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Biomedical subjects

R Abel

Publications and source records attributed to R Abel.

At least 37 records · Page 2Linked to original sources
PubMed2001

[Amputation of the lower extremity in paraplegic patients. Etiology, sequelae and patient management].

Up to now, there are not many reports about indications and guidelines for prosthetic fitting in amputated paraplegics and tetraplegics. In a review of 35 spinal cord patients with 42 amputations of the lower extremity, data on the neurological level, cause of injury, level of amputation, long-term complications, prosthetic fitting, and usage of the prostheses in daily life are presented. Everyday usage of the prostheses is reported for 15 patients.

Adult↗
PubMed2001

Tissue and serum concentrations of levofloxacin in orthopaedic patients.

The level of levofloxacin was determined in serum, bone and several tissues after a single dose of 500 mg i.v. Twenty-one patients (mean age: 56.8 years) undergoing bone surgery (nine patients) or surgical debridement of a decubitus ulcer (12 patients) who received levofloxacin as perioperative prophylaxis were included in the study. During surgery, blood and tissue samples were obtained approximately 1.5 h (range 40-210 min) postdosing. Levofloxacin concentrations in 87 specimens including 21 serum samples were determined using high-performance liquid chromatography (HPLC). The mean serum concentration at 1.5 h was 8.6+/-2.3 microg/ml. Concentrations above the MIC of common pathogens were reached in all tissues during the collection period with a maximum in skin samples (19.9+/-9.9 microg/g) followed by wound tissue and granulation tissue with 17.3+/-6.5 and 13.7+/-6.4 microg/g respectively. In muscle and fatty tissue mean levofloxacin concentrations of 8.0+/-0.9 and 4.0+/-2.2 microg/g were attained. Mean levels in cancellous bone were 6.6+/-3.6 microg/g, lowest levels were measured in cortical bone (2.8+/-1.1 microg/g). Twenty-two different pathogens were cultivated from the lesions of 11 of 12 patients with pressure ulcers. MIC values for levofloxacin were determined and compared with the corresponding tissue concentrations. Levofloxacin may be useful for perioperative prophylaxis and treatment in orthopaedic patients due to its good tissue penetration.

Adult↗
PubMed2001

Clinafloxacin pharmacokinetics in subjects with various degrees of renal function.

As the primary route for elimination of clinafloxacin is renal clearance (CL(R)) of unchanged drug, studies were conducted to determine the pharmacokinetic profile of clinafloxacin following administration to young and elderly subjects, subjects with various degrees of renal function, and subjects requiring dialysis. These were open-label studies in which subjects received single oral clinafloxacin doses. Sixteen young subjects (18 to 35 years old) and 16 elderly subjects (>65 years old) were enrolled in a study comparing pharmacokinetic profiles of clinafloxacin in young and elderly subjects. Twenty subjects having various degrees of renal function were enrolled into one of three groups based on degree of renal function as measured by creatinine clearance (CL(CR)). Twelve subjects with severe renal impairment requiring dialysis enrolled in a third study. Clinafloxacin was generally well tolerated by all subjects. Clinafloxacin pharmacokinetic profiles in elderly subjects were dependent only on age-related decreases in renal function. Clinafloxacin maximum concentrations in plasma, areas under the concentration-time curves, and terminal elimination half-life values increased with decreasing CL(CR) values. Total apparent body clearance of clinafloxacin from the plasma after oral administration (CL(oral)) and CL(R) were dependent on CL(CR) according to the following relationships: CL(oral) = 2.3. CL(CR) + 77 and CL(R) = 1.74. CL(CR). Hemodialysis had no significant effect on clinafloxacin clearance. Based on the relationship between CL(CR) and clinafloxacin CL(oral) and CL(R) values, the clinafloxacin dose should be halved in patients having a CL(CR) of <40 ml/min. Further dose adjustment is not warranted in patients requiring hemodialysis.

Adolescent↗
PubMed2001

Drug interactions with clinafloxacin.

Many fluoroquinolone antibiotics are inhibitors of cytochrome P450 enzyme systems and may produce potentially important drug interactions when administered with other drugs. Studies were conducted to determine the effect of clinafloxacin on the pharmacokinetics of theophylline, caffeine, warfarin, and phenytoin, as well as the effect of phenytoin on the pharmacokinetics of clinafloxacin. Concomitant administration of 200 or 400 mg of clinafloxacin reduces mean theophylline clearance by approximately 50 and 70%, respectively, and reduces mean caffeine clearance by 84%. (R)-Warfarin concentrations in plasma during clinafloxacin administration are 32% higher and (S)-warfarin concentrations do not change during clinafloxacin treatment. An observed late pharmacodynamic effect was most likely due to gut flora changes. Phenytoin has no effect on clinafloxacin pharmacokinetics, while phenytoin clearance is 15% lower during clinafloxacin administration.

