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Biomedical subjects

R H Curry

Publications and source records attributed to R H Curry.

At least 37 records · Page 2Linked to original sources
PubMed1986

Health policy implications of health promotion and disease prevention for allied health.

Regardless of the direction health policies in this country may take, allied health professionals seem uniquely positioned to meet the health promotion needs of a variety of clients, such as patients, families, other providers, employees, and members of communities. If allied health professionals choose to respond to health promotion as an area of clinical expertise, they will have to accept the challenge presented by the numerous complex issues associated with implementing a new discipline. However, the successful application of energy and resources to resolving these problems would allow allied health professionals to provide significant interventions in meeting national health goals. This article reviews the history of health promotion in the United States, discusses current practices in health promotion, and suggests some future trends.

Allied Health Personnel↗
PubMed1984

The role of the primary care PA.

At a time when roles of various allied health care providers frequently overlap, it is important to clearly delineate who does what, so there is less provider and patient confusion. In the case of the PA, it is also advantageous to determine periodically whether there are new functions to the role previously not described in the literature. The roles of primary care PAs were validated by using a mail survey developed through a review of PA roles frequently mentioned in the literature. The survey was sent to 47 training programs and 222 Emory University PA graduates working in primary care and non-primary care practices. Mean and median scores for each role per respondent category are reported and compared with mean differences between groups about role perceptions. Strong agreement occurred between and among respondent groups for PA roles dealing with documentation of health status, analysis of data, formulation and conduction of treatment and/or management plan, management of life-threatening emergencies, and patient education. From these data, competencies, performance criteria, and objectives can be generated for each validated role to assist in creating a competency-based curriculum for PAs.

Georgia↗
PubMed1983

Underserved rural primary care preceptorship project.

In response to the maldistribution of primary care manpower in Georgia, physician assistant (PA) students at Emory were required to participate in a rural and/or underserved primary care preceptorship experience during their terminal months in training. The recruitment and deployment project included selection of students more likely to practice in underserved areas upon graduation, outreach activities to targeted primary care Georgia physicians, training of PA students in underserved and/or rural primary care practice settings in Georgia, as well as employment assistance activities. Of Emory's 274 PA graduates working asd PAs, 70 percent practice in primary care settings (family or general practice, general internal medicine, and pediatrics); 35 percent of these individuals are located in rural and 27 percent in federally designated health manpower shortage areas (HMSAs). Employment of PAs in areas of need can be effected, then, through positive community experiences while in training, financial incentives, and supportive employment services. It is postulated that positive regulatory activities concerning PAs could enhance placement in HMSAs.

Georgia↗
PubMed1981

Postradiation ureteral obstruction: a reappraisal.

Thirty-four patients who received radiation therapy for carcinoma of the cervix developed hydronephrosis. Twelve of 34 (35%) had no evidence of pelvic malignancy, and the obstruction was caused by periureteral fibrosis. The incidence of obstructive uropathy due to periureteral fibrosis not associated with recurrent tumor increased when the obstructing lesion was unilateral, the clinical staging of the cervical carcinoma prior to therapy was Stage IB or Stage II rather than Stage III or Stage IV, and the obstructing lesion appeared 2 or more years after the completion of radiation therapy. The appearance of hydronephrosis in association with ipsilateral leg edema, and sciatic pain these patients strongly suggest a recurrent tumor. The diagnosis of periureteral fibrosis should be considered in all patients who develop obstruction of the urinary tract after radiation therapy for carcinoma of the cervix. Laparotomy is indicated if all other methods of investigation fail to confirm the presence of a malignant lesion.

Edema↗
PubMed1979

Morphologic features of prognostic significance in uterine smooth muscle tumors: a review of eighty-four cases.

Independent microscopic review of the most cellular and pleomorphic areas of 84 smooth muscle tumors of the uterus by two pathologists yielded 23 leiomyosarcomas, 43 cellular leiomyomas, 16 bizarre leiomyomas, and two intravenous leiomyomas. Greater than 5 mitotic figures/10 high-power fields (hpf) correlated with malignant clinical behavior, but this occurred in only 75% of the leiomyosarcomas. Five cases with fewer than 5 mitoses/10 hpf pursued a malignant course. The mean age of the patients with malignant tumors (52.5 years) was similar to the mean age of those with bizarre leiomyomas (48.0 years) but those patients with cellular leiomyomas were significantly younger (42.0 years; p less than 0.01). Gross evidence of extrauterine extension was diagnostic of malignancy as was vascular invasion by anaplastic tumor. Fifteen of the 19 patients with leiomyosarcoma died of disease at an average of 28 months postoperatively. Inadequate sampling and interobserver variation are discussed.

Adult↗
PubMed1979

Proposed replicative role of the NS polypeptide of vesicular stomatitis virus: structural analysis of an electrophoretic variant.

