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Biomedical subjects

M A Berezin

Publications and source records attributed to M A Berezin.

14 recordsLinked to original sources
PubMed1994

Office operative arthroscopy of the knee: technical considerations and a preliminary analysis of the first 100 patients.

Office operative arthroscopy of the knee under local anesthesia with light intravenous sedation was performed on 106 knees in 100 patients between 1989 and 1992. There were 169 procedures performed in these 106 knees. Facility design and necessary equipment and supplies are presented. Patient flow in the office, from check in to check out after surgery, is discussed in detail. Anesthesia techniques, monitoring techniques, and emergency precautions are presented. Patients were asked to complete a questionnaire assessing their comfort level during and satisfaction with office arthroscopy during and following the procedure. Twenty-four patients had undergone previous arthroscopy under general anesthesia in a hospital or ambulatory surgery center setting. These patients were asked to compare their previous procedure with the office procedure as to discomfort and the overall experience. Only 1 of these 24 patients preferred the hospital setting to the office setting. The discomfort experienced during the procedure was almost universally rated as minimal. There were four minor complications, which are discussed in detail. The cost-effectiveness of office operative arthroscopy under local anesthesia with light intravenous sedation is demonstrated and discussed. This preliminary report demonstrates that office operative arthroscopy of the knee is feasible, cost-effective, safe, and preferred by the patient.

Adolescent↗
PubMed1993

Arthroscopically assisted proximal extensor mechanism realignment of the knee.

An arthroscopically assisted proximal extensor mechanism realignment procedure has been designed and performed on 27 knees in 24 patients. The study group has been followed a minimum of 18 months. The procedure consists of a lateral retinacular release and an arthroscopically controlled plication of the medial patellar retinaculum and oblique fibers of the vastus medialis. The indications for this procedure include recurrent patellar instability and acute initial patellar dislocation with a concomitant fracture of either the patella or lateral margin of the intertrochlear sulcus. Using a simple subjective rating system for the patellofemoral joint, 25 of the 27 knees (92.5%) were subjectively rated good or excellent by the patient. Objective criteria also indicated a high success rate. There were two recurrent subluxations. There were two relatively minor complications. The average time for return to full presurgical activities, including previous sports, was 4 months.

Adolescent↗
PubMed1982

Neuroses and character disorders.

This paper emphasizes the importance of understanding and treating the aged with neuroses and character disorders. Although they are often neglected by mental health workers, the aged with these emotional problems form a far larger group than the psychotic aged who receive a greater share of attention. Stereotyped attitudes and commonly accepted myths regarding the aged encourage an attitude of therapeutic nihilism and pessimism. The unconscious motivation for ignoring the obvious distress of older people is discussed. Certain specific myths, such as the "rigidity" of the aged and the tendency to "wastebasket" and to view all pathology as organic or caused by aging alone, are discussed. The fear of the devouring older person is also explored, as well as the myth of "family rejection." A number of clinical examples are given of the types of emotional problems frequently seen among the noninstitutionalized older population. Each case is described from the standpoint of dynamic understanding and management. A trial of observation and psychotherapy is recommended in all situations, since even "organic" signs may be reversed. Generalizations concerning the aged as a group are avoided in the belief that they lead to further stereotyping and the discouragement of scientific investigation. Individual assessment and understanding are emphasized. The persistence of unconscious attitudes, fantasies, and wishes from childhood is pointed out, but it is emphasized that they may not always carry the same value and meaning throughout life. Certain patients achieve insight through treatment, along with a greater capacity to enjoy life than they had before. Others are comforted by the relationship with the therapist for both its "real" and unconscious meanings. Some require assistance in accepting and tolerating more regressive behavior, while others need help in accepting and assimilating their changing feelings about their goals, objects, and sexuality in old age. Reminiscences are emphasized as important sources of elevating self-esteem. Concerns about death and common countertransference problems in work with the aged are examined. The need to be flexible but not to "lean over backward" is emphasized. Patients understand a genuine offer of involvement and concern as the most precious gift.

Aged↗