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Biomedical subjects

A Peyser

Publications and source records attributed to A Peyser.

At least 19 recordsLinked to original sources
PubMed2006

Osteoid osteoma: CT-guided radiofrequency ablation using a water-cooled probe.

BACKGROUND: The purpose of this study was to assess the safety and efficacy of computed tomography (CT) guided percutaneous radiofrequency (RF) ablation of osteoid osteoma by using the water-cooled probe. METHODS: During the period from July 2002 to February 2006, fifty-one patients with osteoid osteomas localized in femur (29), tibia (10), calcaneus (2), talus (2), metatarsus (2), humerus (1), sacrum (1), scapula (1), olecranon (1), patella (1) and thoracic vertebra (1) were treated with CT-guided RF ablation using the Cooltiptrade mark Tyco Healthcare probe. Mean age was 20 (range, 3.5-57 years) and male to female ratio was 36/15. Mean follow-up period was reported 2 years (range, 9-51 months). The procedures were carried out under general anesthesia and the patients were discharged from the hospital within 24 h. RESULTS: Technical failure was reported in only one procedure. Pain disappeared postoperatively in all the patients within 2-3 days and no patients needed analgesic treatment after a week. All patients were allowed fully weight bear and function without limitation after the procedure. Recurrence of the pain was observed in one patient who was treated successfully with a second ablation. Our primary and secondary clinical success rates were 98 and 100% respectively. In one case, wound infection was observed after the procedure as the only post-operative complication in our series. CONCLUSION: CT-guided percutaneous RF ablation of osteoid osteomas using the water-cooled probe is a safe, effective and minimally invasive procedure with high success rate and lack of relapses.

Adolescent↗
PubMed2005

Delayed reaction to shrapnel retained in soft tissue.

BACKGROUND: Treatment of penetrating injuries to soft tissues does not require surgical excision of shrapnel. Metals usually remain inert and do not cause damage and are therefore left in soft tissue. OBJECTIVE: Characterization of delayed reaction to shrapnel retained for many years in soft tissue. PATIENTS: Four patients sustained penetrating injuries to the limbs with embedded shrapnel. Many years later, they experienced delayed reaction to the metals that required surgery, with very unusual findings. CONCLUSIONS: Although nonsurgical treatment of shrapnel in soft tissues is the treatment of choice in most cases, we need to be aware of the possibility of late complications requiring surgical treatment.

Adult↗
PubMed2002

The floating hip injury: patterns of injury.

OBJECTIVE: To evaluate the relationship between mechanism of injury, type of femoral fracture and type of acetabular fracture in floating hip injury. DESIGN: Historical retrospective. PATIENTS: Twenty consecutive patients who sustained a floating hip injury, i.e. simultaneous ipsilateral fracture of the acetabulum and the femur. INTERVENTION: Statistical analysis of the correlation between the mechanism of injury and fracture type. RESULTS: Two main patterns of floating hip injury were observed. The first is the posterior type, which occurs due to a longitudinal force along the femur that causes first, a posterior type fracture of the acetabulum and thereafter, a midshaft femoral fracture. The second pattern is the central type, caused by a lateral blow to the greater trochanter, which then causes a central fracture-dislocation of the acetabulum and a proximal fracture of the femur. CONCLUSIONS: This observation explains the biomechanical nature of this injury and has treatment related implications.

Accidents↗
PubMed1999

Selective delivery of doxorubicin to patients with breast carcinoma metastases by stealth liposomes.

BACKGROUND: Stealth liposomes hold promise as a mode of delivering cytotoxic agents selectively to tumors in cancer patients. The objective of this study was to determine whether stealth liposomal doxorubicin accumulates selectively in bone metastases based on clinical material obtained from two patients with breast carcinoma. METHODS: Tumor tissue was obtained from two women (ages 33 years and 41 years, respectively) with metastatic breast carcinoma who responded to treatment with stealth liposomal doxorubicin and later underwent a surgical fixation procedure to treat a pathologic fracture of the femur. Drug levels in the tumor and adjacent muscle were examined by high performance liquid chromatography analysis in both patients and by fluorescence microscopy in one of the patients. RESULTS: Bone tumor fragments obtained during surgery performed 6 days after the administration of the 12th course of stealth liposomal doxorubicin in 1 patient and 12 days after the administration of the 16th course of stealth liposomal doxorubicin in the second patient had a 10-fold greater concentration of liposomal doxorubicin than tumor free muscle. Doxorubicin fluorescence and specific nuclear staining showed good colocalization, thus confirming the presence of the liposome-delivered drug in the nuclei of tumor cells. CONCLUSIONS: Using skeletal muscle as a comparator, stealth liposomal doxorubicin accumulates selectively in metastatic breast carcinoma cells within bone.

