Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CRIPPLES”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 523 records · Page 29Linked to original sources
PubMed1982

[Etiological and clinical considerations of traumatic mutilating lesions of the hand and their prevention].

The author presents shortly the causes and some clinical aspects of mutilating injuries of the hand based on the experience gathered in two of the major hand-surgery centers of the State of Vaud (population 550,000). It is noted that injuries at work with hydraulic presses and hot-pressing machines tend to diminish drastically, while more and more often mutilating lesions are caused by lawn-mowers, "do-it-yourself" and domestic gadgets. While direct mutilating injuries to the hand are seldom seen in traffic accidents, the high incidence of brachial plexus injuries in young motorcycle drivers cripples the hand beyond repair. Some ideas concerning prevention are ventured.

Accidents↗
PubMed2000

Transanal endoscopic microsurgery: experience with 75 rectal neoplasms.

PURPOSE: The aim of this study was to describe a single institution's experience with transanal endoscopic microsurgery in patients with benign and malignant rectal tumors. PATIENTS: Between January 1992 and April 1998, 75 patients with a mean follow up of 38 months, underwent transanal endoscopic microsurgery excision of benign (46) or malignant (29) rectal tumors, located 3 to 18 cm from the dentate line. RESULTS: A total of 3 of 46 (6.5 percent) patients with benign tumors underwent conversion to radical surgery owing to tumor size. During the follow-up period, benign tumor recurrence was observed in four (9 percent) patients, three of whom were managed by repeat transanal endoscopic microsurgery, whereas one required radical surgery. Histologic staging of malignant tumors was T1 (10), T2 (10), and T3 (9). Seven patients with either inadequate resection margins or T3 tumors were complimented with radical surgery. Of the remaining 22 patients, 11 received adjuvant radiation therapy whereas 11 had no further treatment. Four (18 percent) had recurrent disease, which was managed by repeat transanal endoscopic microsurgery in two, radical surgery in one, and laser ablation in one. No cancer-related deaths were observed during the follow-up period. There was one operative mortality in a cardiac-crippled patient. Postoperative complications were mainly of a minor character and included fever, urinary retention, and bleeding; none of which required reintervention. Rectourethral fistula developed in one patient who underwent repeat transanal endoscopic microsurgery excision for a T3 malignancy. Fecal soiling was transient in three patients and persisted in two. CONCLUSION: Transanal endoscopic microsurgery excision is a safe and precise technique that is well tolerated even in high operative risk patients. Transanal endoscopic microsurgery may become a procedure of choice for benign rectal tumors and selected early malignant neoplasms.

Adenocarcinoma↗
PubMed2002

The making of a polio-free India.

Rotary one of the largest non-government international organization focused mainly towards the up-liftment of the downtrodden worldwide, got involved in the Polio Eradication Program way back in 1979 with a five-year pledge to immunize about six million Philippine children from the crippling disease of poliomyelitis. By 1982, Rotary committed itself to implement the most ambitious program ever, "to immunize all the world's children against polio by 2005" -Rotary's first birth centenary year. Encouraged by Rotary's commitment towards this objective, the World Health Organization (WHO) adopted a resolution of eradicating polio, as part of the Expanded Programme on Immunization (EPI). The World Health Assembly in 1988, in which Governments of over 100 countries including the Government of India resolved to eradicate polio, recognized Rotary International as the key non-government, private partner on the global team. Ever since Rotary has been providing financial assistance to national governments for the purchase of Oral Polio Vaccine and conducting the highest level of advocacy efforts to see that soon polio is eradicated globally. Rotary called its Polio Eradication Initiative" Polio Plus Program" and focused primarily on social mobilization and voluntarism.

Charities↗
PubMedDate not supplied

Risk factors for cerebral palsy.

