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Biomedical subjects

J A Riggs

Publications and source records attributed to J A Riggs.

18 recordsLinked to original sources
PubMed2001

Obesity: assessment and management in primary care.

Obesity is a complex, multifactorial condition in which excess body fat may put a person at health risk. National data indicate that the prevalence of obesity in the United States is increasing in children and adults. Reversing these trends requires changes in individual behavior and the elimination of societal barriers to healthy lifestyle choices. Basic treatment of overweight and obese patients requires a comprehensive approach involving diet and nutrition, regular physical activity, and behavioral change, with an emphasis on long-term weight management rather than short-term extreme weight reduction. Physicians and other health professionals have an important role in promoting preventive measures and encouraging positive lifestyle behaviors, as well as identifying and treating obesity-related comorbidities. Health professionals also have a role in counseling patients about safe and effective weight loss and weight maintenance programs. Recent evidence-based guidelines from the National Heart, Lung, and Blood Institute, as well as recommendations from the American Academy of Pediatrics, American Association of Clinical Endocrinologists/American College of Endocrinology, American Obesity Association, U.S. Clinical Preventive Services Task Force, Institute of Medicine, and World Health Organization can be consulted for information and guidance on the identification and management of overweight and obese patients.

Adolescent↗
PubMed2001

The health and long-term care policy challenges of Alzheimer's disease.

The growth of the aging population, the increasing ethnic and cultural diversity of that population, and the changing nature of Alzheimer treatment and care demand change in the financing and delivery of health and long-term care in the US. These challenges will require public policies that are well informed by behavioral, social, and health policy research. The issues fall into three broad categories, each of which raises questions for research: the cost of Alzheimer care, Medicare and health care policy, and long-term care policy including support of the appropriate role of family caregivers and meeting the need for affordable long-term care. The paper calls for a closer collaboration between the research community, policy makers and advocates to assure that science is addressing the most urgent policy questions and that relevant research is being translated and communicated to policy makers in a timely fashion.

Aged↗
PubMed1999

Certified athletic trainers in secondary schools: report of the council on scientific affairs, american medical association.

BACKGROUND: In June 1997, the American Academy of Pediatrics introduced a resolution asking the American Medical Association (AMA) to support efforts to place certified athletic trainers in all secondary schools. The AMA Council on Scientific Affairs studied that resolution and presented this report to the AMA House of Delegates in June 1998. OBJECTIVE: To identify the professional responsibilities, educational requirements, and current use of certified athletic trainers in the prevention and care of high school sports injuries. DATA SOURCES: MEDLINE and HealthSTAR databases were searched for English-language articles published from 1980 to 1998. Additional references were derived from references in pertinent articles, communication with experts, and the Internet sites of athletic training and sports medicine associations. DATA SYNTHESIS: One in 5 of approximately 6 million adolescents who participate in high school sports each year sustains a sport-related injury. Most of these injuries are minor and occur during practices rather than competitions. Approximately 1 of every 100000 high school athletes will sustain a catastrophic injury. About 35% of US high schools use the services of a certified athletic trainer, who, under a physician's supervision, is responsible for the prevention and care of athletic injuries and coordination of the school athletic health program. CONCLUSIONS/RECOMMENDATIONS: Emphasis should be given to ensuring the health, safety, and well-being of participants in high school sports. Whereas most high school sports injuries are minor, adequately trained personnel should be present on site to ensure that such injuries are recognized early, treated immediately, and allowed to heal properly, thereby reducing the risk of more serious injury or reinjury. For such care, team physicians and coaches should have the assistance of a certified athletic trainer.

Journal Article↗
PubMed1998

Alcoholism and alcohol abuse among women: report of the Council on Scientific Affairs. American Medical Association.

