Search PubMed⌕ Search

Biomedical subjects

F Blotman

Publications and source records attributed to F Blotman.

At least 37 records · Page 2Linked to original sources

Conversion of endogenous arachidonic acid to 5,15-diHETE and lipoxins by polymorphonuclear cells from patients with rheumatoid arthritis.

The conversion of endogenous arachidonic acid (AA) by polymorphonuclear cells (PMN) from patients with rheumatoid arthritis (RA) was studied before (D0) and one day (D1) after antiinflammatory drug therapy. The biosynthesis of 5,15-diHETE and lipoxins (LXS), were investigated ex vivo, after PMN stimulation by ionophore A23187 without exogenous addition of 15-HETE. The eicosanoids were resolved by RP-HPLC and simultaneously detected at 246 and 302 nm respectively. Large amounts of 5,15-diHETE (50 to 400 ng/10(7) PMN) and significant levels of LXS (from 2 to 20 ng/10(7) PMN) were produced with individual differences between donors. Metabolite levels varied between patients but this work showed for the first time a linear relationship between the amounts of 5,15-diHETE and LXS. Moreover LXS production after treatment may be related to long-term clinical improvement of patients.

Adult↗

Diagnostic value of clinical tests for shoulder impingement syndrome.

Results of three clinical tests for detecting shoulder impingement syndrome (Neer's, Hawkins', and Yocum's tests) and four tests for determining the location of the rotator cuff lesion (Jobe's test [supraspinatus], Patte's test [infraspinatus], lift-off test [subscapularis], and palm-up test [long head of the biceps brachii]) were compared to intraoperatively observed anatomic lesions in 55 consecutive patients who had surgery for Neer's syndrome. For Jobe's and Patte's tests, both pain (denoting tendinitis) and functional impairment (denoting tendon rupture) were evaluated. All clinical tests were done by the same examiner and all surgical procedures (acromioplasty with or without rotator cuff repair) by the same surgeon. The location and extent of the lesions (size of the tear in the 34 patients with rotator cuff defects) were determined intraoperatively. The sensitivity, specificity, and positive and negative predictive values of each test were calculated. Sensitivity was satisfactory but specificity was poor, in particular for determining the location and type of rotator cuff lesions. The severity of functional impairment during Jobe's and Patte's maneuvers was not correlated with the size of the tear.

Adult↗

Postoperative shoulder rotators strength in stages II and III impingement syndrome.

In healthy subjects, the shoulder internal rotator muscle strength overrides the external rotators. This has been confirmed in different isokinetic studies showing the ratio of the relative strengths of the internal to external rotators to range from 1.3 to 1.5 points, depending on the study. The authors previously reported a decrease in the relative strength ratio of the internal to external rotators to close to 1 in patients suffering from Neer's impingement syndrome. The aim of the present study was to assess, long after surgery (mean, 44.5 months), the isokinetic strength performance of shoulder rotator muscles in 72 patients who had had operative treatment for chronic subacromial impingement using anterior acromioplasty, sometimes combined with cuff repair surgery. Tests were conducted with a Biodex Multi-Joint System in the plane of the scapula and in 45 degrees abduction at 60 degrees and 180 degrees per second. Peak torque and average power were calculated. The mean ratios of relative strengths of the internal to external rotators ranged from 1.3 to 1.6 points depending on the parameter studied and the test speed. These results indicate that surgery restores normal muscular balance between shoulder rotator muscles affected by the impingement syndrome.

Acromion↗

Are classification criteria for spondylarthropathy useful as diagnostic criteria?

The authors used data from a study conducted under the auspices of the Société Française de Rhumatologie to evaluate the sensitivity and specificity of the individual items of two sets of criteria for spondylarthropathy. The study included 124 patients with spondylarthropathy and 1,964 controls. They found that the spondylarthropathy criteria with the highest sensitivities and specificities were useful not only for classifying patients but also for assisting in the diagnosis of spondylarthropathy.

Humans↗

[Inferior glenohumeral subluxation: an indirect sign of sepsis of the shoulder].

Drooping shoulder is a roentgenographic abnormality consisting in a discontinuity in the scapulo-humeral arch due to inferior subdislocation of the humeral head. Drooping shoulder is commonly seen in patients with injuries to the shoulder or neurological loss. Two cases of drooping shoulder due to staphylococcal arthritis (after local corticosteroid injections) are reported herein. The mechanism of the downward humeral displacement in septic arthritis is discussed. The other causes of drooping shoulder are reviewed. Precautions needed to avoid increasing the displacement during rehabilitation therapy are outlined.

Adult↗

Isokinetic evaluation of rotational strength in normal shoulders and shoulders with impingement syndrome.

The purpose of this study was to determine whether imbalance of the internal and external rotator musculature of the shoulder were etiological factors implicated in impingement syndrome. Shoulder torque measurements were obtained from 15 asymptomatic volunteers and 30 patients with chronic impingement syndrome, 15 of whom were evaluated after arthroscopic anterior acromioplasty. Isokinetic strength was assessed using the Biodex system in a modified position (in the plane of the scapula and in 45 degrees abduction) with test speeds of 60 degrees and 180 degrees per second. Internal and external rotator strength values and ratios were calculated for both peak torque and average power. Shoulder rotational strength values and the internal rotator/external rotator ratio were significantly higher in the dominant and nondominant control group shoulders than in the involved and uninvolved impingement shoulders for operated on and nonoperated on patients. These data demonstrate that primary change in the normal internal rotator/external rotator ratio of the shoulder is an etiological factor implicated in impingement syndrome not modified by anterior acromioplasty.

