OBJECTIVE: The purpose of this study is to prospectively document the incidence of deep vein thrombosis (DVT) in the residual limb after a below-knee amputation. DESIGN: Eight of 13 male patients, admitted to the acute rehabilitation floor after a below-knee amputation, were included in the study. Patients already receiving anticoagulants were excluded. An investigator questioned the patient regarding the patient's risk factors for DVT and history of DVT and pulmonary embolus. A coagulation profile was obtained for all patients. A Doppler ultrasound was completed on the residual limb 2 wk after amputation, and if negative, it was repeated 2 wk later. Patients found to have a DVT were treated appropriately. The incidence of DVT was calculated by a point estimate, and a 95% confidence interval was calculated using simple large sample methods. RESULTS: Four of the eight patients had ultrasound evidence of DVT in the thigh. Two of the four patients had signs or symptoms of a DVT. There were a comparable number of risk factors for DVT in both groups. Laboratory values were not statistically significant in predicting the occurrence of DVT, probably because of the limited number of subjects. CONCLUSIONS: The present study supports the assumption that the diagnosis of lower limb DVT is frequently associated with lower limb amputation. However, a larger sample may be necessary to conclude that a routine screening ultrasound of the lower limbs is indicated after a below-knee amputation.

Adult↗

PubMedDate not supplied

Transitional (intravenous to oral) antibiotic therapy.

Most clinicians feel the best clinical outcome occurs when patients are treated for serious infections with injections for the entire illness. Unfortunately, this type of prescribing style results in considerable indirect costs such as those involved in increased labor (nursing, pharmacy, intravenous technician time), supplies (needles, syringes, intravenous solutions, administration sets, infusion pumps) and nosocomial bacteremia. It now appears from pharmacodynamic and pharmacoeconomic information that this traditional prescribing behavior should change in the management of many infectious diseases, particularly in those clinically stable patients who can ingest or digest a medication. With the presence of numerous antibiotics with high bioavailability, many infections in such patients can now be successfully treated with an oral agent. This review provides examples of common infections (such as community- and hospital-acquired pneumonias, intra-abdominal infections, urinary tract infections, and skin, soft tissue, and bone infections) in which oral therapy can replace parenteral agents.

Administration, Oral↗

PubMedDate not supplied

Evaluation of a burn prevention program in a public school system.

The "Learn Not to Burn" prevention program is a burn prevention curriculum sponsored by the North Carolina Jaycee Burn Center, the State Department of Public Instruction, and the North Carolina Department of Insurance Fire and Rescue Division. The goal of the program is to reduce burn-related deaths and injuries in North Carolina through burn prevention education by making the "Learn Not to Burn" curriculum available to primary school children across the state at no cost to the schools. The curriculum instrument is a reusable notebook that provides a means for teachers to integrate burn prevention into regular class subject areas. At the time of initiation of this study approximately 70% of the school systems in North Carolina had been provided with the "Learn Not to Burn" curriculum.

Accident Prevention↗

PubMedDate not supplied

[Treatment of bladder cancer. New methods, new management].

Explore the source record for details and available documents.

Antineoplastic Agents↗

PubMedDate not supplied

Clinical nurses as teachers of nursing students.

A questionnaire survey of 304 nurses working in clinical areas of 16 hospitals was conducted to investigate the nurses' attitudes to teaching university nursing students during clinical placements. The survey also identified the information and support that clinicians needed to assist them in their teaching role. The study found that most participants saw teaching students as a part of their role; they felt adequately prepared to teach and gained satisfaction from it. Clinicians needed information about students' level of nursing education and what universities expected their students to gain from clinical placements. They expected university clinical teachers to be accessible and to be involved with teaching their students clinical aspects of practice. Less than half the RNs thought that students on clinical placements were adequately taught by their universities' clinical teachers.

Attitude of Health Personnel↗

PubMedDate not supplied

State study of pyrotechnics-related injuries and property damage.

In December 1993, the State of North Carolina legalized the sale of certain types of fireworks. To date, no study has examined the impact of legalization of fireworks on health care and public safety. The purpose of this study was to examine the impact of legalized pyrotechnics specific to our state with regard to injury, property damage, and suppression costs. The population groups surveyed were the state fire departments, county fire marshals, hospital emergency departments, and county forest rangers. Each group was asked to complete a questionnaire on all incidents involving pyrotechnics devices, both legal and illegal, used during the study period. A total of 233 responses were received from the 1644 agencies surveyed. Forty-one injuries and 129 fireworks-related fires were reported. Total property loss was $185,570. Property loss, injury costs, and fire suppression costs totaled $799,450. This study provides a very conservative estimate of the problem within our state. Stronger legislation to restrict access to pyrotechnics may reduce the damage and costs they cause.

Blast Injuries↗