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 631 records · Page 35Linked to original sources
PubMed2000

The Krukenberg procedure: a surgical option for the treatment of double hand amputees in Sierra Leone.

BACKGROUND: For the past 9 years, Sierra Leone has struggled with a cruel civil war in which the civilian population has been the principal target. The International Committee of the Red Cross established a surgical mission in Netland Hospital, Freetown, and during this surgical mission, we treated crippled individuals who had had one or both hands amputated. We assessed the benefit of the Krukenberg procedure to restore manual dexterity in this group. In this operation, radius and ulna are separated and a pincer-like grasp is created. METHODS: From July 15, 1998, to Sept 9, 1998, we carried out the Krukenberg procedure on a group of double and single hand amputees. The main target group was double hand amputees, however, the procedure was initially done on three single hand amputees to assess the functional result. Between the original trauma and the operation, there had been an interval of 3 months or longer in all patients. Patients were followed up for 3 months after the procedure to assess gripping strength and self-sufficiency (feeding, personal hygiene, dressing, and manual dexterity). FINDINGS: 15 Krukenberg procedures were done on 11 patients: eight men and three women (mean age 42 years). Three had single hand amputation and eight had double hand amputation. In only two patients had sufficient time passed for the stumps to heal. Of ten patients who were followed up at 3 months, all could eat and drink by themselves. The simple dressing test was passed by all patients and 75% of the patients had recovered some dexterity. INTERPRETATION: The Krukenberg procedure is a surgical option to achieve some manual dexterity in double hand amputees, where resources for sophisticated hand prostheses are lacking.

Activities of Daily Living↗
PubMed2004

Liver transplantation as a cure for acute intermittent porphyria.

Acute intermittent porphyria occasionally causes frequent and crippling acute neurovisceral attacks associated with increased hepatic production of porphyrin precursors, resulting in long-term damage, poor quality of life, and shortened life expectancy. There has been no cure for this condition, but replacement of deficient hepatic enzymes might restore excretion of porphyrin precursors to normal and prevent acute attacks. We aimed to treat severe acute intermittent porphyria in a 19-year-old woman by liver transplantation. After the transplant, concentrations of haem precursors in the patient's urine returned to normal, and 1.5 years later her quality of life was good. Our report suggests some hope of cure for selected patients with severe forms of this disease.

Adult↗
PubMed1999

Structure determination and refinement of the Al3+ complex of the D254,256E mutant of Arthrobacter D-xylose isomerase at 2.40 A resolution. Further evidence for inhibitor-induced metal ion movement.

The structure of the D254.256E double mutant of Arthrobacter xylose isomerase with Al3+ at both metal-binding sites was determined by the molecular replacement method at a conventional R-factor of 0.179. Binding of the two Al3+ does not alter the overall structure significantly. However, there are local rearrangements in the octahedral co-ordination sphere of the Al3+. The inhibitor molecule moves somewhat away from the active site. Furthermore, evidence was revealed for metal ion movement from site 2(1) to site 2(2) upon double mutation. Xylose isomerase requires two divalent metal cations for activation. The catalytic metal ion is translocated 1.8 A away from its initial position during the catalytic reaction. The fact that both activating and inactivating metals (including Al3+) were found exclusively at a single location in the double mutant was an indication that the consequently missing shuttle may account for the crippled catalytic efficiency.

Aldose-Ketose Isomerases↗
PubMed1998

Rubella and rubeola.

Rubella and rubeola are common viral exanthems that may affect women of reproductive age. Effective vaccination programs have greatly decreased their incidence. Although Rubella is a relatively innocuous illness for the nonpregnant patient, transplacental fetal infection with rubella can result in significant and crippling fetal malformations and handicap. Because some women of reproductive age are not appropriately immunized, rubella is still a threat. The practitioner needs to be vigilant in assuring vaccination of susceptible individuals when seen for routine health maintenance. Additionally, at times the obstetrician will be challenged with the evaluation and care of a susceptible pregnant patient who is exposed to rubella. In contrast, rubeola (measles) infection during pregnancy has not been associated with congenital malformations. Affected mothers, however, experience a higher incidence of spontaneous abortions and premature delivery and are themselves at risk for serious complications such as pneumonia and encephalitis.

Female↗
PubMed1997

Oct proteins are qualitative rather than quantitative regulators of kappa transcription.

