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Biomedical subjects

T Najenson

Publications and source records attributed to T Najenson.

At least 37 records · Page 2Linked to original sources
PubMed1985

Energy cost and physiological reactions to effort during activation of paraplegics by functional electrical stimulation.

In this study, the aim was to evaluate the influence on the cardiopulmonary system of muscular contractions of the paralyzed limbs in paraplegia, activated by FES during treatment, and the energy cost of standing and walking while using FES as an orthotic aid. Three traumatic spastic paraplegics were selected for the measurements. At the end of a 6 month training program heart rate and oxygen consumption of the patients were evaluated as follows: at rest; following 30 minutes of FES in the sitting position; following 15 minutes of standing; and during ambulation. Lactic acid level during maximal effort was evaluated as well. The results indicated a low energy cost of FES in the sitting position and during usage of FES as an orthotic device for standing, confirming the beneficial effect of FES for spastic paraplegics. However, effort invested during ambulation by means of FES was found exhaustive and FES is therefore advisable for young subjects mainly.

Adult↗
PubMed1985

Activation of paraplegic patients by functional electrical stimulation: training and biomechanical evaluation.

A training method for the activation of the lower limb muscles of paraplegics by functional electrical stimulation (FES) for standing and walking is described. It consists of a daily program which does not interfere with the normal routine of the patient. The treatment of four patients, paralysed form 7 to 30 years, is described. In these patients, a good standing position was achieved by stimulating the quadriceps, sometimes supplemented by the gluteus maximus or medius muscles. Gait was obtained by activation of the flexion reflex in a single stimulation and by tilting the trunk. Difficulties during gait were encountered due to the strong adduction of the legs. No mechanical support was required for locking of the lower limb joints. However, to maintain the equilibrium of the body, external support such as parallel bars, walker or Canadian crutches were used. During treatment gait improved due to reduction of spasticity and better stability of the body. Biomechanical measurements of weight bearing on the legs indicated values ranging between 41 to 65% of the body weight. During gait, a steady improvement of velocity was noted, with a parallel decrease in stance and stride times.

Activities of Daily Living↗
PubMed1984

The diagnostic value of three common primitive reflexes.

Systematic attempts were made to elicit the snout, palmomental and corneomandibular reflexes in 50 young patients with prolonged traumatic coma, 50 elderly hemiplegics soon after their first cerebrovascular accident and in 100 normal age-matched controls. None was found significantly more frequently alone in brain-damaged patients than in age-matched controls. Only combinations of two or three reflexes showed diagnostic value in distinguishing between neurologically damaged patients and normal age-matched controls. Only the combination of all three was completely absent in the normal controls; this combination was found in 13% of the brain-damaged subjects.

Adult↗
PubMed1983

Hypothalamic-pituitary function in patients with prolonged coma.

In eight patients (six males and two females) hospitalized for prolonged coma (164-1320 days; five patients were in traumatic coma, two after cardiac arrest during surgery, and one after a venomous scorpion sting), diurnal variation of cortisol secretion, human (L) GH, PRL, TSH secretion as well as the release of the pituitary hormones after TRH and L-dopa stimulation were assessed. Serum T4 cortisol, hGH, hPRL, and hTSH levels were normal. The cortisol diurnal variation was preserved in six patients. In seven of eight patients, the hPRL and hTSH responses to TRH test were normal and in five patients, there was a rise of more than 150% in serum hGH concentrations. After L-dopa administration, five patients responded with a rise in hGH. In three patients, there was no response of hGH to TRH or L-dopa. Five patients responded with significant reduction in the serum hPRL concentration after L-dopa, and in three patients, no change was observed. It was concluded that patients with prolonged coma have variable hypothalamic pituitary function. They preserve the cortisol diurnal variation and the hypothalamic-pituitary-thyroid axis as well as PRL secretion; however, hGH secretion may respond abnormally to various stimuli.

Adult↗
PubMed1983

Childhood head injuries in Israel: epidemiology and outcome.

Results are reported of a regional survey of hospitalized head injuries in Israeli children aged 0-7 years during the period 1970-1976. There were 370 such cases surveyed. Incidence of head injury requiring hospitalization was 1.71/1000 per year. Follow-up examination 4-10 years after injury was achieved in 50 per cent of the cases. Late seizures and focal neurological deficit were rare, while school failure and various neuropsychiatric symptoms were common. Prevalence of seizures and new nervous habits was significantly related to severity of injury, while the prevalence of fears, nightmares, dizziness and school failure was not.

Achievement↗
PubMed1983

Growth hormone and periarticular new bone formation--a causal relationship? A preliminary communication.

In an attempt to examine the relationship between growth hormone (GH) and periarticular new bone formation (PNBF), we studied eight patients with brain lesions of different origins who were in a prolonged comatose state for 164 to 1320 days. Five of them developed PNBF. The latter reacted to both the specific L-Dopa test and to the non-specific TRH test with an increase in GH serum concentration. Those patients who did not develop PNBF, failed to react significantly to either tests. The difference in GH values between the two groups is statistically significant at the 95% level of confidence. We hypothesize that there may be a causal relationship between high concentrations of GH in serum and PNBF.

Adolescent↗
PubMed1982

Variation of time-distance parameters of the stride as related to clinical gait improvement in hemiplegics.

Gait improvement was evaluated in two different ways for 20 hemiplegics during an average follow-up period of 8 weeks in early rehabilitation. One way was by weekly measuring time-distance parameters of the stride on an electrical contact system walkway. The second was a clinical evaluation of gait improvement. The parameters studied were contact time, double contact time, stride length, velocity, time symmetry and distance symmetry. The variation of each of these parameters during the follow-up period was correlated with the variation in gait evaluated clinically. This correlation showed that both evaluations agreed, supporting the usage of time-distance parameters as a tool for an objective follow-up of walking ability of hemiplegics during rehabilitation.

