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Biomedical subjects

A F Anderson

Publications and source records attributed to A F Anderson.

At least 19 recordsLinked to original sources
PubMed2003

China's floating population and the potential for HIV transmission: a social-behavioural perspective.

Historical, geo-economic and behavioural perspectives are used in an exploratory analysis of China's migrant or 'floating' population as a factor in the spread of HIV on the mainland. Participants in the interview format survey (N = 506) included in-transit individuals in Beijing, and peddlers, restaurant workers, and employment seekers in Shanghai. When viewed in light of various social dynamics, the convenience survey data suggest that elements within this migrant population, as well as their rurally located partners and spouses, may be at increased risk of acquiring the virus. Given the sheer size and broad movement of this population, it is contended that it may well be a 'tipping point' factor in AIDS prevention and control in China.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Clinical analysis of the pivot shift tests: description of the pivot drawer test.

A clinical analysis of the pivot shift was performed by evaluating 100 patients with unilateral anterior cruciate ligament (ACL) insufficiency in an office setting. Each patient was examined in a random order using the Macintosh, Losee, Hughston, Slocum, pivot drawer, and flexion rotation drawer versions of the pivot shift test. Pathologic anterior tibial displacement was estimated with the Lachman test and quantitatively measured using the KT-1000 knee ligament arthrometer. Pivot shift was graded as 0 (absent), grade I (slight), grade II (definite subluxation), and grade III (subluxation and momentary locking). The presence or absence of any degree of pivot shift was correlated with the arthroscopic finding of a torn ACL. Results indicated the "drawer type" tests were significantly more sensitive than other versions of the pivot shift because they can be performed without causing significant pain and muscle spasm, and the limb position maximizes pathologic coupled motion. A correlation between increasing displacement estimated with the Lachman test and measured displacement with the KT-1000 arthrometer revealed that as pathologic displacement increases so does the grade of the Slocum, pivot drawer, and flexion rotation drawer tests. We recommend using the pivot drawer or flexion rotation drawer as a standard method for assessing the pivot shift phenomenon.

Anterior Cruciate Ligament↗
PubMed1997

Antegrade drilling for osteochondritis dissecans of the knee.

Twenty-four knees with osteochondritis dissecans of the femoral condyles failed a conservative program and were treated with antegrade drilling. To our knowledge, this represents the largest reported series using this technique. The average age at the time of surgery was 13 years 6 months. Seventeen patients had open physes, and four were skeletally mature. Nineteen lesions involved the medial femoral condyle, and five involved the lateral femoral condyle. The average follow-up was 5 years. Postoperative evaluation included rating by the International Knee Documentation Committee (IKDC) form and the Hughston Rating Scale for osteochondritis dissecans. Twenty of the 24 lesions healed after antegrade drilling, and the average time of healing was 4 months. According to the criteria on the IKDC grading form, 14 were normal, 6 nearly normal, three abnormal, and one severely abnormal. The results of the Hughston Rating Scale were similar: 15 were excellent, seven good, one fair, and one poor. Only two of the four skeletally mature patients healed after antegrade drilling. Antegrade drilling is an effective method of treatment for osteochondritis dissecans of the knee that occurs in adolescents with open physes. This operation is not as likely to result in a successful outcome in patients with closed physes; consequently, other methods should be considered in skeletally mature patients.

Adolescent↗
PubMed1996

Prostitutes, prostitution and STD/HIV transmission in mainland China.

China's opening to the world has enabled massive social and economic transformations and the liberalization of many policies, but also the rise of coincident social problems and diseases. A revival of wide-scale female prostitution since the 1980s has now accelerated to a nationwide dilemma. Prostitutes have long been considered to be reservoirs, if not 'vectors' for the transmission of sexual diseases. A well established STD epidemic in the last decade, plus the presence of growing HIV infections in China now, underscore the need to evaluate the prostitute's role in STD and HIV propagation. This report examines unobtrusive data on female prostitutes in the People's Republic of China through an analysis of prison records from eight sexually segregated prisons (six in Sichuan Province and two in Guizhou Province), two female re-education institutions, and arrest records for convicted prostitutes from four counties in Sichuan Province and Chengdu City (also in Sichuan). Collectively, these data represent 2057 female prostitution cases, and span the years 1988-1990. Demographics are examined to enable a profile of the prostitute as based on data reviewed, and this is contrasted to the stereotype of the prostitute as described in government propaganda against prostitution. STD prevalence rates in the samples are examined and contrasted to two other studies on STDs in nonprostitution populations made available to the authors. Prostitute arrest records reveal a majority had active STD infection[s] at the time of their apprehension, with gonorrhea being the most common bacterium; in many instances, prostitutes also had a history of other sexually transmitted diseases. Thus, data examined support the notion of prostitution as an agent in STD transmission. Presence of HIV infection in prostitutes could not be corroborated through sampled records, nor could prostitution itself be confirmed as an agent in HIV transmission at present. However, given the type of clients serviced by prostitutes in China, a prostitute's own risk of HIV infection is discussed. Control measures by the Chinese government to curb prostitution are examined at both national and provincial levels. Questions are raised as to the effectiveness of present tactics as adjunctive strategies in reducing STD infection and HIV risk in the prostitution population.