The 3' flanking sequence of kappa promoter octamers was found to contain either a conserved A or G residue which increased the affinity of the octamer core motif for Octl and Oct2A. By transient transfections it was shown that decreasing the affinity of an octamer for Oct binding was crippling the transcription unit when the octamer was used in a minimal promoter, while it had only marginal effects when it was analysed in the context of an intact kappa promoter. As the octamer in a kappa promoter was replaced by a TAATGARAT motif with equal affinity for Oct protein binding the latter could still participate in synergistic transcriptional stimulation. Thus, the synergistic interactions involved in kappa promoter transcriptional stimulation are dependent on the presence of Oct proteins but not on the octamer DNA motif per se. Since the transcriptional coactivator OCA-B cannot interact with Oct protein bound to the TAATGARAT motif, the role of OCA-B in these interactions seems to be limited.

DNA-Binding Proteins↗
PubMed1995

Analysis of the acute ophthalmic manifestations of the erythema multiforme/Stevens-Johnson syndrome/toxic epidermal necrolysis disease spectrum.

PURPOSE: To evaluate the epidemiology, possible etiologic factors, complications encountered, and treatment administered to a group of patients with ocular involvement in the erythema multiforme/Stevens-Johnson syndrome/toxic epidermal necrolysis disease spectrum who were seen at two large tertiary referral centers over a 34-year period. METHODS: Hospital records from 1960 to 1994 at the Massachusetts General Hospital and Shriners Hospital for Crippled Children were reviewed for patients with erythema multiforme, Stevens-Johnson syndrome, or toxic epidermal necrolysis. Only patients fulfilling specific clinical diagnostic criteria and those who received a diagnosis by a dermatologist were included in the review. RESULTS: A total of 366 patients with erythema multiforme, Stevens-Johnson syndrome, or toxic epidermal necrolysis were identified. Drugs were the most commonly identified etiologic factor in all three conditions: sulfonamides were the most frequently identified agents. Eighty-nine patients (24%) had ocular manifestations at the time of their acute hospital stay. Ocular involvement was seen in 9% of patients with erythema multiforme, in 69% with Stevens-Johnson syndrome, and in 50% with toxic epidermal necrolysis. The ocular problems were more severe in patients with both Stevens-Johnson syndrome and toxic epidermal necrolysis. There was no significant difference between the number of patients who were treated with systemic steroids and those who were not (P = 0.42). CONCLUSIONS: The erythema multiforme/Stevens-Johnson syndrome/toxic epidermal necrolysis disease spectrum remains an important cause of severe visual loss in a significant number of patients. Systemic steroids used during the acute phase of the disease appear to have no effect on the development of ocular manifestations. Studies on the acute immunopathogenic mechanisms occurring in these disease are warranted if more effective therapies are to be found.

Acute Disease↗
PubMed1998

Environmental risk factors for sporadic Escherichia coli O157 infection in Scotland: results of a descriptive epidemiology study.

The objective of the study was to obtain detailed descriptive epidemiological information on sporadic verocytotoxin-producing Escherichia coli O157 infection in Scotland in relation to transmission routes and host-related risk factors. Using a standardized questionnaire, the study was carried out throughout Scotland over an 18-month period from July 1992 and co-ordinated at the Communicable Diseases and Environmental Health (Scotland) Unit, Glasgow (CDEH(S)U). The subjects were laboratory-confirmed cases of Escherichia coli O157 infection, of whom 138 met the criteria for inclusion in the study. The most important findings were the high proportion of cases who had been exposed to environmental factors such as farm animals and/or their by-products; or who had participated in gardening or garden-play; or who had suspected or confirmed household water supply problems, prior to the onset of illness. The frequency and relative importance of environmental risk factors requires further quantification and study in order to assess where control measures can be directed most effectively. The implications for the NHS in preventing this crippling, life-threatening infection are considerable, not least in relation to hospitalization, dialysis and renal transplantation costs.

Adult↗
PubMed2002

Identification of mechanisms of natural resistance to African trypanosomiasis in cattle.

