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P Riegels-Nielsen

Publications and source records attributed to P Riegels-Nielsen.

At least 19 recordsLinked to original sources
PubMed2000

Bone and joint tuberculosis in Denmark: increase due to immigration.

We studied the epidemiology of bone and joint tuberculosis (TB) in Denmark during the period 1993-1997, using data in the national Danish TB register. We found 95 cases, accounting for 4% of all tuberculosis cases and 15% of extrapulmonary cases, giving a mean annual incidence of 0.4 per 10(5) in the period. 26 cases were found among native Danes (3-8 cases per year) with a median age of 66 (10-92) years and giving a mean annual incidence of 0.1 per 10(5). Among immigrants, an increasing number of cases of bone and joint TB were diagnosed, increasing from 5 in 1993 to 28 in 1997, giving a total of 69 cases with a mean age of 35 (11-75) years and a mean annual incidence of 4 per 10(5) in the period. The spine was affected in half of the cases. 28 patients had active TB elsewhere in the same period. In most patients, there were no predisposing or risk factors for disease except for ethnicity. Compared to a study of bone and joint TB in Denmark in the 1980s, the total incidence is the same, but there has been a shift in patients from old Danes to young immigrants. The increasing number of bone and joint TB cases among immigrants is due to recent immigration of Somalian refugees, who have a high incidence of TB and a high proportion of extrapulmonary TB. The diagnosis was often delayed several months or years. This study shows that attention must be paid to this condition, particularly in young patients from an endemic immigrant population.

Adolescent↗
PubMed2000

Duration of postoperative antibiotic therapy following revision for infected knee and hip arthroplasties.

In the period from 1990 to 1998 28 patients (14 males and 14 females) were treated for infected hip (19 cases) and knee (9 cases) arthroplasties. The median age at index operation was 72 y (range 34-82 y) and at revision surgery 74 y (range 36-83 y). The primary diagnosis was osteoarthritis (16 cases), rheumatoid arthritis (5 cases), failed femoral neck fracture (6 cases) and arthritis secondary to congenital hip dislocation (1 case). Nine cases were infected early, i.e. within 3 months postoperatively, and 19 had late infections. The median interval from index operation to diagnosis of the infected arthroplasty was 18 months (range 1-156 months). Postoperatively, all patients received antibiotics based on susceptibility studies of the causative organism according to culture specimens. The erythrocyte sedimentation rate and CRP level were controlled twice a week during hospitalization and antibiotics were continued until normalization of CRP. The indication for the shift from intravenous to oral antibiotics was a rapid fall in CRP. Antibiotic therapy was terminated when CRP was close to or below 10 mg/l and there was evidence of clinical recovery. Based on the screening of ESR and CRP in this study we believe that CRP is a valuable parameter in deciding when to stop antibiotic therapy. However, it is not clear whether a shorter treatment period is effective or not.

Adult↗
PubMed1998

[MRI scanning in suspected fractures of the scaphoid bone].

MR examination was performed in 20 patients clinically suspected of having a fracture of the scaphoid bone. The patients also followed the normal routine with conventional radiographs in the acute fase and after 10-12 days. The MR was in most cases performed within a day after the trauma. All fractures seen on conventional radiographs were depicted on MR. MR further showed four fractures, five bone contusions (bone bruise) and lesions of the soft tissues in 75% of the patients. In patients with suspected fracture of the scaphoid, MR seems to be the best primary imaging method and displays a wide range of lesions.

Adolescent↗
PubMed1998

The epidemiology of Achilles tendon rupture in a Danish county.

The epidemiology of Achilles tendon ruptures was examined during the 13-year period 1984-1996 in a Danish county. Five hospitals, serving a population of 220,000 cooperated. There were 718 ruptures, 544 men (75.8%) and 174 women (24.2%). The male to female ratio was 3:1. The average age was 42.1 years (3-82) and 62% were between 30-49 years. 74.2% of the ruptures were sport-related and 89% of these occurred in ball and racket games. The annual incidence of achilles tendon ruptures increased from 18.2/10(5) inhabitants in 1984 to 37.3/10(5) in 1996. The peak incidence in sport-related ruptures occurred in the age group 30-49 years, but ruptures not related to sport occurred in older patients with a peak incidence in those 50-59 years.