The structural lesion in the temperature-sensitive mutant E1 of the New Jersey serotype of vesicular stomatitis virus has been assigned to the NS protein. Although the packaged wild-type and mutant NS proteins were similarly phosphorylated, the mutant NS protein migrated faster than the wild-type NS protein in polyacrylamide slab gels electrophoresed in the presence of sodium dodecyl sulfate. The resolution appears to be the result of conformational rather than size differences since the two proteins comigrated in polyacrylamide gels which contained 4 M urea in addition to sodium dodecyl sulfate. Peptide maps, obtained by limited proteolysis of 32P-labeled wild-type and mutant NS proteins with Staphylococcus aureus V8 protease and papain, revealed striking differences which suggested that the mutant alteration could involve an aspartic or glutamic acid residue. Since NS proteins obtained from naturally occurring revertants of E1 were indistinguishable from the wild-type protein in all of these analyses, the structural alteration in the mutant NS protein correlates with the functional lesion. Because E1 is defective in the RNA replication pathway at the restrictive temperature, a replicative role is proposed for the NS protein.

Electrophoresis, Polyacrylamide Gel↗
PubMed1977

Role of aspiration breast biopsy.

Review of the results of 100 consecutive aspiration breast biopsies disclosed that this technique failed to identify 11 of the 33 breast cancers in the series; however, it identified 3 breast cancers that were not recognized by clinical examination. In one patient who had a fibroadenoma, suspicious cells were seen in the material sent for cytologic examination. It is concluded that a negative aspiration biopsy does not contraindicate tissue biopsy when the clinical findings suggest cancer. Aspiration biopsy can uncover clinically unsuspected cancers. When the lesion appears to be malignant on a clinical basis, aspiration biopsy can obviate formal biopsy. In this way time is saved for all those involved and the fashioning of the mastectomy flaps is facilitated.

Biopsy, Needle↗
PubMed1975

Cystic adventitial disease of the popliteal artery.

The first case of cystic adventitial disease of the popliteal artery recorded in Canada is reported and discussed in conjunction with a review of the world literature of 45 reported cases. This rare cause of arterial insufficiency occurs usually in young men and should be considered in the differential diagnosis of claudication. Angiographic findings are diagnostic and surgery is usually corrective. The theories of etiology and pathogenesis are discussed and the gross and microscopic pathology is demonstrated.

Adolescent↗
PubMedDate not supplied

The content of internal medicine residency training and its relevance to the practice of medicine: implications for primary care curricula.

Using survey items from Kern et al. (1985), 192 former residents rated their preparation in, and the importance of, three content areas of their residency training ("basic skill and knowledge areas," "allied medical disciplines," and "areas related to the practice of medicine"). Mean ratings replicated those reported by Kern et al. (r = 0.70 to 0.97, p less than 0.004). Using additional data about current practice patterns, ratings by general internists were compared with ratings by subspecialists. Both groups identified basic skill and knowledge areas as most important and felt that many areas related to practice management had been underemphasized. Most allied medical disciplines, however, were more important to generalists. Exposure to non-internal medicine areas seems important for residents considering subspecialization. However, all residents may benefit from increased emphasis on basic clinical skills and practice management. Program directors may want to address these issues, given the recent decline in applications to internal medicine programs.

Curriculum↗
PubMedDate not supplied

The use of electronic medical records: communication patterns in outpatient encounters.

OBJECTIVE: To assess physician-patient communication patterns associated with use of an electronic medical record (EMR) system in an outpatient setting and provide an empirical foundation for larger studies. DESIGN: An exploratory, observational study involving analysis of videotaped physician-patient encounters, questionnaires, and medical-record reviews. SETTING: General internal medicine practice at an academic medical center. PARTICIPANTS: Three physicians who used an EMR system (EMR physicians) and three who used solely a paper record (control physicians). A total of 204 patient visits were included in the analysis (mean, 34 for each physician). MAIN OUTCOME MEASURES: Content analysis of whether physicians accomplished communication tasks during encounters; qualitative analysis of how EMR physicians used the EMR and how control physicians used the paper chart. RESULTS: Compared with the control physicians, EMR physicians adopted a more active role in clarifying information, encouraging questions, and ensuring completeness at the end of a visit. A trend suggested that EMR physicians might be less active than control physicians in three somewhat more patient-centered areas (outlining the patient's agenda, exploring psychosocial/ emotional issues, discussing how health problems affect a patient's life). Physicians in both groups tended to direct their attention to the patient record during the initial portion of the encounter. The relatively fixed position of the computer limited the extent to which EMR physicians could physically orient themselves toward the patient. Although there was no statistically significant difference between the EMR and control physicians in terms of mean time across all visits, a difference did emerge for initial visits: Initial visits with EMR physicians took an average of 37.5 percent longer than those with control physicians. SUMMARY: An EMR system may enhance the ability of physicians to complete information-intensive tasks but can make it more difficult to focus attention on other aspects of patient communication. Further study involving a controlled, pre-/post-intervention design is justified.

Academic Medical Centers↗