Natural resistance to African trypanosomiasis in certain Bos taurus cattle in West Africa, called trypanotolerance, may hold solutions for control of this economically crippling disease. Comparison of immune responses between trypanotolerant and trypanosusceptible cattle have shown some differences in antibody response, complement level and cytokine expression, but it is not known whether these differences are the cause of resistance. Two experiments were carried out to assess the contribution of the immune and haemopoietic systems to trypanotolerance. The production of haemopoietic chimaeras from trypanotolerant and susceptible twin calves and comparison of their responses after infection with singleton calves, allowed an assessment of the role of the haemopoietic system in trypanotolerance. An in vivo depletion of CD4 cells in the two breeds allowed an appraisal of the role of T and B lymphocytes in trypanotolerance. The results of the two experiments suggest that natural resistance comprises at least two mechanisms, an innate mechanism that controls parasite growth, and another, involving the haemopoietic system, that is able to limit anaemia. This supports the hypothesis that innate mechanisms in trypanotolerant cattle are more efficient in controlling disease, making them less reliant on antibody responses.

Animals↗
PubMed2003

Th1 and Th2 indices of the immune response in pigs vaccinated against Taenia solium cysticercosis suggest various host immune strategies against the parasite.

Kinetics of the production of serum antibody levels and Th1 (IL-2, IFN-gamma) and Th2 (IL-4, IL-10) cytokines was studied in five pigs vaccinated with a synthetic tri-peptide vaccine (S3Pvac) against Taenia solium, a vaccine that has been shown protects pigs against naturally acquired infection. Healthy pigs of mixed genetic background, similar to those bred in rural villages of Mexico, were vaccinated with S3Pvac or with adjuvant alone, kept in sanitary conditions and bled at different times after vaccination to study the development of their specific immune response. Peripheral blood mononuclear cells (PBMCs) of vaccinated pigs showed a significant increment in the production of Th1 cytokines (IL-2 and IFN-gamma) but not of Th2 cytokines (IL-4 and IL-10) after specific PBLs stimulation with all the individual peptides. A Th1-inclined cytokine profile leading to an exacerbated local inflammation at the early installation stage of the cysticercus may possibly interfere with their successful establishment in the serum antibodies against total cysticercus antigens and against each of the three different peptides comprising S3Pvac were detected 7-51 days after vaccination. Antibodies against GK-1 interfered with the cysticerci development into intestinal tapeworms in prednisolone-treated hamsters. The sub-lethal crippling effect of anti-GK-1 antibodies upon cysticerci indicates to a therapeutic application of S3Pvac in infected pigs having potential epidemiological consequences, as it could aid in decreasing the number of tapeworms expected to develop from the few cysticerci that survive in the vaccinated pigs.

Animals↗
PubMed2001

Comparison of RNA and cDNA transfection methods for rescue of infectious bursal disease virus.

Specific alterations in the genetic material of RNA viruses rely on a technique known as reverse genetics. Transfection of cells with the altered generic material is a critical step of this procedure. In this report we have compared RNA and cDNA transfection methods for the efficiency of transient protein expression and rescue of (recombinant) infectious bursal disease virus (IBDV). Quantitative expression analysis of the secreted alkaline phosphatase reporter protein, and qualitative expression levels of an IBDV protein showed both that cDNA transfection results in a much higher level of protein expression than RNA transfection. Because the rescue of a crippled variant of IBDV was achieved consistently using the cDNA transfection method, but failed when we used the RNA transfection method, we favor the cDNA transfection method for the rescue of (recombinant) IBDV from cloned cDNA.

Animals↗
PubMed2003

Detecting Rice stripe virus (RSV) in the small brown planthopper (Laodelphax striatellus) with high specificity by RT-PCR.

Rice stripe disease, caused by Rice stripe virus (RSV), may lead to severe or even crippling losses in many rice-cultured countries and regions. As the most important vector of RSV, the small brown planthopper (SBPH) (Laodelphax striatellus) is largely responsible for the epidemic phase of the disease. Therefore, a rapid identification of RSV in the SBPH is of a great need for disease forecasting. A reverse transcription polymerase chain reaction (RT-PCR) assay is described to amplify a RSV gene in individual L. striatellus. By using primers matched to the viral RNA dependent RNA polymerase gene in RNA1, a 445 bp product was detected in viruliferous SBPHs. Meanwhile, the PCR products produced by the SBPH actin primers constructed across the boundary of an intron and an exon were used as RNA specific positive control for each stage of the experiment to ensure the validity of the negative results. Duplex RT-PCR conditions were established for the simultaneous detection of RSV and actin. This approach can be used for the early detection of RSV in L. striatellus and the subsequent rice stripe disease forecasting.