Adult↗
PubMed2001

Prevalence of anaemia and iron deficiency in three trimesters in Rural Vellore district, South India.

A multistage sampling technique was used to select 845 pregnant women from two blocks in Vellore district. Haematological measurement of haemoglobin (Hb) was done on all women and serum ferritin (SF) on a subsample of 445. The prevalence of anaemia (Hb <11 g/dl) was 56.6%, 70.2% and 69.5%, respectively among the first, second and third trimester women. The mean Hb of 10.7 g/dl was significantly higher among the first trimester than among the second and third trimester women, which was less than the recommended value of 11 g/dl. Iron deficiency (SF <12 microg/L) was significantly (P< 0.05) more among the third trimester women than among the first. The high prevalence of anaemia in each trimester in pregnancy indicates the need for iron supplementation as early as possible starting from the fourth month of pregnancy.

Anemia, Iron-Deficiency↗
PubMed2000

Can iron status be improved in each of the three trimesters? A community-based study.

OBJECTIVE: Intervention with iron supplementation, deworming, and information, education and communication (IEC) to improve the haematological status among each of the three trimesters of pregnant women in a rural community. DESIGN: A community-based study was carried out using a two-group pre-post experimental design in a rural community. SETTING: Two rural blocks in Vellore district were selected for the study. KV Kuppam block with a population of 120,000 and the adjacent Gudiyatham block with a population of 132,000 served as study and control areas for the study. SUBJECTS: Using a multistage sampling, initially 50% of the panchayats, the local village administrative units, were randomly selected and all pregnant women were the subjects. In the pre-intervention survey 458 and 387 pregnant women had haemoglobin tested and the post-intervention survey covered 403 and 425 pregnant women in the study and control areas, respectively. Similarly serum ferritin was tested in a randomly selected sub-sample with 254 and 191 pregnant women before intervention and in 216 and 223 pregnant women after intervention in both study and control areas, respectively. INTERVENTION: Iron supplementation and deworming were provided to all pregnant women in the study area from the fourth month of their pregnancy. An intensive information, education and communication was carried out with facts on anaemia and diet modification to each pregnant woman, using a one-to-one approach in the community, and a group method in the mobile clinics. This was carried out for a period of 18 months. RESULTS: A significant decrease in the prevalence of anaemia was found, from 56.1% to 25.07% (P<0.001), 73. 4% to 49.2% (P<0.001) and 68.8% to 56.8% (P<0.01) among women in the first, second and third trimesters, respectively, in the intervention area. Significant (P<0.001) increases in the mean haemoglobin of 0.85 g/dl (95% CI 10.18-10.84, 11.09-11.63), 0.59 g/dl (95% CI 9.98-10.34, 10.55-10.95) and 0.36 g/dl (95% CI 9.93-10. 33, 10.25-10.73) were also observed in each of the groups. CONCLUSION: A comprehensive community-based intervention with iron supplementation, helminthic treatment and increase in knowledge using IEC through effective strategies can improve the haematological status of pregnant women in each trimester.

Anemia↗
PubMed1999

Residual deformity of the spinal canal in patients with traumatic paraplegia and secondary changes of the spinal cord.

INTRODUCTION: The effect of spinal deformity with posttraumatic kyphosis and stenosis of the spinal canal in producing secondary changes of the spinal cord has been discussed for quite some time. Since the advent of magnetic resonance imaging (MRI), 20-40% of patients with posttraumatic paraplegia are found to develop hydromyelia. PURPOSE OF OUR STUDY: To evaluate the influence of residual spinal deformity, defined by the extent of the posttraumatic kyphosis and stenosis, in the development of posttraumatic hydromyelia. MATERIAL AND METHODS: Two hundred and seven cases of traumatic paraplegia with MRI follow-up were reviewed retrospectively. A minimum of 3 years duration between trauma and MRI study was required (mean 10.6 years [3.2-38.3]). For statistical analysis two groups of patients were formed: with hydromyelia and without hydromyelia. After healing of the fracture, the extent of the kyphosis and stenosis, as well as the characteristics of the paraplegia were noted. RESULTS: We found that 53 patients had hydromyelia. A highly significant correlation was found for the extent of spinal stenosis and the amount of kyphosis. Cluster analysis indicated that patients with more than 15 degrees of posttraumatic kyphosis and more than 25% of stenosis were twice as likely to develop hydromyelia. The level of the lesion and the remaining neurological function was not proven to have any influence towards the development of hydromyelia. CONCLUSIONS: These results support the idea that chronic mechanical stress to the spinal cord increases the risk for the development of hydromyelia. Surgical reconstruction should be considered for all patients to prevent secondary changes of the spinal cord.