Adult↗
PubMed1999

[CT-guided excision of osteoid osteoma].

CT-guided excision of osteoid osteoma is a new surgical technique that enables accurate resection of the nidus during 1-day hospitalization. We present 5-year results in 42 patients (26 males and 16 females, mean age 18 years, range 3-46). In 40 out of 42, complaints disappeared immediately after the procedure. The recovery period was short and the return to normal activity was faster than in the open surgical approach. Complications were minimal and transient.

Adolescent↗
PubMed1999

Focal, steroid responsive myositis causing dropped head syndrome.

The dropped head syndrome, which occurs in a variety of neuromuscular disorders, is usually not due to an inflammatory process and generally either self-limited or nonresponsive to therapy. We present an 80-year-old woman who developed progressive neck weakness over a few months due to a focal and restricted inflammatory process involving the neck extensor muscles. She responded dramatically to treatment with immunosuppressive therapy.

Aged↗
PubMed1999

Combined injuries to the lower limbs.

Several patterns of severe lower limb injuries are presented. They all indicate high energy trauma and affect the immediate care of the patient. The improvement of evacuation systems and resuscitating methods in intensive care create many reconstruction challenges for the orthopaedic surgeon. Awareness of the different combinations which are presented can serve as a tool that may be helpful in these demanding injuries. Guidelines for management of combined injuries are essential to improve the outcome of these life-threatening situations.

Femoral Fractures↗
PubMed1999

In vitro forces in the normal and cruciate-deficient knee during simulated squatting motion.

Three orthogonal components of the tibiofemoral and patellofemoral forces were measured simultaneously for knees with intact cruciate ligaments (nine knees), following anterior cruciate ligament resection (six knees), and subsequent posterior cruciate ligament resection (six knees). The knees were loaded using an experimental protocol that modeled static double-leg squat. The mean compressive tibial force increased with flexion angle. The mean anteroposterior tibial shear force acted posteriorly on the tibia below 50 deg flexion and anteriorly above 55 deg. Mediolateral shear forces were low compared to the other force components and tended to be directed medially on both the patella and tibia. The mean value of the ratio of the resultant tibial force divided by the quadriceps force decreased with increasing flexion angle and was between 0.6 and 0.7 above 70 deg flexion. The mean value of the ratio of the resultant tibiofemoral contact force divided by the resultant patellofemoral contact force decreased with increasing flexion and was between 0.8 and 1.0 above 55 deg flexion. Cruciate ligament resection resulted in no significant changes in the patellar contact forces. Following resection of the anterior cruciate ligament, the tibial anteroposterior shear force was directed anteriorly over all flexion angles tested. Subsequent resection of the posterior cruciate ligament resulted in an approximately 10 percent increase in the quadriceps tendon and tibial compressive force.

Analysis of Variance↗
PubMed1998

Fracture of the posterior body of the talus--the hidden fracture.

Fractures of the entire posterior process of the talus are rare and may be easily missed. Both the ankle joint and the subtalar joint are involved. This leads to malunion and early degenerative changes. We describe four patients with fractures of the posterior process of the talus which were initially missed. The patients were treated conservatively, and early mobilization or cast immobilization did not change the poor late results. The pitfalls in the diagnosis and imaging evaluation of such fractures are discussed.

Adult↗
PubMed1995

Bone scintigraphy in the assessment of the hallucal sesamoids.