Aged↗
PubMed1981

Widespread periarticular new-bone formation in long-term comatose patients.

Widespread periarticular new-bone formation (myositis ossificans) was studied in 45 patients with brain damage who were in long-term coma. Thirty-six of these patients displayed myositis ossificans around at least one major joint. The development of myositis ossificans was shown to be independent of the sex and age of the patient and also of the aetiology, duration and outcome of the coma. Radiographic evidence first appeared between one and two months after the onset of coma. The maximal spread of myositis ossificans was reached in the first five months after the onset of coma. Progression of the disease was not observed after 14 months. Myositis ossificans was defined as a progressive self-limiting disease found in comatose patients.

Adolescent↗
PubMed1980

The value of electroencephalography in prolonged coma: a comparative EEG-computed axial tomography study of two patients one year after trauma.

Interest was aroused in two patients of 16 and 17 years of age and similar craniocerebral trauma, but who had differing EEG's 1 year after injury while their later situation was the reverse of what the EEG would have led one to expect. The patient with an iso-electric EEG showed clinical improvement during the course of the second year, as indicated by a rise in his Glasgow coma rating from 8 to 11. This patient had marked cortical atrophy with discrete central atrophy, shown by computed axial tomography (CT); the isotope cisternogram showed good peripheral absorption of the isotope and no penetration into the ventricles. The other patient showed diffuse slow-wave activity in his EEG but failed to improve clinically or electroencephalographically. His CT-scan showed marked central and discrete cortical atrophy; his isotopic cisternogram showed penetration of isotope into the ventricles with poor peripheral absorption. These two cases illustrate the hazard of relying on an iso-electric EEG after 1 year of coma as an indicator of brain death, and the value of the CT-scan in the initial assessment of such cases.

Adolescent↗
PubMed1980

Rehabilitation outcome of brain damaged patients after severe head injury.

The multidisciplinary team approach to the prolonged treatment of head injured patients in widely discussed. The rehabilitation process of the 147 subjects of this paper started while they were comatose and continued throughout the various stages of their progress towards full integration into society; the assessment of this process was carried out by testing their reintegration into work according to their capacities. Brain damage is classified in four categories: Physical-locomotor, communicative, cognitive and behavioural. The gap between the team's expectations and the patients' factual functioning within the community was found to be proportional to the extent of damage caused by the original injury. Treatment procedures and the influence of various factors on the factual functional state are discussed at length.

Adolescent↗
PubMed1980

Arterial occlusive disease in amputee patients: assessment with the Doppler ultrasound flowmeter and correlation with rehabilitation.

The vascular status of 14 below-knee (BK) amputee patients and 12 above-knee (AK) amputee patients who had undergone amputation for arterial occlusive disease was assessed with the Doppler ultrasound technique. Ten healthy subjects were investigated as a control group. The ankle-arm pressure index in the sound leg and thigh-arm pressure index in the stump were classified in 4 grades. Rehabilitation was graded according to the amputee patients' ability to use their prostheses. The vascular condition of the BK amputees was generally better than that of the AK amputees. The vascular condition of the stump in both groups was better than that of the sound leg. A good correlation was found between prosthetic rehabilitation and the vascular condition of the sound leg, but not with that of the stump. It is suggested that amputation removes the most severely affected part of the lower extremity and the so-called sound leg thus becomes the restricting factor in rehabilitation.

Aged↗
PubMed1979

End-bearing characteristics of patellar-tendon-bearing prosthesis--a preliminary report.

The present work was aimed at investigating the degree of participation of the stump end in the weightbearing process in PTB prostheses. Despite the belief that the stump end is not capable of withstanding high loads, it was revealed that most patients can bear from 15 percent up to 45 percent and more of their weight on the stump end. The limited number of patients studied diminishes the statistical significance, but the results of this work do suggest that the weightbearing mechanism of a PTB prosthesis can be further improved by transferring more load through the stump end. It is suggested that a nondestructive technique for assessing the end-bearing efficiency of the prosthesis be developed. Also, the criteria for design of the socket end in order to produce the desired load-bearing features needs further investigation.

Adult↗
PubMed1978

The influence of the deep femoral artery on wound healing in amputees.

Seventeen patients with arterial occlusive disease, of whom 14 were diabetics, were studied by angiography after amputation of the lower extremity. In one patient the angiography was normal and the stump wound healed well. In two patients the angiographic findings indicated extremely severe impairment of blood supply and wound healing was considerably delayed. Of the remaining 14 patients: in five the superficial femoral artery alone was occluded and wound healing was normal and in nine patients, both the superficial and deep femoral arteries were occluded and wound healing was delayed. Wound healing of the stump after amputation of the lower extremity due to extensive arterial occlusive disease is decided by the patency of the deep femoral artery.

Aged↗
PubMed1978

Gastrointestinal hemorrhage in long-lasting traumatic coma.

Sixteen cases, aged 19 to 61 years and suffering from traumatic coma were studied for periods varying from 7 to 20 months. Obvious or occult gastrointestinal hemorrhage appeared in every case, the earliest presentation being after a few weeks and the latest at 20 months. Gastric acidity was normal in 15 cases. Five patients had duodenal ulceration in repeated roentgenological examination. Concomitant clinical findings included clubbing and paraarticular new bone formation in 9 patients. In addition, hypoxia with repeated values between 63 and 88 mm was observed in 13 of the 16 patients. The latter observation strongly suggests that hypoxia of gastrointestinal mucosa may, indeed, play a pathogenetic role in gastrointestinal hemorrhage of patients with C.C.I.

Adult↗