Work station positioning equipment keeps employee safety within reach. Lift, tilt or rotating tables are advantageous from the standpoint of safe ergonomic design.
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Equipment Design↗
Biomedical subjects
P Pedersen
Publications and source records attributed to P Pedersen.
An overview of European chiropractic practice.
OBJECTIVE: The aim was to survey chiropractic practice in Europe. DESIGN: A postal questionnaire survey of all chiropractors in the European Chiropractors' Union (1990) yielded demographic information and practice characteristics. Patient case forms, completed by randomly selected practitioners, revealed the demographic features, presenting complaints, diagnoses and management procedures used. SETTING: The survey was conducted in private chiropractic practices of 13 European countries. PARTICIPANTS: Nine hundred five practitioner questionnaires (70% response) and 1014 patient case forms were used. MAIN RESULTS: Demographic features of chiropractors and patients compare well to previous studies. Most chiropractors, one-quarter of whom are now females, were European trained. Many practice in groups and in cooperation with other health professions, especially in relation to radiology. Radiographs are used in nearly two-thirds of cases, yet only 25% of patients were X-rayed in chiropractic clinics. Nearly half of the patients consulted in the first month of their complaints, which were mainly of musculoskeletal pain. Virtually no evidence appeared of attempts to manage viscerosystemic disease. The manual techniques used varied considerably according to country. Most patients were at work during the course of their treatment. CONCLUSIONS: The results reflect a considerable maturation of the profession over the past two decades. The study highlights the socioeconomic potential for the treatment of chronic and severe musculoskeletal pain.
Adult↗
The efficacy of Na-naproxen after diagnostic and therapeutic arthroscopy of the knee joint.
The purpose of the study was to evaluate the effect of na-naproxen after diagnostic arthroscopy and arthroscopic surgery of the knee joint. In a double-blind trial, 41 patients were randomized to treatment with na-naproxen, and 46 patients were given placebo after surgery. For additional analgesia, patients got acetaminophen if necessary. In patients who underwent arthroscopic surgery, there were no differences between those treated with na-naproxen and those who received placebo in pain levels, but patients receiving na-naproxen had significantly less need for additional analgesia and returned significantly more quickly to work than patients receiving placebo (median 10 versus 30 days). In patients who had only diagnostic arthroscopy, there were no differences between the na-naproxen and placebo groups.
Acetaminophen↗
Metastatic choriocarcinoma with coexistent term pregnancy following four recurrent consecutive moles.
A case is reported of a 38-year-old woman with metastatic choriocarcinoma which followed four recurrent consecutive hydatidiform moles occurring within the preceding 5-year period. She conceived while having pulmonary metastasis, had a coexistent normal pregnancy and delivered a normal infant at term. Surgical resection of the lung lesion together with chemotherapy accomplished a sustained remission, with no evidence of disease after 20 months' follow-up.
Adult↗
[Vascular compression of the duodenum caused intestinal obstruction after nephrectomy].
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Duodenum↗
Bone densitometry of excised vertebrae; anatomical relationships.
Bone mineral density (BMD) was determined in 32 excised vertebrae using three methods: (1) dual-energy quantitative computed tomography (QCT), (2) dual-photon absorptiometry (DPA) with 153-Gd in an anteriorposterior projection and (3) scanning slit X-ray absorptiometry (SSXA) in both AP and lateral projections. The QCT region-of-interest in the anterior vertebral body had a lower density than that of the total trabecular portion of the body, but was highly correlated to this larger region (r = 0.96; SEE = 8 mg/cm3). The anterior QCT region also correlated moderately with BMD from DPA (r = 0.77; SEE = 18 mg/cm3). Measurements of the vertebral body in lateral projection were less well correlated (r = 0.5-0.7) to QCT densities. Both the anterior QCT region (r = 0.81; SEE = 18 mg/cm3) and the BMD from DPA (r = 0.86; SEE = 16 mg/cm3) and the BMD from DPA (r = 0.86; SEE = 16 mg/cm3) were similarly predictive of density of the integral vertebral body. Differences among densitometric methods on the spine depend on the projection used and the region examined.
Absorptiometry, Photon↗
Normal pregnancy after curative multiagent chemotherapy for choriocarcinoma with brain metastases.
A case is reported of a metastatic gestational choriocarcinoma in a 25-year old woman. Extensive pelvic, pulmonary and brain metastases were associated with clinically manifest thyrotoxicosis. Multiagent chemotherapy alone was successful in achieving a durable remission and euthyroid state. The chemotherapy regimen consisted of cis-platinum, etoposide, actinomycin-D, and intrathecal methotrexate (PEA-M). The Patient conceived 2 years after completing therapy and gave birth at term to a normal infant.
Adult↗
Effect of catabolic hormone infusion on protein turnover and amino acid uptake in skeletal muscle.
