Biomedical subjects

Suzanne Anderson

Publications and source records attributed to Suzanne Anderson.

4 recordsLinked to original sources

PubMed2002

Association of plasminogen activator inhibitor-1 genotype with avascular osteonecrosis in steroid-treated renal allograft recipients.

BACKGROUND: The mechanism of avascular osteonecrosis (AVN) is controversial. Besides an increased bone marrow pressure with reduced blood supply, an enhanced coagulation has been considered. We hypothesize that a genetic variant of the plasminogen activator inhibitor-1 (PAI-1) determines the risk of AVN in glucocorticoid-treated patients. METHODS: Genotyping for the 4G/5G PAI-1 polymorphism was performed in 228 glucocorticoid-treated renal transplant patients. AVN of the hip was present in 26 patients. Magnetic resonance imaging (MRI) of the hips was obtained in 81 of the remaining renal transplant patients without clinical symptoms of AVN. RESULTS: The presence of the homozygous 4G/4G PAI-1 genotype was higher in patients with AVN (60.3%) as compared with patients without either clinical (20.6%, P<0.007) or radiological signs of AVN (17.3%, P<0.002). The prevalence of AVN by genotype was 1.8% with the 5G/5G, 7.7% with the 5G/4G, and 30.3% with the 4G/4G alleles (P<0.001 vs. 5G/4G and 5G/5G). The prevalence of AVN increased with increasing body mass index (BMI) (P=0.04). The prevalence of AVN by genotype in subjects with persistent hyperparathyroidism was 4.2% with the 5G/5G, 15.2% with the 5G/4G, and 55.5% with the 4G/4G alleles (P<0.003 vs. 5G/4G and P<0.001 vs. 5G/5G). CONCLUSIONS: Hypofibrinolysis conferred by the 4G/4G PAI-1 gene variant is a major predisposing factor for AVN in renal transplant patients. The risk is particularly high in obese subjects or patients with persistent hyperparathyroidism. A prospective intervention study of early anticoagulation after renal transplantation is needed to assess whether glucocorticoid-associated AVN can be prevented.

Adult↗

PubMed2002

Noninvasive management of a dorsal patellar defect.

We present the case of a 13-year-old girl with bilateral anterior knee pain in which an unilateral dorsal patellar defect (DDP) was diagnosed. The pathology was extensively assessed with noninvasive imaging techniques including plain radiographs, computed tomography, magnetic resonance imaging, and scintigraphy. Based on the findings, a biopsy could be avoided. The characteristic findings and value of the above-mentioned imaging techniques as well as the differential diagnosis are discussed.

Adolescent↗

PubMed2002

Factors associated with attitudes toward medication use by pregnant women, with implications for prenatal care providers.

Women continue to have concerns about use of a prescription medication for the treatment of infection during pregnancy. Although we surveyed adults of all ages to determine if parents of reproductive age women were harboring concerns about medication and advising their pregnant daughters to be cautious, we found it was the young women who were most concerned about the balance between medication use and impact of infection. Clinicians should be clear about the risk of infection for both the mother and the infant when medication is prescribed for infectious illness during pregnancy so women can make an informed decision about adherence to the treatment regime.

Adolescent↗

PubMed2002

Orthopaedic recertification.

This report summarizes a symposium presented at the 2001 Annual Meeting of the American Orthopaedic Association that was designed to assess the current status of recertification by the American Board of Orthopaedic Surgery (ABOS) and to determine how it will change in the near future. Recertification is a process whereby the general public is assured of quality medical care by a competent and knowledgeable physician. As a professional organization, we have an obligation to provide quality care. The nature of the public demand for standards ensuring competence and the history of recertification in orthopaedic surgery are examined. The recertification of commercial airline pilots is reviewed, as it provides a model of an unrelated but highly skilled profession requiring intellectual and technical proficiency. The goals and plans of the American Board of Medical Specialties (ABMS), which encompasses the views of all twenty-four major specialty boards including orthopaedic surgery, are reviewed. Finally, the future plans of the ABOS for recertification are considered.

Certification↗