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Biomedical subjects

B D Weiss

Publications and source records attributed to B D Weiss.

89 records · Page 5Linked to original sources
PubMed1982

Cecal volvulus: A diagnostic and therapeutic challenge.

Cecal volvulus is a malrotational abnormality of the intestine that causes obstruction. Diagnosis is difficult and, if delayed, the results may be intestinal ischemia, perforation, sepsis, and even death. Cecal ischemia or gangrene cannot always be determined from physical and laboratory findings. Although not always conclusive, contrast radiography may be helpful; however, laparotomy is often required for definitive diagnosis and therapy. If vascular compromise of the cecum is found, right hemicolectomy is the treatment of choice. In the absence of ischemia, decompressive tube cecostomy, simple detorsion, and cecopexy have all been recommended, but the optimal treatment is a matter of controversy.

Barium Sulfate↗
PubMed1982

The Majzlin spring revisited.

The Majzlin spring is a stainless steel intrauterine device that was used by about 100,000 women between 1967 and 1973. Although the device was withdrawn from the market, some women still have this IUD in place. Many physicians have little knowledge of the Majzlin spring and its potentially serious complications, which include bleeding, infection, perforation and difficult removal.

Adult↗
PubMedDate not supplied

Nontraumatic injuries in amateur long distance bicyclists.

All 132 participants in a 500 mile, 8 day bicycle tour were surveyed by questionnaire to characterize the demographics and bicycling experience of the riders, and to determine the frequency and severity of nontraumatic injuries they experienced. Riders who developed significant symptoms were interviewed and/or examined. Eighty-six percent of ride participants responded to the survey. The average age of the riders was 41.4 years (+/- 11.7 years). They rode an average of 95.8 miles per week on a routine basis, but the majority were new to long distance touring. Most were healthy, but 5% had serious cardiovascular disease and bicycled as part of a rehabilitation program. The most common nontraumatic injury was buttocks pain (experienced by 32.8% of riders); four had skin ulceration of the buttocks. Knee problems occurred in 20.7% of riders; patellar pain syndromes and lateral knee complaints were the most common knee problems. One cyclist withdrew from the tour because of knee pain. Neck-shoulder pain occurred in 20.4% of the riders. Groin numbness and palmar pain or paresthesias each occurred in approximately 10%. Other less common problems were foot and ankle symptoms and sunburn.

Adult↗
PubMedDate not supplied

Longitudinal residency training in family medicine: not ready for prime time.

Many family medicine educators have called for changing the family practice residency curriculum from a series of block rotations to a longitudinal curriculum. A longitudinal curriculum is one in which residents are based in the family practice center every day or nearly every day of all 3 years of their residency training. Residents learn most of the clinical content offamily medicine through experiences with patients from their continuity clinics, under supervision of family medicine faculty, rather than through specialty-specific block rotations supervised by specialists. An important purported benefit of longitudinal training is improved continuity of care between residents and their patients. Unfortunately, definitions of longitudinal training vary widely, and at least one study shows that supposedly longitudinal curricula do not result in better continuity of care. Further, there is some evidence that acquisition of knowledge by residents may be better with intensive block rotations than with longitudinal training. Thus, the supposed benefits of longitudinal residency training remain unproven.

Adult↗
PubMedDate not supplied

Family physicians' colposcopy practices.

BACKGROUND: The objectives of this study were to determine (1) the extent to which family physicians are performing colposcopy, (2) which colposcopic procedures are performed by these family physicians, (3) demographic characteristics of physicians who perform colposcopy, and (4) whether physicians who do not perform colposcopy plan to do so in the future. METHODS: A questionnaire was mailed to all 757 self-identified family practice physicians in Arizona. RESULTS: The return rate was 72 percent, and the response rate was 55.5 percent. Results indicated that 19.3 percent of respondents were trained to perform colposcopy, and 9.5 percent actually have performed it. For those performing colposcopy, the mean number of procedures performed during the previous 6 months was 25 (range 2-100). CONCLUSIONS: Certain barriers to performing colposcopy were identified: (1) lack of available training, (2) interspecialty "turf battles," (3) quality assurance, and (4) the cost of malpractice liability insurance. Nevertheless, there were no insurmountable reasons why family physicians could not perform colposcopy.