Acromion↗

Sacral insufficiency fractures presenting as acute low-back pain. Biomechanical aspects.

Sacral insufficiency fractures are an often unsuspected cause of low-back pain in elderly women with osteopenia who have sustained unknown or only minimal trauma. The authors describe 10 cases of spontaneous sacral insufficiency fractures, confirmed by computed tomography, characterized by the onset of acute low-back pain. Differential clinical and radiographic diagnosis of these fractures is often difficult. Recognition of the characteristic scintigraphic patterns in sacral fractures, which are frequent in osteopenic patients, could avoid mistaken diagnoses and unnecessary tests or treatment. One of the striking feature of these sacral fractures is their invariable location. The fractures extend vertically in the sacral alae, parallel to the sacroiliac joints. They are located just lateral to the margins of the lumbar spine. This distribution suggests that such fractures could be partially caused by weight-bearing transmitted through the spine.

Aged↗

Measurement of the bone mineral density of the os calcis as an indication of vertebral fracture in women with lumbar osteoarthritis.

In women with lumbar osteoarthritis, measurement of the os calcis bone mineral density (BMD) using dual-energy X-ray absorptiometry (DEXA) as an indication of vertebral fracture was evaluated. The in vivo precision of the method was 1.28%. Age- and sex-matched control curves were evaluated using a control of 193 females. The correlation between spine BMD and os calcis BMD was significant (r = 0.65, p << 0.001). For the osteoporotic women without osteoarthritis (n = 34), there was no significant difference in the spine and the os calcis Z-scores (-1.99SD and -1.83SD respectively). Whereas for osteoporotic women with osteoarthritis (n = 30) the spine Z-score was -0.49SD the os calcis Z-score was -1.92SD. The difference was significant (p < 0.001). Receiver operating characteristic (ROC) curves demonstrate the superiority of the os calcis as a measurement site over the lumbar spine, in correlation with existing crush fractures in the presence of osteoarthritis. It is concluded that when lumbar osteoarthritis occurs measurement of the os calcis BMD using DEXA is clinically useful for the estimation of bone mass.

Absorptiometry, Photon↗

[Determination of the instantaneous center of rotation of the shoulder using the ELITE system. Application to the study of normal and pathological abduction].

The authors determined the in vivo displacement of the instantaneous center of rotation (ICR) of the shoulder from data supplied by an optoelectronic system (ELITE System) which uses a specifically designed software program to achieve 3-dimensional analysis of abduction. The study involved 10 control subjects and 20 patients suffering from a periarticular disorder of the shoulder capsule retraction in 10 cases and rotator cuff tears before and after rehabilitation in 10 cases. This method provides an objective assessment of humeral head misalignment in relation to the glenoid cavity induced by the periarticular shoulder disorder and of the realignment achieved through rehabilitation. The proposed ICR calculation technique is entirely harmless for the patient in (particular because it requires no radiation analysis).

Adult↗

Rotation-abduction analysis in 10 normal and 20 pathologic shoulders. Elite system application.

Kinematics of shoulder rotation-abduction in the plane of the scapula were analysed using the Elite system. We evaluated 10 asymptomatic subjects and 20 patients with painful conditions affecting the shoulder, 10 adhesive capsulitis and 10 rotator cuff-tears. The last pathologic cases were reexamined after rehabilitation treatment. The Elite system computed on line the trajectories of 8 retro reflective markers glued on the main reference points (3 on the spine, 3 on the scapula and 2 on the humerus). Angles and linear velocities were also evaluated. The lower humeral site displacement and gleno-humeral angle increase allowed differentiation of the normal shoulder rotation-abduction from the abnormal movement. Hence, rehabilitation progress could be followed up.

Adult↗

Stenosis of the lumbar spinal canal in vertebral ankylosing hyperostosis.

Certain morphologic features frequently observed in radiography or computed tomography (CT) scan in patients with hyperostosis led us to study the association between a narrowed spinal canal and vertebral hyperostosis. Twenty-eight items were selected and studied by three different investigators (two rheumatologists and one radiologist) in radiographs and CT scans of 100 patients with acquired stenosis of the lumbar canal, with or without hyperostosis (46 and 54 cases, respectively). The most distinctive points that we suggest can be used as diagnostic criteria of the hyperostotic narrowed lumbar canal are anterior or posterior lateral marginal somatic osseous proliferations, proliferations of the nonarticular aspects of the posterior apophyses, and ossifications of the posterior articular capsule and of the ligaments (yellow ligament, posterior longitudinal ligament, and the supraspinal ligament). Four of these six criteria should be present to establish the diagnosis of hyperostotic lumbar stenosis. The appearance of lumbar hyperostosis on X-ray or CT scans differs from that of simple degenerative changes due to arthrosis, and the hyperostosis can be held responsible for dural compression.

Aged↗