Biomedical subjects
Publications and source records attributed to J W Bachman.
Management of premenstrual syndrome (PMS) includes psychosocial as well as medical therapy. Nonmedical treatment involves patient education, physician and family support, stress reduction, and dietary changes. If these methods do not alleviate symptoms, drug therapy may be necessary. Because the exact cause of PMS is unknown, treatment is largely empirical. More research is imperative to improve therapy for patients with PMS.
Carpal tunnel syndrome, a common and well-described clinical disorder, usually has been considered a chronic disorder with a fixed set of symptoms and typically affecting middle-aged women. Because of the many variations in its initial clinical manifestations, however, its diagnosis at times can be difficult. In this review, we describe nonclassic manifestations of carpal tunnel syndrome and discuss the differential diagnosis, the importance of electrodiagnostic studies, and treatment modalities.
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In recent years, several studies have produced contradictory data regarding the impact of emergency medical technicians trained in defibrillation on hospital admission and dismissal survival rates in rural areas. Fourteen communities (service area populations, 4,000 to 36,000) in rural south-eastern Minnesota participated in a two-year crossover study to further define the factors necessary for success. Automatic external defibrillators were used to defibrillate and record patient rhythms in the treatment group and to only record in the control group. Although six of 36 patients (17%) in ventricular fibrillation who experienced a witnessed arrest survived in communities using automatic external defibrillators, compared with one of 27 (4%) in the control group, five of the six survivors were from a single large community with a 911 system, full-time emergency medical technicians, police first-responders, and a well-equipped emergency facility. Our data suggest that certain prerequisites, especially CPR prior to ambulance arrival and collapse to defibrillation times of less than ten minutes, are clearly essential to produce significant benefits from emergency medical technicians trained in defibrillation in rural communities.
This article deals with improving the clinical examination of breasts, benign breast disorders, and breast cancer. The early detection of cancer is emphasized.
Hypertension-aid in physician treatment (HTN-APT) is an expert computer system that assists the physician in determining the best form of treatment for the individual hypertensive patient. The HTN-APT system aids the physician in managing the hypertensive patient by keeping a record of the patient's progress, allowing easy access to drug information, and generating recommendations and critiques about treatment options. The treatment recommendations are ranked by an analogue indication-contraindication scheme whereby each drug both singly and in combination is evaluated for patient suitability on the basis of more than 30 possible patient factors. When the computer-generated recommendations were evaluated by a group of family physicians, the HTN-APT system was found to make beneficial treatment recommendations without major judgmental error.
Training in advanced cardiac life support and defibrillation and community programs in cardiopulmonary resuscitation (CPR) had limited success in resuscitating patients with cardiac arrest in the Arrowhead region of Minnesota. Factors associated with survival included advanced cardiac life support within 16 minutes, ambulance traveling less than 1 mile (less than 1.6 km), use of paramedics, CPR within four minutes, and a call for help within two minutes. The use of technicians trained in defibrillation was associated with a statistically significant increase in hospital admissions, but not in survivors. The study failed to confirm the findings of previous studies of resuscitation in some rural areas. It was consistent, however, with reports that associated poor survival in rural areas with poor response times. No victims of unwitnessed arrests survived. Of the hospital deaths, 80% were due to neurologic causes, and overall survival was low.
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