China↗
PubMed1991

Residual functional deficit after partial fibulectomy for bone graft.

The residual functional deficit caused by partial fibulectomy for bone graft was documented with subjective assessment and clinical and instrumented examination in ten patients. The donor leg often remained mildly symptomatic. Residual weakness occurred when the middle one third of the fibula was excised. However, mild discomfort, residual weakness, and laxity were not considered significant enough to discourage transplantation of large segments of the fibula. Postoperative therapy should emphasize muscular strength to minimize the functional deficit.

Adult↗
PubMed1990

Acute pulmonary edema, an unusual complication following arthroscopy: a report of three cases.

Acute pulmonary edema in the young athlete is a rare complication following arthroscopic surgery. It is not related to fluid absorption during arthroscopy, but rather to a brief period of upper airway obstruction. Pink, frothy pulmonary edema fluid appears along with other signs of hypoxia. Treatment consists of oxygenation, diuretics, and nitrates. Young athletes may be at increased risk for laryngospasm-induced pulmonary edema because they have the ability to generate large negative intrathoracic pressures. This condition must be recognized promptly to minimize morbidity and mortality.

Adolescent↗
PubMed1986

Tears of the anterior cruciate ligament in adolescents.

Tears of the anterior cruciate ligament in adolescents are rare. From 1977 to 1983 we did a surgical reconstruction of that ligament, using the semitendinosus and gracilis tendons, in twenty-four athletes who were twelve to fifteen years old. We routinely supplemented that procedure with the Ellison or Losee extra-articular reconstruction. The length of follow-up averaged thirty-five months. There were sixteen excellent, seven good, and one fair-plus result. Only one patient showed a significant growth abnormality. Use of the semitendinosus and gracilis tendons did not significantly decrease the strength of flexion or internal rotation as measured by the Cybex-II dynamometer.

Adolescent↗
PubMedDate not supplied

Correlation of anthropometric measurements, strength, anterior cruciate ligament size, and intercondylar notch characteristics to sex differences in anterior cruciate ligament tear rates.

We performed a prospective study based on the hypothesis that physiologic differences exist between men and women in strength after adjustments for body weight; that the size of the anterior cruciate ligament is proportionate to the strength of its antagonists, the quadriceps muscles; and that women have a relatively small anterior cruciate ligament, thus predisposing them to a disproportionate number of anterior cruciate ligament injuries. One hundred matched high school basketball players, 50 male and 50 female, were evaluated with anthropometric measurements, body fat analysis, muscle strength evaluation, and magnetic resonance imaging measurements of the intercondylar notch and cross-sectional area of the anterior cruciate ligament at the outlet. The male players were taller and heavier than their female counterparts, although they had 11% less body fat. Male players had statistically greater quadriceps and hamstring muscle strength than female players, even when adjustments were made for body weight. With adjustments for body weight, the size of the anterior cruciate ligament in girls was found to be statistically smaller than in boys. There was no statistically significant difference in the notch width index between the sexes. The study data support our hypothesis that sex differences in anterior cruciate ligament tear rates are caused primarily by several interrelated intrinsic factors. Most importantly, stiffness and muscular strength increase stress on the anterior cruciate ligament in female athletes. The anterior cruciate ligament, when adjustments have been made for body weight, is smaller in female athletes, and therefore, probably does not compensate for the lack of stiffness and strength.

Adolescent↗
PubMedDate not supplied

Anterior cruciate ligament reconstruction. A prospective randomized study of three surgical methods.

A prospective randomized study was performed to determine the differences in results between three methods of anterior cruciate ligament reconstruction: autogenous bone-patellar tendon-bone graft (group 1), semitendinosus and gracilis tendon graft reconstruction combined with an extraarticular procedure (group 2), and semitendinosus and gracilis tendon graft reconstruction alone (group 3). Preoperatively, there were no significant differences between groups. At a mean of 35.4 +/- 11.6 months postoperatively, 102 patients returned for evaluation. International Knee Documentation Committee knee evaluation revealed no significant differences in symptoms, function, return to pre-injury activity, harvest site abnormalities, or limitation of motion between groups 1 and 3. Patients in group 2 had a higher incidence of patellofemoral crepitation and loss of motion than did patients in group 3. The mean manual maximum KT-1000 arthrometer side-to-side difference was 2.1 +/- 2.0 mm in group 1, which was statistically significantly better than the difference in group 3 (3.1 +/- 2.3 mm). Final knee rating showed that 34 of 35 patients in group 1, 23 of 34 patients in group 2, and 26 of 33 patients in group 3 had a normal or nearly normal overall knee rating. Anterior cruciate ligament reconstruction with a semitendinosus and gracilis or a patellar tendon autograft may yield similar subjective results; however, the patellar tendon autograft may provide better objective stability in the long term. In addition, there appears to be no benefit to combining an intraarticular anterior cruciate ligament reconstruction with an extraarticular procedure.