Achilles Tendon↗
PubMed1998

Osteochondritis dissecans of the femoral condyle treated with periosteal transplantation. Poor outcome in 14 patients followed for 6-9 years.

We evaluated 14 consecutive periosteal transplantations to treat osteochondritis dissecans lesions of the femoral condyle. 1 year postoperatively, 9 knees were pain-free, but with 6-9 years follow-up, only 2 knees were pain-free. Formation of hyaline-like cartilage, assessed in 12 knees, was documented in 1 patients and assessed as possible in 1 more, but in 10 patients the tissue formed in the defects was not or probably not hyaline cartilage. 6 knees had developed arthrosis.

Adolescent↗
PubMed1995

Collagen with gentamicin for prophylaxis of postoperative infection. Staphylococcus aureus osteomyelitis studied in rabbits.

In 34 rabbits, both tibiae were inoculated with Staphylococcus aureus. 14 legs received no treatment and served as controls. In 12 legs, the wound was treated with pure collagen and in 18 legs, collagen with gentamicin (Gentacoll) in a dose of 10 mg/kg body weight was applied to the wound before closure. Postoperatively 12 received 10 mg/kg body weight gentamicin intravenously and no local treatment. The animals were killed 7 days after inoculation and evaluated macroscopically and microbiologically for infection. 6 rabbits (12 legs) were used for pharmacokinetic studies only and they were killed after 2, 4, and 18 hours, respectively. 11/14 untreated legs developed a macroscopically acute osteomyelitis. No infection was found in the 18 legs treated with Gentacoll and 1/12 treated with gentamicin systemically had growth of the inoculated bacteria in tissue biopsies. The concentrations of gentamicin in the serum as well as locally reached peak values were well above the MIC value in all groups, with a maximum after 1-2 hours. No gentamicin could be detected after 18 hours, independently of the mode of administration.

Animals↗
PubMed1992

The anterior interosseous nerve syndrome.

A follow-up examination of 21 cases of anterior interosseous nerve syndrome in 20 patients is presented. In 15 patients the anterior interosseous nerve was explored, with objective signs of compression in nine. 11 of these patients showed satisfactory function and three had a tendon transfer. Five cases were not operated on. Two recovered and three had continuous paralysis after more than four years. One patient had a primary tendon transfer. We conclude that exploration of the anterior interosseous nerve is the treatment of choice, and that expectant treatment can be reserved for patients with slight disability or poor general health. As recovery may take over a year, tendon transfer should be postponed until after this period in patients who do not show satisfactory recovery.

Female↗
PubMed1991

Synovectomy for septic arthritis. Early versus late synovectomy studied in the rabbit knee.

Thirty rabbits with established unilateral septic arthritis of the knee after inoculation with Staphylococcus aureus received cloxacillin 50 mg/kg x 2 i.m. and probenecid 250 mg x 1 p.o. from Day 3 to 21. In 26 knees, synovectomy was performed 3, 5, and 7 days after the inoculation, and four knees were not operated on. Further, synovectomy was performed in eight noninfected knees. The rabbits were killed 3 or 7 weeks after the operation, and the specimens were examined macroscopically and microscopically. All the cultures taken postoperatively and at killing were negative. Infected knees synovectomized on Day 3 differed, although marginally, 3 weeks postoperatively from the operated on, uninfected group; a minor loss of cartilage cellularity and glycosaminoglycans was observed, but there were no changes indicating arthrosis. At 7 weeks postoperatively, this difference was more pronounced. If synovectomy was performed at a later stage, increased destruction was observed: after 7 days of infection, all the knees presented cloning and vascular crossing of the tidemark, indicating arthrosis, which did not differ from those knees treated with only antibiotics. We conclude that synovectomy performed early in the course of infection may stop the destructive influence of enzymes and of the synovial membrane leading to irreversible changes in the cartilage.

