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Biomedical subjects

D W Leitner

Publications and source records attributed to D W Leitner.

10 recordsLinked to original sources
PubMed1996

An epidemiologic approach to assessing primary care needs in rural Illinois.

One persistent problem that faces state and federal health policy-makers is determining the level of primary care needs of the citizens they serve. To refine the decision making process in Illinois, a model was developed to compare the 84 rural counties of Illinois and their potential need for additional primary care interventions. Using expert panel methods, a group of public health professionals selected a set of 31 health status indicators that were available at the county level throughout the state. Next, the panel developed a weighting system for those indicators. These weighted values were then applied to the demographic and epidemiologic data from each of the counties to rank the counties on the basis of need. Indicators having the highest correlation with the weighted sum were the percent of the population enrolled in Medicaid, lung cancer mortality rate, general population mortality rate, proportion of population at poverty level, and percent of births to teens. Data also showed that the rural counties with the greatest needs clustered in five geographic regions. The identification of these five geographic clusters may facilitate collaborative efforts in meeting the primary care needs of these populations.

Epidemiologic Methods↗
PubMed1985

Partial nail plate removal after digital replantation as an alternative method of venous drainage.

Partial nail plate removal, systemic anticoagulation, and the application of topical heparin to the exposed nail bed were used to provide and maintain venous drainage for 14 digital replantations in which an arterial repair but no venous repair was done ("artery only" replantation). In each case venous repair was not possible since no vein of an acceptable size could be found either because of a distal amputation level or because an avulsive or crushing injury had damaged the veins in the amputated part. The average operating time per "artery only" replantation was 2 1/2 hours. Ten of the 14 "artery only" replantations survived (71.4%). The active range of motion, sensibility, strength, activities of daily living, and hospitalization for this group of patients were comparable with replantations in which both arterial and venous anastomoses were done.

Adolescent↗
PubMed1985

Hand reconstruction for multiple amputations by double microsurgical toe transplantation.

Double microvascular toe transplant procedures were used to restore function in 16 mutilated hands. In eight hands, both opposing surfaces were reconstructed with the great toe or second toe used for the thumb and the contralateral second toe for the ulnar side of the hand. In eight hands in which the thumb was still present, two fingers were reconstructed with a second toe from each foot. All 33 transplanted toes survived. In all patients, hand function was substantially improved, with an average of 9.15 pounds of pinch strength between the transplanted opposing digits or the transplanted digit and a normal thumb. Adequate sensibility was restored. The two transplant procedures were done sequentially in six patients, while the two transplantations were performed simultaneously in 10 patients. Simultaneous reconstruction proved time- and cost-effective.

Adult↗
PubMed1985

Serial quantitative skin surface fluorescence: a new method for postoperative monitoring of vascular perfusion in revascularized digits.

Postoperative monitoring of vascular perfusion was performed in 72 revascularized/replanted digits in 40 patients. Sodium fluorescein (1.0 to 1.5 mg/kg) was administered intravenously every 2 hours for 36 to 48 hours beginning immediately after surgery. Quantitative fluorescence readings of each injured digit were obtained 10 minutes after fluorescein injection and were compared with readings from an uninjured (control) digit. A ratio between the fluorescence of the injured digit and that of the control digit was used for analysis. Viable digits had a fluorescein perfusion ratio of 86.4 +/- 16. Digits that did not survive had fluorescein perfusion ratios of 5.2 +/- 10 (p less than 0.001). The results of this study indicate that quantitative surface fluorescence assessment of revascularized/replanted digits is a minimally invasive, and reliable tool for monitoring vascular perfusion.

Child↗
PubMed1985

The extensor digitorum brevis as a muscle island flap.

The use of the extensor digitorum brevis muscle as a local muscle island flap for the coverage of the soft-tissue defects in the region of the lateral malleolus is presented. The anatomy of the muscle, the donor dissection, and the utilization of the extensor digitorum brevis muscle as a local muscle flap in the lower extremity are discussed. This flap was used successfully in a patient with a wound over the lateral malleolus and ankle.

Adult↗
PubMed1983

Inguinal lymphocele as a complication of thighplasty.

This report describes an inguinal lymphocele following thighplasty. Lymphoceles are caused by a continuing leak of lymph from transected lymphatic ducts. They usually appear several weeks following surgery and can be identified by characteristic physical findings and laboratory tests present in predisposing clinical situations. The size and location of a lymphocele will determine the treatment required. In this particular case, the infected lymphocele was incised and drained and it healed secondarily.

Adult↗