Cerebral palsy is a major cause of crippling in children, but it's etiology is poorly understood. This case control study was done to assess some of the identified risk factors for cerebral palsy, 125 cerebral palsy cases selected from hospital clinic and 125 age and sex matched neighbourhood controls, all aged less than 5 years and residing in Delhi (India) were studied. Information regarding antenatal, natal and postnatal period was collected by mother's interview, and wherever available, from hospital records with the study subjects. Most common type of cerebral palsy was spastic (88%). Quadriplegia was the commonest topographical subtype (86.4%). Birth asphyxia was found to be present in only 25.6% of cases. The commonest risk factor amongst cases was low birth weight (28.8%). The multivariate odds ratios (confidence limits) for the risk factors found to be significantly associated with cerebral palsy were 36.1 (7.76-160) for birth asphyxia, 13.8 (4.95-38.3) for low birth weight, 37.4 (4.47-313) for neonatal convulsion, 23 (4.7-112) for neonatal jaundice, 14.4 (3.69-56.4) for neonatal infection, 24.9 (2.78-223) for instrument assisted delivery and 15.4 (1.57-152) for antepartum hemorrhage. Precipitate labour, caesarean section, twins, toxemia, breech delivery and head injury were not found to be significantly associated with cerebral palsy. Thus birth asphyxia, low birth weight, neonatal convulsions, neonatal jaundice, neonatal infection, instrument assisted delivery and antepartum hemorrhage are significant risk factors for cerebral palsy.

Analysis of Variance↗
PubMedDate not supplied

Stiff man's syndrome.

Myositis ossificans progressiva is an autosomal dominant disease resulting in progressive ossification and skeletal deformities, mainly in the connective tissue of muscle. The diagnosis is based on clinical and radiological findings and demonstration of skeletal malformations. We report a singular case of advanced myositis ossificans progressiva in a fourteen year old male and analyse the natural history, etiopathology, treatment alternatives and prognosis of this crippling disorder.

Adolescent↗
PubMedDate not supplied

Exstrophic anomalies: recent advances and long-term outlook.

Exstrophy-epispadias complex has been a difficult disease to treat. As in the minds of the public and most physicians alike, these children are crippled with life-long ailments and multiple operations. Much of the morbidity of this condition relates to failure to preserve urogenital tract function in these children. In recent years, through better understanding of the exstrophic anatomy and improved surgical techniques, complete repair of the exstrophic anomaly has become possible as soon as the child is born. Results of such closure indicate that such repair is not only feasible but mandatory for a successful outcome. Continence rate and cosmetic appearance are superior to the conventional 3-stage technique. Such repair is also socially acceptable as the parents will bring home a normal-looking baby with much fewer operations expected in the future. It is anticipated that complete one-stage exstrophy closure in the newborn period will revolutionize the outcome of all exstrophy patients.

Abnormalities, Multiple↗
PubMed1996

Curable and non-curable malignancies: lessons from paediatric cancer.

The tremendous progress achieved in understanding the molecular basis of cancer, was unfortunately not followed by a mutual improvement in the morbidity and mortality of adult cancer. In contrast, the success rate achieved in paediatric oncology has increased significantly during the past 30 years, and more than two-thirds of the children with cancer can now be cured. p53 has been shown to have a central role on apoptosis in various cells. As apoptosis is a final common pathway for much of our anti cancer therapy, resistance to apoptosis due to a normal activity of p53 is an important mechanism of tumor resistance and treatment failure. Contrary to the findings in most adult tumors, where about 50% of the tumors lack p53 activity, the rate of p53 mutations in childhood cancer is surprisingly low. This may be the key to the much better prognosis of children with cancer. In most adult tumors, multiple genetic events, between five and seven, are usually involved. The oncogenes involved in such tumors usually represent those located upstream of the nuclear transcription factors. In most paediatric tumors, in contrast, the initiating event is the activation of nuclear transcription factors secondary to chromosomal translocations. It can be speculated that multiple events activating various components of the signal transduction machinery are needed for tumorigenesis, and hence the evolution and progression of such tumors is slow. Moreover, if the malignant cell has to accumulate multiple mutations, the chances of crippling the apoptotic mechanism are higher. Genomic instability evidenced by microsatellite variation has been found in colon, pancreas, breast, liver and ovarian adult tumors, and not in paediatric tumors. As multiple somatic mutations are needed for the initiation and progression of the common adult malignancies, inherent genomic instability can dispose to accumulation of multiple mutations. All these molecular interactions are discussed with relevance to the difference between non-curable, mostly adult tumors, and curable, mostly paediatric tumors.

