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Biomedical subjects

E Rath

Publications and source records attributed to E Rath.

At least 19 recordsLinked to original sources
PubMed2000

Is there a need for lumbar orthosis in mild compression fractures of the thoracolumbar spine?: A retrospective study comparing the radiographic results between early ambulation with and without lumbar orthosis.

Compression fractures of the thoracolumbar spine are common in spinal trauma. Most patients are treated with early ambulation. Bracing is an option not always recommended by the treating team. There are no definite recommendations so far regarding the need for lumbar orthosis in this type of injury. The authors retrospectively compared two methods for treating patients with compression as great as 30%: early ambulation with and without lumbar orthosis. The results show that although demographic variables, type of injury, and cause of injury were similar between the groups, neither treatment emerged as superior. Thoracolumbar fractures with compression as much as 30% can be treated with early ambulation and no external support. Close clinical and radiographic follow-up is essential.

Adult↗
PubMed2000

The menisci: basic science and advances in treatment.

Once described as a muscle remnant, and therefore treated with disrespect, the meniscus is now known to be a vital structure within the knee. Minimal partial meniscectomy performed arthroscopically, or meniscal repair when practical, have become the standard treatments. In spite of the advancements in understanding meniscal function and its preservation, much remains to be studied. In the future, availability of better repair techniques and the option of meniscal replacement with allograft or prosthetic menisci are expected to improve outcomes.

Anterior Cruciate Ligament Injuries↗
PubMed1998

[Necrotizing soft tissue infection].

The dramatic course of necrotizing soft tissue infection represents a medical emergency, since it is limb- and life-threatening. Most necrotizing soft tissue infections are caused by mixed aerobic and anaerobic Gram-negative and Gram-positive organisms. Most case have been reported in immuno-compromised hosts after penetrating trauma or surgery. We describe a unique series of cases of necrotizing soft tissue infection. The mainstay of treatment is early and daily debridement of devitalized tissue and broad-spectrum antibiotics. Hyperbaric oxygen therapy should be considered.

Aged↗
PubMed1998

[Pelvic lytic lesion, and the need to suspect osteoporosis-related fractures].

Insufficiency fractures of the pelvis may be overlooked as a cause of hip or groin pain. These fractures occur in the elderly, usually those with pronounced osteopenia of the pelvis. Predisposing factors include corticosteroids, local irradiation and postmenopausal osteoporosis. These fractures are difficult to detect clinically and plain radiographs and other studies may be misleading, delaying diagnosis and treatment. A 65-year-old woman had left groin and hip pain for 2 months with no history of trauma. Plain radiographs showed lytic lesions in the left pubic rami. Bone scan revealed increased uptake in that region, suggesting metastatic bone disease. Computed tomography and magnetic resonance imaging demonstrated fractures in the left superior and inferior pubic rami, with callus formation with no involvement of soft tissues. Quantitative computed tomography indicated low calcium concentration, below fracture threshold. The diagnosis of insufficiency fractures of the pelvis was confirmed by the favorable clinical and radiographic outcome. It is therefore important to be familiar with the appearance and location of these fractures.

Aged↗
PubMed1998

[Vacuum phenomenon in the hip joint: diagnostic value].

Vacuum phenomenon is well known in degenerative spinal disease in the elderly, but is seldom seen in other joints, especially in children. The phenomenon does not represent a pathological finding, and can be used for imaging of the articular facets, mainly in the hip and knee joints. We report a patient with this phenomenon in the hip joint.

Arthrography↗
PubMed1997

[Combined treatment for adhesive capsulitis of the shoulder].

Adhesive capsulitis is a problem for the orthopedic surgeon due to the difficulty of treatment. Although it is self-limited, few patients will wait for spontaneous resolutions while suffering pain and progressive loss of motion. Our aim was to modify the course of the disease and to shorten recovery time by combining intensive physiotherapy with intra-articular infiltration and gentle manipulation. 49 patients with 50 frozen shoulders were enrolled in the study. All patients were treated initially with physiotherapy for 4-8 weeks. If no improvement was noted the affected shoulder was infiltrated and gently manipulated. 27 of 49 patients (55%) improved dramatically with the initial physiotherapy regimen. They achieved full or nearly full range of motion, with significant relief of pain. 22 patients were infiltrated and manipulated. Elevation improved significantly from an average of 110.95 to 165.71 degrees (p < 0.001), external rotation from an average of 9.52 to 43.57 degrees (p < 0.001) and internal rotation also improved significantly (p < 0.001). Self assisted physiotherapy is the corner stone of treatment in adhesive capsulitis. When pain and limitation of passive range of motion persist, infiltration and gentle manipulation dramatically shortens the debilitating process.

Anesthetics, Local↗
PubMed1997

Bilateral dislocation of the hip during convulsions: a case report.

Simultaneous bilateral posterior dislocation of the hip is very uncommon and most cases are caused by road accidents. Simultaneous bilateral posterior dislocation of the hip due to convulsions is extremely rare. We report the case of a man who was diagnosed late and operated on 15 weeks after the injury. We discuss the treatment of chronic dislocation of the hip and review the literature.

Adult↗
PubMed1995

Digitalis-induced visual disturbances with therapeutic serum digitalis concentrations.

