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Biomedical subjects

M Ehrenfeld

Publications and source records attributed to M Ehrenfeld.

At least 73 records · Page 4Linked to original sources
PubMed1996

[Treatment of mandibular fractures with different fixation techniques--results of a prospective fracture study].

In a prospective study 150 adult patients with mandible fractures were analysed. Criteria for entry into the study were fractures of the mandibular body with and without associated condylar fractures. The fractures must fit to the Spiessl-classes F1 and F2, L1 to L4, W0 to W3 and the patients must have had a sufficient dentition to judge their occlusion. Not included were patients with combinations of mandible and Le Fort fractures, comminuted and defect fractures and patients who could not communicate preoperatively in order to have a full preoperative examination. The patients were equally distributed among 3 different treatment groups. Group 1 was treated conservatively with MMF, only displaced fractures which needed open reduction were internally fixed with wire osteosynthesis. Group 2 received rigid internal fixation with AO 2.7-plates from an intraoral approach, group 3 internal fixation with miniadaption-plates also from an intraoral approach. Using a standardized treatment protocol the patients were followed in defined intervals up to a maximum of 2 years after therapy. Group 1 presented with the lowest complication rate, group 2 with the highest rate of overall complications as far as disturbances of the occlusion and sensory disturbances were concerned. Except one plate fracture in group 3 with subsequent pseudarthrosis, which required a reosteosynthesis with a rigid plate, no major complications in bone healing were observed.

Adult↗
PubMed1996

[Lag screw osteosynthesis in median mandibular fractures--technique and outcome].

The lag screw technique for treatment of simple median and paramedian fractures of the mandible is reemphasized. Major advantages over bone-plate fixation are the rapid application since adapting and bending of a bone plate is obviated as well as the lower costs of the osteosynthesis material. A review of 12 patients with fractures of the anterior mandible who had lag screws placed for fracture treatment showed that it is a successful method of providing rigid internal fixation associated with a low postsurgical complication rate.

Bone Screws↗
PubMed1996

[Gunshot injuries of the mandible].

43 patients with gunshot wounds of the mandible were treated in Tübingen and Basel between 1968 and 1995. Among them were 31 patients ( = 72.09%) with bone loss and defect fractures. Over that time period the treatment principles of gunshot wounds have not changed. They are based on an early soft tissue closure and an approach from the inside to the outside. Besides that modern techniques in maxillofacial reconstructive surgery, which include the application of biocompatible plates and screws and the introduction of microvascular reconstructive techniques, have enlarged the therapeutical options. Every patient needs an individual approach to his special medical condition, which is illustrated in three exemplary cases. The combination of the above mentioned modern reconstructive techniques prevents long and multiple hospital stays and invalidity. Furthermore it is the basis for social reintegration as well as functional and esthetic rehabilitation.

Adolescent↗
PubMed1996

[Therapy of infected mandibular fractures].

In a follow-up study the results after rigid internal fixation (RIF) in 23 patients with mandible fractures showing signs of bone infection at the fracture sites are presented. Depending on the bony defect RIF was performed with or without additional autogenous bone grafts. RIF led to a calculable and uneventful bone healing despite the infections. The plates must be fixed with at least 3 screws on each fracture site and outside the infected areas. An adequate soft tissue coverage is a prerequisite for primary or secondary bone transplantation. In our series infected fractures were usually observed in problem patients as alcoholics, drug addicts or uncooperative patients as mentally disabled or aged persons. These patients also frequently escape from the follow-up program. To prevent complications an osteosynthesis in problem patients should be performed with enough stability so no compliance is required.

Adolescent↗
PubMed1996

[Development of a mandibular model for evaluating and optimizing the design of osteosynthesis materials using finite element analysis].