Antineoplastic Agents↗
PubMed2002

Molecular aspects of pathogenesis in osteoarthritis: the role of inflammation.

Arthritic diseases cause enormous burdens in terms of pain, crippling, and disability. Osteoarthritis (OA), the most common form of arthritis, is characterized by a slow progressive degeneration of articular cartilage. The exact etiology of OA is not known, but the degradation of cartilage matrix components is generally agreed to be due to an increased synthesis and activation of extracellular proteinases, mainly matrix metalloproteinases. Insufficient synthesis of new matrix macromolecules is also thought to be involved, possibly as a consequence of deficient stimulation by growth factors. Although OA is defined as a noninflammatory arthropathy, proinflammatory cytokines such as interleukin-1 have been implicated as important mediators in the disease. In response to interleukin-1, chondrocytes upregulate the production of nitric oxide and prostaglandin E2, two factors that have been shown to induce a number of the cellular changes associated with OA. The generation of these key signal molecules depends on inducible enzymes and can be suppressed by pharmacological inhibitors.

ADAM Proteins↗
PubMed2003

[Mitoxanthrone in the therapy of multiple sclerosis].

The recent publication of the MIMS study (Mitoxantrone in multiple sclerosis), approval by local health authorities, and the recommendation by the MS Therapy Consensus Group (MSTCG) support the use of mitoxantrone in patients with active multiple sclerosis. This review provides an outline of relevant preclinical and clinical studies, discusses relevant side effects of the compound, and compares its use with other therapeutic approaches to this crippling disorder.

Animals↗
PubMed2000

[200 years orthopedics. Images from the past].

The term orthopaedics was first used by a French physician named Nicolas Andry in 1742. Since then the meaning of the term has changed dramatically. Starting as the planned title of a guidebook for parents it developed to become the name of a new medical discipline. During the 19th century orthopaedic surgery was dominated by private institutions, which were a privilege of the wealthy. Orthopaedic surgery as we know it in Germany today developed mostly from the so called "cripple asylums" (Krüppelheime). Their main objective was the treatment of infections of bones and joints, scoliosis and of hereditary diseases. Many of these orthopaedic diseases lost their importance due to prophylaxis and early diagnosis. The great improvements in the living conditions led to a change regarding the age of the patients and the diseases treated. Until world war II mostly children were treated by orthopaedic surgeons. After world war II orthopaedic surgeons have adjusted to the demographic change and have increasingly been treating elder patients. The development and the spread of prostheses display the increasing importance of age related illnesses.

History, 18th Century↗
PubMed2001

[The German Orthopedics Society 1918-1932. Developments and trends].

The German Orthopedic Society was founded in 1901. The period between 1918 and 1932 was characterized by the aftermath of World War I. Up to the middle of the 2nd decade, orthopedic surgeons mainly treated soldiers and civilians affected by the war. Almost every congress dealt with amputations and artificial limbs. At the same time, orthopedic surgery became a specialty at the German universities, legitimizing it as a subject of its own. Besides the large number of victims of the First World War who had to be treated by orthopedic surgeons, there was a second group of patients, the so-called cripples. These handicapped people had not previously been treated in general. A new law established in 1920 guaranteed the government's support for treatment and education of these patients. This law was called "Krüppel-Fürsorge-Gesetz," which entailed welfare but also resocialization of the handicapped, including their return to work. The German nation recognized the economic benefit of this law and accepted the financial burden. During this period, German orthopedic surgeons developed many important surgical techniques, diagnostic tests, and technical findings for the production of orthoses and artificial limbs. Some examples of techniques are described in the article: UVirradiation for the treatment of rickets according to K. Huldschinsky, Borggreve's rotationplasty of the leg (Umkehrplastik), hallux valgus arthroplasty according to Brandes, and Bragard's sign.