Animals↗
PubMed2004

Petro-state constraints on health policy: guidelines for workable reform in Venezuela.

This article reviews the performance of the Venezuelan health care sector and suggests guidelines for workable health policy under difficult conditions. Two special circumstances constrain policy options. First, Venezuelans share a traditional value, solidarity, which includes a strong desire for equity. Reforms must comply with this norm to succeed. Second, foreign sales of state-controlled oil constitute the bulk of the government budget and the gross domestic product (GDP). Petroleum market fluctuations expose the country to extreme economic cycles. In response, policy making and stakeholders adopt a rentier attitude, focusing on preserving or enlarging entitlements to government oil monies. The side effects of this largesse include poor productivity, a weak private sector, a widespread sense of entitlement without accountability, and a crippled state which controls most of the available resources yet is unable to effectively tax, regulate, steer the economy, or pursue long-term policies. The health care sector shares these problems. As a result, Venezuela's health systems are fragmented, poorly coordinated, excessively centralized, inequitable, and ineffective. Policies to improve public health and public and private medical care must take into account these constraints.

Delivery of Health Care↗
PubMed2000

Neuroanatomically based approaches to obsessive-compulsive disorder. Neurosurgery and transcranial magnetic stimulation.

Obsessive-compulsive disorder is a severe condition. Unfortunately, current medication and behavior therapies fail to adequately benefit some patients most severely affected. Advancing knowledge of brain circuit involvement has potential treatment implications. The neurosurgical techniques most often used in the United States for crippling, treatment-refractory obsessive-compulsive disorder are reviewed in the context of anatomic models of the illness. The use of transcranial magnetic stimulation to probe possible neuroanatomic and neurophysiologic substrates of this disorder is considered, and how the knowledge gained from such studies might advance treatment is presented.

Brain↗
PubMed2000

Plastipore implants in the surgical treatment of atrophic rhinitis: technique and results.

BACKGROUND: Atrophic rhinitis is a distressing and socially crippling disease. Surgical treatment has been used for patients with severe disease that is unresponsive to medical therapy. METHODS: Eight patients with primary atrophic rhinitis were treated surgically by narrowing of the nasal fossae with implantation of 2 Plastipore plates per affected side into submucosal pockets into the floor of the nose and septum, thus reducing the volume of the nasal fossae. RESULTS: Excellent results were obtained in 6 patients, with complete resolution of symptoms and good results and only minor crusting in 2 patients. One implant was extruded spontaneously 18 months after implantation and was reimplanted. Results in this patient before and after reimplantation were excellent. There were no cases of infection and no other complications. CONCLUSION: We implanted Plastipore, a high-density polyethylene sponge with micropores, which enables tissue ingrowth, anchoring the implants to the surrounding tissue. The surgical technique is performed with the patient under local anesthesia and is relatively easy and avoids complicated flap procedures, allogeneic bone harvesting, and the discomfort of nostril closure for prolonged periods.

Adult↗
PubMed1992

Total hip arthroplasty for treatment of canine hip dysplasia.

Cemented THA is an established procedure for treating arthropathies of the hip in large, healthy mature dogs. CHD with secondary osteoarthritis is the most common indication. Although comparative studies between THA and excision arthroplasty have not been reported, our experience with both procedures and studies in the literature support THA as the best available treatment for crippling degenerative joint disease secondary to CHD in large, mature dogs. Negative aspects of the procedure include high cost, the potential of significant complications, and the sophisticated surgical technique required. Improvements in patient selection, design of implants, surgical technique, and postoperative care have decreased the incidence of complications and improved the success rate to over 90%. However, concerns in human applications about cement disease and the desire to increase the functional life of the prosthesis have renewed interest in cementless systems. Advantages of cementless THA are fixation via bony ingrowth and avoidance of problems associated with PMMA. Important technical aspects of cementless THA relate to optimal fit and fill so that the prosthesis is stable, bone ingrowth is promoted, and weight-bearing forces are transferred to the proximal femur physiologically. Problems recognized with cementless systems include fissure fracture, bone resorption, and excessive motion between the implant and bone. Currently, investigations are being conducted to develop prosthetic materials that more closely match the stiffness of bone, stem designs that provide optimal fit and maintain normal strain patterns in the bone, and coating materials that promote permanent fixation by bone ingrowth. Early clinical results in humans and research results in dogs have been encouraging but have not withstood the test of time. Results of cementless techniques must be compared to the standards set by cemented THA over the last 20 years in humans and the last 10 years in dogs.