Adolescent↗
PubMedDate not supplied

Development and validation of the international knee documentation committee subjective knee form.

A committee of international knee experts created the International Knee Documentation Committee Subjective Knee Form, which is a knee-specific, rather than a disease-specific, measure of symptoms, function, and sports activity. The purpose of this study was to evaluate the reliability and validity of the new International Knee Documentation Committee Subjective Knee Form. To provide evidence for reliability and validity, we administered the final version of the form, along with the Short Form-36, to 533 patients with a variety of knee problems. Analyses were performed to determine reliability, validity, and differential item function related to age, sex, and diagnosis. Factor analysis revealed a single dominant component, making it reasonable to combine all questions into a single score. Internal consistency and test-retest reliability were 0.92 and 0.95, respectively. Based on test-retest reliability, the value for a true change in the score was 9.0 points. The International Knee Documentation Committee Subjective Knee Form score was related to concurrent measures of physical function (r = 0.47 to 0.66) but not to emotional function (r = 0.16 to 0.26). Analysis of differential item function indicated that the questions functioned similarly for men versus women, young versus old, and for those with different diagnoses. In conclusion, the International Knee Documentation Committee Subjective Knee Form is a reliable and valid knee-specific measure of symptoms, function, and sports activity that is appropriate for patients with a wide variety of knee problems. Use of this instrument will permit comparisons of outcome across groups with different knee problems.

Factor Analysis, Statistical↗
PubMedDate not supplied

Clinical diagnosis of meniscal tears. Description of a new manipulative test.

The accuracy in clinical diagnosis of meniscal tears was assessed in 100 knees. Arthroscopy was performed in each case to establish the diagnosis. The clinical diagnosis was correct in 87 cases, correct but incomplete in 4, and incorrect in 9. In those with meniscal tears repeated popping occurred in 43%, swelling in 51%, and pain localized to the joint line in 63%. Tenderness over the joint line, the most accurate clinical sign, was positive in 77% and false positive in 11% of meniscal tears. McMurray's test was positive in 58% and false positive in 5%, while the medial-lateral grind test was positive in 68% and false positive in 1%. At least one of these manipulative tests was positive in 79% of meniscal tears. Repeated examination and addition of the medial-lateral grind test to the clinical evaluation of meniscal tears significantly improves diagnostic accuracy.

Adolescent↗
PubMedDate not supplied

Analysis of the intercondylar notch by computed tomography.

The purposes of this study were to document the dimensions and configuration of the intercondylar notch in the normal knee; to compare normal knee intercondylar notches to those of knees with unilateral and bilateral ACL tears to determine if there is a relationship between intercondylar notch stenosis and ACL tears; and to determine if generalized ligamentous laxity is associated with intercondylar notch stenosis and ACL tears. Three groups were compared: Group I, bilateral ACL tears; Group II, unilateral tears; and Group III, normal knees. Notch dimensions were computer-generated from CT scans. All patients were examined for ligamentous laxity. Statistically significant differences were found between normal and ACL-injured knees in regard to opening notch angle, ratio of notch width at two-thirds of the notch length to condylar width, and ratio of maximum notch width to condylar width, suggesting a significant association between anterior outlet stenosis and unilateral and bilateral ACL tears. The shapes of the notches were determined from tracings of the distal CT scan. Shapes ranged from inverted U to cresting wave. Narrow notches tended to be waveshaped, but more study is needed in this area. Notch-plasty is recommended for those with documented stenosis. The ratio of maximum notch width at two-thirds of the notch height to maximum condyle width should not be much less than 0.2, and the opening notch angle should be at least 50 degrees.

Adult↗
PubMedDate not supplied

Analysis of rehabilitation techniques after anterior cruciate reconstruction.

Numerous postoperative therapies have been advocated for the rehabilitation of patients who have undergone ACL reconstruction. The effectiveness of these various methods, many of which are based on sound scientific principles, has yet to be documented. The purpose of this study was to determine the efficacy of five commonly used rehabilitation programs. Five groups of 20 patients, all of whom underwent the same method of ACL reconstruction, were compared in order to determine the effects of the following treatments (some in combination): transcutaneous electrical nerve stimulation (TENS), immobilization in flexion, immobilization in extension, electrical muscle stimulation (EMS), and continuous passive motion (CPM). Clinical evaluation, volumetric thigh measurements, instrumented varus-valgus stress testing, KT-1000 arthometer (Medmetric, San Diego, CA) measurements, and Cybex II (Cybex, Division of Lumex, Ronkonkoma, NY) muscle evaluation were used to examine the patients. TENS did not reduce the amount of pain medication required, nor was there improvement in any other clinically measurable parameter of performance. There was no clear difference in stability between those treated in extension and those treated in flexion; however, since three patients who were treated in extension required manipulation, there may be some advantage to treating patients with early limited range of motion in flexion. EMS did not reduce atrophy but it did minimize strength decrease during immobilization. EMS also resulted in significantly greater range of motion than those treated with extension or flexion with early limited motion. Compared to all groups, EMS patients had a significant reduction in the incidence of patellofemoral crepitation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