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Biomedical subjects

D Rosenbaum

Publications and source records attributed to D Rosenbaum.

117 records · Page 7Linked to original sources
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Diagnosis and treatment for children who cannot control urination.

Primary NE is probably a condition rooted in biologic problems. There is a strong hereditary component. Altered nervous system function may lead to disorganization of how bladder function is controlled and how vasopressin is released. In extreme cases, this disorganization may also be reflected in psychologic issues, such as attention-deficit disorder. Primary NE should not be viewed as laziness of the child, but as an obstacle the child needs professional help to hurdle. The practitioner should collaborate with a pediatrician, urologist, and psychologist in managing children who wet. Routine office evaluation should exclude incontinence as a cause of wetting. When a screening ultrasonogram is normal, this helps the practitioner determine that striking birth defects are unlikely. Follow-up of management by interview with interested staff is necessary. Wetting is reliably correctable and probably best addressed by combination treatment structured as an ETP. Specific treatments vary according to personal preferences. The treatment with strongest scientific research, desmopressin, may be the least effective for cure. The most effective treatment for cure, alarm with behavior reinforcement, is the least often prescribed. A miscellany of adjunctive treatments should be suggested when there are abnormalities in functional bladder capacity, defecation, urethritis, vulvitis, diet sensitivity, upper-airway obstruction, and other areas.

Child↗
PubMedDate not supplied

[Objective measures of gait following revision hip arthroplasty. First medium-term results 2.6 years after surgery].

AIM: The purpose of the study was to identify the functional impairments after revision arthroplasty by gait analysis. METHODS: This retrospective study compared 33 patients (mean age 58.5 years) who have undergone revision of an acetabular component (mean follow-up 2.6 years) with a group of normal control subjects. Gait analysis including recording of the three dimensional kinetics and kinematics was performed in all patients. Surface electromyography of seven leg and trunk muscles were registered bilaterally. The vertical ground reaction forces were determined by two force plates. These data were correlated with the Harris Hip Score, the d'Aubigné Score and the radiographic analysis (centre of rotation). RESULTS: The analysis revealed a decreased hip range of motion during gait (p < 0.0001). In the sagittal plane there was a significant decrease in the hip extension at the end of the stance phase (p < 0.0001). The control group reached a mean extension of - 7.6 degrees, the operated patients were limited by the extension deficit (+ 9.1) in step length (p < 0.0016) and velocity (p < 0.0001). Kinetic parameters indicated a reduced hip abductor moment (p < 0.0001). Compensation of gait instability was observed in an extended stance phase (p = 0.0389). The hip muscle activity was increased to stabilize the impaired hip. The changed kinematic parameters are observed with secondary impairments in knee extension and reduced dorsiflexion in ankle motion (p < 0.0001). Neither the Harris Hip score (77.8 points) nor the d'Aubigné score (14.9 points) were associated with the motion analysis (p > 0.05). Deterioration in kinematics are indicated by cranialisation of the centre of rotation (p = 0.18). However, medial movement of the centre of rotation does not influence the kinematic data (p > 0.05). CONCLUSION: Despite sufficient satisfactory clinical data the gait analysis confirmed objective impairments of the operated hip and neighboring joints. Gait instability is revealed in a decreased hip extension and deficient hip abduction.

Acetabulum↗
PubMedDate not supplied

[Influence of postoperative shoes on plantar pressure patterns].

AIM: There are several different types of shoe devices in the postoperative treatment of forefoot surgery. They all have the aim to unload the operated region. Examples for forefoot surgery are hallux valgus operations or correction of claw toes. The aim of this study was to compare a special forefoot shoe (Darco's Ortho Wedge) with a lengthwise and crosswise prepared postoperative shoe (Darco's Medical Surgical). METHOD: Plantar pressure distribution measurements were used to evaluate the unloading effect of the shoe conditions. The pressure in a standard shoe (Nike's Air Triax) was measured for further comparison. RESULTS: The results demonstrate that all analyzed shoes relieve weight under the medial forefoot region. The lengthwise prepared Medical Surgical achieves the highest pressure reduction under the medial forefoot, but the midfoot and the lateral forefoot are subjected to significantly higher loads. The Ortho Wedge reduces the load under the toes and the forefoot and relieves the midfoot region. The pressure is redistributed under the hindfoot. The crosswise prepared Medical Surgical also relieves pressure under the forefoot but not to the same extent as the Ortho Wedge. CONCLUSION: In conclusion it can be stated that the Ortho Wedge shows the best results of the tested shoes for pressure relief and load transfer under the forefoot.

Adolescent↗
PubMedDate not supplied

[Retrospective analysis of march fractures in the german armed forces in the years 1998 to 2000].

AIM: The aim of this study was to determine the incidence/frequency of march fractures in the German Armed Forces in the years from 1998 to 2000. In particular, the age, length of service, distribution of the metatarsals and the occurrence of anthropometric risk factors were considered. METHODS: At the Medicostatistical Institute of the German Armed Forces the records of soldiers, 191 cases with 204 fractures, with diagnosed "march fractures" were selected and analyzed. RESULTS: 82% of the affected soldiers were between 19 and 22 years old. More than 50% of the fractures occurred within the first eight weeks of service. In about 64% the 3rd metatarsal was affected, in 25% the 2nd metatarsal and in only 11% of all cases the 4th, 5th, and 1st metatarsals. Soldiers were exempted from duty for an average of 26.5 days. No specific anthropometric risk factors were found to be connected with the occurrence of march fractures. CONCLUSION: March fractures in the German Armed Forces are non-predictable injuries of young and physically fit individuals; youth is not a protective factor. There is an increased risk for march fractures during the first weeks of military service. There appears to be no possibility for a screening.

Adolescent↗
PubMedDate not supplied

Neurologic complications of pediatric femoral nailing.

Neurologic complications of femoral rodding with interlocking nails were investigated in 35 consecutive pediatric patients, aged 10-17 years, with traumatic femur fractures. We examined various risk factors for neurologic complications, including timing and duration of surgery, preoperative and intraoperative traction type, adequacy of preoperative traction, intraoperative patient position, degree of comminution of the fracture, and use of interlocking screws. There were eight (22.2%) neurologic complications. Of these, only two (5.6%) persisted for longer than a week. The combination of surgical delay > 48 h, preoperative shortening, and the use of boot traction increased the incidence of all palsies to 5.68 times and peroneal palsies to 11.4 times that of patients without this combination of risk factors. Adequate pre- and intraoperative skeletal traction, especially in patients with hours of surgical delay, may decrease the incidence of neurologic complications in pediatric femoral nailings.

Adolescent↗