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Biomedical subjects

J Seibert

Publications and source records attributed to J Seibert.

16 recordsLinked to original sources
PubMed2000

Risk factors for bone mineral density loss in pediatric renal transplant patients.

Bone mineral density (BMD) is decreased in both adult and pediatric renal transplant recipients. To investigate the risk factors associated with this decrease in BMD post-renal transplant, we studied 33 children, aged 7-22 yr, who had received a renal transplant from 0.3 to 10 yr prior to this study. BMD analysis of the total body, spine, and femur was carried out by using dual-energy X-ray absorptiometry (DEXA). Age, weight, Tanner stage, time on dialysis prior to transplantation, cumulative corticosteroid dosage, and cyclosporin A (CsA) dosage since transplantation, and use of corticosteroid therapy prior to transplantation, were recorded. Spine, femur, and total body BMD Z-scores were greater than two standard deviations (2 SD) below the mean in 45%, 42%, and 17% of patients, respectively. Age correlated inversely with total body and spine BMD Z-scores (p = 0.001 and p = 0.008); no child under 14 yr of age had a total body or spine BMD Z-score greater than 2 SD below the mean for age. Patients at a Tanner stage of 4 or 5 had lower total body and spine BMD Z-scores than did patients at Tanner stages 1-3 (p = 0.043). Time post-transplant correlated inversely with both spine and total body BMD Z-score (p = 0.013 and p = 0.023). Only total body BMD Z-score correlated inversely with cumulative corticosteroid dose (in g, p = 0.045). BMD did not correlate with cumulative CsA dose. Black patients tended to have decreased total body BMD compared with Caucasian patients. In pediatric renal transplant patients, decreases in BMD start in adolescence. Risk factors for BMD loss in these patients include increasing age, time post-transplant, increasing Tanner stage, and ethnicity. Longitudinal studies in these patients and strategies to improve BMD are needed.

Absorptiometry, Photon↗
PubMed1994

The utilization of rubber dam as a barrier membrane for the simultaneous treatment of multiple periodontal defects by the biologic principle of guided tissue regeneration: case reports.

The principle of guided tissue regeneration has demonstrated a level of success in regenerating the periodontal attachment apparatus lost to periodontal disease. Several types of membrane barriers, each one with distinct properties, have been utilized to apply this principle in periodontal wound healing. A series of case reports introduces and discusses the attributes of rubber dam as a barrier membrane for the treatment of multiple periodontal osseous defects. Comparison of preoperative and postoperative clinical measurements as well as reentry procedures are utilized to highlight successful osseous regeneration.

Adult↗
PubMed1993

Various methods of breast reconstruction after mastectomy: an economic comparison.

This study is an economic comparison of various methods of breast reconstruction after mastectomy. The hospital bills of 287 patients undergoing breast reconstruction at three institutions from June of 1988 to March of 1991 were analyzed. The procedures examined included mastectomy, implant and tissue-expander reconstruction, and TRAM and latissimus pedicle flaps, as well as free TRAM and free gluteal flaps. These procedures were subdivided into those which were performed at the time of mastectomy and those performed at a later admission. In addition, auxiliary procedures (i.e., revision, nipple reconstruction, tissue-expander exchange, and contralateral mastopexy/reduction) also were examined. Where appropriate, these procedures were subdivided into those performed under general or local anesthesia and by inpatient or outpatient status. Data from the three institutions were converted to N.Y.U. Medical Center costs for standardization. A table is presented that summarizes the costs of each individual procedure with all the pertinent variations. In addition, a unique and novel method of analyzing the data was developed. This paper describes a menu system whereby other data regarding morbidity, mortality, and revision rates may be superimposed. With this information, the final cost of reconstruction can be extrapolated and the various methods of reconstruction can be compared. This method can be applied to almost any complex series of multiple procedures. The most salient points elucidated by this study are as follows: The savings generated by performing immediate reconstruction varies between $5092 (p < 0.05) for free gluteal flaps and $10,616 (p < 0.05) for pedicled TRAM flaps.(ABSTRACT TRUNCATED AT 250 WORDS)

Breast Neoplasms↗
PubMed1992

Efficiency of the bone scan for occult limping toddlers.

Fifty consecutive occult limping toddlers were prospectively evaluated by acute triphase 99mTc MDP scintigraphy (TTS) at Arkansas Children's Hospital from 1984 through 1989. Only patients with a limp that could not be diagnosed by an orthopaedist were included. TTS proved essential in localizing the lesion in 27 patients (54%). With only two false negatives and one false positive, this test was shown to be highly sensitive, specific, efficient, and predictive, especially as compared with temperature, white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and plain radiography. Because no infections were missed by TTS, patients with a normal TTS could be safely observed as outpatients, saving thousands of health care dollars in this small series.