OBJECTIVE: To assess the role of digitalis in the development of visual symptoms severe enough to warrant ophthalmologic consultation in patients who received digitalis and who had no other clinical or laboratory evidence of digitalis toxicity. DESIGN: Clinical case study. SETTING: Neuro-ophthalmology referral practice. PATIENTS: Six elderly patients (aged 66 to 85 years) who received digitalis were referred to ophthalmologists for evaluation of photopsia (five patients) or decreased visual acuity (one patient). No patient had chromatopsia or nonvisual clinical manifestations of digitalis intoxication at the time of examination. MEASUREMENTS: All patients had serum digitalis concentrations within or below the therapeutic range. In most patients, the electroretinographic cone b-wave implicit time was longer than normal. RESULTS: Discontinuation of digitalis therapy, which was possible in five patients, was followed by resolution of visual symptoms and by shortening of the b-wave implicit time. Characteristic features of digitalis-induced photopsia were its dependence on illumination and its tendency to be localized in peripheral visual fields. CONCLUSIONS: In an elderly patient receiving digitalis, the development of photopsia characterized by innumerable points of light in the peripheral visual fields or a decrease in visual acuity raises the possibility that the patient's visual disturbance may have been digitalis induced. Digitalis-induced visual disturbances other than chromatopsia or disturbances of color vision may occur in elderly patients who have no other clinical manifestations of digitalis intoxication and who have a serum digitalis concentration within or below the therapeutic range.

Aged↗
PubMed1994

[4-Log leukocyte depletion of erythrocyte concentrates--a comparison with 3 other filters].

Whole blood (WB) and SAGM-resuspended red cell concentrates (RCC) were leucocyte-depleted 1 h after donation by filtration using BF 4 (PALL), Sepacell RS 200 (Asahi Med.) and Bio R01 Plus (Biotrans). We compared the handling of the filter system, focusing routine blood bank practice, filtration efficiency [residual white cell count; flow cytometry (Ortho Cytoron) and Nageotte chamber] and the loss of red cells. Spontaneous filling was found to be an advantage of the Bio R01 Plus system, whereas the BPF 4 and the RS 200 have to be filled by pressure. The filtrations were of similar duration, even those of WB and resuspended RCC. Red cell loss was found to be 10-15% on RCC higher than on WB (7-10%) and varied between the filters used: BPF 4 < Bio R01 Plus < RS 200. The residual white cell count on WB was 1.2-5.8 x 10(6) (RS 200 < Bio R01 Plus < BPF 4) and on RCC was 0.5-3.0 x 10(5) (RS 200 < BPF 4 < Bio R01 Plus). The filters used are highly effective (4-log depletion on RCC) even on fresh WB and are therefore potential in-line filters.

Blood Donors↗
PubMed1994

[In-line-filtration of erythrocyte concentrates using the Leukotrap-RC system].

'In-line filtration' was performed on whole blood (WB) of 12 healthy donors. The WB was drawn into the triple-bag Leukotrap-RC system. Six red cell concentrates (RCC) were filtrated 1 h after donation either with or without buffy-coat and stored 35 days in AS-3. We measured the loss of red cells, the residual white cell count (Nageotte chamber), platelet count in fresh frozen plasma (FFP); 2,3-DPG, K+, Hbe, pH, O2Hb and pO50. The system was easy to handle but needed circular centrifugation holders because the filter is placed and fixed just at the top of the bags during centrifugation. RCC without buffy coat led to a faster filtration (15 vs, 38 min) and to an improved FFP quality (platelet count 23 vs, 54 Gpt/l). The leucocyte removal rate of the integrated PALL-RC-350 was similar, residual white cell count less than 3 x 10(6), in both preparations. All storage parameters were found within the normal range except a significant increase of O2Hb in filtrated red cells compared with the unfiltered control.

Blood Donors↗
PubMed1994

[Large volume lymphocytapheresis for the collection of peripheral stem cells].

We performed 29 large-volume leukaphereses of 20 patients for collection of peripheral blood stem cells. All patients have been pretreated with cytokines after chemotherapy. In 9 patients with precounts of > or = 3 x 10(9) mononuclear cells/l we achieved a sufficient transplantation doses with one LVL. If the MNC precount was < or = 3 x 10(9)/l we had to perform more than one LVL. On 16 patients we compared a standard apheresis procedure with the LVL procedure. It seems that especially patients with a lower MNC precount can profit from LVL. From patients with higher MNC precounts we harvested the double amount of MNCs, from patients with lower MNC precounts the triple amount.

Female↗
PubMed1994

[Stem cell pheresis and deep temperature preservation--a problem of transfusion medicine?].

In Germany, Transfusion Medicine belongs to various medical disciplines. We would like to demonstrate our model of interdisciplinary collaboration in stem cell transplantation. Since 1989 we performed 339 leukaphereses in 53 patients. On average we got 1.4 x 10(8) MNC/kg body weight from one single apheresis procedure. To observe graft quality we measured the content of CD34-positive cells and the amount of CFU-GM. Despite diagnosis and therapeutical regimen the content of CD34+ cells was found to be 3.3% (0-20). The proliferation was 21.7 GM-CFU per 1 x 10(5) MNC seeded (0-393). The results of the first 17 transplantations showed a fast haematological recovery (WBS 1.0 Gpt/l after 9 days Plt 20 Gpt/l after 11 days). Close collaboration of Transfusion Medicine and Haematology leads to optimization of stem cell transplantation.

Blood Transfusion↗