The present study was designed to investigate biomechanical and clinical changes in the mandibular complex by means of finite element analysis. An analytical model developed from human native mandibles was used for this model, CT image data were transferred to a computer, and an edge extraction program generated the cross-section of bone by specifying a range of CT values for each slice. Pixel data from the CT scan were converted into a vector of points (x, y, z) which can specify the boundaries of bone. Lateral surfaces are defined by stacking up the slices and making use of the vectorized data. The constructed model was used as input data for the finite element analysis. The models were solved for stresses and forces. The highest principal stresses occurred at the bite point, anterior aspects of the coronoid processes, symphyseal region, and right and left sides of the mandibular corpus. For further investigation muscular structures have to be integrated to establish a model, which can be analysed under multivariate aspects.

Biomechanical Phenomena↗
PubMed1996

Clinical manifestations of temporal arteritis: a report from Israel.

OBJECTIVE: To examine the clinical manifestations of 39 patients with temporal (giant cell) arteritis (GCA), allocated during a 10 year period in the largest medical center in Israel. METHODS: The patients were included in the analysis if they fulfilled the new American College of Rheumatology Classification Criteria for the diagnosis of GCA. Patients were divided into biopsy-proven (30 patients) and biopsy-negative (9 patients) groups, and their clinical manifestations were compared using Student's t test for comparison of continuous variables, and Fisher's exact test for comparison of proportions. RESULTS: The most common presenting symptoms of the patients with TA included headache (87% of the biopsy-proven patients), fever (64%), visual abnormalities (41%), and polymyalgia rheumatica (PMR) or weight loss (20% each). Pulmonary involvement occurred in 5 patients. Ten percent of the biopsy-proven patients presented with occult presentation. Analysis of biopsy-proven and biopsy-negative groups revealed the feasibility of making the diagnosis of temporal arteritis on the basis of simple clinical variables, even without a positive biopsy, as the 2 groups of patients had comparable manifestations. However, the biopsy-proven group was older, included more males and presented significantly more with fever, compared to the biopsy-negative patients. Moreover, although not reaching statistical significance, the biopsy-proven patients tended to have more systemic and extracranial symptoms, including pulmonary manifestations. CONCLUSION: Compared to a previous report from Israel on patients with temporal arteritis, almost 2 decades ago, our data suggest that the incidence of the disease in Israel has increased, whereas the ethnic distribution has not changed.

Age Distribution↗
PubMed1996

[Tripano-triatomine infection of Triatoma spinolai in a zone with epidemiological risk].

BACKGROUND: Triatoma spinolai is the only wild vector for Chagas disease in Chile and its epidemiological importance is being studied. AIM: To study the proportion of insects infected with Trypanosoma cruzi (tripano-triatomine index) in a zone with epidemiological risk in the Metropolitan Region of Chile. METHODS: Four hundred ninety two specimens of Triatoma spinolai were collected in four sites of a quarry zone, 14 kilometers north of Santiago. Their maturity and the presence of Trypanosoma cruzi in their intestinal contents were determined. RESULTS: Mean tripano-triatomine index was 26.02 +/- 2% (range 0 to 34% in different sites). The proportion of infected insects increased along with their maturity and 58% of adult specimens were infected. There was a seasonal variation of the proportion of infected specimens, being lower in March and June and higher in July and February. CONCLUSIONS: The studied zone has a potential epidemiological risk for the transmission of Chagas disease by Triatoma spinolai.

Animals↗
PubMed1995

Absence of an association between rubella vaccination and arthritis in underimmune postpartum women.

In a double-blind historical cohort study, 485 underimmune women who received rubella vaccine post-partum during 1985-1990 and 493 controls matched for age, place of residence and date of delivery were queried by phone concerning joint complaints following the pregnancy in question. Those reporting joint symptoms were invited for a personal interview at which joint symptoms and dates of their occurrence were explored in detail. Nineteen women in the vaccinated group (3.9%) and 16 from the control group (3.2%) were judged to have had joint symptoms compatible with the study definition of arthritis. The difference was not statistically significant. Thus, we were unable to find evidence for an association between rubella vaccination of underimmune adult women vaccinated post-partum and the subsequent development of arthritis. Rubella vaccine should continue to be used to immunize susceptible adult women against rubella in order to further the goal of elimination of the congenital rubella syndrome.

