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Biomedical subjects

S Weller

Publications and source records attributed to S Weller.

At least 19 recordsLinked to original sources
PubMed1991

Health and safety in day care: parental knowledge.

Because injuries and illnesses occur among children, even in licensed child care facilities, parents need to be aware of existing hazards. We developed a questionnaire to assess parental knowledge of 16 health and safety features in their child's care facility. These health and safety features were identified by parents, in a pilot study, as being the most important features in a child care facility. This questionnaire was completed by 91 parents who use day care. Parents were well-educated employees of a health care institution. Our results indicate that even well-educated parents often do not check child care facilities for health and safety features. Parents tolerated a mean of 9.3% of 16 unsafe features and did not know the status of 22.4% of the features. Fifteen percent of the children has been removed from their child care facility because of health and safety concerns, 7.7% reported an injury. Our results suggest that it is important that physicians, during well child visits, include discussions about health and safety issues in the day care environment.

Accident Prevention↗
PubMed1991

[Primary valgisation osteotomy in femoral neck fractures].

Technique and results after primary valgisation osteotomy in 41 patients with femoral neck fractures are described. 2 non unions and 9 avascular femoral head necroses were observed. The primary valgisation most probably does not influence the rate of necrosis. When performed by accurate technique it lowers the incidence of non union of the femoral neck. Postoperative leg lengthening is always evident. The most current avoidable mistake is an external rotational deformity. The procedure requires proper preoperative planning.

Adult↗
PubMed1991

Detection of infection in postoperative orthopedic patients with technetium-99m-labeled monoclonal antibodies against granulocytes.

A prospective study of 106 orthopedic patients was performed for the detection of infection in the early postoperative stage using 99mTc-labeled murine Mabs directed against epitopes on granulocytes. Accuracy was 81% in the hips (n = 26), 81% in the thigh (n = 21), 84% in the knee (n = 19), and 100% in the tibia (n = 27). The technique did not work well in the spine where false-negative results were observed in the three patients studied. One patient suffered transient swelling of the eyelids following injection. Optimal imaging results were obtained 2-6 hr postinjection.

Adolescent↗
PubMed1991

[External fixator montage].

In connection with the workshop on External Fixation of Fractures, some introductory remarks concerning indications, biomechanics, some technical details, aftercare, and possible complications are given. Each implant and technical system has advantages and disadvantages. Experiences with different implants and systems are described and demonstrated.

Biomechanical Phenomena↗
PubMed1991

[Arthrolysis as a surgical treatment concept of post-traumatic stiffness of the knee joint].

In the period from 1977 to 1989 105 arthrolyses were performed in 102 patients. There were mainly posttraumatic fibroarthroses: 51 consecutive to fractures, 39 after ligamentous injuries, 13 post-infectious of which 11 were also post-traumatic and only 2 patients with rheumatological diseases. Remarkable is the increased number of fibroarthrosis after polytrauma (n = 26). The preoperative range of motion was under 30 degrees in 26 patients and 48 patients had a severely limited range of motions between 30 and 60 degrees. The follow-up examination performed in an average of 2 years after the operative mobilization showed that the initial mobility was more than doubled. These results are related to atiology, operative procedure and degree of severity of the preoperative stiffness. Fair to excellent results were obtained in almost 3/4 of the patients. We explain these results by an adapted extraarticular or combined procedure which were used in 63 cases. The open release is backed by an intensive rehabilitation program in which painlessness through PDA and an immediate postoperative continuous passive motion are of most importance.

Adolescent↗
PubMed1990

[The dynamic hip screw in comparison with Ender nailing].

Mainly the Ender, Simon-Weidner nailing and the dynamic hip screw (DHS) of the AO compete along with other procedures for the treatment of proximal femur fractures by elderly individuals. The opportunity was taken to control the operative strain and postoperative development of 51 patients with Ender-nailing and 45 patients with DHS from the years 1985 to 1987. Prompt ability to walk and full load bearing capability is obtained by both procedures. Both procedures have slight strain due to operating time and operative trauma. Specific technical complications such as wandering of the nail and defective external rotational positioning were found mainly by the Ender-nailing. Reoperations were necessary in a few cases. The complication rate could be sunk further through the application of the DHS.

Aged↗
PubMed1989

[Diagnosis of infection in surgery of the locomotor system with Tc-99m-HMPAO leukocyte scintigraphy].

70 patients with confirmed (23 patients) or suspected (47 patients) bacterial infection in the skeleton following diseases, injuries or operations in orthopedic surgery were investigated using Tc-99m-HMPAO leucocyte scintigraphy in order to evaluate the accuracy of this procedure. Infections could be detected correctly in 37 of 70 patients (right positives) while 28 patients had negative scans corresponding to the clinical course (right negatives). One false negative finding was observed. Five patients with clinically suspected infection had a focal uptake in the WBC-scan and were not operated subsequently. They range as false positive results, although they belong to a special group (Infection: Yes-Operation: No [IYON]-group). In the assessment of the Tc-99m-HMPAO-WBC-scan there was a senstivity of 97.1%, specificity of 82.9% and an overall accuracy of 90%. The method is suitable for detection of early and late infection as well as chronic or hematogenous osteomyelitis in the locomotor system. This means an important contribution in diagnosis of infection determining further operative or conservative treatment.

Abscess↗
PubMed1989

Bioequivalence assessment of zidovudine (Retrovir) syrup, solution, and capsule formulations in patients infected with human immunodeficiency virus.

