Biomedical subjects
Publications and source records attributed to T Curtis.
Despite the valid purpose of the Health Care Quality Improvement Act of 1986--to restrict the practice of incompetent physicians through effective peer review--the author believes the Act will increase the number of unfair disciplinary hearings, while eliminating a physician's remedies for such wrongful conduct.
Successful treatment of an infant with chylous ascites secondary to "congenital leaky lymphatics" is described, followed by a literature review of cases of pediatric chylous ascites. The infant was placed on home total parenteral nutrition for 10 weeks, during which time the chylous ascites resolved and did not recur with the introduction of a normal diet. Forty cases of pediatric chylous ascites have been reported since 1960, with an age range from birth to 18 years. The presenting signs and symptoms were secondary to abdominal distension in over 80% of cases. The chylous ascites was secondary to trauma, which included child abuse (19%), obstruction (27%), or lymphatic abnormalities (54%). Most studies described were not helpful in making the diagnosis, except for lymphangiography and exploratory laparotomy. Many patients were treated with a high-protein, low-fat diet, with or without medium-chain triglycerides, with variable success. Total parenteral nutrition (TPN) was the primary therapeutic modality in five patients, and in all but one of the cases there was complete resolution of the chylous ascites over 3 to 10 weeks with no significant side effects. Total parenteral nutrition, including home TPN, is a safe and effective therapeutic modality for some cases of chylous ascites.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Because of the lack of a source listing comprehensive literature for individual specialties, a thorough search was made of the available monographs and journals of value to both the respiratory therapist and the chest physical therapist. The items reviewed included three published lists of recommended books and journals, reference tools listing books currently in print, National Library of Medicine computerized literature searches of the data bases CATLINE and SERLINE, sources of forthcoming books, and an abstracting service that lists books currently being published. This list would be of value to the interested individual or library wishing to build a literature collection on respiratory and chest physical therapy.
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This is the first article in a two-part series dealing with the effects and manifestations in the oral cavity of radiation therapy of head and neck tumors. In this section, oral mucous membranes, taste buds, edema and trismus, diet, salivary glands, bone, periodontium, teeth, and composition of oral flora are discussed. Dental management of the dentulous patient is then approached; criteria for preradiation extraction are delineated. In the next issue of Head & Neck Surgery, the final article in this series will discuss preradiation and postradiation extractions and will elaborate on the dental management (fluoride treatments, follow-up, and restorative care) of the dentulous patient. Dental management of the edentulous patient will also be presented.
This is the concluding portion of a two-part series dealing with the effects and manifestations in the oral cavity of radiation therapy of head and neck tumors. Preradiation and postradiation extractions in dentulous patients, as well as dental maintenance of such patients (including fluoride treatments follow-up, and restorative care), are discussed. Guidelines for the dental management of edentulous patients are also presented at length (this section covers risk of bone necrosis, soft liners, timing of denture placement, dentures and preexisting bone necrosis, soft-tissue necrosis and dentures, morbidity, and prosthodontic procedures). The article concludes with a brief discussion of osteoradionecrosis and soft-tissue necrosis.
The extent of the effect of the ICU environment on the psychological functioning on the ICU patient is explored. There is a need to understand all potential causes of disruption in psychological functioning in ICU patients. Co-ordination of all care carried out by multi-disciplinary team can help re-orientate patients and re-establish normal routines.