Socio-economic status and dental caries experience of 3911 five-year-old natives of Contra Costa County, California.
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Dental Caries↗
Biomedical subjects
E Fletcher
Publications and source records attributed to E Fletcher.
A clinico-pathological study of diabetic foot ulcers.
During a 32-month period 94 foot ulcers in 54 diabetic patients aged 38-90 years (mean 64 years) were managed in a specialist foot clinic. Fifty-six percent were men, and they were significantly younger than women; 46% were taking insulin. Mean duration of diabetes was 13.4 years. Comparison with controls revealed a higher prevalence (p less than 0.01) of retinopathy (60% vs 23%), neuropathy (89% vs 31%), vasculopathy (71% vs 34%), arterial calcification (31% vs 20%) and previous lesions (54% vs 4%). There was no difference in quality of diabetic control, or smoking habit. A simple classification of lesions was used. All types yielded mixed cultures of microorganisms (average 2.1 per swab); the flora obtained was affected by systemic antibiotics. Abnormal pressure was judged to have contributed to all lesions occurring in areas of callus. In addition definable trauma precipitated the event in up to 60% of all other types. Lesions in areas of callus were more likely to have healed by the end of the study period, but average time to healing was significantly longer than other lesions. Despite intensive outpatient support, 33 patients spent a total of 1188 days in hospital during the 974 day period, an average of 36 days per patient and 1.2 beds per day. Further research is urgently required to define optimal methods of prevention and treatment of diabetic foot ulcers.
Adult↗
Prolapse of the posterior cusp of the mitral valve: the auscultatory-electrocardiographic syndrome.
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Adolescent↗
Foot problems in people with diabetes.
People with diabetes are liable to suffer potentially disastrous foot problems, including gangrene with subsequent amputation. This article describes the risk factors, management, and ulcer-prevention methods which are essential knowledge for nurses working with this patient group.
Diabetes Mellitus↗
Launching the Tidal Model in an adult mental health programme.
AIM: To implement a new model of psychiatric nursing that uses person-centred care to empower people with acute mental health problems. METHOD: A pilot study involved the introduction of the model into two wards in the acute mental health services in Newcastle City Health Trust. This was followed by introduction of the model into all nine adult acute wards in the service. One ward was evaluated for six months before and six months after introducing the model and nurses' perceptions of the model have been assessed using questionnaires. RESULTS: Preliminary findings of the ward evaluation show that since the model has been implemented, more people have been admitted on an informal basis and fewer have been subject to sections of the Mental Health Act (MHA); the number of admissions has doubled while the length of stay has decreased; violent incidents and episodes of self-harm have decreased; the use of restraint has decreased; and the interval between admission and assessment has decreased. Preliminary analysis of the nursing questionnaires shows positive perceptions of the model. CONCLUSION: The introduction of this model appears to have had a positive impact on the care being given to patients and the nurses using the model appear to be satisfied with the use of patient-centred care.
Adult↗
[Ureterocele. Our experience with 61 cases, in 23 years at the Hospital del Niño].
Different surgical treatments for the ureteroceles were reviewed, but their comparison is difficult. Frequently the results are different, due to the type of patients treated, the different techniques and the recovery criteria used. We present and analyze the results in 61 patients treated during 23 years at the Children's Hospital in Panama City. 25% of our cases were reoperated (statistically acceptable). There is not one surgical technique for all cases. Each one has to be treated according to the type of lesion they present.
Child↗