Bone scintigraphy is frequently used to evaluate suspected hallucal sesamoid pathology. Increased scintigraphic activity of the hallucal sesamoid is assumed to corroborate clinical suspicion of pathology, but the incidence of such increased uptake has not been studied in an asymptomatic population. Using a 0 to 2 bone scintigraphic rating system, 25 of 86 (29%) asymptomatic infantry recruits and 7 of 27 (26%) asymptomatic sedentary adults were found to have grade 1 or grade 2 activity. When using scintigraphy to evaluate hallucal sesamoid pathology, caution should be used in interpreting the meaning of increased scintigraphic activity.

Adolescent↗
PubMed1995

A double-blinded, randomized, controlled clinical trial to compare cefazolin and cefonicid for antimicrobial prophylaxis in clean orthopedic surgery.

A double-blind, prospective randomized study was performed to compare cefazolin and cefonicid given for prophylaxis to 102 patients undergoing orthopedic surgery. Risk factors (e.g., age, sex, type of operation performed) among the two groups were similar. All patients had foreign material (prosthesis or other hardware) inserted at operation. There was a total of 6 infections (3 wound and 3 urinary tract) in 6 patients among the 48 receiving cefazolin (12.5%), whereas no infections were observed among the 54 patients who received cefonicid. Cefonicid, given once daily, provides protection against postoperative infection that is not inferior to cefazolin. A larger study is needed to confirm whether cefonicid is indeed superior to cefazolin.

Adolescent↗
PubMed1994

[The indigenous population in Latin American censuses].

"On reviewing the information about the indigenous population in the [Latin American] census data, clear discrepancies can be found. The main problem lies in the various definitions of indigenous population....The greatest difficulty arises from the multiple dimensionality of socio-cultural elements.... Existing estimates on indigenous population for the whole region largely vary and, in most cases, seem to be determined by strong emotions or, at least, based on highly subjective criteria. In spite of the strong criticism about the estimates taken from the population censuses, this source is generally one of the few with a real base." (SUMMARY IN ENG)

Censuses↗
PubMed1994

[Maternal mortality in Latin America and the Caribbean].

"The underlying analytical scheme in this study [focuses] on the phenomena of maternal mortality in relation to fertility rates [in Latin America and the Caribbean].... The countries of the region are classified under a typology, formulated in function of the association between maternal mortality and fertility rates. Using that typology, the causes of maternal death are then presented, stressing...recent trends. Finally, the intermediate factors and the contextual variables related to fertility are discussed...." (SUMMARY IN ENG)

Americas↗
PubMed1993

Avascular necrosis of the femoral head following intertrochanteric fracture.

Two cases are reported of avascular necrosis of the femoral head occurring as a late complication of an intertrochanteric fracture. The cases are presented to emphasize the importance of including this condition in the differential diagnosis of any late clinical deterioration following such an injury.

Aged↗
PubMed1992

Use of dual-energy X-ray absorptiometry (DEXA) to follow mineral content changes in small ceramic implants in rats.

Dual energy X-ray absorptiometry (DEXA) imaging was used to quantify bone ingrowth into hydroxyapatite (HA) ceramic implants in rats. HA cylinders implanted in the proximal tibiae were followed for 13 wk. The increase in alkaline phosphatase (ALP) activity within the implants preceded the increase in mineral content as measured non-invasively by the DEXA technique. This was consistent with the timing of ALP activity in respect of mineralization as they occur during fracture healing. The results show that DEXA imaging is useful in measuring bone ingrowth into small ceramic HA implants in vivo, despite the high mineral content background of the implant scaffold.

Absorptiometry, Photon↗
PubMed1991

[Interlocked intramedullary nailing of the femoral shaft].

Femoral shaft fracture is usually caused by significant trauma. Conventional treatment is surgical fixation with an intramedullary nail. The addition of interlocking screws has enabled control of rotation at the fracture site as well as the maintenance of correct femoral length. During 1987-1989 we operated on 21 patients with 22 fractures of the femur using the interlocked nail. All fractures had united after an average of 3 months, and the patients returned to normal activity after about a year. There was no mortality nor were there deep wound infections or neurovascular injuries. Complications were infrequent and consisted of pressure signs in the perineum, shortening of the femur and discomfort along the edges of the hardware. Our results support the use of the interlocked nail for femoral fractures when there is no other way to control femoral length or prevent rotation of the fractured elements.

Bone Nails↗