Animals↗
PubMedDate not supplied

[Systemic complications of beta-blocking eyedrops. Apropos of 6 cases].

Six cases of systemic reactions to topical treatment with beta-blocking eyedrops are reported, bradycardia and faintness due to an overdosage of ophthalmic timolol; decompensated heart failure one month after the prescription of carteolol eyedrops: bronchospasm after two weeks of treatment with metipranolol eyedrops; crippling Raynaud's phenomenon of otherwise unknown origin, which had begun with timolol eyedrops, continued with carteolol eyedrops and regressed after discontinuation of ophthalmic beta-blockers; aggravation of an anaphylactoid shock in a patient treated with ophthalmic timolol, and myocardial infarction possibly due to the abrupt withdrawal of timolol eyedrops. It cannot be overstressed that the rules governing the prescription of oral beta-blockers also apply to ophthalmic preparations of these drugs: respect of contra-indications, strict adherence to the dosage recommended, gradual drug withdrawal and regular supervision. Only controlled studies and long-term follow-up will be able to demonstrate differences in safety between the five beta-blockers commercialized as eyedrops in this country.

Adrenergic beta-Antagonists↗
PubMed1999

[Treatment of rheumatoid polyarthritis: evolution of concepts and strategies].

INTRODUCTION: The treatment of rheumatoid arthritis includes non-steroid anti-inflammatory drugs (NSAID), low-dose steroids and drugs which modify the evolution of the disease (disease modifying anti-rheumatic drugs, [DMARD]). In the last few years, the long-term efficiency of the recommended treatment strategies in rheumatoid arthritis has been a matter of debate and their basic assumptions have been challenged. Numerous studies were undertaken to settle the question. They tried to delineate the rules for an optimal use of current drugs and other therapeutic means. CURRENT KNOWLEDGE AND KEY POINTS: Rheumatoid arthritis is a crippling disease. It decreases life expectancy and irreversible bone and joint damage may develop even in the first months of evolution. The sooner the prescription of DMARD, the higher the frequency and quality of rheumatoid arthritis improvement and, in the long-term, the lesser the functional impairment. Low dose steroids, when administered early, can slow down the development of radiologic lesions. Some of their effects are thus closer to those of DMARD than to those of symptomatic treatment. NSAID are at least as equally dangerous as DMARD and possibly more so in terms of the potential number of severe side effects. The combination of several DMARD does not increase their overall toxicity. An evaluation of the most efficient combinations and of the clinical situations in which combinations show promise of improved results is in progress. FUTURE PROSPECTS AND PROJECTS: At present, the tendency is to treat early and intensively, in order to obtain complete remission, improve evolution and reduce functional impairment. This strategy requires early diagnosis and early evaluation of prognosis of rheumatoid arthritis. Rheumatoid arthritis with benign evolution would not warrant intensive treatment. Studies are in progress to evaluate the prognostic factors in early rheumatoid arthritis that would enable us to adapt the strength of initial treatment to the disease's putative severity.

Adrenal Cortex Hormones↗
PubMed1993

Radiological and histological improvement of oxalate osteopathy after combined liver-kidney transplantation in primary hyperoxaluria type 1.

A 15-year-old patient with severe bone disease (with bilateral fractures of hips and shoulders) due to primary hyperoxaluria type 1 (PH1) was treated with combined liver-kidney transplantation after a 4-year hemodialysis period. Normalization of excessive oxalate synthesis brought in by the liver graft combined with the slow excretion of skeletal oxalate stores by the renal graft led to progressive improvement of clinical, radiological, and histological evidence of oxalate osteopathy. This allowed bilateral hip replacement 3 years after transplantation, which led to complete physical rehabilitation of the crippled patient. Combined liver-kidney transplantation constitutes the treatment of choice for end-stage renal failure due to PH1, even in the face of severe oxalate bone disease.

Adolescent↗