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Biomedical subjects

Shay Shabat

Publications and source records attributed to Shay Shabat.

At least 37 records · Page 2Linked to original sources
PubMed2003

Ocular expression of vascular cell adhesion molecule (VCAM-1) in 2-butoxyethanol-induced hemolysis and thrombosis in female rats.

We demonstrated previously that exposure of rats to 2-butoxyethanol (BE) was associated with morphological changes in red blood cells, hemolytic anemia, and disseminated thrombosis and infarction in different organs including the eyes. In order to elucidate the mechanism of thrombosis formation, we examined in this study the histology and immunohistochemical expression of vascular cell adhesion molecule-1 (VCAM-1), endothelial intercellular adhesion molecule-1 (ICAM-1), and P-selectin in the eyes of the female F344 rat exposed to 2, 3, or 4 daily doses of BE/250 mg/kg body weight. In this BE hemolysis and thrombosis model, positive VCAM-1 expression occurred only in eyes of rats exposed to 3 and 4 doses and was localized in the iris (epithelium lining the posterior surface, anterior mesenchymal epithelium), ciliary processes (lining epithelium, stromal cells), and retina (hypertrophic retinal pigment epithelium). Only weak immunolabeling was seen in eyes exposed to 2 doses. The appearance of VCAM-1 immunostaining correlated with the development of thrombosis located in the same structures. No change in ICAM-1 or P-selectin expression was seen. This immunolabeling distribution suggests that VCAM-1 functions in the pathogenesis of BE-related thrombosis by promoting adhesion of erythrocytes to the endothelium.

Animals↗
PubMed2003

The second hip fracture--an analysis of 84 elderly patients.

OBJECTIVES: Evaluation of patients with a second hip fracture, which means a fracture of the contralateral hip. DESIGN: Retrospective database analysis. SETTINGS: Academic teaching hospital. PATIENTS: All patients who were admitted for their second hip fractures between November 1999 and September 2001 and had their first hip fracture treated in our institution. INTERVENTION: In this study, we epidemiologically analyzed the fracture types, the interval between the two fractures, general status of the patients, type of operation performed, and the postfracture independence level. RESULTS: This survey comprises 84 patients (65 females and 19 males). Their ages ranged from 57 to 91 years (mean: 79) and 58 to 93 years (mean: 82) for the first and the second operation, respectively. The interval between the operations ranged from 2 to 297 months (mean: 35 months, median: 30 months). Twenty-three patients had subcapital fractures in both hips. In 54 patients, bilateral intertrochanteric fractures were noted. Only 7 patients had a previous subcapital fracture and a second intertrochanteric fracture. The general status of the patients' health was defined by the number of pre-existing major medical conditions and was found to be between 0 and 4 (mean: 2.15). Thirty-two patients (38%) had additional fractures somewhere between 1 and 8 years prior to the hip fracture (vertebra, proximal humerus, or distal radius). Sixty-eight and 56 out of the 84 patients reached the same mobility status after the first and second operation, respectively. CONCLUSIONS: A tendency was found for the second hip fracture to be of the same type as the previous one. Most patients showed a good potential for rehabilitation and for maintaining their prefall functional level.

Activities of Daily Living↗
PubMed2003

Outcome of resection of a symptomatic os trigonum.

BACKGROUND: While an os trigonum at the posterolateral aspect of the talus is usually asymptomatic, this inconsistently present accessory bone has been associated with persistent posterior ankle pain, which has been described as the os trigonum syndrome. We present the clinical results of excision of the os trigonum through a posterolateral approach and report several factors affecting the clinical outcome. METHODS: During a five-year period from 1994 through 1999, forty-one patients had a failure of nonoperative treatment of os trigonum syndrome and underwent excision of a symptomatic os trigonum. In all cases, the os trigonum syndrome was diagnosed on the basis of the history, physical examination, and radiographs. Postoperatively, the patients were evaluated according to the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale. A questionnaire was used to evaluate the effect of several factors on the clinical outcome. RESULTS: The average duration of follow-up was forty-four months. The postoperative AOFAS score averaged 87.6 points. The thirty-three patients who had had symptoms for two years or less prior to the surgery had an average postoperative score of 90 points compared with 78 points for the eight patients who had had preoperative symptoms for more than two years (p = 0.011). Eight patients had sural nerve sensory loss, which was temporary in four and permanent in four. A superficial wound infection developed in one patient, and reflex sympathetic dystrophy developed in another. CONCLUSIONS: An os trigonum that is persistently symptomatic after a minimum three-month trial of nonoperative treatment can be excised through a posterolateral approach with highly satisfactory results. The main complication of this procedure is sural nerve injury.

