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Biomedical subjects

S Nade

Publications and source records attributed to S Nade.

At least 19 recordsLinked to original sources
PubMed1992

Fracture bracing the humerus.

The use of humeral fracture braces has become our preferred method of treatment for fractures of the shaft of the humerus. These braces are easy to apply and adjust; the patient's acceptance of this method of treatment is high. We compared this method of treatment with the traditional method of plaster U-slab immobilization. A group of patients treated with a plaster U-slab were matched for type and level of fracture with a group treated with a humeral fracture brace and compared with regard to fracture healing and functional outcome. There was no difference between groups for healing time and final alignment of the fracture. However, there was a greater range of elbow motion at the time of union in the fracture brace group (11 degrees-126 degrees) compared with the U-slab group (50 degrees-119 degrees P less than 0.05). These results confirmed that humeral fracture bracing permits greater functional use of the limb without affecting fracture healing and alignment.

Adult↗
PubMed1992

Bone and joint infections caused by multiply resistant Staphylococcus aureus in a neonatal intensive care unit.

Twenty cases of osteomyelitis and/or septic arthritis caused by multiply resistant Staphylococcus aureus were documented in an Australian tertiary neonatal unit between 1981 and 1987. Eighteen (90%) occurred in the 3 years 1985 to 1987, an incidence of 9.6/1000 admissions in that period. All osteomyelitis and/or septic arthritis occurred in sick premature infants requiring intensive support. Eleven (55%) had a birth weight of less than 1500 g. An intravascular device was the most common portal of entry (14 of 20, 70%). Systemic symptoms were prominent at presentation, with local signs developing later in 18 (90%), usually within a week. Radiologic changes were almost always present by 10 days; radionuclide bone scanning was insensitive and did not hasten diagnosis. Osteomyelitis was multifocal in 11 cases (55%), with the long bones, particularly of the upper limb, most commonly affected. Large joint involvement was uncommon (15%). Intravenous vancomycin for a mean of 32 days was associated with low mortality (1 of 20) and toxicity; surgical drainage was not performed. Follow-up at a minimum of 4 months (mean, 25.5 months) showed residual signs in the affected limb in 30%, none with significantly impaired function. Skeletal infection should be searched for rigorously in neonatal multiply resistant S. aureus sepsis. In the absence of large joint disease, vancomycin therapy alone for a minimum of 3 weeks gives good short term results with minimal toxicity.

Arthritis, Infectious↗
PubMed1992

Outcome after fractures of the femur in Paget's disease.

We reviewed ninety-three patients who had one hundred and seven complete fractures of the femur between them and were treated over a twenty-five year period in Western Australia and South Australia. Operative surgical management of complete fractures in the middle and distal thirds was usually successful. In contrast, fractures proximal to the middle third were regularly associated with non-union, implant failure and requirement for revision surgery. In view of this significant difference in outcome after fracture of the pagetic femur in different sites, a comprehensive surgical management strategy is recommended in order to avoid complications.

Aged↗
PubMed1992

Malignant fibrous histiocytoma in Paget's disease of bone. A report of seven cases.

Malignant change in Paget's disease of bone usually has the histological features of osteosarcoma, but follows a different clinical course from cases not associated with paget's disease of bone. Malignant fibrous histiocytoma is an uncommon neoplasm which may be associated with pagetic bone and its clinical course is not well defined. Seven cases of malignant fibrous histiocytoma in Paget's disease were reviewed from two Australian bone tumour registries. In stage IIB and III disease there was a three year survival rate of 57%, suggesting a better prognosis than for patients with other sarcomas in Paget's disease.

Adult↗
PubMed1991

Open subtalar dislocation.

Open subtalar dislocation is a rare injury, accounting for about 0.1% of all dislocations and, consequently, the natural history and outcome of this injury and their relevance to treatment are not well documented. A retrospective study at Westmead Hospital revealed 10 patients who presented with this injury between 1978 and 1988. We had the opportunity to review all of these patients in 1987 and again in 1989. We found a high incidence (60%) of poor results, and that the only factor that influenced the outcome was infection. It is concluded that the poor prognosis is due to the nature of the injury itself, rather than any particular factors in the subsequent management. Specifically, there was no relation to the direction of the dislocation, the presence of fractures in the foot, the time elapsed before reduction, or the period of immobilization.

Adult↗
PubMed1989

Metastasis in a patella: a rare site.

Primary neoplasms of the patella are rare, and metastases of the patella are rarer still. A case is presented of a 64 year old woman whose pain in the left knee, resulting from patellar neoplasms, was subsequently found to result from secondary spread from a renal adenocarcinoma.

Bone Neoplasms↗
PubMed1989

Giant cell reaction in a phalangeal bone.

A case of the rare and non-neoplastic lesion, giant cell reaction of bone, is described. The pathological and radiological features of this lesion are reviewed and an aetiological mechanism is proposed to account for its unique histopathological features. Recognition of this lesion and its non-neoplastic nature are important so as to avoid surgical ablation of the affected bone.

Adult↗
PubMed1988

Acute staphylococcal septic arthritis: the effect of cloxacillin therapy in an avian model.

An experimental model of acute staphylococcal septic arthritis in chickens was used to study the effect of different therapeutic regimens of the antibiotic cloxacillin on the natural history of the disease. Three different therapeutic regimens were used in order to assess the effect of increasing the frequency and of delaying the commencement of administration. The results were assessed by measurement of animal growth rate, clinical condition, bacterial and leukocyte counts in synovial fluid, and histological appearance. An inadequate dosage regimen (a single daily dose) prevented spread of bacteria but did not control abscesses. Delay in commencing treatment permitted persistence and spread of abscesses with destruction of the secondary (epiphyseal) ossification center and even transphyseal spread into metaphyseal bone. Repair by fibroblasts was mainly seen in articular and epiphyseal cartilage but was not seen in the epiphyseal ossification center during the duration of the experiments (up to 18 days). Synovial fluid sampling with measurement of leukocyte and bacterial concentrations appears to be a useful guide to the effectiveness of treatment, because the numbers of cells correlate with the pathological process.

