[A toy in their bundle. From image to object].
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Autistic Disorder↗
Biomedical subjects
S Martin
Publications and source records attributed to S Martin.
[Multi-level traumatic lesions of the thoracic and lumbar spine. Value of the Cotrel-Dubousset instrumentation].
Trauma of the spine involving several thoracic and lumbar vertebrae is rare (4 case in 250 spine operated in our unit from 1985 to 1990) and require difficult therapeutic decisions. The patients has one or more unstable fractures which could require 4 screw-plates that would be mechanically unsatisfactory, or an unstable fracture combined with other stable lesions requiring a mixed orthopaedic and surgical treatment that would lead to long term decubitus with a corset. The Cotrel-Dubousset system makes it possible to approach each lesion separately with segmentary instrumentation. Using different combinations of the implants we were able to obtain a construction which was both technically and mechanically satisfactory and allowed recovery of the sagittal spinal curvatures without external contention. A single operation treating all the different lesions was sufficient in 3 Frankel E patients, allowing them to return to their former activities in 3 to 6 months. The material was removed at about 20 months allowing good spinal mobility.
Adolescent↗
Prevalence of high serum and red cell ferritin levels in HIV-infected patients.
We report a high prevalence of elevated serum and red cell ferritin (SF and RCF) levels in 168 patients with HIV infection. SF levels increase with clinical worsening of infection and with decreasing CD4+ lymphocyte counts (ANOVA, p < 0.001) while RCF is significantly higher in asymptomatic AIDS patients (ANOVA, p < 0.001) and in those treated with zidovudine (AZT) (ANOVA, p < 0.001). It is suggested that, although inflammatory processes may explain high SF levels, if we also take in account RCF levels a possible association between iron overload and HIV infection might exist, and this may be worsened by AZT treatment. The significance of these high ferritin levels and their effects on immune system suppression and susceptibility to infectious and neoplastic complications in these patients merits further investigation.
Analysis of Variance↗
International perspectives. Facing the future.
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Adult↗
Executive summary.
The Canadian health system is at a crossroads. Significant health services restructuring is occurring across the country. This restructuring process provides a unique opportunity for Public Health and others to reorient the system away from illness to a focus on health--the health of individuals and communities. The purpose of this paper is to motivate and equip Public Health workers to take leadership in the restructuring, to outline key responses and strategies for Public Health associations, to raise public awareness about restructuring, and to challenge decision makers to integrate the Public Health perspective into the restructured health system. This Issue Paper describes the unique contributions Public Health has to offer health services restructuring, outlines the Public Health response to specific restructuring issues, and identifies some successful strategies for influencing change. Two key messages are explored in the paper: 1. Restructuring will be successful if it is based on an investment in health. The health of the public can be maintained and improved through changes to the institutional sector and support for health promotion, disease prevention and health protection services. 2. Public Health must be a full partner in the restructuring of health services. The Public Health perspective includes a broad understanding of the issues that are relevant to the health of individuals and communities. The skills and knowledge base offered through Public Health provide balance and equity in decision making, by ensuring full and representative involvement of community workers and the public. The uniqueness of Public Health is manifested in three distinct ways: its approach within an organized system of practice; its historical contribution; and its purposeful combination of perspectives, skills and knowledge. In partnership with communities, other health professionals and other health-determining sectors, Public Health works to protect, maintain and improve the health of Canadians. While other sectors undertake some of the functions outlined below, what makes Public Health unique is that these contributions are offered collectively through an organized system of practitioners to create a synergistic effect. Eight contributions of Public Health are identified in this paper. Specifically Public Health: Focuses on individuals and communities in a societal and global context. Builds capacity in individuals and communities to improve health. Facilitates community mobilization through community participation. Embraces promotion, prevention, protection. Influences the orientation of the health system toward health outcomes. Provides disease surveillance and control. Builds partnerships among sectors at the local level. Advocates for the health of the public. In addition to describing these contributions, the Issue Paper addresses the major trends in health services restructuring by providing an overview of the issues and outlining the Public Health response. While there is no one single model of restructuring occurring in the provinces and territories, many common themes exist. This paper highlights four categories of restructuring issues: I. Making a Difference in Health II. Skills and Knowledge Base III. Allocation of Financial Resources IV. Governance and Management.(ABSTRACT TRUNCATED AT 400 WORDS)
Canada↗
Collaborative care for obstetric patients at low and high risk: an evolving model.
OBJECTIVE: In this article we describe a program that evolved from collaborative care given to a low-risk population into collaborative care that included patients at high risk. STUDY DESIGN: The study population comprised women attending a prenatal program in an urban, underserved neighborhood. Clinic records were reviewed for number of patient enrollments and total patient visits, as well as providers utilized. Episodic audit over a 3-year period of 180 of 869 patients initiating prenatal care was done. Data from vital statistics for 1992 and 1993 were evaluated for adequacy of prenatal care and yearly births for the census tract served. Analysis was descriptive. RESULTS: Almost all of the patient population served was found to be at psychosocial high risk. Approximately 10% had significant obstetric or medical complications. Infections, especially sexually transmitted diseases, were common. Fewer than 1% of the patients were referred to another provider for treatment. The program demonstrated an increase in patient volume, improved retention of patients for complete prenatal care and delivery, a reduction in patients receiving no or inadequate care, and a reduction in yearly births. CONCLUSION: The collaborative practice model may be extended to high-risk populations.
Adolescent↗
Pemphigus vulgaris on an old surgical scar: Koebner's phenomenon?
Pemphigus is an autoimmune bullous skin disorder. Several cases have been reported to originate in traumatized areas or on a scar, suggesting Koebner's phenomenon. Pemphigus can either remain localized or subsequently extend. This paper reports on a 60-year-old man in whom pemphigus vulgaris began on a 40-year-old surgical scar. The pemphigus initially remained localized to the scar and subsequently extended after two months. The time to onset of this bullous disease on the scar was especially long, compared to that which has been previously reported in the literature. A few cases have been reported where pemphigus developed a few months to a few years after surgery. A time to onset exceeding 3 years is extremely rare.
Autoimmune Diseases↗