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  • 1
    Electronic Resource
    Electronic Resource
    Cardiopulmonary and haemodynamic changes during total hip arthroplasty (1997)
    Springer
    International orthopaedics 21 (1997), S. 253-258 
    Details
    ISSN: 1432-5195
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé. Pendant l’arthroplastie de hanche nous avons observé de multiples altérations hémodynamiques et cardiorespiratoires. Nous avons réalisé une étude prospective de 30 patients opérés de coxarthrose par prothèse totale avec le but de rechercher des données sur la nature et lórigine de ces phénomènes. La série a consisté en 17 prothèses cimentées et 13 non cimentées. Nous avons relevé des paramètres de la fonction cardiopulmonaire, et des paramètres hématologiques, les concentrations plasmatiques de methyl-metacrylate (MMM), la pression intramedulaire et réalisé une échocardiographie transesophagienne pour contrôler par monitorage les phénomènes emboliques pendant toute l’intervention. Les résultats revelent deux schémas écogéniques bien différenciés qui apparaissent constamment à différents moments de l’arthroplastie. Nous avons observé une élévation importante de la pression intra-médulaire au moment de la cimentation et noté des modifications dans les paramètres hémodynamiques qui apparaissent quelques secondes après la fin de la de cimentation et se maintiennent pendant quelques minutes: élèvatíon de la tension artèrielle moyenne, de la pression artèrielle pulmonaire et de la pression capillaire pulmonaire; diminution de la pression partielle artèrielle de O 2 et de la saturation veineuse mixte de O2; une consommation supérieure de O2 tissulaire. Même si nous avons enregistré des élèvations significatives de MMM dans le sang veineux et artèriel, après la cimentation, il n’y pas d’evidence du faite que le monomère soit le responsable des changements hémodynamiques dans le groupe avec une implantation cimentée.
    Notes: Summary. We report a prospective study of 30 patients who underwent total hip arthroplasty for osteoarthrosis in order to investigate the haemodynamic and respiratory changes which occur during operation. Cement was used in 17 cases and the implants were not cemented in 13. Pulmonary and cardiac function, blood levels of methylmethacrylate monomer, intramedullary pressure and transoesophageal echocardiography were recorded. Two well differentiated echogenic patterns appeared consistently during the operation. The intramedullary pressure became raised as the cement was inserted. The following changes occurred within seconds and continued for some minutes: elevation of mean arterial pressure and mean pulmonary artery pressure; decrease of arterial oxygen tension and of mixed venous PO 2 , and greater tissue consumption of oxygen. Although we recorded raised concentration of methylmethacrylate monomer in venous blood after the cement was inserted, there is no evidence that the monomer is responsible for the haemodynamic changes which take place.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002640050161
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Unreamed intramedullary locking nailing for open tibial fractures (1998)
    Springer
    International orthopaedics 22 (1998), S. 97-101 
    Details
    ISSN: 1432-5195
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé. Les auteurs rapportent les résultats du traitement de vingt-quatre fractures ouvertes de la jambe stabilisées avec un enclouage verrouillé sans alésage. On a classifié les fractures en suivant le systeme de Gustilo: 7 grade I, 7 grade II et 10 grade III. La moyenne de consolidation fut de 22 semaines avec un pourcentage de pseudarthroses de 26%. Il n’y a pas eu d’infection profonde. Cinq cas ont consolidé avec un raccourcissement de plus d’un cm mais on n’a pas observé d’angulation. On a noté une limitation de la mobilité articulaire chez deux patients qui avaient des lésions articulaires. On a eu deux ruptures du clou et cinq de vis. Nous concluons que cette technique chirurgicale est bien tolerée par la patient, elle permet un bon maniement des tissus nous, une réhabilitation précoce et elle a un pourcentage bas d’infection ou mauvaise consolidation. Le principal désavantage a été la relative incidence de pseudarthroses et de ruptures du matériel par stabilité insuffisante.
    Notes: Summary. We reviewed the results of the treatment of 24 cases of open tibial fractures using unreamed intramedullary locking nailing. The fractures were classified, following the Gustilo system as grade I-7, grade II-7 and grade III-10. The average time to achieve bony union was 22 weeks with a 26% incidence of pseudoarthrosis. There were no cases of deep infection. Five cases healed with shortening of over 1 cm, but we did not observe angular deformity in any of the patients. In 2 fractures with associated articular lesions, joint motion was limited at final follow up. The nail broke in 2 cases and the screws in 5. The surgical procedure is well tolerated by patients, allows good management of soft tissue lesions and rehabilitation with low rate of infection and malunion. The main disadvantages have been the relative high incidence of nonunion and breakage of metal.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002640050217
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Comparison of aceclofenac with piroxicam in the treatment of osteoarthritis (1997)
    Springer
    Clinical rheumatology 16 (1997), S. 154-159 
    Details
    ISSN: 1434-9949
    Keywords: Aceclofenac ; NSAID ; Piroxicam ; Osteoarthritis ; Efficacy ; Safety
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A multicentre, double-blind, randomised, parallel group study was undertaken to investigate the efficacy and safety of aceclofenac (123 patients, 100 mg twice daily) in comparison to piroxicam (117 patients, 20 mg once daily and placebo once daily) in patients with osteoarthritis of the knee. The treatment period of two months was preceded by a washout period of one week duration. On completion of the study, patients in both aceclofenac and piroxicam-treated groups exhibited significant improvement in pain intensity and functional capacity of the affected knee, as represented by the Osteoarthritis Severity Index (OSI) (p〈0.0001 and p〈0.001 respectively). This was further substantiated following the patient's assessment of pain intensity using the Visual Analogue Scale (VAS), in which significant improvements were demonstrated at all time points for each treatment group (p〈0.001). Although both treatment groups showed a significant improvement in all investigator's clinical assessments (functional exploration of the knee, knee flexion and extension (EXT)), there were no significant differences between the groups. There was, however, a more rapid improvement in knee flexion in the aceclofenac group after 15 days of treatment. Both aceclofenac and piroxicam were well tolerated by patients, the most commonly reported adverse events being gastrointestinal, although their incidence was low. Only 24 patients on aceclofenac, as opposed to 33 on piroxicam complained of dyspepsia, epigastralgia and pyrosis. While 7 patients in each group were withdrawn because of adverse events, only one patient with piroxicam was withdrawn because of severe upper gastrointestinal bleeding. Twice as many reports of fecal blood loss were made in the piroxicam group in comparison to the aceclofenac group. In summary, this study confirms the therapeutic efficacy of aceclofenac and suggests that it is a well-tolerated alternative NSAID to piroxicam in the treatment of osteoarthritis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02247844
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    Paper (German National Licenses)
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