We describe characteristics of women alcohol abusers, risk factors for alcoholism in women, barriers to treatment, and implications and strategies for physicians dealing with alcohol abuse in women patients, including risk assessments and intervention strategies. Alcohol abuse and alcoholism have a different physiologic effect on women than on men. Societal attitudes about women and alcohol and internal (self-perception) and external (environmental) factors can create barriers to the detection and treatment of female alcohol abusers. Physicians are in an excellent position to address the medical, psychologic, and social concomitants of alcoholism and alcohol abuse. The Council on Scientific Affairs recommends that physicians become more active in the prevention, diagnosis, and treatment of alcohol-related problems in women, including the diseases that may be associated with chronic alcohol abuse and the effect of alcohol on the developing fetus. Specific American Medical Association policy and recommendations for physician practice are included.

Alcoholism↗
PubMed1995

Protein-rejecting ability of surface-bound dextran in end-on and side-on configurations: comparison to PEG.

There is much interest in attaching polyethylene glycol (PEG) and other hydrophilic, neutral polymers to surfaces to reduce the extent of protein and cell adsorption. Interestingly, these same surface-bound polymers are effective in masking surface charge and reducing electrokinetic effects such as particle electrophoretic mobility, streaming potential, and electroosmosis. It is apparent that similar molecular properties are responsible for both protein and cell rejection and reduction of electrokinetic effects. In this work we compared the fibrinogen-rejecting ability and the effect on electrophoretic mobility of three polymer coatings bound to polystyrene. The three polymers were side-bound dextran, end-bound dextran, and end-bound PEG. The results of these measurements were used to elucidate the importance of polymer packing density and polymer layer thickness on protein adsorption and reduction of electrokinetic effects. Protein adsorption appears not to be sensitive to polymer layer thickness or the presence of dilute polymer tails in a surface coating, while electrokinetic effects are. Protein adsorption is, however, very sensitive to the availability of exposed surface. Finally, the unique effectiveness of PEG is apparent in this research as in previous studies.

Adsorption↗
PubMed1986

Retropubic cystourethropexy: a review of two operative procedures with long-term follow-up.

The purpose of this report is to present a personal experience, with an up to 16-year follow-up, in the management of stress urinary incontinence using a retropubic cystourethropexy. An attempt is made to prove that, in addition to the standard Kelly anterior colporrhaphy, a transvaginal retropubic cystourethropexy helps to improve long-term results. Also, the results of transvaginal retropubic cystourethropexy (modified Pereyra procedure) and abdominal retropubic cystourethropexy (modified Marshall-Marchetti-Krantz procedure) are reviewed. Two hundred fifty-two patients received a modified Pereyra procedure and 490 patients underwent a modified Marshall-Marchetti-Krantz procedure in a 17-year period. The final corrected results of both of these procedures indicate that the percentage of patients clinically cured are almost identical (93%). Thus, for the treatment of genuine stress urinary incontinence, either the modified Pereyra procedure plus anterior colporrhaphy or the Marshall-Marchetti-Krantz procedure can be used with almost identical results. The route of the procedure performed, either abdominally or vaginally, is often determined by associated findings.

Adult↗
PubMed1983

Hysterectomy in the United States.

Hysterectomy is the most frequently performed major operation in the United States--and one of the most controversial. Although there are large regional differences in hysterectomy rates, the nationwide rate declined between 1975 and 1980. Leiomyomas, dysfunctional uterine bleeding, and pelvic relaxation are among the most frequent indications for hysterectomy. One fourth to one half of all women who undergo hysterectomy develop some morbidity, with fever and hemorrhage the most common types. Late sequelae may include the residual ovary syndrome, depression, and an increased risk of cardiovascular disease. The mortality rate appears to be about one death per 1000 operations. Neither prevention of cancer nor contraceptive sterilization appears to justify elective hysterectomy in asymptomatic women. Hysterectomy will continue to be an important component of women's health care. Ongoing peer review activities, improvements in surgical technique, and continued research should help ensure that each hysterectomy performed is both appropriate and safe.

Adolescent↗