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Biomedical subjects

R Buschbacher

Publications and source records attributed to R Buschbacher.

11 recordsLinked to original sources
PubMed2000

Electrodiagnostic reference values for the lateral antebrachial cutaneous nerve: standardization of a 10-cm distance.

OBJECTIVE: To derive a normative database for nerve conduction values of the lateral antebrachial cutaneous nerve (LACN) using a large and varied subject population. DESIGN: Descriptive study. SETTING: Private office or university-based clinic. PARTICIPANTS: Volunteers (n = 213), recruited through advertisements, who met inclusion criteria. MAIN OUTCOME MEASURES: Onset latency, peak latency, baseline-to-peak amplitude, peak-to-peak amplitude, area, rise time, duration, side-to-side differences, and the effects of age, race, sex, height, and body mass index (BMI) were investigated on 213 healthy volunteers between the ages of 19 and 79 years. RESULTS: The mean +/- SD onset latency was 1.7+/-0.2 ms. The 95th and 97th percentile values for onset latency were 2 and 2.1 ms, respectively. Mean peak latency was 2.2+/-0.2 ms. Both the 95th and 97th percentile values for peak latency were 2.5 ms. Mean onset to peak amplitude was 18+/-10 microV. The 5th and 3rd percentile values for onset to peak amplitude were 6 and 5 microV, respectively. Mean peak-to-peak amplitude was 22+/-15 microV. The 5th and 3rd percentile values for peak-to-peak amplitude were 7 and 6 microV, respectively. Mean area was 11+/-7nV-s, mean rise time was 0.5+/-0.1 ms, and mean duration was 1.1+/-0.2 ms. Mean side-to-side difference was 0.1+/-0.2 ms for onset latency, 0.1+/-0.2 ms for peak latency, 1+/-12 microV for onset to peak amplitude, and 0+/-17 microV for peak-to-peak amplitude. Increasing age and BMI were associated with lower mean amplitudes, but did not affect the lower limits of normal. CONCLUSION: These normative values will be useful in electrodiagnostic study of the LACN.

Adult↗
PubMed1998

Incidence of the inability to flex the proximal interphalangeal joint in normal subjects.

OBJECTIVE: To evaluate the incidence of the inability to flex the proximal interphalangeal (PIP) joints in normal subjects and to find clinically useful patterns of symmetry between hands. SUBJECTS, DESIGN, AND SETTING: Two hundred consecutive patients (122 women, 78 men) from a musculoskeletal clinic and inpatient rehabilitation service without history of hand or forearm injury underwent finger flexion testing. RESULTS: Forty-eight percent were able to independently flex all of their PIP joints. Thirty-three percent could not do so in both fifth digits, and 19% could not do so on either the left or the right hand alone. Four subjects could not independently flex their fourth PIP joints. Nineteen percent of subjects showed asymmetry between hands. CONCLUSION: These findings suggest that the finger flexor test should be interpreted with caution when evaluating the fifth finger PIP joint flexion. Symmetry patterns are of doubtful usefulness in predicting the function of the injured hand on the basis of the function of the uninjured hand.

Adolescent↗
PubMed1997

Side-to-side confrontational strength-testing for weakness of the intrinsic muscles of the hand.

A prospective study of 217 patients was performed to determine the sensitivity and specificity of standard manual testing and of a new method, termed confrontational testing, for detecting weakness of the intrinsic muscles of the hand. Electrodiagnostic testing was used to identify the presence of any neurological disorder and to provide a control for the manual testing methods. Standard manual testing of the muscles innervated by the ulnar nerve revealed a sensitivity of 14 per cent, a specificity of 100 per cent, a predictive value of a positive result of 100 per cent, and a predictive value of a negative result of 57 per cent. Confrontational testing of the muscles innervated by the ulnar nerve revealed a sensitivity of 82 per cent, a specificity of 100 per cent, a predictive value of a positive result of 100 per cent, and a predictive value of a negative result of 87 per cent. Standard manual testing of the muscles innervated by the median nerve revealed a sensitivity of 6 per cent, a specificity of 100 per cent, a predictive value of a positive result of 100 per cent, and a predictive value of a negative result of 49 per cent. Confrontational testing of the muscles innervated by the median nerve revealed a sensitivity of 16 per cent, a specificity of 100 per cent, a predictive value of a positive result of 100 per cent, and a predictive value of a negative result of 52 per cent.

Adult↗
PubMed1994

Overuse syndromes among endoscopists.

A survey of 400 gastroenterological endoscopists was carried out to determine what kinds of overuse syndromes they suffer from as a result of doing endoscopic procedures. The response rate was 72%. Thumb pain, hand pain, elbow pain, low back pain, and possibly shoulder pain all appear to be caused by endoscopy to at least some extent. Physicians who perform the most procedures tend to have the highest risk of developing such problems. Age, sex, practice setting, and hobbies did not seem to have an impact on the overuse conditions identified. These conditions are most likely due to the equipment and technique of endoscopy. Further study is needed to determine the anatomic lesions causing the various pain states, so that they can be treated or prevented.

Cumulative Trauma Disorders↗
PubMed1992

Warfarin in prevention of heterotopic ossification.

Patients with spinal cord injuries among others, commonly develop neurogenic heterotopic ossification. Current treatment with Didronel (disodium etidronate) inhibits bone matrix mineralization but not matrix production. To eliminate much morbidity and cost, a more efficatious prophylactic treatment is desirable. Because one of the proteins in bone, osteocalcin, is produced by a vitamin K-dependent carboxylation, this raises the possibility that treatment with warfarin may prevent the formation of ectopic bone. In the present study, 227 cases of spinal cord injury were reviewed. Among these patients, 15% were treated with warfarin and another 15% developed heterotopic ossification. None of the patients who were treated with warfarin developed heterotopic ossification, thus suggesting that warfarin may inhibit heterotopic ossification. Further prospective studies are planned.