Adolescent↗
PubMed2003

Economic consequences of operative delay for hip fractures in a non-profit institution.

This retrospective study evaluated the economic consequences of delaying hip fracture surgery in 191 elderly patients. Data was collected regarding fracture type, surgery, timing of surgery, background diseases, postoperative hospital stay, and complications. In addition, calculation of the drugs administered to the patients, cost of the surgery, blood transfusion, physiotherapy, laboratory examinations, radiographs, and any financial data were evaluated. Spending more resources for performing hip surgery within 48 hours is more cost-effective than delaying surgery past the third day.

Aged↗
PubMed2002

A chemically induced rat model of hemolysis with disseminated thrombosis.

Although hemolytic anemia and thrombosis, which can be serious or even lethal, are often encountered in daily common practice, their pathogenesis has remained obscure, partially because of the absence of appropriate models. Here we present a unique chemically induced rat model of hemolytic anemia and disseminated thrombosis in which the organs developing infarction are comparable to those seen in humans. We exposed male and female Fischer F344 rats to two, three, or four daily doses of 2-butoxyethanol (BE) at 250 mg/kg body weight and examined for hemolysis and histopathological evidence of disseminated thrombosis on d 2, 3, 4, and 29. Time-course BErelated erythrocytic changes were statistically significant in both sexes. Evidence of thrombosis and infarction was seen mainly in females dosed more than once with widespread thrombotic crisis after two or three dosing, likely explicable by the more significant morphological changes in erythrocytes and hemolysis observed in this gender. We documented thrombosis and infarction in the heart, brain, lungs, eyes, and bones. Our model with its list of target organs similar to that observed in human diseases characterized by hemolysis and thrombosis [for example, thalassemia, sickle cell disease (SCD), paroxysmal nocturnal hemoglobinuria (PNF), disseminated intravascular coagulation (DIC), thrombotic thrombocytopenic purpura (TTP), and hemolytic uremic syndrome (HUS)] suggests that it can be an excellent tool to study the pathogenesis of such complications.

Animals↗
PubMed2002

The double-loop technique for meniscal suture.

The authors describe a modified method for arthroscopic meniscal repair in which polydioxanone sutures are placed in the torn meniscus using needles and nylon loops. Conventional methods require the use of expensive instruments, which are not always available. However, our method is fast and simple. This technique also simplifies inserting multiple sutures to achieve adequate stability of the torn meniscus.

Arthroscopy↗
PubMed2002

Rehabilitation process and functional results of patients with amputated fingers.

Digit amputation is a physical and psychological trauma that can influence the daily living of a person. The rehabilitation of patients with digit amputation is a complex process and should take into consideration all influencing factors, such as the functional, emotional, social, and professional profile of the patient. This study was conducted to evaluate the functional level of patients with amputated fingers and to understand the factors that influence their rehabilitation. Fifty patients (42 male and 8 female with an age ranging from 7 to 84 years) who had digit amputation(s) between January of 1990 and December of 1998 at the level of the metacarpus or distal to it and who had at least 6 months of follow-up were examined. The patients were divided into three different study groups: patients with distal amputation were compared with patients who had proximal amputation, patients with one finger amputation were compared with patients who had multiple finger amputations, and patients who suffered finger amputations caused by work-related accidents were compared with those who suffered amputations caused by other incidents. In addition, the time lapse from the amputation was checked as an influencing factor for different functional levels. The results showed that patients with distal amputation reached a higher motor and sensory functional level than patients with proximal amputation. Patients with one-finger amputation reached higher motor, sensory, and activities of daily living functional levels than patients with multiple amputations, and the level of motor and sensory function of patients with finger amputations caused by work-related accidents was lower than that of patients who suffered amputations in other incidents. Time was proven to be an important factor in the process of motor and emotional recovery.

