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Biomedical subjects

A van Kampen

Publications and source records attributed to A van Kampen.

47 records · Page 3Linked to original sources
PubMed1996

Optimising antimicrobial drug use in surgery: an intervention study in a Dutch university hospital.

Following a one-month prospective study of antimicrobial drug use in surgical departments, new guidelines were implemented. The review was repeated after two years. In both study periods, one third of patients were prescribed antimicrobial drugs. Prophylactic antibiotic consumption decreased from 0.75 to 0.53 defined daily doses/operation. Compliance with guidelines improved from 32% to 79%. Duration of prophylaxis > 24 h decreased from 21% to 8%. Single dose prophylaxis increased from 34% to 80%. Quality of the prophylactic courses improved, as evaluated by experts using established criteria. For prophylaxis, cost savings amounted to 57%. Better quality of therapeutic courses was associated with a cost increase of 15%. Indicators of satisfactory outcome with the new policy were a stable median length of stay (5.5 days in the first review and 5.0 days after intervention) and a reduction in the number of nosocomial infections treated with antimicrobial drugs/100 bed days (1.0 before intervention vs 0.77 after intervention).

Anti-Infective Agents↗
PubMed1995

Grading medial collateral ligament injury: comparison of MR imaging and instrumented valgus-varus laxity test-device. A prospective double-blind patient study.

PURPOSE: The role of MR imaging in grading medial collateral ligament (MCL) injury of the knee in comparison to other grading methods (clinical findings and instrumental measurement) is hardly documented in the literature. The purpose of this study is to compare the results of MR imaging in grading acute MCL injuries to the results of a clinical grading by an instrumented valgus-varus laxity tester (VVLT). MATERIALS AND METHODS: Twenty-one patients clinically suspected of acute MCL injury were tested by VVLT, a well documented and instrumented test-device. All patients subsequently underwent MR imaging of the knee. MCL injury was graded independently by VVLT and MR imaging using a classification method with reference to Petermann. RESULTS: Nineteen patients had corresponding grading results by VVLT and MR imaging (kappa, 0.83; S.E., 0.10); 14 patients had a Grade I, four a Grade II and two patients had a Grade III MR imaged MCL injury. Associated lesions were also depicted on MR imaging (bone contusion (n = 3), ACL disruption (n = 2) and medial meniscal rupture (n = 1)). CONCLUSIONS: This study shows a very high degree of agreement between the results in grading acute MCL injuries with MR imaging and an instrumented valgus-varus laxity tester (VVLT). MR imaging depicted important, clinically undetected, additional lesions which can determine the treatment of MCL injury.

Anterior Cruciate Ligament↗
PubMed1995

Bone grafting in cemented knee replacement. 45 primary and secondary cases followed for 2-5 years.

From 1989 through 1993, we treated 36 knees in 30 patients by bone grafting (31 tibial and 14 femoral grafts) and a cemented total knee prosthesis. We used 23 morsellized and 22 solid bone grafts. After a mean follow-up period of 3 years, the mean clinical (IKS) knee score was 90. Radiographic signs of incorporation of the tibial bone graft were noted in 28 cases. Of the 8 solid femoral bone grafts, we observed twice a disintegration of the graft.

Adult↗
PubMed1993

Intraoperative bone and bone marrow sampling: a simple method for accurate measurement of uptake of radiopharmaceuticals in bone and bone marrow.

Accurate estimation of bone marrow uptake of radiopharmaceuticals is of crucial importance for accurate whole body dosimetry. In this study, a method for obtaining normal bone marrow and bone during routine surgery without inconvenience to volunteers is suggested and compared to an indirect method. In five volunteers (group 1), 4 MBq 111In-labelled human polyclonal IgG (111In-IgG) was administered 48 h before placement of a total hip prosthesis. After resection of the femoral head and neck, bone marrow was aspirated from the medullary space with a biopsy needle. In five patients, suspected of having infectious disease (group 2), bone marrow uptake was calculated according to a well-accepted method using regions of interest over the lumbar spine, 48 h after injection of 75 MBq 111In-IgG. Bone marrow uptake in group 1 (4.5 +/- 1.3% D kg-1) was significantly lower than that in group 2 (8.5 +/- 2.1% D kg-1) (P < 0.01). Blood and plasma activity did not differ significantly for both groups. This method provides a system for directly and accurately measuring uptake and retention in normal bone marrow and bone of all radiopharmaceuticals at various time points. It is a safe and simple procedure without any discomfort to the patient. Since small amounts of activity are sufficient, the radiation dose to the patient is low.

Aged↗
PubMed1992

[Arthroscopic ankle arthrodesis: a new technique].

We report on 5 patients who successfully underwent an arthroscopic ankle arthrodesis in the department of Orthopaedics of the University Hospital in Nijmegen. Three patients had haemophilia, one rheumatoid arthritis, and one arthrosis following trauma. The results were satisfactory. The patients had surprisingly little postoperative pain. It appears from the literature that regarding morbidity in terms of infection, pseudarthrosis and consolidation time, arthroscopic arthrodesis compares favourable with the open procedures.

Adult↗
PubMed1992

Kingella kingae intervertebral diskitis in an adult.

Kingella kingae rarely causes infection and is mainly associated with endocarditis and septic arthritis in adults. The organism is also capable of causing intervertebral diskitis in children, but thus far, no reports of this infection occurring in adults have been published. A case of diskitis due to K. kingae in an adult is reported for the first time, and the literature on this infection in children is reviewed.

Adult↗
PubMed1990

The three-dimensional tracking pattern of the human patella.

A study was undertaken to provide data on the three-dimensional tracking pattern of the patella, relative to the femur, in human knee-joint specimens. For this purpose, a highly accurate roentgen stereophotogrammetric analysis (RSA) method was applied. The three-dimensional motion patterns of the tibia and the patella were measured and represented in terms of three translations and three rotations each, during knee flexion in neutral (unloaded), endorotated, and exorotated pathways. We found that the patella displays complex but consistent three-dimensional motion patterns during flexion, which include flexion rotation, medial rotation, wavering tilt, and a lateral shift relative to the femur. The motion patterns are very much affected by tibial rotations accompanying flexion.

Humans↗
PubMedDate not supplied

The effect of different graft tensioning in anterior cruciate ligament reconstruction: a prospective randomized study.

A prospective study was performed to establish the influence on stability of tensioning the graft after anterior cruciate ligament reconstruction with a bone-patellar tendon-bone graft. There were 38 consecutive patients randomly divided into two groups; in the first group (19 patients) the graft was tensioned at 20 N, and in the second group the tension was 40 N. Evaluation included Lysholm scores, instrumented Lachman tests, IKDC level, and lateral radiographs to measure the tibia position versus the femur. One year after surgery we did not find any significant difference between the two groups. We conclude that the importance of graft tensioning has yet to be established in the clinical situation. Based on our results, graft tension of 20 N seems to be sufficient, without the risk of overconstraining the knee joint.

Adult↗
PubMedDate not supplied

Limited value of arthroscopic evaluation and treatment of painful knee prostheses: a retrospective study of 27 cases.

Twenty-seven painful knee replacements were evaluated arthroscopically. The diagnostic and therapeutic value of these arthroscopic procedures was studied retrospectively. In 5 of the 27 cases, the arthroscopy revealed no diagnosis for the pain. Some form of arthroscopic treatment was performed in 20 cases; in 6 of these 20 cases, however, the treatment did not reduce the pain. Based on these findings, we conclude that the indications for arthroscopic evaluation and treatment of painful knee prostheses are limited.

Adult↗