Adolescent↗
PubMed1995

Professional expectations and activities of nurses in Israel.

A total of 159 nurses participating in study days throughout Israel responded to a questionnaire on professional expectations and activities. Their age ranged from 26 to 73; 66% received their basic nursing education in diploma schools for registered nurses, but 36.5% had completed or were studying towards a post-basic baccalaureate degree in nursing and 23.2% were studying towards or had completed a master's degree. The highest percentage of respondents--92% expected to be involved much and very much in clinical decision-making. The professional activity most nurses were involved in (86.8%) was 'professional reading'. Multiple stepwise regression showed that continuing education explained 25.9% of the variance of professional activities. No satisfactory explained variance was achieved on professional expectations. In this convenience sample the percentage of academic nurses was higher than in the working force in Israel.

Adult↗
PubMed1995

Stimulating research thinking: the case for mini-research.

1. Nursing faculty of Tel Aviv University developed a tool to improve care in geropsychiatric units. This resulted in the establishment of a national "forum" of geropsychiatric nurse practitioners, administrators, and educators. The forum conducts study days, publishes a journal, and encourages research activities. 2. A major achievement of the forum was the organization of more than 15 mini-research groups of grass-roots nurses guided by an academic adviser. The groups examined nursing interventions, such as dolls as therapy, and specific patient care problems, such as violence, interpersonal relationships among patients, and needs of families. 3. The meetings and mini-research have had a positive impact on quality of patient care, increased family involvement, enhanced self-image of personnel, new ways of thinking, and a model for cooperation between service and academia.

Creativity↗
PubMed1994

Sjogren's syndrome in Israel: primary versus secondary disease.

Sixty Israeli patients, 30 with primary Sjögren's syndrome (SS) and 30 with rheumatoid arthritis (RA) and secondary SS, were evaluated. The Schirmer-1 test and a positive labial salivary gland biopsy were found to be the most helpful tools in assessing the diagnosis of SS. Extraglandular features such as Raynaud's phenomenon, lymphadenopathy and CNS involvement as well as parotid gland enlargement (p < 0.05) were more common in primary SS. Antinuclear antibodies, especially anti-Ro (SSA) and anti-La (SSB) were also more common in primary SS (p < 0.05). Our results are in accord with those of many European centers, despite the different genetic background.

Adult↗
PubMed1994

The benign long-term effect of cholesterol crystal synovial cysts.

Synovial effusions containing cholesterol crystals are uncommon. Most of the few reported cases have been found in patients with seropositive rheumatoid arthritis. In vitro studies, as well as an animal model, have suggested that cholesterol crystals could have a role in inflammation of the joints. In this report we present a case of seronegative arthritis, complicated by large carpal synovial cysts which contained numerous cholesterol crystals. The long-term presence of the cysts, without evidence of joint destruction, suggests that cholesterol crystal formation is probably a rare epiphenomenon, rather than a harbinger of inflammation.

Aged↗
PubMed1994

[Compared dynamics of Triatoma infestans cohorts in residential environment].

Triatoma infestans is an insect with a high colonization capacity, capable of maintaining populations near saturation levels in different environments. However, it has a great lability in its population parameters when exposed to variable environmental conditions. The aim of this work was to explore the response of two cohorts with 4 initial egg densities, in two environmental conditions ("shelter" at 24 +/- 2.7 degrees C and 73 +/- 7% of relative humidity and "room" at 16.9 +/- 2.1 degrees C and 69.8 +/- 5% of relative humidity), similar to those commonly found in houses at Santiago, Chile. The proportion of fertile egg was higher in shelter conditions (93.7 vs 74.6%). Survival curves were similar in both environments and mortality was not influenced by density or maturity of individuals. Maturation was retarded in both environment, specially in the colder one, compared to constant environments. It is concluded that maturation of T infestans is the most affected parameter in the unprotected environment. Even though, considering the insect's longevity, its reproductive function is probably accomplished. The great lability of T. infestans population parameters, suggests that the finding of favorable microenvironments is essential for their survival.

Animals↗