Biomedical subjects
Publications and source records attributed to R L Fisher.
The vast majority of patients with patellofemoral pain respond to conservative treatment. Nonoperative management consists of rest and avoidance of activities producing increased patellofemoral pressure, combined with quadriceps strengthening exercises with the knee extended. Anti-inflammatory drugs and special braces may assist in the treatment program.
The arthritis that may be a part of Lyme disease, a spirochetal infection transmitted by ticks, has not been widely reported in the orthopaedic literature. Established chronic arthritis in patients who have Lyme disease most commonly affects the knee and may cause erosive joint disease. Antibiotics given early in the course of the disease can prevent chronic arthritis. When the arthritis is established, penicillin administered intravenously is curative in as many as 55 per cent of patients, but medical therapy alone may be insufficient to successfully treat the chronic stage of arthritis.
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Filiform polyposis is an unusual form of inflammatory polyposis which complicates inflammatory bowel disease. Recognition of this variant is important in that its radiographic and endoscopic picture may mimic villous adenoma or adenocarcinoma. Filiform polyposis may precipitate obstruction by stricture formation or give rise to major hemorrhage. We report five patients with inflammatory bowel disease complicated by asymptomatic filiform polyposis to emphasize the pathology of this lesion. We also review the literature regarding this topic.
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Simultaneous and sequential operations for bilateral total knee arthroplasties (TKA) for arthritis were examined for determination of the relative safety of each method. The postoperative morbidity was analyzed in three groups of patients who were similar with respect to age, sex, type of arthritis, preoperative range of motion, and postoperative management. Group I (22 patients) had both knees replaced simultaneously under one anesthesia. Group II (26 patients) had two operations staged about 17 days apart during a single hospitalization. Group III (20 patients) had TKA in two hospitalizations with the operations separated by about eight months. In this small series of cases there were fewer complications and a significantly shorter hospitalization in the group having simultaneous bilateral TKA.
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Most of the literature on supervising PAs is concerned with clinical management. The authors address the other areas of concern that the literature neglects--compliance with quality assurance, continuing education, and legal and regulatory requirements, and the normal personnel matters that occur with any employee. The policies and procedures that have evolved over the Geisinger Medical Center's ten-year experience with PA utilization and management are outlined, and are offered as a possible basis for similar policies and procedures that may be used in other tertiary medical centers.
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Within the experimental design of this study, the following conclusions were drawn: A unilateral vertical dislodging force applied to a distal-extension removable partial denture is transmitted to the supporting structures with a vertical and horizontal component. The presence of indirect retainers transmits the vertical component of force to both indirect retainer abutment teeth while the horizontal component is transmitted to the indirect retainer and primary abutments on the side opposite the loading force. The presence of indirect retainers reduces the stress to the primary abutment teeth. The presence of indirect retainers distributes stress to more supporting teeth.
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The values and child-rearing attitudes of parents of three groups of children (enuretics, clinically symptomatic non-enuretics, normals) were evaluated with the Study of Values and Parental Attitude Research Instrument. The parents of the clinically symptomatic enuretics and non-enuretics did not differ. However, the patterns of the two clinical groups differed significantly from the parents of the normals on a number of PARI variables.
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In children with Legg-Perthes disease who were less than four years old, better results were seen after treatment by recumbency and abduction bracing than with no treatment. All results were better in children having mild epiphyseal involvement (Catterall Groups I and II) than in those with more extensive disease.