Arthritis, Infectious↗
PubMed1990

Localized ridge augmentation in dogs: a pilot study using membranes and hydroxyapatite.

This study was designed to evaluate the potential to reconstruct localized ridge defects with bone by preventing non-osteogenic extraskelatal connective tissue from participating in the process of healing following experimental ridge augmentation treatment procedures. Following the elevation of buccal muco-periosteal flaps, buccal, interproximal, and interradicular bone was removed to the apical level of the second and third premolar teeth and the teeth were extracted to create bucco-lingual ridge defects that averaged 13 mm x 7 mm x 3.5 mm in each quadrant of two adult beagle dogs. The defects were permitted to heal for 90 days. The defects did not fill in with new bone. Subsequently, buccal muco-periosteal flaps were elevated and a membrane was placed over the defect and positioned so that it rested on bone that was exposed adjacent to the defect. In two quadrants test support materials were used to ensure that a space was maintained between the surface of the defect and the membrane. One quadrant was maintained as a sham-operated control site, three sites received membranes and no supporting implants and two sites received supporting implants and no membranes. The surgical schedule was designed to yield sacrifice times of 8 to 12 weeks. In the three quadrants available for study that were covered with membranes, bone and/or non-mineralized connective tissue was found to fill all of the space that had been provided by the membrane. Histologic examination confirmed that the space was filled with young, actively growing bone by 90 days. No new bone formation (bone fill) was observed in the sham-operated control site.

Alveolar Process↗
PubMed1979

The effect of head position and angle of tracheal bifurcation on bronchus catheterization in the intubated neonate.

The effect of head position and angle of tracheal bifurcation on bronchus catheterization was studied in newborn infants. Frequency of bronchus catheterization following appropriate head positioning was evaluated radiographically after passage of a No. 5 French feeding tube in eight intubated neonates within 30 minutes post mortem. Positioning the infants head to the right in preparation for a suctioning procedure may facilitate but not assure catheterization of the left main stem bronchus (LMSB). Positioning the infant's head straight or rotating to the left appears to be equally effective in catheterization of the right main stem bronchus (RMSB). The predominance of RMSB catheterization in infants with their head in the straight position may be explained by the different angles of mainstem bronchi divergence which we determined using radiographs. The angles of divergence of the LMSB and the RMSB from the trachea averaged 44.4 degrees and 24.1 degrees, respectively.

Asphyxia Neonatorum↗
PubMedDate not supplied

Patient surveys and quality improvement.

Patient satisfaction may be the ultimate measure of quality but it is only part of the quality measurement and improvement equation. Customers may be good at telling you what needs fixing but they cannot be expected to tell you how to fix the problem. It is important to let patient satisfaction measures guide the focus of your process improvement efforts, but these efforts must include the appropriate process measurement tools. A customer-focused survey will be valid only if it emphasizes key quality characteristics (KQCs), as defined by patients. You'll need to develop a sampling plan that will produce useable data. The design of the questionnaire and the reliability of the survey tool are critical to using patient surveys for quality improvement (QI). Surveys that don't meet standard criteria have a greater potential for error. Another challenge is the report format and analysis that are used to understand the patient responses. Having an external benchmark is critical to accurate measurement in patient surveys. Comparative data can also help prioritize QI projects. In summary, a well designed patient survey system can identify key quality characteristics, determine which KQCs have the most impact, help prioritize QI efforts, and measure patients' satisfaction in a reliable manner.

Health Care Surveys↗
PubMedDate not supplied

Clinical experience with the technetium-99 scan in children.

A study of 86 bone scans in 79 patients was conducted to determine ways to enhance the usefulness of this test and learn what factors influence its results. While the overall value of the bone scan as we initially used it was not what we had hoped, it could be improved substantially by utilizing all initial clinical information when ordering as well as interpreting the scan. Its main value in suspected sepsis is to localize affected areas in and around the pelvis and spine. The scan is often unnecessary in the diagnosis of long-bone osteomyelitis and is seldom indicated when diagnosing cellulitis or synovitis. In occult trauma it is valuable for further investigation of specific areas with possible nondisplaced fractures. Needle aspiration of the bone or joint does not seem to alter the scan. We conclude that the bone scan is chiefly valuable in locating focal areas of skeletal pathophysiology.

Bone Diseases↗