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Biomedical subjects

J M Mazur

Publications and source records attributed to J M Mazur.

At least 19 recordsLinked to original sources
PubMed2005

Instructional practices at Farm Safety 4 Just Kids (FS4JK) safety day camps.

The instructional methods used with 1,347 youth in seven Farm Safety 4 Just Kids (FS4JK) day camp sessions conducted in five states during the summer and fall of 2002 were videotaped. The videotapes, instructor questionnaires, and day camp materials were analyzed using an observation protocol that focused on instructional practices and an interaction analysis of instructor-student talk during the sessions. Results showed that instruction focused on hazard recognition, a high level of participant attention during all the sessions observed, and safety day camp content relevant to rural participants regardless of whether they live or work on a farm. Recommendations for improving instructional practice include better use of print materials, more interactive, participatory activities for students, and reduction of instructor-centered, didactic approaches. Given the high level of students' attention, increased involvement of students in active, participatory approaches might enhance the effectiveness of the instruction by: (1) further engaging students through personalizing hazard recognition, (2) contextualizing reports of injuries, (3) examining the complexities of choosing safe behaviors, and (4) paying more attention to the consequences of injury events. Role-playing, narrative simulations, and other types of interactive and collaborative exercises are instructional approaches that support the inclusion of the pre-event contingencies and post-event consequences that are part of all injury events.

Accident Prevention↗
PubMed2000

Acetabular dysplasia associated with hereditary multiple exostoses. A case report.

Hereditary multiple exostoses is an autosomal dominant disorder characterised by multiple osteochondromata, most commonly affecting the forearm, knee and ankle. Osteochondromata of the proximal femur have been reported to occur in 30% to 90% of affected patients with coxa valga in 25%. Acetabular dysplasia is rare but has been described. This is the first report of a patient requiring surgical intervention. A girl was seen at the age of nine with hereditary multiple exostoses and when 12 developed bilateral pain in the groin. Radiographs showed severely dysplastic acetabula with less than 50% coverage of the femoral heads and widening of the medial joint space. Large sessile osteochondromata were present along the medial side of the femoral neck proximal to the lesser trochanter, with associated coxa valga. The case illustrates the importance of obtaining initial skeletal surveys in children with hereditary multiple exostoses to identify potential problems such as acetabular dysplasia and subluxation of the hip.

Acetabulum↗
PubMed1998

Interobserver reliability and intraobserver reproducibility of the system of King et al. for the classification of adolescent idiopathic scoliosis.

The classification of adolescent idiopathic scoliosis with use of the system of King et al. has become widely accepted since its introduction. The purpose of the present study was to establish the interobserver reliability and intraobserver reproducibility of this classification system. The preoperative radiographs of sixty-three patients who were managed operatively for adolescent idiopathic scoliosis were classified by five observers with the system of King et al. Interobserver reliability was assessed by comparison of the classification of the curves among the observers, and intraobserver reproducibility was evaluated by comparison of the classifications of each set of radiographs by each observer on two occasions three weeks apart. The median interobserver reliability kappa coefficient for the classification system of King et al. was 0.44 (range, 0.28 to 0.50), and the median intraobserver reproducibility kappa coefficient was 0.64 (range, 0.44 to 0.72). According to the definition of Landis and Koch, the classification system of King et al. is substantially reproducible but is only moderately reliable. However, according to the stricter definition of Svanholm et al., its reproducibility is only fair and its reliability is poor.

Adolescent↗
PubMed1991

Neurologic status of spina bifida patients and the orthopedic surgeon.

The purpose of this paper is to review recent developments in the neurologic assessment of spina bifida patients. Determination of the neurosegmental level of the lesion, recognition of spasticity and progressive paralysis, the potential for deformity, and functional expectations are described. The status of the neurologic deficit remains the most important factor in determining the myelomeningocele patient's ultimate functional abilities. Accurate neurologic assessment will assist in meeting the aims of orthopedic management, which include preventing joint contracture, correcting deformity, preventing skin sores, and obtaining the best possible locomotor function.

Adolescent↗
PubMed1991

Ankle arthrodesis in children.