Adolescent↗
PubMed1999

Dietary vitamin A intakes of preschool-age children in South India.

The vitamin A intake of children aged 1-3 y (n = 683) was assessed using a quantitative food-frequency questionnaire in a vitamin A intervention study in South India. Trained field workers interviewed mothers about their children's usual consumption of common sources of vitamin A and collected information on portion sizes using standard cups. Mothers were asked to state the number of months in a year during which specific seasonal foods were available. Information about current breast-feeding was also obtained. Vitamin A intakes from nonbreast milk sources were extremely low at all ages. The median intake of total vitamin A, beta-carotene and retinol was 121, 100 and 21 retinol equivalents (RE), respectively. Maternal education and socioeconomic status (SES) were positively associated with total vitamin A and retinol intakes. Girls had significantly lower intakes than boys even after adjusting for differences in age, maternal education, SES and breast-feeding status. Breast-feeding was common, but declined to 60% by 24 mo and to 15% by 36 mo. Vitamin A intakes from nonbreast milk sources increased with age only for currently breast-fed children, who tended to be of lower SES. After taking into account the potential contribution of breast milk by using published estimates, nonbreast-fed children met only 60% of the Indian recommended dietary allowance (RDA; 250 RE/d), whereas breast-fed children met approximately 90% of the RDA during y 2 of life.

Anthropometry↗
PubMed1999

Is knowledge of leprosy adequate among teachers? A comparative study.

A cross-sectional comparative study on the levels of knowledge and attitude on leprosy among teachers and students was carried out in a rural area of Vellore district in Tamil Nadu, India. A total of 30 teachers and 120 students participated in the study. It was found that knowledge about leprosy among teachers was inadequate. Only 23.4% of teachers stated that germs caused leprosy, while 23.4% mentioned immoral conduct, 20.0% marrying a leprosy patient, 6.6% insects and 26.6% did not know the causes of leprosy. While 80.0% of teachers knew that anaesthetic hypopigmented patches were a sign of leprosy, enlarged painful nerves were not mentioned by a single teacher, although this sign was identified by 17.5% of students. Teachers had a more positive attitude towards leprosy than students and this was statistically significant (p < 0.001). This paper discusses the need for continuous education, especially for teachers and through them the students, using different media so as to ensure sustained knowledge for behavioural change in the community.

Adolescent↗
PubMed1998

A study of chest radiography with mobile X-ray units.

A survey of radiographic technique and estimated entrance surface dose has been carried out for 364 chest radiographs performed with mobile X-ray equipment in the Intensive Therapy Unit (ITU) and 30 wards at Aberdeen Royal Infirmary. Data for these two types of location were compared, as were those for two film/screen systems used on the wards. Image quality assessments were made on sets of radiographs for two patients. Entrance skin doses for chest radiographs performed in the ITU were 50% greater than on the wards with the same film/screen system. The main technique difference was the use of shorter focus-to-skin distances (FSDs) in ITU. Doses with the Kodak Insight system were 20% higher than those using Du Pont Quanta III in similar locations. No correlation was found between image quality and entrance surface dose (ESD). Results from the survey were used to recommend exposure factors for shorter FSDs. A follow-up study revealed a 35-45% reduction in ESD for Kodak Insight and a 20% reduction for Quanta III.

Follow-Up Studies↗
PubMed1998

Hemarthrosis as a major complication after arthroscopic subcutaneous lateral retinacular release: a prospective study.

The use of arthroscopic lateral release and medial imbrication of the vastus medialis obliquus for recurrent dislocation of the patella was evaluated prospectively in 31 patients. Patients were examined clinically as well as radiologically; the average length of follow-up was 34.4 months. Seventy-one percent of the patients were satisfied with the operative result. Seven patients experienced redislocation of the patella. Postoperative effusion occurred in 13 (42%) patients, with 4 patients requiring aspiration and 3 patients requiring open revision because of hemarthrosis. Seven patients developed a long-lasting stiffness of the joint following a 3-week period of immobilization with a dorsal plaster splint of the whole leg.

