Positive tuberculin reactions among children of United States military personnel in Germany.
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Biomedical subjects
Publications and source records attributed to J J James.
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Viral hepatitis rates among U.S. Army soldiers in Europe have been found to be two to three times higher than corresponding rates for soldiers stationed in the U.S. Sera from 89 per cent of a representative Army unit with 865 members and a known hepatitis problem were tested for HBsAg, anti-HBs, anti-HBc, and anti-HA. The prevalence of HB markers was 20 per cent, and hepatitis A antibody was present in 25 per cent. A six-month follow-up, conducted on 260 individuals initially negative for all four tests, revealed that 11 of these were now HB seropositive, whereas none had seroconverted to anti-HA positive. The HB virus was the principal agent responsible for hepatitis in the unit surveyed.
The Los Angeles County (California) physician strike of January 1976 resulted in a partial withdrawal of physician services. Among recorded impacts were a $17.5 million loss in hospital revenues and an $8.5 million pay loss for hospital employees. Several surveys revealed no evidence of a significant impact on the general public in finding medical care. Analysis of emergency room visits and paramedical ambulance calls showed no significant increases during the strike. County mortality statistics for the strike were not affected. Eighty-eight fatalities among 2,171 patients transferred during the strike were analyzed; a Case Attributable Mortality Probability generated on 21 cases selected for final review by a five-physician multispecialist panel indicated that 29 per cent of the Attributable Mortality could be ascribed to the strike itself and 71 per cent to ongoing "patient dumping" from private sector to County hospitals. Even if sample attributable mortality rates were generalized to overall county deaths, the resultant figures are below the estimated range of 55 to 153 deaths that did not occur because of the number of elective operations not performed secondary to the strike.
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A case of hypothyroidism as a complication of lithium maintenance therapy is reported. Clinicians should be aware of this condition and patients receiving long-term lithium maintenance therapy should have their thyroid gland function assessed periodically.
The primary purpose of this study conducted at two army hospitals was to evaluate the feasibility of using the physical therapist as the primary 'screener' for patients presenting with a complaint of low back pain. The study was organized into two phases. A base line phase consisted of a data collection period under standard operating conditions. Patient waiting times, treatment times, and total care times were measured for patients presenting to various clinics with a complaint of low back pain. The same data were collected during a screeing phase in which all patients presenting with a complaint of low back pain were referred directly to the physical therapist for primary evaluation. An assessment of physical therapist and patient satisfaction and acceptance was made. The quality of care rendered in the screeing clinic was assessed through patient interviews, physician interviews, and record reviews. This concept and the quality of care rendered were found to be acceptable to the patient, the physician, and the physical therapist.