The indications, surgical technique, and long-term functional results for ankle arthrodesis differ between children and adults. In children, the reasons for performing a tibiotalar fusion include pain, most commonly from traumatic and septic arthritis, and instability from congenital anomalies or paralytic disorders. The most appropriate procedure is Chuinard's fusion, which achieves a tibiotalar fusion without causing a growth arrest of the distal tibial growth plate. In the long term, young patients with ankle arthrodesis function very well with minimal pain or disability. Stressful activities such as hill climbing, stair climbing, and running may be restricted or require compensatory movements.

Ankle Joint↗
PubMed1990

Swing-through vs. reciprocating gait patterns in patients with thoracic-level spina bifida.

Three thoracic level spina bifida patients were evaluated in a gait laboratory. The patients first were asked to walk with a swing-through gait pattern using conventional hip-knee-ankle-foot orthosis and then with a reciprocating gait pattern using the reciprocating gait orthosis (RGO). The reciprocating gait was modestly more efficient than the swing-through gait pattern. The average speed of free walking was 11.4 meters per minute with the swing-through pattern and 16.2 meters per minute with the reciprocating pattern. The stride length was 0.31 meters and 0.54 meters with the swing-through and reciprocating patterns respectively. The RGO needs further modifications to improve the walking ability of spina bifida patients. The hip joints permit only flexion and extension and no rotational movement. The lack of internal and external rotation inhibits hip movement, reduces stride length, reduces the speed of walking and causes the cables to bind and eventually break. With design changes, future bracing systems will permit improved walking in the high level spina bifida patients.

Braces↗
PubMed1989

Quantitative evaluation of AFO use with myelomeningocele children.

Although the sample size is small, results are very positive for the use of AFO's with the myelomeningocele child. The increase in pertinent gait parameters in conjunction with a decrease in excess hip, knee, and ankle flexion demonstrate the benefits gained in using AFO's to assist the myelomeningocele child in ambulation. Further, the decrease in excess muscle activation time and co-contraction facilitate a decrease in energy expenditure, thus allowing for more ambulation the limited results from this study provide a basis from which further research may be gleaned. The use of quantitative measures in evaluating the benefits of AFO's provides objective data from which future design and application recommendations may be made.

Ankle Joint↗
PubMed1989

Orthopaedic management of high-level spina bifida. Early walking compared with early use of a wheelchair.

To determine whether it is worth while to encourage patients who have high-level spina bifida to walk at an early age, we compared the cases of thirty-six patients who had participated in a walking program with those of thirty-six patients for whom a wheelchair had been prescribed early in life. The patients in the two groups were matched for age, sex, level of the lesion, and intelligence. Only twelve of the patients who had been able to walk at an early age were still able to do so effectively at the time of this study, when their ages ranged from twelve to twenty years, but still these patients fared somewhat better than the other patients did. The patients who walked early had fewer fractures and pressure sores, were more independent, and were better able to transfer than were the patients who had used a wheelchair from early in life. However, during childhood and early adolescence, the patients who had always used a wheelchair had spent fewer days in the hospital than did those who had participated in the walking program. There were no major differences between the two groups with regard to skills of daily living, function of the hands, and frequency and severity of obesity.

Activities of Daily Living↗
PubMed1988

Impaired mental capabilities and hand function in myelomeningocele patients.

Hand function and intelligence were evaluated in 82 spina bifida cystica patients, aged 9 to 20 years. The patients required significantly more time to complete hand function tests and had significantly lower IQs than the test standardization populations. Inverse relationships were found between hand function times and IQ scores; patients with lower IQs (especially those with IQ scores less than 80) took significantly longer to complete the hand function tests. Patients with three or more shunt operations for correction of hydrocephalus required more time to complete the hand function tests and had lower IQs than patients with no shunt operations. Patients with higher level spinal cord deficits (particularly those with thoracic level lesions) required more time to complete the hand functions tests and had significantly lower IQ scores than patients with lower level lesions.

Adolescent↗
PubMed1986

The significance of spasticity in the upper and lower limbs in myelomeningocele.