Adult↗
PubMed1997

Meta-analysis of steady-state pharmacokinetics of troglitazone and its metabolites.

The object of this study is to evaluate the effects of age, gender, age-by-gender interaction, Type II diabetes, body weight, race, smoking, and formulation on steady-state pharmacokinetics of troglitazone, Metabolite 1 (sulfate conjugate), and Metabolite 3 (quinone metabolite) following multiple-dose oral administration of troglitazone. Pharmacokinetic parameter estimates [Cl/F (apparent oral clearance), AUC0-24 (area under plasma concentration-time curve), and ratio of AUC for troglitazone to Metabolite 1 and to Metabolite 3] obtained from 84 healthy volunteers and 171 patients with Type II diabetes in 8 studies were analyzed using a graphical method (for race and smoking) or a weighted ANCOVA model incorporating gender, health status (healthy vs Type II diabetes), and formulation as main effects; age, age-by-gender interaction, and body weight as continuous covariates. Ratio of AUC for troglitazone to metabolites was also examined by inspection of log-probit plots. Age, gender, age-by-gender, Type II diabetes, and formulation had negligible effects on troglitazone Cl/F, AUC0-24 (all analytes), and AUC ratio of troglitazone to metabolites. Race and smoking did not appear to influence steady-state pharmacokinetics of troglitazone and its metabolites. Although body weight was a significant covariate for AUC0-24 and Cl/F, the explanatory power of the overall model was weak (R2 < 0.2). Log-probit plots did not reveal a polymorphic distribution in AUC ratio of troglitazone to Metabolite 1 or Metabolite 3. Based on pharmacokinetics, dose adjustment for troglitazone in relation to the demographic factors examined is not required due to their poor predictive ability on steady-state pharmacokinetics of troglitazone and its metabolites.

Age Factors↗
PubMed1997

Atorvastatin does not alter the anticoagulant activity of warfarin.

Twelve patients chronically maintained on warfarin were administered 80 mg atorvastatin for 2 weeks. Mean prothrombin times decreased slightly, but only for the first few days of the two-week treatment period. Thus atorvastatin had no consistent effect on the anticoagulant activity of warfarin and adjustment in warfarin dosing should not be necessary.

Adult↗
PubMed1997

Resection of heterotopic ossification of the hip in spinal cord injured patients.

Twenty nine spinal cord injury patients were treated by resection of heterotopic ossification in 41 hips. The average follow-up period after surgery was 4.2 years. The mean time to surgery after injury was 82.1 months. The indications for surgery were seating problems, loss of function, pressure sores and pain. The average preoperative motion in flexion and extension was 21.95 degrees, the average intraoperative motion was 94.51 degrees. The average motion at follow-up evaluation was 82.68 degrees. Clinical relevant recurrence occurred in three patients. Complications excluding recurrence occurred in 10 hips, including deep and superficial wound infections, fracture, aneurysm and pressure ulcer. The operation was followed by a specific regime of physiotherapy and radiation therapy.

Adult↗
PubMed1997

Perioperative antibiotic, steroid, and nonsteroidal anti-inflammatory agents in cataract intraocular lens surgery.

Ophthalmologists continue to choose topical antibiotics and corticosteroids more frequently than injectable agents for their current cataract surgical techniques. The preoperative use of povidone-iodine 5% and the postoperative use of impregnated soft contact lenses have helped augment our therapeutic armamentarium. NSAIDs play an important role in decreasing postoperative convalescence with fewer side effects. The intracameral administration of heparin and antibiotic solutions is discussed.

Anti-Bacterial Agents↗
PubMed1996

Perioperative antibiotic, steroidal, and nonsteroidal anti-inflammatory agents in cataract intraocular lens surgery.

Ophthalmologists are choosing topical antibiotics and corticosteroids more frequently than injectable agents for their current cataract surgical techniques. The preoperative use of povidone-iodine 5%, dilute intracameral antibiotics (via the balanced saline solution infusion), and postoperative impregnated collagen shields or soft contact lenses augment the therapeutic armamentarium. Nonsteroidal anti-inflammatory drugs, especially diclofenac 0.1%, have played an important role in decreasing postoperative convalescence through maintaining preoperative mydriasis, reducing anterior chamber reactions, and inhibiting cystoid macular edema. With fewer side effects, nonsteroidal anti-inflammatory drugs are minimizing the role of topical steroids.

Administration, Topical↗