The objectives of this open-labeled, multiple-dose, three-way-crossover trial were to evaluate the safety and tolerance of zidovudine (Retrovir) oral syrup and to assess the bioequivalence of this formulation relative to zidovudine solution and capsule formulations in human immunodeficiency virus-infected patients. Over the 7-day study, 12 adult male subjects received 12 administrations each of the capsule, solution, and syrup formulations every 4 h (six times daily) in a randomized sequence. Frequent blood samples were collected over the 4-h period after dose 12 was administered. Zidovudine concentrations in plasma were determined by a specific and sensitive radioimmunoassay. Results from statistical analyses indicated that all three formulations were bioequivalent with respect to systemic availability (area under the time-concentration curve) and that the syrup was also equivalent to the solution with respect to the maximum peak concentration in serum. The lower relative maximum peak concentration in serum (approximately 81%) and small delays in time to peak concentration (less than 30 min) of the capsule formulation as compared with the liquid formulations are thought to be due to the additional processes of disintegration and dissolution associated with capsule administration. All three preparations were well tolerated during the 7-day study.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Surgical treatment of aseptic forearm shaft pseudarthrosis].

Non union of a lower arm fracture (without infection) is the result of inadequate immobilization or of too extensive devastation of the bone. Within 1975 to 1985 in the accident-hospital of Tübingen we saw 131 pseudarthroses of the ulnar or radius shaft in 111 patients. Among these a hypertrophic pseudarthrosis is mostly seen after conservative treatment or operative treatment with intramedullary nailing. Atrophic pseudarthroses or defect pseudarthroses mostly occur after open fractures, comminuted fractures or insufficient plate osteosynthesis. The operative treatment was regularly a plating of radius and/or ulna (mostly with the 3.5 mm AO-DC-plate) combined with correction of axis or rotation deformity. Depending on the type of the pseudarthrosis, decortication was also performed as well as an autogenous bone-grafting or an interposition of a cortical-cancellous-block. All but one of the pseudarthroses each of the ulna and radius, healed completely. Most patients had a reduction of pain, improvement of mobility of the elbow or wrist joint, especially an improvement of supination/pronation, regarded as an index of correction of a malrotation. Postoperative physiotherapy has to be most careful; the best physiotherapy is the everyday active use of the arm by the patient himself.

Adult↗
PubMed1989

[A new general orthopedic universal intramedullary nail for the tibia. Clinical development and experiences].

The new AO-Universal-Nail was developed through intensive cooperation between fundamental research, technicians and clinical application. We are now able to transfer the concept of a Universal-Nail (initially for the femur) to the tibia as well. The existing technique of the medullary nail was maintained as far as possible. Special features to be highlighted: The new AO-bend obtains better impact behavior and a more anatomical stabilization of the bone cavity. The tapered tip eases the gliding of the tip of the nail along the inner wall of the dorsal corticalis and past the fracture. Proximal locking is obtained through three transverse extending holes. They offer many choices for optimal placement of the locking bolts. Interlocking from anterior to posterior has been logically abandoned, due to danger for nerves and vessels. Distal looking offers a large selection for stabilization through one a.p.-hole and two transverse holes for the locking bolts. The design from anterior to posterior entables the protection of the soft tissue. The Universal-nail can either be inserted with or without interlocking. A free decision is possible during the operation. The new AO-Universal-Nail for the tibia (as for the femur) maintained reliable aspects and was consequently converted to meet new demands and findings. The basic fundamentals of the AO, namely the observance and application of biomechanical principles and safe operation procedure were attained through simple instrumentation and have been proved successful for clinical application.

Fracture Fixation, Intramedullary↗
PubMed1989

[Quality of life after trauma surgery interventions].

Integral factors of a patient's Quality of life include the absence of pain, unimpaired mobility, intact capacity to think and judge, as well as access to a good social environment. Surgery for injuries provides a prime example of how much surgery can influence the quality of life. The abrupt change from psychosomatic integrity to a more or less reduced quality of life, especially in trauma patients, is particularly upsetting to the patient. Thus all possibilities of effecting a rapid change together with improvement by operative measures are especially important. Injured patients expect an operation to give quick and, if at all possible, complete reinstatement of the their condition before the injury. The great progress that has been made in surgery, especially in accident surgery, however, should not delude us that there are still technical and biological limits to full recovery.

Activities of Daily Living↗
PubMed1988

[The infected hip joint].

The deep infection of a hip joint (after operative treatment of a fracture, after corrective osteotomy or as a haemtogeneous joint infection) is a severe, locally and systemically dangerous sickness; her treatment ist difficult because of the multifactorial genesis. In the accident hospital of Tübingen were treated 35 empyemas of hip joint (excluding after implantation of a prosthesis) within 10 years. The therapeutic management normally needs three steps: 1. Control of acute empyema or septicaemia (Debridement, Drainage, antibiotic treatment) 2. Achievement of fracture or osteotomy stability (by changing of osteosynthesis or bone-grafting under continuous drainage) 3. Definitive healing by removing of metal, resection of a destroyed or necrotic femoral head, by arthrodesis of the joint or--in special cases--by implantation of a prosthesis. In this way it was possible to control all of the 35 deep hip joint infections and to maintain function in 28 cases. Within the follow up (in the average 4 years) all the patients were free of infection.

Anti-Bacterial Agents↗