Biomedical subjects
Publications and source records attributed to A Perrenoud.
The posterior dislocation of the shoulder is frequently unrecognized for many days, months or even years after the initial accident. After the presentation of its clinical and radiological features, as the different ways of its treatment, some cases will illustrate this entity, too frequently missed or wrongly treated.
Our physiotherapy program after total hip arthroplasty is presented, and certain modifications in relation to cemented or cementless implantations are discussed. Three different stages must be considered: preoperative instructions of the patient, mobilization of the patient and his joints, water gymnastics to enable the patient to obtain total independence. During the first three months only partial weight should be put on the operated leg. In comparison to the cemented system, the biomechanical properties of the cementless prosthesis permit only a careful and delayed mobilization and charge of the operated leg, as long as a secondary stability of the implant has not been reached. In more complicated cases it is of importance that the whole planning of postoperative physiotherapy should be discussed individually and in detail with the surgeon concerned.
For the twenty years of 1740-1759, the authors analyze, for the city of Geneva, the causes of death as officially indicated on the bills of mortality. This study is part of a larger analysis of mortality: over a longer period, the whole gamut of disease--pathocoenosis--will be studied, and some light should be shed by this on the causes of the decline of mortality in the 18th century. The data are analyzed with regard to age, sex and season and interpreted according to ancient as well as modern medical criteria.
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PURPOSE: A cause for the resistance to intranasal salmon calcitonin (sCT) therapy in patients with Paget's disease is the occurrence of neutralizing antibodies to sCT. As a result, a new formulation of intranasal human calcitonin (hCT) was developed, and the efficacy investigated in patients treated earlier with sCT. PATIENTS AND METHODS: Twelve patients with Paget's disease were treated twice daily for 6 months with 1 mg synthetic hCT administered intranasally. Five patients demonstrated low-titer antibodies to sCT, and four of the patients did not respond previously to 1-year therapy with intranasal sCT. The hypocalcemic effect of 3 mg hCT was compared to that of 0.1 mg sCT before and after the intranasal hCT therapy. Serum alkaline phosphatase and the ratio between the urinary excretion of hydroxyproline and creatinine were measured before and during intranasal hCT treatment. RESULTS: The hypocalcemic response to 3 mg intranasal hCT (-6.60 +/- 0.67%, mean +/- standard error) was similar before and at the end of intranasal hCT therapy (-5.92 +/- 0.80%, p greater than 0.1). Intranasal sCT (0.1 mg) lowered serum calcium less effectively (-2.86 +/- 0.76%) than 3 mg intranasal hCT (p less than 0.05). The presence of low-titer antibodies to sCT did not affect the hypocalcemic response to sCT or hCT. As a result of the 6-month intranasal hCT regimen, serum alkaline phosphatase and urinary hydroxyproline/creatinine ratio were reduced to 62 +/- 5% (p less than 0.001) and 80 +/- 7% (p less than 0.05) respectively, of pretreatment levels. In four patients previously resistant to intranasal sCT therapy because of neutralizing antibodies to sCT, serum alkaline phosphatase was similarly lowered by intranasal hCT to 66 +/- 6% of pretreatment levels (p less than 0.05). CONCLUSION: A new formulation of intranasal hCT effectively lowered serum calcium levels, alkaline phosphatase concentrations, and urinary hydroxyproline excretion in patients with Paget's disease, some of whom were previously resistant to intranasal sCT because of neutralizing antibodies.
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