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JAMA
Article . 1983 . Peer-reviewed
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JAMA
Article . 1983
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Adverse Effects of Chemonucleolysis

Authors: I. Leonard Bernstein;

Adverse Effects of Chemonucleolysis

Abstract

To the Editor.— The article about chemonucleolysis by Phil Gunby (1983; 249:1115) was accurate and informative. General availability of intradiscal therapy with chymopapain offers a worthwhile alternative to surgery for patients with recalcitrant symptoms and signs of the lumbar disk syndrome. Moreover, the splendid cooperative effort by the American Academy of Orthopaedic Surgeons (AAOS) and the American Association of Neurological Surgeons (AANS) in organizing supervised instructional courses of this technique will serve as a prototype of professional postgraduate education. Participants in these courses were also warned about the risks of anaphylactic reactions to chymopapain, one of a family of enzymes that are particularly prone to induce IgE-mediated sensitization in susceptible persons. 1,2 The generalized incidence of chymopapain-induced anaphylaxis in the hospital is 1%, or ten times higher than the risk of penicillin anaphylaxis in the hospital, as determined by prospective statistics of the Boston Collaborative Drug Surveillance Program. 3 The

Keywords

Male, Risk, Sex Factors, Endopeptidases, Humans, Chymopapain, Female, Anaphylaxis, Intervertebral Disc Displacement

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
10
Average
Top 10%
Top 10%
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