One hundred and nine children with myelodysplasia were evaluated and classified according to the level and type of paralysis and its effect on functional ability. Thirty-one per cent of the patients were paralysed at the thoracic level, 26% at the upper lumbar level, 30% at the lower lumbar level and 13% at the sacral level. Fifty-four per cent of these patients demonstrated the classic flaccid paralysis in the lower limbs with normal upper limbs; 9% were flaccid in the lower limbs, but were spastic in the upper; 24% were spastic in the lower limbs; 13% were spastic in the upper and lower limbs. Patients with spastic lower limbs required more orthopaedic procedures, more days in hospital and in casts, and were less likely to walk than those with flaccid paralysis. Patients with spastic upper limbs were less likely to be independent in activities of daily living and were more likely to require special schools than patients with normal upper limbs. In addition to the spinal cord level of the lesion, the degree of spasticity is important in the evaluation, treatment and prognosis of myelodysplastic patients.

Activities of Daily Living↗
PubMed1984

A biomechanical comparison of vascularized and conventional autogenous bone grafts.

Vascularized and conventional autogenous rib grafts were used to reconstruct 6-cm ulnar defects in the forelegs of the nine dogs. Each dog served as its own control. Biomechanical torsional testing of the grafted ulnas showed that vascularized grafts were 234 percent stronger than the conventional grafts. Bone toughness (energy absorbed) was 483 percent greater in the vascularized grafts, and elastic modulus and proportional limits were 263 and 246 percent greater, respectively. We conclude that vascularized bone grafts are significantly stronger than conventional autogenous bone grafts after 3 months of healing in the dog ulna model.

Animals↗
PubMed1984

Femoral neck abnormalities in spina bifida.

Femoral neck abnormalities in spina bifida can be of two types: Type A, consisting of widening of the physis and often associated with varus deformity, and Type B, characterized by marked narrowing of the femoral neck, resulting in a typical mushroom appearance. The Type A deformity is usually associated with an abduction contracture of the hip. This physeal lysis seems to be secondary to microtrauma sustained during persistent exercise done by the parents and therapist to overcome the abduction contracture. No treatment is required, even when varus deformity is present. These patients require an orthosis with a pelvic band for ambulation, and their mobility will not be affected by the deformity.

Child↗
PubMed1983

Unrecognized spinal instability associated with seemingly "simple" cervical compression fractures.

This paper described 27 patients who had seemingly stable compression cervical vertebral fractures. All were treated in cervicothoracic orthoses. None was initially treated in a Halo device or with surgery. Twenty patients were stable and healed without progressive displacement, angulation, or pain. One patient demonstrated an angular deformity, which spontaneously stabilized within six months with anterior bony ankylosis in a kyphotic position. Six patients demonstrated persistent progressive post-injury instability related to posterior ligament rupture. As muscle spasm diminished, the patients could be given a more reliable flexion-extension radiographic examination, unmasking the hidden posterior instability. Five of the six who demonstrated this instability were disabled because of pain. Two of the six patients were treated with a two-segment fusion. The other four have had fusion recommended and are currently being followed clinically. This paper emphasizes the need for better initial criteria of potential instability and close follow-up of patients with simple compression fractures of the cervical spine.

Adolescent↗
PubMed1983

Cervical vertebrae subluxation.

Rotary subluxation of the atlantoaxial joint is an uncommon complication of head and neck surgery and infections. Reported sequelae of this disorder range from torticollis to death from compression of the spinal cord. Two cases of C1-C2 rotary subluxation will be discussed. These complications occurred following otitis media, repair of choanal atresia, and an adenoidectomy. The literature is reviewed.

Atlanto-Axial Joint↗
PubMed1983

Iatrogenic exostosis in a patient treated for osteomyelitis.

A 10-month-old child treated surgically for osteomyelitis of the distal femur subsequently developed an exostosis at that site. No previous similar case has been reported. The etiology of exostoses is reviewed here, with evidence that this patient's exostosis could be iatrogenic.

Child, Preschool↗
PubMed1982

A torsional strength comparison of vascularized and nonvascularized bone grafts.

Comparisons of torsional strength are made on the ulnae from the forelegs of short haired hounds where a nonvascularized graft was performed on one leg and a vascularized graft performed on the other. By using the forelegs of a dog as the experimental model and microsurgical techniques, a vascularized bone segment was used to graft a five centimeter nonunion in one leg and at the same time a conventional bone graft was performed on a similar nonunion in the other leg. Similar segments of rib bone were used for each graft. Torsional strength data are shown for nine experimental animals. A successful method for mounting the bones for testing of torsional strength in a torsion machine is given. In each case for which the bones healed properly, the vascularized bone graft proved to be significantly stronger in torsion.

Animals↗