Artificial Limbs↗
PubMed2005

Sexual function after partial cystectomy and urothelial stripping in a 32-year-old woman with radiation cystitis.

We report a case of a 32-year-old woman who underwent a partial cystectomy to preserve sexual function. After radiotherapy for stage IB1 cervical cancer, cystectomy was indicated because of severe radiation cystitis. During this procedure we resected the upper part of the bladder followed by stripping off urothelium of the remaining bladder to spare the neurovascular bundle. Follow-up after 3 months indicated intact sexual function including orgasm. In our opinion the cystectomy procedure described in this case report is a good, novel option in women who are candidates for cystectomy because of a crippled bladder, after radiotherapy, and want to retain sexual function.

Adult↗
PubMed2005

Evidence-based guidelines for the prevention and treatment of glucocorticoid-induced osteoporosis: a consensus document of the Belgian Bone Club.

Glucocorticoids (GCs) are frequently prescribed for various inflammatory and/or life-threatening conditions concerning many systems in the body. However, they can provoke many aftereffects, of which osteoporosis (OP) is one of the most crippling complications, with its host of fractures. The dramatic increase in bone fragility is mainly attributable to the GC-induced rapid bone loss in all skeletal compartments. We have reviewed the meta-analyses and randomized controlled studies reporting medical therapeutic interventions currently registered in Belgium for the management of GC-OP comparatively with a placebo. Based on this research, an expert meeting developed a consensus on the prevention and therapy of GC-OP. The pathophysiology of GC-OP is complex. Several factors, acting separately or synergistically, have been described. Their great number could help to understand the rapidity of bone loss and of bone fragility occurrence, indicating that a rapid therapeutic intervention should be implemented to avoid complications. All patients on GCs are threatened with OP, so the prevention and/or therapy of GC-OP should be considered not only for postmenopausal females, but also for osteopenic premenopausal females and for males put on a daily dose of at least 7.5 mg equivalent prednisolone that is expected to last at least 3 months. Non-pharmacological interventions, such as exercise and avoidance of tobacco and alcohol, should be recommended, even if their role is not definitely settled in GC-OP prevention. Supplemental calcium and vitamin D should be considered as the first-line therapy because of the decrease in intestinal calcium absorption provoked by GCs. They also could be considered either as isolated therapy in patients taking less than 7.5 mg prednisolone daily and/or for a predicted period shorter than 3 months or as adjuvant therapy to other more potent drugs. Hormone replacement therapy could be considered in young postmenopausal females on GC, such as in postmenopausal OP, or in men with low androgen levels. Calcitonin appears to have a protective effect on trabecular bone in GC-OP, just as in postmenopausal OP. There is an increasing body of evidence supporting the antifracture efficacy of bisphosphonates, notably alendronate and risedronate. Preventative and curative therapy of GC-OP should be maintained as long as the patient is on GC treatment and could be stopped after weaning from GC, because there is more than circumstantial evidence of some recovery of BMD when GCs are stopped. There is no indication in GC-OP for any combination of two antiresorptive agents (except for calcium and vitamin D) or for an antiresorptive and an anabolic agent. There is indeed no proof that the increased costs of combined treatments will translate into increased therapeutic efficacy.

Bone Density↗
PubMed2003

Characterization of the Penicillium chrysogenum antifungal protein PAF.

The filamentous fungus Penicillium chrysogenum abundantly secretes the small, highly basic and cysteine-rich protein PAF ( Penicillium antifungal protein). In this study, the antifungal activity of PAF is described. PAF inhibited the growth of a variety of filamentous fungi, including opportunistic human pathogenic and phytopathogenic fungi, whereas bacterial and yeast cells were unaffected. PAF reduced the conidial germination and hyphal extension rates in a dose-dependent manner and induced severe changes in cell morphology that resulted in crippled and distorted hyphae and atypical branching. Growth-affected hyphae suffered from oxidative stress, plasma membrane leakage, and metabolic inactivity, which points to an induction of multifactorial effects in sensitive fungi. In contrast to other known antifungal proteins, the effects of PAF were only partially antagonized by cations.

