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Biomedical subjects

Joseph H Piatt

Publications and source records attributed to Joseph H Piatt.

23 records · Page 2Linked to original sources
PubMed2003

A late result of an early operation for unilateral coronal synostosis.

An infant underwent strip craniectomy for unilateral coronal synostosis in 1967. This report presents the cosmetic, functional and psychosocial outcome at 34 years of age. Although aggressive, reconstructive treatment of the various forms of single-suture craniosynostosis is the current standard of care, neither the natural history of these conditions nor the long-term results of treatment have been documented systematically.

Adult↗
PubMed2003

Pump implantation for intrathecal baclofen infusion after laparotomy for necrotizing enterocolitis.

Necrotizing enterocolitis (NEC) and spastic cerebral palsy are both familiar complications of prematurity. Children who are otherwise candidates for intrathecal baclofen infusion occasionally have long, transverse, right midabdominal laparotomy incisions from past management of NEC, and these incisions may interfere with selection of a site for pump implantation. Successful pump implantation immediately beneath a laparotomy incision was accomplished using a modification of the popular subfascial technique.

Baclofen↗
PubMed2003

Ultrasonographic screening in infants with isolated spinal strawberry nevi.

OBJECT: The authors performed spinal ultrasonography and/or magnetic resonance (MR) imaging in 20 consecutive newborns with spinal strawberry nevi. METHODS: In 15 patients the strawberry nevi were isolated and in five they were associated with other cutaneous markers of occult spinal dysraphism (OSD). In four of five patients with additional cutaneous markers, but in none of those without, MR imaging and surgical exploration demonstrated OSD. The authors found that strawberry nevi in isolation do not appear to indicate underlying dysraphic states. The sparse clinical literature on this topic, which is reviewed, confirms an association between OSD and strawberry nevi presenting in conjunction with other cutaneous signatures. By contrast, spinal strawberry nevi occurring alone may not indicate the presence of underlying dysraphism. CONCLUSIONS: A prospective study of larger numbers of patients with isolated strawberry nevi, undergoing MR imaging evaluation, is necessary to determine whether neuroimaging screening in these patients is indicated.

Female↗
PubMed2002

Objective measurement of muscle strength in children with spastic diplegia after selective dorsal rhizotomy.

OBJECTIVES: To examine changes in isometric muscle strength at the elbow, knee, and ankle at 6 months and 1 year after selective dorsal rhizotomy (SDR) and to determine if SDR altered the frequency of muscle cocontraction. DESIGN: Prospective outcome study of a consecutive sample. SETTING: Children's hospital. PATIENTS: Ten children with spastic diplegia (7 independent and 3 dependent ambulators who used assistive devices) and 8 age-matched controls. INTERVENTIONS: SDR; physical and occupational therapy; elbow, knee, and ankle measured for flexion and extension strength during three 10-second isometric contractions for each muscle group; and monitored cocontraction measured via muscle electrodes. MAIN OUTCOME MEASURES: Absolute and normalized values of isometric strength; and alterations in the frequency of cocontraction at 6 months and 1 year postoperatively. RESULTS: Children with spastic diplegia showed significantly weaker knee extensors, ankle dorsiflexors, and ankle plantarflexors than age-matched controls. There were no significant differences in strength between the 2 groups in the elbow flexors, elbow extensors, and knee flexors. Isometric strength did not increase or decrease significantly after SDR. Cocontraction during knee extension was normalized after SDR, whereas cocontraction during ankle plantarflexion was unchanged by SDR in the majority of children. CONCLUSION: SDR did not result in a significant decrease in muscle strength in ambulatory children with spastic diplegia. The normalization of the electromyographic patterns at the knee and not the ankle after SDR lends support to the premise that in children with cerebral palsy cocontraction is multifaceted, representing a volitional strategy to enhance control, as well as a disorder of the mechanisms that govern patterns of muscle activity.

Cerebral Palsy↗