Nederlands tijdschrift voor geneeskunde
-
Ned Tijdschr Geneeskd · Jan 1993
[Favorable effect of hematopoietic stem cells isolated from blood on hematologic recovery following high-dosage chemotherapy].
Peripheral blood stem cells can reconstitute bone marrow function after high-dose chemo-/radiotherapy. We describe 17 patients treated with a three-day course of chemotherapy consisting of cyclophosphamide or ifosfamide and etoposide (malignant lymphoma and germ cell tumor) or a one-day course of 5-fluorouracil, epidoxorubicin and cyclophosphamide (breast cancer), followed by the administration of recombinant human granulocyte colony-stimulating factor (G-CSF). Maximum numbers of peripheral blood stem cells were recruited on day 9-10 of the G-CSF administration with 0.1 x 10(9)/l CD34+ cells (median; range 0-0.36). ⋯ The accelerated haemopoietic recovery was associated with a reduction in platelet and red blood cell transfusion, reduction in fever periods and earlier discharge from hospital. Peripheral stem cell transplantation may become an important alternative to autologous bone marrow transplantation. This transplantation technique may also allow application of multiple-cycle intensive chemotherapy.
-
Ned Tijdschr Geneeskd · Jan 1993
[The dynamic hip screw in medial fractures of the femoral neck: results in 51 patients].
Femoral neck fractures are common in the elderly, especially in female patients. Pseudarthrosis and femoral head necrosis were complications with a high incidence in earlier days, when the femoral neck fracture was treated by obsolete osteosynthesis techniques. Replacement of the femoral head by an endoprosthesis was introduced in the seventies because of these complications. ⋯ Femoral head necrosis was seen in two patients more than 30 days after the operation. Pseudarthrosis was not observed. Because of the low complication rate, we can conclude that DHS osteosynthesis, on a correct indication, can be used as first choice in femoral neck fractures.
-
Ned Tijdschr Geneeskd · Nov 1992
[The value of skull and cervical spine radiography in patients following blunt head injury].
In a consecutive series of 100 patients with blunt head trauma the efficacy of routine skull and cervical radiography was studied. Neurocranial and facial skeletal lesions were present in 8 patients, only 1 skull fracture being completely unsuspected clinically. In all 79 patients without cervical signs or symptoms the cervical spine films were within normal limits. ⋯ Although this study confirms the low yield of routine conventional radiography in patients with blunt head trauma, the authors state that optimal conventional examination of the cervical spine is mandatory in all patients with blunt head trauma and the slightest suspicion of cervical symptoms or complaints and in those patients in whom either clinical examination or the clinical history is not completely satisfactory. The cervicothoracic junction should be adequately visualised. A CT or MRI scan of the brain should be preferred over conventional skull films in those patients in whom examination of the skull is considered indicated.