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Biomedical subjects

J L Opitz

Publications and source records attributed to J L Opitz.

15 recordsLinked to original sources
PubMed1990

Cervical fractures and spinal cord injury: outcome of surgical and nonsurgical management.

Data were collected retrospectively for 102 consecutive patients with a cervical spinal cord injury admitted to a spinal cord injury center between 1976 and 1986. Frankel's classification and level of spinal cord injury stayed the same or improved in all patients. The complications that occurred compared favorably with outcomes reported in the literature. Approximately 60% of patients achieved a catheter-free voiding status before dismissal from primary rehabilitation. Patients treated with early surgical stabilization of the cervical column were hospitalized a mean of 21 fewer days than their nonsurgical counterparts. In addition, patients treated with early surgical stabilization achieved their first therapeutic leave of absence from primary rehabilitation approximately 40 days sooner than patients stabilized nonsurgically. At final follow-up, however, no appreciable differences in achievement in activities of daily living and mobility were noted between patients treated with surgical stabilization of the cervical spinal column and those treated nonsurgically.

Adult↗
PubMed1985

Mortality, survival and prevalence: traumatic spinal cord injury in Olmsted County, Minnesota, 1935-1981.

Mortality, prevalence, and survival from traumatic spinal cord injury were examined in Olmsted County, Minnesota, from 1935 through 1981. One hundred and fifty-four incident cases and 30 additional cases who were Olmsted County residents on at least one of four prevalence dates were identified. The average annual age-adjusted mortality for spinal cord injury, including deaths attributable to spinal cord injury occurring at any time after injury was 28.5 per million population. The rates in males were consistently greater than females, peaking to 61.0 in the period 1965-74. Thirty-eight percent of cases did not survive long enough to be hospitalized. Survival was 58% in the first week post-injury. However, for those who survived the first day and the first year, the 10-year survival was 77 and 87%, respectively. Early fatality in males was associated with single marital status (p = 0.0033) and concomitant head trauma (p = 0.0122), and in females with pedestrian or bicyclist status at injury (p less than 0.0001). Long-term survival was dependent on age (p less than 0.0001) and functional disability (p = 0.04). Point prevalence of spinal cord injured patients increased from 197 per million population in 1950 to 473 in 1980. This increase in prevalence was due at least in part to increasing incidence over time. An improvement in survival over the time period of the study could not be detected.

Accidents, Traffic↗
PubMed1985

Traumatic spinal cord injury in Olmsted County, Minnesota, 1935-1981.

The incidence rate for acute traumatic spinal cord injury in Olmsted County, Minnesota, for 1935-1981, standardizing for age, sex, and calendar year, was 54.8 per million person-years--83.4 for males and 27.7 for females. Thirty-eight per cent of cases died prior to hospitalization. The annual incidence rate for those reaching hospital alive was 34.2 per million person-years. The proportion of cases dying during initial hospitalization was 11.5%. Considering all deaths within the first year after injury, the standardized mortality rate from spinal cord trauma was 25.5 per million person-years. Automobile-related injuries constituted half of all causes of spinal cord injury and death. An increase in both incidence and hospitalization rates of traumatic spinal cord injuries in the past 17 years was observed in young men, attributable to recreational and motorcycle-related events.

Accidents, Traffic↗
PubMed1979

Prostatosis, prostatitis or pelvic floor tension myalgia?

Patients with symptoms suggestive of prostatitis or prostatosis who do not have pathogenic bacteria in the prostatic secretions may, in fact, not have prostatic problems. The possibility of pelvic floor tension myalgia should be considered in these patients.

Diagnosis, Differential↗
PubMed1979

Total joint arthroplasty: principles and guidelines for postoperative physiatric management.

Postoperative physiatric treatment is an integral part of the replacement of hips, knees, ankles, shoulders, elbows, wrists, and digital joints. Neuromuscular substitution patterns and incoordination usually prevail after joint replacement because of the usual long-term expectation and experience of pain, limitation of motion, fatigue, weakness, and the unavoidable operative trauma. The goals of postoperative physiatric treatment, in line with those of joint replacement surgery, are relief of pain and reestablishment of comfortable, normal neuromuscular functions and their reasonable, safe application in appropriate activities of daily living and of locomotion. By close collaboration between the Department of Orthopedic Surgery and that of Physical Medicine and Rehabilitation, certain principles and detailed protocols of postoperative management have been developed over the last 10 years. These are described in some detail for each of the joint replacements. Optimal results can be achieved only through meticulous attention to physical and psychosocial details, with close cooperation and communication among the involved services and persons.

Ankle Joint↗
PubMed1978

Nonvalue of neomycin instillation after intermittent urinary catheterization.

This study evaluated weekly urine cultures of patients with neurogenic bladder disease who underwent intermittent urinary catheterization for bladder retraining. One group of 53 patients in 1974 received regular instillations of 0.1% neomycin after each catheterization. A similar group of 55 patients in 1975 did not receive neomycin and constituted a control group. Distribution of age, sex, diagnosis, and duration of bladder retraining was comparable in both groups. Quantitative bacterial colony counts of 10(4) to 10(5) or greater per ml of urine were considered significant. There was no difference in the incidence of bacteriuria between the neomycin-treated group and the control group (53 versus 49%, respectively), and most patients in each group had colony counts >10(5)/ml. Escherichia coli was seen less frequently in neomycin-treated patients (43.4 versus 62.5%), but a greater percentage of infections due to Pseudomonas aeruginosa, group D streptococci, and yeasts was noted in the neomycin-treated group than in the control group (41.5 versus 22.5%).

Bacteriuria↗
PubMed1978

Hand function after metacarpophalangeal joint replacement in rheumatoid arthritis.

Hand function, determined by a standardized test, was compared before and after total metacarpophalangeal joint replacement with the Swanson Silastic rubber metacarpophalangeal prosthesis in patients with destructive rheumatoid arthritis. Two groups of rheumatoid patients were tested. Group 1 consisted of 10 patients who were examined 3 to 4 months after surgery. Group 2 included 11 patients who were evaluated 6 to 12 months postoperatively. Each group represented 43 prosthetic replacement procedures performed on 12 hands. Results indicate substantial postoperative improvement in tip prehension and grasp, while performance remained essentially unchanged for lateral prehension, pinch force, and power grip. A postoperative program of therapeutic exercises, functional hand activities and splinting is discussed.

Arthritis, Rheumatoid↗
PubMed1976

Bladder retraining. An organized program.

The management of neurogenic bladder dysfunction has been associated with a relatively high incidence of upper urinary tract infections and urosepsis. Today, the regular use of modern diagnostic tools in roentgenology and urodynamics is available. Moreover, contraindications to bladder retraining are better defined, and we have available better methods of evaluating urodynamics, superior reconstructive and corrective urologic surgery, judicious use of intermittent catheterization, and prompt detection and treatment of recurrent bacteriuria. We also know that, with an organized program of bladder retraining and follow-up, a substantial decrease in morbidity of patients with neurogenic bladder dysfunction has become possible.

Electromyography↗
PubMed1974

Editorial: ITE-74.

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Academies and Institutes↗