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Biomedical subjects

S Weller

Publications and source records attributed to S Weller.

At least 91 records · Page 5Linked to original sources
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↗
PubMed1988

[The unstable elbow joint following dislocation. Diagnosis and therapy].

The meaning of instability after elbow dislocation (unstable dislocation) is pointed out. We support the trend to surgical treatment in cases of obvious instability and emphasize a differentiated concept in diagnosis and therapy. 32 patients after elbow dislocation were treated and followed up after an average period of 7.5 months. Good to very good results could be achieved in 24/32 patients (75%).

Adolescent↗
PubMed1988

[Costoclavicular syndrome--a rare complication of clavicular fracture].

Neurological or vascular complications in clavicle fractures as a primary lesion are rare. More often these complications develop later caused by large callus formation to encroach the costoclavicular space. That is due sometimes to an additional fracture of the clavicle, which healed under shortening. The prognosis of the costoclavicular syndrome can be improved by early resection of the callus formation and--in special cases--by reconstruction of the original length of the clavicle combined with a stable plate osteosynthesis.

Adult↗
PubMed1988

[Therapy of joint infections].

The therapy of septic arthritis should lead to control of infection and a good joint function as well. So it is necessary to combine the classic methods (revision, immobilisation, antibiotic therapy) with functional treatment. The possibilities, aims and limits of early CPM or replacement of an infected prosthesis (in one or two steps) are discussed.

Anti-Bacterial Agents↗
PubMed1988

[99mTc-HMPAO leukocyte scintigraphy in the diagnosis of inflammations of the skeletal system. Initial experiences].

Subsequent to orthopedic surgery 23 patients were studied by leukocyte scintiscanning using 99mTc-HMPAO to detect inflammation. 12 patients had all signs of bacterial infection. In 11 patients infection of the wound area was suspected. There was one false negative and no false positive scintigraphic finding. 2 patients with an unclear postoperative course after internal fracture fixation showed intensive uptake. Several days after the scan both patients developed severe bacterial infection. From that experience we conclude that the method may be of higher sensitivity than clinical symptoms. Further investigations are necessary for an accurate assessment of the method.

Adult↗
PubMed1988

[Sprains and dislocations of large joints. The shoulder joint].

Injuries of the shoulder joint require exact diagnostic assessment. Soft tissue lesions which lead to instability of the joint must be recognized and treated adequately. Besides clinical and radiological examination, arthroscopy and sonography are becoming increasingly important. Acute sprain of the shoulder joint without instability is treated by a short immobilisation followed by active exercises, sprain (distorsion) with instability (dislocation!) may be treated by short immobilisation (two weeks) and early functional exercises or operatively by repair of a Bankart lesion, rupture of the rotatorcuff etc. A correlation between duration of immobilisation and subsequent recurrent dislocation has not be proven yet.

Adult↗
PubMed1987

[Special problem in the replacement operation in cemented prostheses].

The replacement of a loose total hip prosthesis requires a great amount of surgical skill and experience. Severe bony defects in the acetabulum should be filled by homogeneous bone grafts. Implantation of a Schneiderring together with the graft gives sufficient stability. The new shaft should be cemented very carefully, avoiding cavities between bone, cement and stem. The shaft of the femur should be reinforced by a long bridging plate.

Bone Cements↗
PubMed1987

Pharmacokinetics of acyclovir suspension in infants and children.

Eighteen children from 3 weeks to 6.9 years of age were given an oral acyclovir suspension for herpes simplex or varicella-zoster virus infections. Thirteen patients who were 6 months to 6.9 years old received 600 mg/m2 per dose, and three infants and two children less than 2 years old were given 300 mg/m2 per dose. The drug was given four times a day, except to one infant who was treated with three doses a day. Among the 13 children who received the 600-mg/m2 dose, the maximum concentration in plasma (Cmax) was 0.99 +/- 0.38 microgram/ml (mean +/- standard deviation), the time to maximum concentration (Tmax) was 3.0 +/- 0.86 h, the area under the curve (AUC) was 5.56 +/- 2.17 micrograms.h/ml, and the elimination half-life (t1/2) was 2.59 +/- 0.78 h. The three infants less than 2 months of age who received the 300-mg/m2 dose had a Cmax of 1.88 +/- 1.11 micrograms/ml, a Tmax of 4.10 +/- 0.48 h, an AUC of 6.54 +/- 4.32 micrograms.h/ml, and a t1/2 of 3.26 +/- 0.33 h. The acyclovir suspension was well tolerated by young children. No adverse effects requiring discontinuation of the drug occurred.

Acyclovir↗
PubMed1987

Sexual activity, contraceptive use, and other risk factors for symptomatic and asymptomatic bacteriuria. A case-control study.

In a study to determine the risk factors for urinary tract infection in college-aged women, women who presented with acute urinary tract infection to the student health service were compared to women without bacteriuria who presented with complaints of other acute illnesses. Among women who were sexually active, the following multivariate adjusted odds ratios (95% confidence intervals) were found; intercourse in the previous 48 hours, 58.1 (11.9 to 284.1); intercourse only in the previous 3 to 7 days, 9.1 (1.9 to 44.1); diaphragm use in the previous 48 hours, 8.4 (3.4 to 21.1); urination after intercourse, 0.5 (0.3 to 0.9); and past history of urinary tract infection, 2.7 (1.5 to 5.0). Several other factors previously postulated to be related to urinary tract infection were found not to be associated, including oral contraceptive use, tampon use, and direction of wiping after a bowel movement. When the women with symptomatic bacteriuria were compared to women with asymptomatic bacteriuria, the results were similar, except diaphragm use and urination after intercourse were no longer associated with urinary tract infection. When the women with asymptomatic bacteriuria were compared to women without symptoms and without bacteriuria, diaphragm use remained the only statistically significant risk factor. These findings should be taken into account in attempts to prevent urinary tract infection, as well as in subsequent studies of this disease.

Adult↗
PubMed1987

[Integral therapy of complex joint injuries].

The final treatment result in severe joint injuries especially in polytraumatized patients, after a correct primary care, depends on a logical sequence of application of all necessary supporting measures. The importance of these special steps depending on the overall type of injury should preferably be assessed and controlled by the surgeon who performed the initial treatment. Several examples of an integral treatment of different joint injuries are demonstrated.

Ankle Injuries↗
PubMed1987

[Conservative therapy of acetabular fractures--indications and results].

Conservative treatment of acetabular fractures seems to be indicated either in cases of little displacement or wherever reconstruction of the acetabulum by operation is impossible. Following the classification of Judet and Letournel a satisfactory result can be expected only in fractures with little dislocation, such as the caudal transverse type and the anterior wall type. The indication for open reduction and reconstruction is given if cranial and/or dorsal components of the acetabulum are involved. In special cases treatment by vertical traction must be combined with a side traction by means of a trochanter screw; in the early phase of traction frequent radiological controls are obligatory. Early physiotherapy is also necessary to achieve satisfactory functional results. Based on the follow-up examination of 38 patients with 39 fractures of the acetabulum, conservative treatment is discussed in respect of fracture type, the extent of displacement and the clinical results.

Acetabulum↗