Adult↗
PubMed1991

Noninflammatory knee joint effusions in spinal cord-injured and other paralyzed patients. Four case studies.

Four patients with knee effusions are described. Three had spinal cord injuries and the fourth had Guillain-Barrè syndrome. Of the spinal cord-injured patients, the effusions were unilateral in one case and bilateral in another. The third patient developed effusions on two separate occasions with bilateral involvement once and unilateral involvement once. The patient with Guillain-Barrè syndrome had bilateral knee joint effusions. All effusions were tapped and revealed type I synovial fluid except for one joint that contained some blood cells. Two of the three spinal cord-injured patients had heterotopic ossification at the knees documented by 99mTe bone scans and two were lying prone for the treatment of decubitus ulcers. Similar knee joint effusions have been described by several authors in the past. The etiology is unknown; however, we offer the hypothesis that paralysis of the muscles adjusting intra-articular knee joint structures may be the cause. It is important for clinicians to recognize that benign knee joint effusions are likely to be encountered in paralyzed patients. They can be evaluated with a simple synovial fluid analysis.

Adult↗
PubMed1983

Decreased complement mediated binding of antibody/3H-dsDNA immune complexes to the red blood cells of patients with systemic lupus erythematosus, rheumatoid arthritis, and hematologic malignancies.

The complement mediated binding of prepared antibody/3H-dsDNA immune complexes to the red blood cells obtained from a number of patient populations has been investigated. Patients with solid tumors have binding activity similar to that seen in a normal group of individuals. However, a significant fraction of patients with systemic lupus erythematosus, rheumatoid arthritis, and hematologic malignancies have lowered binding activity compared with normal subjects. Quantitative studies indicate the lowered activity probably arises due to a decrease in complement receptors on the respective red blood cells. The potential importance and implications of these findings are briefly discussed.

Adolescent↗
PubMedDate not supplied

Guillain-Barré syndrome leading to a conversion reaction in a teenage girl. Case report.

Conversion disorder can sometimes simulate Guillain-Barré Syndrome (GBS). This often involves the mimicry of organic symptoms similar to those experienced by a relative or acquaintance. The patient with the conversion unconsciously adopts these symptoms to convert their psychologic stress to a physical phenomenon. This case is of 15-yr-old girl who had a documented case of GBS and who subsequently had recurrent episodes of a conversion disorder that simulated her original GBS presentation. The methods for diagnostically separating recurrent GBS from conversion reaction are noted.

Adolescent↗
PubMedDate not supplied

Outcomes and problems in pediatric pulmonary rehabilitation.

OBJECTIVE: To provide baseline information on the state of pediatric pulmonary rehabilitation, including data regarding diagnosis, age, gender, race, gestational age, disposition, medications, complications, procedures, consultations, pulmonary status, and outcomes. DESIGN: Retrospective review. SETTING: Pediatric pulmonary rehabilitation unit of a pediatric rehabilitation hospital that is free-standing, but that receives most of its referrals from a tertiary care pediatric hospital. PATIENTS: All patients (70 subjects) who had completed a course of inpatient rehabilitation over the 5-yr life of the hospital. MAIN OUTCOME MEASURES: Descriptive data were collected in regard to the objectives. In addition, outcome measures were developed for this study. They include measurements of developmental equivalence at admission and discharge and the changes in these scores, both actual and expected. RESULTS: Descriptive characteristics are listed in the text. Forty-six patients had bronchopulmonary dysplasia (BPD). The success rate of weaning those with BPD who were admitted with a goal of ventilator weaning was 81% (24% for those without BPD). On admission, 36 of those with BPD required three pulmonary aids (O2, continuous positive airway pressure, ventilator, and tracheostomy); at discharge, 28 required three aids. Of those without BPD, 16 required three aids at admission and 14 did so at discharge. CONCLUSIONS: Basic descriptive data are provided. The characteristics are similar to those in previous studies, although with a larger sample size and more detail. The outcome measures described cannot be compared with a criterion standard, but do offer a starting point in this underdeveloped field and will assist in future research directions.

Bronchopulmonary Dysplasia↗
PubMedDate not supplied

Resident versus program director perceptions about PM&R research training.

A survey of all residents and residency program directors in Physical Medicine and Rehabilitation (PM&R) was done to assess perspectives of residents and directors regarding research training, resources, mentorship, and encouragement available to residents. A response rate of 55% was obtained from 1188 resident mailings, and 83% of 77 program directors responded. A number of discrepancies in perceptions of residents v program directors responded. A number of discrepancies in perceptions of residents v program directors were identified. In general, residents perceived that they had less research support and training than directors felt their departments were offering. Only 24% of residents felt that they got adequate training in statistics, 40% for research design, and 26% for writing research papers. The corresponding numbers for residency program directors were 47%, 73%, and 61%. There were similar discrepancies in the perception of the quality of research training. On a 1 to 5 scale, residents registered a mean score of 2.8 (SD 1.0) to the question of how qualified their faculty was to teach principles of research. Program directors' mean response was 3.2 (SD 1.0). Residents were also often not aware of resources available for research in their departments. Only 19% of residents knew of access to a research coordinator/grant writer, 36% for statistical support, and 67% for library assistance. The corresponding numbers for program directors were 31%, 69%, and 97%. Additional results of the survey are summarized, and suggestions for further study to improve the resident research training experience are given.

Attitude of Health Personnel↗