Characterization of standard work tools for intrathecal baclofen therapy.

Purpose: Intrathecal baclofen (ITB) has been an effective therapy since the 1980s, with widely reported revision, infection, and complication rates. Publications targeting surgical workflow have resulted in decreased infection and revision rates, but a standard workflow for the entire pathway has not been described. To present, define, and test standard work tools for patients receiving ITB to promote uniformity and standard of care in the field.

Effect of discontinuing TNFalpha antagonist therapy in patients with remission of rheumatoid arthritis.

Objective: The objective of this study was to determine the time to relapse after tumor necrosis factor alpha (TNFalpha) antagonist discontinuation in patients with remission of rheumatoid arthritis (RA).

Methods: Among 304 patients taking TNFalpha antagonist therapy for RA, 21 achieved a remission and were taken off the TNFalpha antagonist. Remission was defined as DAS28<2.

Clinical follow-up of 50 patients treated by percutaneous lumbar discectomy.

A series of 50 patients presenting with lumbar discogenic disease, and treated by percutaneous discectomy using the Dekompressor system (Stryker, Kalamazoo, MI, USA), were followed for more than 6 months, by analyzing the evolution of the painful symptomatology with the visual analog scale (VAS) system. All patients had been under treatment with analgesic or anti-inflammatory agents. The intensity of the pain was measured 2, 7, 30, and 180 days after the percutaneous discectomy.

[Vacuum assisted closure for the treatment of sternal wound infections -- rapid infection control and bridging to reconstructive surgery].

Vacuum Assisted Closure (V.A.C.

Percutaneous nucleotomy: preliminary communication on a decompression probe (Dekompressor) in percutaneous discectomy. Ten case reports.

For the past years, new therapeutic options have been proposed secondary to the progress in the interventional imaging. The purpose of this article is to report a preliminary study on the use of the 1.5 mm "Dekompressor probe" (Stryker, Kalamazoo, MI, USA) in the percutaneous discectomy by decompression.

[Etanercept--infliximab switch in rheumatoid arthritis 14 out of 131 patients treated with anti TNFalpha].

Objective: Patients with severe rheumatoid arthritis and resistant to at least three DMARDS can benefit from anti-TNFalpha (tumor necrosis factor) therapy. In some patients, because of inefficacy or adverse events, treatment with one of the two available TNFalpha drugs (etanercept and infliximab) must be stopped. In this study, we explored the results in efficacy and tolerance of switching from one anti-TNFalpha to the other.

Hip osteoarthritis: short-term efficacy and safety of viscosupplementation by hylan G-F 20. An open-label study in 22 patients.

Unlabelled: We studied the short-term safety and efficacy of intraarticular hylan G-F 20 (Synvisc) in patients with symptomatic hip osteoarthritis.

Methods: In this open-label prospective study, patients who had hip osteoarthritis with a visual analog pain scale score greaterthan 40/100 and a Lequesne index greater than 6 received one or two intra-articular injections of hylan G-F 20 under fluoroscopic guidance. The patients were evaluated once a month.

Reactive arthritis induced by Strongyloides stercoralis.

Reactive arthritis induced by Strongyloides is exceedingly rare. A case in a 53-year-old man from the Guadeloupe (French Antilles) is reported. The outcome was rapidly favorable under thiabendazole therapy.

Psychological characteristics and the effectiveness of patient-controlled analgesia.

We have evaluated the level of state and trait anxiety, neuroticism, extroversion and coping style as predictors of the effectiveness of patient-controlled analgesia (PCA) in 110 patients undergoing total abdominal hysterectomy. After operation patients were allocated to receive pain control with either PCA or i.m.

The effects of data-driven and conceptually driven generation of study items on direct and indirect measures of memory.

Two experiments are reported which investigated the effects of data-driven generation of study items on direct and indirect measures of memory. Previous research in the field of implicit memory has traditionally employed generation procedures at encoding which focused on conceptually driven processing. The present study undertook to device data-driven generation procedures that were predicted to lead to a generation effect on word-stem completion.

Pyomyositis: cervical localization.

We describe an uncommon case of cervical pyomyositis in a 60-year-old woman without predisposing factors, admitted for cervicobrachial neuralgia with fever and paravertebral contracture. Ultrasonography and computed tomography (CT) showed a collection in the left longissimus capitis. Ultrasonography guided needle aspiration yielded thick pus, which cultured Staphylococcus aureus.

Isokinetic back testing in the athlete.

With increasing numbers of professional, collegiate, and high school athletes developing low back pain, isokinetic back testing could prove to be a way of preventing the development of severe problems and extended stays on injured lists. Isokinetic testing provides an advantage over other testing procedures by more closely simulating the way muscles perform functional activities. This type of testing allows comparison between patients, normals, preoperative and postoperative status, and pre-rehabilitation and post-rehabilitation protocols.

Multicentric reticulohistiocytosis. Immunohistological and ultrastructural study: a pathology of dendritic cell lineage.

A case of multicentric reticulohistiocytosis is presented with extensive immunohistochemical study of the infiltrate in both paraffin and cryostat sections. Factor XIIIa dermal dendrocyte marker was demonstrated in the cytoplasm of histiocytes, which has not been reported previously in this disease. In addition, the S100 protein stained positive.

Progress in limb and digital replantation: Part B.

Progress in micro- or macroreplantation has resulted in higher survival rates of formerly amputated parts. Progress has been made as a result of intensive laboratory training and considerable experience due to the popular application of microsurgical techniques. More amputated digits or limbs may survive because the time of ischemia can be exceeded in using cold storage or perfusion.

[Vascular complications in free tissue transfers].

The causes of vascular complications after 306 cases of free vascularized tissue transfers were examined. The technique and success of the explorative operations were determined. The results show that 22 flaps were lost because of failures in indication, technique and monitoring.

[Clinical aspects and surgical treatment of Dupuytren contracture].

The etiology of Dupuytren's contracture is still not clear. Many theories have been proposed, but no basic data are currently available that would make it possible to treat Dupuytren's contracture by other methods than surgical intervention. The surgical technique used in our clinic is described, and a postoperative treatment is also outlined.

Muscle transfers in brachial plexus lesions.

The concept of reconstruction to regain lost function after brachial plexus lesions has to be as broad and complex as possible. We have been exploring wider and more novel clinical concepts at the Clinic of Plastic, Hand, and Reconstructive Surgery at the Medical School of Hannover. Our ideas are supported by experience in 160 patients.

[Criteria for amputation, reconstruction and replantation of extremities in multiple trauma patients].

The paper defines indications for amputation, reconstruction and replantation of severely injured extremities of multiple traumatised patients using the trauma score PTS (Hannover Polytrauma Score) and the fracture grading for open and closed fractures.

[Combination of cancellous bone grafts and free microvascular bone transplantation in large osseous defects].

Fourteen autogenous vascularized fibular bone grafts have been performed. The indications for surgery were segmental bone defects 17 cm in length on average, seven times because of radical tumor resection (three malignant, two locally aggressive tumors) and seven times because of primary or secondary bone loss in trauma patients. Two free vascularized fibular grafts were done in the upper extremity, four in the femur and eight in the tibia.