Administration, Oral↗
PubMed1990

[Purulent arthritis].

At all ages, Staphylococcus aureus is the most common microorganism responsible for septic arthritis, but in children below five years of age Haemophilus influenzae is frequently found. In about 1/3 of the cases cultures are negative, primarily because of initiation of antibiotic therapy prior to sampling. A distended joint should be treated as infection until otherwise proved. Today repeated aspirations of the infected joint are recommended as initial treatment, if possible with additional joint lavage, together with systemic antibiotic therapy. In case with no clinical response within 2-4 days, surgical debridement of the joint with synovectomy is of utmost importance. Exercises without weight-bearing are initiated at an early stage and weight-bearing avoided for six weeks.

Arthritis, Infectious↗
PubMed1990

Fibrin fixation of osteochondral talar fracture.

Six osteochondral talar fractures in 5 patients were fixed with fibrin sealant. All the lesions healed uneventfully. After 1 year, 3 of the 4 athletes in the study had resumed their sports activities at the same level as prior to the accident.

Adolescent↗
PubMed1989

Antibiotic treatment insufficient for established septic arthritis. Staphylococcus aureus experiments in rabbits.

We treated septic arthritis of the knee in 38 rabbits with cloxacillin i.m. once and twice daily combined with probenecid for 7 or 21 days, respectively, or with only cloxacillin i.m. thrice daily for 7 days. The animals were killed weekly in groups up to 5 weeks after inoculation. Aspirated cultures obtained after 4 days of treatment were always negative. Histologic specimens revealed progressive joint destruction, but at a slower rate after frequent treatment independent of the period. We concluded that antibiotic therapy alone could not prevent destruction of articular cartilage once bacterial arthritis was established.

Animals↗
PubMed1987

Antibiotic penetration into the infected knee. A rabbit experiment.

We investigated the diffusion of penicillin-G, cloxacillin, clindamycin, and netilmicin into synovial fluid and membrane in rabbits. Purulent arthritis was induced in the right knee of each rabbit by inoculation of Staphylococcus aureus phage type 3C, whereas sterile saline was injected into the left knee to serve as a control. Two days later, concentrations of antibiotics were determined in serum, synovial fluid, and membrane after an intramuscular single dose. All four drugs diffused readily into infected joints, whereas the corresponding concentrations in the normal joints were 2-3 times lower. Clindamycin showed the highest intraarticular penetration, cloxacillin the lowest. The lower penetration of cloxacillin corresponded to its higher protein binding in rabbit serum. Considering the sufficient local concentrations achieved, parenteral treatment obviates the need for local instillation of these antibiotics.

Animals↗
PubMed1986

Scrotal reconstruction after Fournier's gangrene.

After primary treatment for Fournier's gangrene, patients are left with skin defects in the genital region. In extensive lesions the whole scrotum may be lost. In these cases various methods for scrotal reconstruction have been recommended. In 3 patients we succeeded in reconstructing the scrotum and covering the penis using split-thickness skin grafts only. We found it a safe and relatively easy method giving the best possible cosmetic results and only minor functional sequelae.

Adult↗
PubMed1984

Fournier's gangrene: 5 patients treated with hyperbaric oxygen.

The classic syndrome of Fournier's gangrene was observed in 5 men with involvement of the external genitals and lower abdominal wall. Mixed flora of anaerobic and aerobic microorganisms were grown, and extensive necrosis of the skin and subcutaneous gas were present in all patients. Soon after hospitalization all 5 patients were treated by excision of all necrotic and undermined tissue, intravenous broad-spectrum antibiotics and hyperbaric oxygen administered at 3 atmospheres of pressure. One patient died of septic shock without any response to the therapy. The infection subsided shortly after the hyperbaric oxygen was instituted in the remaining 4 patients, who were cured. It is proposed that the treatment of Fournier's gangrene should be limited to centers capable of administering hyperbaric oxygen therapy. Our series does not prove that hyperbaric oxygenation is necessary for successful treatment but evidence suggests a beneficial effect of such therapy for nonclostridial gas gangrene.

Adult↗