Increased plasma levels of the catabolic hormones glucagon, epinephrine, and cortisol have been implicated in mediating various metabolic alterations in trauma and sepsis. Their role in altered protein turnover and amino acid transport in skeletal muscle during sepsis, however, is not known. In the current study, rats were infused with a mixture of the catabolic hormones for 16 hours. Control animals were infused with vehicle solution. Protein synthesis and degradation rates were measured in incubated, intact soleus muscles as incorporation of 14C-phenylalanine into protein and release of tyrosine into incubation medium, respectively. Muscle amino acid uptake was determined by measuring the intracellular to extracellular ratio of [3H]-alpha-aminoisobutyric acid after incubation for 2 hours. Infusion of catabolic hormones for 16 hours resulted in elevated plasma glucose and lactate levels, reduced plasma concentrations of most amino acids, and accelerated muscle protein breakdown, similar to previous findings in septic rats. Protein synthesis rates and amino acid uptake in incubated muscles were not significantly different in control and hormone-infused rats. The current study suggests that increased muscle proteolysis in sepsis and severe injury may be mediated in part by catabolic hormones. In contrast, reduced muscle protein synthesis and amino acid uptake are probably signaled by other substances or mechanisms.
Amino Acids↗
Long saphenous vein saving surgery for varicose veins. A long-term follow-up.
The autologous saphenous vein is widely recognised as the graft material of choice in infra-inguinal arterial reconstructions. This study was undertaken to evaluate the long-term results of long saphenous vein saving surgery compared with standard stripping. Forty-two patients with varicose veins were randomly allocated to treatment, either with standard stripping of the long saphenous vein or high ligation. In both groups, local varicosities were avulsed and insufficient perforators ligated, on the basis of physical examination and phlebography. Follow-up was performed 52 +/- 5 months postoperatively. The recurrence rate was 12 and 11% in the stripping and the high ligation group respectively. At follow-up, the venous return time was increased significantly in both groups (P greater than 0.001). Vein mapping by means of high-resolution, real-time ultrasound at follow-up showed that 78% of the preserved saphenous veins were suitable for use as arterial conduits. These results suggest that removal of the long saphenous vein per se is of no therapeutic value if insufficient perforators have been ligated. It is possible to perform elective vein surgery for varicose veins with good results and preserve the long saphenous vein, which in turn can be used for future arterial reconstruction in most cases.
Adult↗
Combined treatment with indomethacin and low-dose heparin after total hip replacement. A double-blind placebo-controlled clinical trial.
We studied the safety of combining the postoperative use of a non-steroidal anti-inflammatory drug with low-dose heparin. In a double-blind, placebo-controlled clinical trial we reviewed the complications in 235 patients after total hip replacement, all treated with low-dose heparin and either indomethacin or a placebo. The incidence and type of complications in the two groups were nearly equal; indomethacin-treated patients had no increase in complications related to bleeding. Postoperative bleeding into drains was marginally greater in the indomethacin group, although the difference was not statistically significant. We conclude that treatment with indomethacin and low-dose heparin after hip replacement does not significantly increase the bleeding or other complications. We also found that patients receiving indomethacin were mobilised an average of one day before those on placebo.
Clinical Trials as Topic↗
[New illuminated spectacles for vestibular diagnosis].
Frenzel's spectacles have been essential tools for the clinical examination of the vestibular system since 1925. However, they may lead to false-negative results because they enable the patient to fixate, or to false-positive results because they induce pseudospontaneous nystagmus. Both pitfalls originate from direct illumination of the patient's eyes, and we propose a new design using indirect illumination.
Diagnosis, Differential↗
[Pseudoaneurysm of the deep femoral artery after osteosynthesis of a pertrochanteric fracture of the femur].
A woman aged 66 years developed a pseudoaneurysm from the deep femoral artery after osteosynthesis of a pertrochanteric fracture of the femur. During operation, it is important to avoid boring into the soft tissues on the medial aspect of the thigh and a screw of the correct length should be chosen.
Aged↗
Factors associated with heterotopic bone formation following total hip replacement.
In order to delineate groups of patients suitable for treatment to prevent heterotopic bone formation (HBF) following total hip replacement, 99 patients were examined to evaluate predisposing factors. One year after surgery, HBF was found in 73% of the patients. A significantly increased frequency of HBF was found among men. There was no correlation between age, severity of osteoarthritis, size of osteophytes, or preoperative hip movement and HBF. Previous ipsilateral hip surgery did not increase the risk of HBF. Although not significant, all patients who developed heterotopic bone after previous ipsi- or contralateral hip surgery showed HBF of the same or even a higher grade after the present replacement.
Adult↗
Protein synthesis in liver following infusion of the catabolic hormones corticosterone, epinephrine, and glucagon in rats.