Acute Disease↗
PubMed1987

Growth of bone marrow cells on porous ceramics in vitro.

Following the transplantation of bone marrow cells to extra-osseous sites, bone formation occurs in those sites. This osteogenic potential of bone marrow cells might be utilized for filling defects in bone if they could be transported on porous ceramic materials. Before such an approach becomes feasible, it is important to know what happens to the cells in the presence of the ceramics that might be used. In order to investigate the interaction between bone marrow cells and ceramics, in vitro, a system for culturing bone marrow cells on ceramic materials has been developed. Bone marrow cells adhered well to the surface of calcium hydroxyapatite and tricalcium phosphate ceramics, and this was followed by the formation of fibrous tissue on and within the ceramics. These ceramics were compatible with bone marrow cells even in culture conditions in which there was a large surface area of ceramic interfacing with cells. The results support the proposal that calcium hydroxyapatite and tricalcium phosphate are appropriate as bone replacement materials. In contrast, calcium aluminate had an adverse effect on bone marrow cells when there was a high proportion of ceramic to culture medium. However, this effect was not present if the proportion of ceramic to culture medium was low. Therefore, a large amount of biodegradable porous calcium aluminate ceramic should not be used as an alternative to autogeneous bone grafting.

Aluminum↗
PubMed1987

Natural history of acute septic arthritis in an avian model.

An experimental model of acute septic arthritis is described, utilizing the injection of S. aureus into chicken hock joints. The course of the infection was monitored over a 14-day period by measurement of chicken growth rate, histopathology of the joint, number of bacteria, and number and type of leukocytes in the synovial fluid. Bacterial numbers decreased initially then increased rapidly over the first 24 h. Leukocyte counts rose sharply, starting between 60 and 90 min after injection. Gross destruction of articular cartilage was observed at 4 days, and appeared to be initiated by the adherence of the staphylococci to the cartilage surface followed by their penetration and invasion of vascular tunnels in the epiphyseal cartilage. Extensive (but focal) erosion of the articular surface was evident by 14 days.

Animals↗
PubMed1987

Pseudomonas osteomyelitis of the spine. Report of a case not associated with drug abuse.

Pseudomonas aeruginosa, as a cause of vertebral osteomyelitis, has previously been described as occurring in drug abusers. Various empirical methods of treatment have been employed without good follow-up studies. This case report provides a radiological and clinical evolution of pseudomonas vertebral osteomyelitis together with a successful treatment regimen in a 73 year old man who had spontaneous onset of the disease.

Aged↗
PubMed1985

Bone ingrowth into three different porous ceramics implanted into the tibia of rats and rabbits.

Three different porous ceramics--calcium aluminate, calcium hydroxyapatite, and tricalcium phosphate--were implanted into the proximal tibia in rats and rabbits to study the interactions between these ceramics and a bony site that is abundant in bone marrow. New bone was consistently formed within the bone marrow surrounding and adjacent to all three types of ceramics. Calcium hydroxyapatite and tricalcium phosphate ceramics permitted bone ingrowth into their pores. The newly formed bone was found only in the part of the ceramic intruding into the bone, not in the portion protruding in the soft tissues outside the tibia. Partial replacement of the new bone opposite the medullary portion by new hemopoietic marrow occurred with longer implantation times. In contrast, no bone was seen within the pores of any of the calcium aluminate implants.

Aluminum↗
PubMed1979

Clinical implications of cell function in osteogenesis. A reappraisal of bone-graft surgery.

Although fresh cancellous bone autografts are considered to be the best material for clinical bone grafting, there are times when there is insufficient, or it is undesirable to use this source, for the bone replacement required. There is a need for a 'bone bank'. On the basis of printed reports, clinical observation, and experimental studies it is argued that bone formation can be stimulated and controlled using easily prepared and stored 'bone-bank' materials in combination with living cells from the recipient requiring bone formation.

Animals↗
PubMed1978

Higher medical and surgical degrees in the University of Sydney.

Three hundred and twenty-six higher medical and surgical degrees were awarded by the University of Sydney between 1883 and 1977. A questionnaire was sent to 209 graduated known to be alive to gather data regarding their prior and subsequent careers. As many of the graduates were in their fourth decade before commencing the research studies for the M.D. thesis, there would appear to be reasons for recommending the Ph.D. degree, with its three years of supervised course work, to prospective higher degree candidates. 286 B.Sc. (Med.) degrees were awarded midway through the medical course between 1949 and 1974. This earlier introduction to research probably does more to encourage and academic or research career than the M.D. degree which currently appears to be a prerequisite to a University appointment. Some concern is raised by the comment of 27% of M.D. graduates who claimed no personal scientific benefit from their studies.

Age Factors↗
PubMed1978

Antibiotics in the management of acute haematogenous osteomyelitis and acute spetic arthritis in infancy and childhood.

The introduction of antibiotic therapy has changed the natural history of acute haematogenous osteomyelitis and acute septic arthritis. Early diagnosis and early effective treatment are the means of preventing the devastating sequelae which can occur. Although several different organisms can cause these conditions, the most appropriate antibiotics to exhibit before bacteriological proof of diagnosis is established can be deduced from a study of their historical microbiology. This paper reports such a study and makes recommendations regarding antibiotic treatment.

Acute Disease↗