Accidents, Occupational↗
PubMed2002

Iatrogenic forearm compartment syndrome in a cardiac intensive care unit induced by brachial artery puncture and acute anticoagulation.

A previously healthy patient developed late compartment syndrome in the cardiac intensive care unit after a brachial artery puncture due to acute heparinization after successful percutaneous transluminal coronary angioplasty (PTCA) and stent implantation. The cardiologists recognized the problem and immediately consulted an orthopedic surgeon, who promptly performed surgery. The latter consisted of decompression and fasciotomy. The patient recovered excellent hand function without any neurologic or muscular deficits. Knowledge and understanding of the clinical aspects of this complication are crucial in this devastating syndrome.

Aged↗
PubMed2001

Avulsion fracture of the flexor digitorum profundus tendon ('Jersey finger') type III.

Avulsion fracture of the flexor digitorum profundus tendon (Jersey finger) is an uncommon injury. This injury involves mainly young and active patients, especially during sports activities. It is classified into three types according to the extent of the tendon retraction. Type III Jersey finger is very rare, and only a few cases have been described so far.In this article, we report a case of a type III Jersey finger. Rapid diagnosis accompanied by surgery which included open reduction and internal fixation with 2 mini screws, followed by physiotherapy, led to restoration of a full range of motion of the involved digit.

Adult↗
PubMedDate not supplied

Relationship between low back pain in post-menopausal women and mineral content of lumbar vertebrae.

Until recently, chronic low back pain in post-menopausal women was commonly attributed to osteoporosis. This opinion has since been challenged on many counts, but controversy persists. The objective of this study was to examine this relationship. In 67 post-menopausal women, the mineral content of the lumbar vertebrae was measured by dual-energy X-ray absorptiometry and the age-normalized bone mineral index (ANBMI), the Z-score, was determined. Mean ANBMI in 40 subjects who complained of chronic low back pain (Group 1) was compared with mean ANBMI in the 27 who did not (Group 2). Pain intensity and related disability were quantified using standard questionnaires. Their respective correlations with ANBMI index and age at onset of menopause were examined. Correlation coefficients and significance of group differences were examined by appropriate statistical methods. The results showed that the mean ANBMI in Group 1 subjects was 96.5 +/- 16.9%, in Group 2 subjects it was 88.6 +/- 10.0%. Neither pain intensity nor disability was correlated with ANBMI. A weak but significant positive correlation was noted between body mass index and intensity of low back pain (r = 0.37; P < 0.05). The occurrence and severity of chronic low back pain in post-menopausal women, and the disability thereof, appear to be unrelated to the mineral content of lumbar vertebrae.

Absorptiometry, Photon↗
PubMedDate not supplied

Does the combination of a simultaneous subcapital fracture of humerus and hip fracture in elderly patients carry a prognostic value?