Arizona↗
PubMedDate not supplied

Health status of illiterate adults: relation between literacy and health status among persons with low literacy skills.

BACKGROUND: In nonindustrialized nations, illiteracy is independently associated with poor health. The objective of this research was to determine whether such a relation exists in the United States. METHODS: One hundred ninety-three persons were randomly selected from a group of adult students enrolled in a publicly funded literacy training program. Subjects' health status was measured with the Sickness Impact Profile (SIP), a behaviorally based measure of sickness-related dysfunction. Subjects' literacy skills were also measured. Multivariate statistical techniques were then used to evaluate the relation between health status and literacy level and to adjust for confounding sociodemographic factors. RESULTS: The physical health (measured by the SIP) of subjects with extremely low reading levels was poor compared with that of subjects with higher reading levels. The relation between reading level and physical health was statistically significant (P less than 0.002), even after adjusting for confounding sociodemographic variables. Psychosocial health (measured by the SIP) was poor across all levels of reading skills and was comparable with the psychosocial health of populations with severe psychosocial disability. The relation between reading level and psychosocial health was statistically significant (P less than 0.02) after adjusting for confounding variables. CONCLUSIONS: In the United States, illiteracy and poor health status are independently associated.

Adolescent↗
PubMedDate not supplied

The current status of family medicine geriatric fellowships.

A questionnaire was sent to directors of all family medicine-affiliated geriatric fellowship programs to characterize trends and changes since institution of ACGME accreditation of fellowships. The number of fellowships has more than doubled since 1986, but few fellows graduate from these programs. There is currently a surplus of fellowship positions; over half of all programs did not recruit a first-year fellow for the 1989 academic year. In 1986, most family medicine-affiliated programs had independent administration. Almost half of the programs are now jointly sponsored with an internal medicine department. These programs are over six times more likely to train internists than family physicians. Although there has been a growth in geriatric training programs over the past three years, the number of family physicians seeking such training remains negligible.

Accreditation↗
PubMedDate not supplied

The postpartum Papanicolaou smear.

This study was performed to evaluate the importance of obtaining postpartum Papanicolaou (Pap) smears routinely. Four hundred eighty-nine patients receiving pregnancy care had a normal prenatal Pap smear and a repeat Pap smear at their postpartum visit. Twenty-four (4.9 percent) had an abnormal postpartum Pap smear (95 percent confidence interval: 3.1-6.9 percent). Twenty-one (87.5 percent) of the abnormal smears showed squamous dysplasia; three (12.5 percent) showed squamous atypia. No specific risk factors were identified that predicted the occurrence of an abnormal postpartum Pap following a normal prenatal Pap except for age. Women more than 30 years of age were less likely to have an abnormal postpartum Pap smear (P = 0.008). The results of this study support the practice of performing Pap smears during prenatal care and again at postpartum examination, even when the prenatal Pap smear is normal.

Adult↗
PubMedDate not supplied

Prevention of bicycle-related head injuries.

Each year in the United States, bicycling accidents cause approximately 1,300 deaths and 60,000 injuries. The death and injury rates are particularly high among children. The death rate from bicycle injuries in children exceeds the death rate from accidental poisonings, falls, firearm injuries, and many major illnesses. Head trauma is the most frequent cause of death and serious injury among bicyclists. Bicycle helmets have the potential to decrease the frequency and severity of bicycle-related head injury. Unfortunately, however, most bicyclists do not use a helmet. The helmet-use rate is extremely low among children. The failure of bicyclists, particularly children, to use bicycle helmets presents an opportunity for prevention of thousands of the traumatic head injuries that occur annually in the United States. Helmet use could be encouraged by schools, community safety programs, and office-based education by physicians.

Accidents, Traffic↗