have terminal illnesses. Although several nonoperative and operative treatment options are available to improve the patient's quality of life, providing palliative care requires more than technical expertise and knowledge. Orthopedic surgeons need to be supportive facilitators who inform patients of the available treatments, risks, and benefits and incorporate these treatments into the wishes of patients and their families. Realistic expectations and outcomes of treatment need to be discussed with patients so that they can decide what risks they are willing to accept and what measures of success are meaningful to them. Advances in medical treatments and surgical techniques and principles are available to patients who have metastatic bone disease that were not available less than a decade ago. Although many orthopedic surgeons are involved in the care of patients who have metastatic disease, at times, expertise from an orthopedic oncologist may be required to optimize palliative care.

Bone Neoplasms↗
PubMed2002

Prereferral evaluation of patients with suspected bone and soft tissue tumors.

One hundred consecutive patients referred to an orthopaedic oncology practice for evaluation of suspected bone or soft tissue tumors were studied prospectively. There were 76 patients with bone lesions and 24 patients with soft tissue lesions. At the time of initial consultation, information regarding the referring diagnosis, number of prior physician office visits, and prereferral imaging studies obtained was collected. There were 50 patients with benign tumors, 17 patients with primary malignant tumors, 11 patients with metastatic tumors, and 22 patients with nonneoplastic conditions. The average number of physician visits before referral for the entire group was 4.8 visits and was highest for patients with malignant bone tumors (6.2 visits). Imaging studies obtained before referral included plain radiographs, magnetic resonance imaging, bone scans, computed tomography scans, and ultrasound. None of the plain radiographs were thought to be unnecessary; however, 26 of 76 (34.2%) magnetic resonance imaging scans, 17 of 40 (42.5%) bone scans, and 13 of 36 (36.1%) computed tomography scans were excessive and did not contribute to the evaluation of the lesion. Although only 58% of the study group included patients with benign bone tumors and nonneoplastic bone lesions, they accounted for the majority (79%) of unnecessary imaging studies. Primary care physicians and general orthopaedic physicians were equally likely to order unnecessary imaging studies (48% and 52%, respectively).

Adolescent↗
PubMed2002

Imaging of soft-tissue myxoma with emphasis on CT and MR and comparison of radiologic and pathologic findings.

PURPOSE: To determine the imaging characteristics of soft-tissue myxoma, with emphasis on computed tomographic (CT) and magnetic resonance (MR) imaging findings and pathologic comparison. MATERIALS AND METHODS: Records of 45 pathologically confirmed soft-tissue myxomas in 44 patients were retrospectively reviewed. Patient demographics and radiographs (n = 20), bone scintigrams (n = 2), angiograms (n = 3), and ultrasonographic (US) (n = 6), CT (n = 14), and MR images (n = 33) were evaluated by two musculoskeletal radiologists with agreement by consensus for lesion location, lesion size, and intrinsic characteristics. RESULTS: Soft-tissue myxoma more commonly affected women (59%; average age 52 years) and manifested as a slowly enlarging (64%) painful (51%) mass. Lesions were most frequently intramuscular (82%) and involved the thigh (51%). An appearance similar to that of a cyst was seen at CT (at which the lesions demonstrated low attenuation) and at MR imaging (at which the lesions demonstrated markedly high signal intensity on T2-weighted images) in all cases because of the high water content of mucin that was seen histologically. The true solid architecture of these lesions was best depicted in all cases at US (at which the lesions were hypoechoic, not anechoic) and on MR images obtained with contrast material (at which the lesions demonstrated internal enhancement). A small amount of tissue similar to fat surrounding these intramuscular myxomas (71% at MR imaging) corresponded histologically (70%) to atrophy of surrounding muscle. CONCLUSION: Soft-tissue myxoma often demonstrates characteristic US, CT, and MR imaging findings, including intramuscular location, intrinsic high water content, and a surrounding rim of fat.

Adolescent↗
PubMedDate not supplied

Pediatric soft-tissue tumors.

Soft-tissue tumors in children (<18 years) are a heterogeneous group of lesions. Masses may be asymptomatic or associated with pain or discomfort. Although most lesions are benign, developing an appropriate differential diagnosis requires knowledge of the clinical and radiographic characteristics of tumors and tumorlike conditions in children. A thorough history and physical examination, followed by appropriate imaging studies, when indicated, can establish a correct diagnosis and help determine appropriate treatment recommendations.

Adolescent↗