Antifungal Agents↗
PubMed2003

Bone mineral density of the spine and femur in early postmenopausal Turkish women with endemic skeletal fluorosis.

The aim of this prospective, comparative study was to investigate the bone mineral density (BMD) changes in a group of early postmenopausal Turkish women with endemic skeletal fluorosis and to study effects of endemic fluorosis on BMD. Bone mineral density of L2-L4 vertebra, femur neck, femur trochanter, and Ward's triangle were measured in 45 female patients with endemic skeletal fluorosis and 41 age-matched controls by dual X-ray absorbtiometry (DXA). The BMD of L2-L4 vertebra and Ward's triangle were higher in the endemic fluorosis group than in the control group (P < 0.001). Patients with endemic fluorosis had higher femur neck and femur trochanter BMDs than did controls (P < 0.01 and P < 0.05, respectively). There was a positive correlation between serum fluoride content and BMD at the spine (r = 0.345, P = 0.001), femoral neck (r = 0.274, P = 0.011), Ward's triangle (r = 0.295, P = 0.006), and trochanter (r = 0.217, P = 0.045). In conclusion, higher bone mineral density levels were seen in early postmenopausal women with endemic skeletal fluorosis. BMD measurement is a tool in the diagnosis and management of this preventable crippling disease.

Absorptiometry, Photon↗
PubMed2006

Structural constraints and mutational bias in the evolutionary restoration of a severe deletion in RNA phage MS2.

A 4-nucleotide (nt) deletion was made in the 36-nt-long intercistronic region separating the coat and replicase genes of the single-stranded RNA phage MS2. This region is the focus of several RNA structures conferring high fitness. One such element is the operator hairpin, which, in the course of infection, will bind a coat-protein dimer, thereby precluding further replicase synthesis and initiating encapsidation. Another structure is a long-distance base pairing (MJ) controlling replicase expression. The 4-nt deletion does not directly affect the operator hairpin but it disrupts the MJ pairing. Its main effect, however, is a frame shift in the overlapping lysis gene. This gene starts in the upstream coat gene, runs through the 36-nt-long intercistronic region, and ends in the downstream replicase cistron. Here we report and interpret the spectrum of solutions that emerges when the crippled phage is evolved. Four different solutions were obtained by sequencing 40 plaques. Three had cured the frame shift in the lysis gene by inserting one nt in the loop of the operator hairpin causing its inactivation. Yet these low-fitness revertants could further improve themselves when evolved. The inactivated operator was replaced by a substitute and thereafter these revertants found several ways to restore control over the replicase gene. To allow for the evolutionary enrichment of low-probability but high-fitness revertants, we passaged lysate samples before plating. Revertants obtained in this way also restored the frame shift, but not at the expense of the operator. By taking larger and larger lysates samples for such bulk evolution, ever higher-fitness and lower-frequency revertants surfaced. Only one made it back to wild type. As a rule, however, revertants moved further and further away from the wild-type sequence because restorative mutations are, in the majority of cases, selected for their capacity to improve the phenotype by optimizing one of several potential alternative RNA foldings that emerge as a result of the initial deletion. This illustrates the role of structural constraints which limit the path of subsequent restorative mutations.

Base Sequence↗
PubMed2000

D-2-hydroxyglutaric aciduria in association with spondyloenchondromatosis.

D-2-hydroxyglutaric aciduria is a rare metabolic disorder, first reported in 1980, and does not yet have a clinically specific presentation pattern nor any specific treatment regime. We report a girl born with this uncommon metabolic disorder, who, at the age of 12 months, was also found to have a severe crippling form of skeletal dysplasia, spondyloenchondromatosis.

Bone Diseases, Developmental↗