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Biomedical subjects

L Newman

Publications and source records attributed to L Newman.

At least 55 records · Page 3Linked to original sources

Pretreatment swallowing function in patients with head and neck cancer.

BACKGROUND: Few objective data characterizing the pretreatment swallow function of patients with head and neck cancer are available. METHODS: Pretreatment swallowing function in 352 patients with various lesions was evaluated with videofluoroscopy and compared with control subjects. RESULTS: Patients had significantly longer oral and pharyngeal transit times, greater amounts of oral and pharyngeal residue, shorter cricopharyngeal opening durations, and lower swallow efficiencies. Swallow function worsened significantly with increased tumor stage, and patients with oral or pharyngeal lesions had worse swallow function than patients with laryngeal lesions. Frequency of complaint of swallow difficulty before treatment was 59%. Patients with lower stage tumors had fewer complaints of swallowing, as did patients with oral cavity lesions. CONCLUSIONS: Despite demonstrating significant differences from control subjects, patients had highly functional swallows before treatment. The tendency for patients not to perceive a swallowing problem is consistent with the highly functional nature of their pretreatment swallow.

Adult↗

Efficacy of continuing advocacy in involuntary treatment.

OBJECTIVE: The effectiveness of an experimental model of personal advocacy for involuntarily hospitalized psychiatric patients was examined. In the model, a personal advocate represented the needs and best interests of patients throughout the period of involuntary hospital treatment. METHODS: The sample consisted of 105 involuntarily hospitalized psychiatric inpatients in Canberra, Australia. Fifty-three consecutive patients received personal advocacy, which started soon after they entered the hospital and lasted through the commitment process to the time of discharge from involuntary care. The outcome of this group was compared with that of 52 consecutive patients in a control group who received routine rights advocacy from hospital entry through the commitment hearing only. RESULTS: The experimental and control groups were similar in demographic characteristics, diagnosis, and severity of illness. At the start of hospital care, satisfaction with care was similar in both groups; however, it improved significantly in the experimental group while it declined in the control group. Aftercare attendance was significantly better in the experimental group. The experimental subjects' risk of involuntary rehospitalization was less than half the risk of control subjects, and community tenure was significantly increased. Clinical staff reported that the experimental advocacy facilitated management of patients. CONCLUSIONS: Compared with routine rights advocacy, the experimental advocacy based on patients' needs and best interests, which was maintained throughout the patients' involuntary hospitalization, significantly improved patients' and staff members' experience of involuntary treatment. Better compliance with aftercare among patients receiving personal advocacy led to a statistically and economically significant reduction in rehospitalization.

Adult↗

A clinical evaluation of the long-term outcome of patients treated for bilateral fracture of the mandibular condyles.

The object of the study was to present our experience of the treatment of bilateral condylar fractures between 1979 and 1995 and give the long-term outcome. The subjects were 61 patients, of whom 33 attended for review. There were 41 men and 20 women, age range 12-80 years (although nearly all the patients were between 17 and 32 years old). Thirty-one patients (51%) had bilateral fractures of the mandibular condyles alone, the remainder also having another mandibular fracture, usually at the parasymphysis. Over half the patients had been injured in falls. Only 8/122 fractures (7%) were intracapsular, 59 were of the condylar neck (48%), and the remaining 55 (45%) were subcondylar. Nearly half of the fractures were undisplaced. Thirty-nine patients (21%) were treated with wire intermaxillary fixation for a mean of 37 days, 13 (21%) were managed conservatively, and 9 (15%) with 10 fractured condyles were managed by open reduction and internal fixation (ORIF). The most common complaint after treatment was persistent limitation in mouth opening, which was significantly less in the ORIF group mean (SD) 44 mm (2 mm) than in the intermaxillary fixation group 28 mm (2 mm), P < 0.01. It is concluded that if either of the condyles is displaced ORIF is the most satisfactory method of treatment.

Accidental Falls↗