The mediator(s) and mechanism(s) of acute-phase protein synthesis in the liver following injury and sepsis are not fully known. Elevated plasma levels of the catabolic hormones cortisol, glucagon, and epinephrine have been reported in trauma and sepsis. In previous reports, when these hormones were infused simultaneously (triple hormone infusion), several, but not all, of the metabolic alterations characteristic of sepsis occurred. In the current investigation, the effect of triple hormone infusion on hepatic protein synthesis was studied. Rats were infused intravenously during 16 hours with a solution containing corticosterone (4.2 mg/kg/h), glucagon (2.5 micrograms/kg/h), and epinephrine (6 micrograms/kg/h). Control animals were infused with a corresponding volume of vehicle. Total hepatic protein synthesis in vivo was measured with a flooding dose technique using [14C]-leucine. The synthesis of total secretory proteins and of the individual proteins albumin, complement component C3, and alpha 1-acid glycoprotein was measured in isolated, perfused liver using [3H]-leucine and a recirculating technique. Urinary excretion of nitrogen and plasma concentration of glucose were higher and plasma total amino acid concentration was lower in hormone-infused than in control rats. Total hepatic protein synthesis in vivo, expressed as the proportion of the protein pool that was replaced each day, was increased from 39% +/- 2% per day to 48% +/- 3% per day (P less than .05) by hormone infusion, but synthesis of secretory proteins in perfused liver was not significantly altered. The results suggest that although total hepatic protein synthesis may be increased by catabolic hormones, other mediator(s) are probably responsible for the stimulation of acute-phase protein synthesis in sepsis.
Acute-Phase Proteins↗
[Clinical use of click evoked oto-acoustic emissions at the Freiburg ENT clinic].
Click-evoked otoacoustic emissions appear to be an efficient way to assess cochlear function in infants and neonates. A new technique developed by Bray and Kemp (1987) enables data to be gathered under clinical conditions. A total of 310 children aged between one day and five years were examined in a realistic clinical situation: 204 of them were admitted to the authors' outpatient department for evaluation of a hearing impairment and 106 were special-care babies or normal newborns. Otoacoustic emissions were successfully tested in 244 of these 310 children at the first attempt after performing behavioural tests. A classification of the emissions by the coefficient of the cross-correlation function and the frequency response spectrum was used. Emissions were observed in 95% (n = 181 ears) of the three- to five-year-old children with a mean behavioural threshold better than 20 dB. In 82% (40/49) of the special-care babies and in 89% (51/57) of the normal newborns a successful emission recording was be obtained. Such findings suggest that this technique for detecting emissions may be useful in early diagnosis of hearing impairments, especially when combined with simple behavioural tests.
Acoustic Stimulation↗
Early radiolucencies following cemented total hip replacement. Influence of postoperative treatment with indomethacin.
The influence of treatment with indomethacin in the first 6 postoperative weeks on the incidence of early loosening and radiolucencies following cemented total hip replacement were studied in 102 hips. Ninety-nine hips in 99 patients without postoperative antiinflammatory treatment served as control group. One year after surgery, two patients in the indomethacin group and five patients in the control group were suspected of having loosening of one or both prosthetic components. However, no patients had a revision. The lateral acetabular cement-bone interface most frequently showed a radiolucent line. Concerning the incidence of radiolucent lines in any acetabular or femoral cement-bone interface zone, no difference could be shown between the two groups. When evaluated 1 year after surgery, postoperative treatment with indomethacin does not increase the incidence of aseptic loosening or cement-bone interface radiolucencies in cemented total hip replacement.
Bone Cements↗
Erythrocyte sedimentation rate and heterotopic bone formation after cemented total hip arthroplasty.
The erythrocyte sedimentation rate (ESR) was analyzed in 176 patients treated with cemented total hip arthroplasty (THA) for primary osteoarthritis and correlated with the degree of heterotopic bone formation (HBF) one year after the THA. Ninety patients were treated with indomethacin in the first six postoperative weeks, and 86 patients had no antiinflammatory treatment during that same period. The ESR was measured with the Westergren method and estimated preoperatively and six and 12 weeks after THA. Patients treated with indomethacin had no or only Grade I HBF and no significant elevation in the six- and 12-week ESR. In the placebo group, 44 patients (51%) developed Grade II or Grade III HBF, and six weeks after THA, patients with Grade III HBF had a significant elevated ESR when compared with patients without or with Grade I HBF. Moreover, in patients not treated with indomethacin in the first six postoperative weeks, an ESR above 35 mm/hour 12 weeks after THA was found to be a reliable predictor for the development of severe HBF.
Aged↗
[The use of digital subtraction angiography/phlebography in pediatrics].
In a retrospective analysis of fourteen digital subtraction angiographies and phlebographies on 12 children during the last 18 months the diagnostic accuracy and safety were evaluated. Accurate diagnosis was possible in all cases and no complications occurred. The subtraction procedure most likely could not be replaced by other modes of investigation. It is superior to conventional angiography and phlebography and can be performed quickly and safely.
Adolescent↗