The most important factor to cause hip fractures in elderly is probably osteoporosis. Other factors are the increase in fall frequency and the protective response to trauma. Osteoporotic fractures occur most commonly, at the hip, vertebra, distal radius and proximal humerus. A combination of these is uncommon. Thirty-two women and six men treated between January 1990 and December 1999 for a combination of subcapital fracture of the humerus and hip fractures were evaluated retrospectively. The following parameters were reviewed: age, sex, pre-fall function, use of drugs, chronic and acute comorbidity, circumstances of the fall, length of hospitalization, treatment procedure, complications and post-hospitalization rehabilitation. Group I consisted of 15 patients aged 70-80 years and group II consisted of the remaining 23 patients, older than 80 years. In all 38 patients the simultaneous fractures were ipsilaterally. Hospital stay ranged from 7 to 17 days for the discharged 37 patients. Twenty-six of 28 patients, who were transferred to a rehabilitation center, returned to their previous activity of daily living (ADL). Among the nine remaining patients only five gained full recovery. A combination of fractures, occurs in the higher-age group, is quite traumatic to the patient and probably involves a greater impact force. In all patients it occurs in the ipsilateral side. In the elderly, even a minimal transmission to the osteoporotic hip can cause a fracture. The double trauma represents a better pre-morbid condition relative to patients in the same age group, thus it may serve as a prognostic indicator for success in rehabilitation.

Journal Article↗
PubMedDate not supplied

Surgical management of spinal stenosis: a comparison of immediate and long term outcome in two geriatric patient populations.

This retrospective study was performed to assess and compare the immediate safety and long term outcome of surgical decompression of spinal stenosis when performed for geriatric patients aged 65-74 years (Group A) and those >75 years (Group B) of age. Some 283 patients were studied (179 and 104 patients in Groups A and B, respectively). The mean follow-up time was 41.5 months (range: 9-115) and 42.9 months (range: 9-106) for Groups A and B, respectively. Within both treatment groups, there was a significant (P<0.0001) subjective improvement in low back and radicular pain, as well as the ability to perform daily activities. When compared to preoperative levels, the oral scores for pain while performing daily activities were significantly (P<0.001) improved in both treatment groups. The overall postoperative complication rate was similar between the groups. Age is not a contraindication for decompressive lumbar spine surgery. However, since both Group A and B patients are likely to suffer minor perioperative complications, increased vigilance and careful monitoring are essential for this high risk population.

Activities of Daily Living↗
PubMedDate not supplied

Functional results after patellar fractures in elderly patients.

Elderly patients tend to fracture the patella because of a simple fall. In this group of patients restoration of primary functional level is crucial. Sixty-eight patients more than 65 years of age with patellar fractures, who were treated in our institution between January 1990 and December 1999 were evaluated. There were 43 females and 25 males. The ages ranged from 65 to 88 years (17 patients>80). We focus on the mechanism, which led to the fracture, the pre-morbid and post-morbid state of the patients and the various aspects of treatment in this group of patients. The majority (82%) had a simple fall. Half of the patients had background diseases. Forty-five patients (66%) had comminuted patellar fracture. In 58 patients (85%) the extensor mechanism was disrupted, which therefore, necessitated an operation (group I). The rest, ten patients, were treated conservatively (group II). Follow-up time ranged between 0.5 and 10.5 years (mean 4.5 years). Minor complications were noted in five patients. Sixty patients (88%) had intact extensor mechanism, while five patients in group I (9%) and three in group II (30%) had extension-lag of 10-30 degrees (P<0.05). None of the patients had non-union, cosmetic disturbances or developed osteoarthritis. Fifty-six patients (82%) (41 patients in group I and five in group II, P<0.05) achieved the same independence mobility status post-fracture. In elderly patients the cause of the fracture is a direct blow by simple fall to the patella causing comminuted fractures; however, with these patients excellent or good results were eventually achieved. Surgical treatment yielded better results than non-surgical.

Aged↗
PubMedDate not supplied

Scoring systems to evaluate elderly patients with hip fractures.

PURPOSE: To report about different scales and scoring systems used to evaluate elderly patient with hip fracture during the acute post-fracture phase and during post-operative rehabilitation. METHODS AND RESULTS: Report of the different scales from a literature review. CONCLUSIONS: Standard validated scales are one of the tools to perform such an evaluation process as objectively as possible and to evaluate surgical, medical and rehabilitative management in these elderly patients. These scales are only a complementary tool, and they cannot replace physical examination. However, these validated tools are probably more accurate than just clinical impression. The appropriate combination of clinical experience and these scales may well contribute to a better care of elderly patients with hip fractures.

Aged↗