Clinical evaluation of zomepirac in the treatment of acute orthopedic pain.
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Adult↗
Biomedical subjects
T G Mayer
Publications and source records attributed to T G Mayer.
Rhinoplasty record and retrieval system.
The rhinoplastic surgeon must vary technique to fit the anatomic variations of nose and face. Our system to record and correlate preoperative findings with surgical methods could help accomplish this. It includes three forms to record pertinent findings of the history and physical examination, operative findings and techniques, and postoperative evaluations. These forms are numerically coded, and data can be transferred to a punch card system or computer cards for quick and easy retrieval and statistical analysis. The system tries to simplify the many anatomic and surgical variations, yet remain complete. We hope that this system, which has been used in other disciplines, can be applied to rhinoplasty. In this way, more scientific statistical data can be used to support surgical approaches.
Adult↗
The facial nerve coursing inferior to the oval window.
Congenital anomalies of the facial nerve are of great concern to the otologic surgeon. Nine cases from the literature are reviewed and three of our own are reported in which the facial nerve coursed inferior to the oval window. All cases were explored for congenital conductive hearing impairments and were accompanied by severe stapes abnormalities.
Adolescent↗
Hairline aesthetics and styling in hair replacement surgery.
Punch grafting and flap surgery are proven methods of correcting baldness. Using either method, the location and shape of a new hairline on the frontal and temporal scalp is one of the most important aspects of hair replacement surgery. If the hairline is not aesthetic, the results can be unacceptable or even devastating for the patient and surgeon alike. The principles of planning the frontal and temporal hairline are presented using punch grafts as well as flaps. Postoperative styling of the "new" hair will vary depending upon the method used to transfer the hair (flaps or grafts), the local factors involved (texture, direction, density, tufting, etc.), as well as the patient's preference. The various advantages and disadvantages of styling possibilities with each method are presented. These factors should be discussed with the patient preoperatively.
Adult↗
Scalp flaps--reconstruction of the unfavorable result in hair replacement surgery.
Complications in hair replacement surgery are inevitable. However, many of the most common problems can be avoided. All surgeons should learn by careful analysis of complications. The use of scalp flaps in the reconstruction of unfavorable results is described.
Adult↗
The North American Spine Society focuses on multidisciplinary spine care.
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Humans↗
Recurrent disabling work-related spinal disorders after prior injury claims in a chronic low back pain population.
BACKGROUND CONTEXT: Multiple compensation injury claims are an understudied phenomenon in the chronic back pain and occupational injury literature. Assumptions about poor treatment outcomes for patients presenting with prior injury can lead to denial of treatment, even though these assumptions have not been empirically addressed. Functional restoration has been demonstrated to be an effective rehabilitation treatment for disabling, work-related chronic back pain, although its' relative utility with recurrent injury (RI) patients has not been previously evaluated. PURPOSE: To assess demographic, psychosocial and work history/adjustment differences between the two groups, and to investigate whether patients with recurrent work-related spinal injury claims benefit from functional restoration treatment at a level equivalent to patients with nonrecurrent injuries. STUDY DESIGN/SETTING: A prospective cohort design assessing characteristics and outcomes of patients with recurrent work-related spinal disorders, compared with a group of patients without prior work-related spine injury claims, all treated with the same interdisciplinary rehabilitation protocol. PATIENT SAMPLE: A cohort of consecutively treated functional restoration rehabilitation patients (n=395) divided into two groups based on a history of prior work-related injury. The RI (n=172) group had at least one prior work-related injury claim (with or without lost time), whereas the nonrecurrent injury (NRI; n=223) group did not. OUTCOME MEASURES: The RI and NRI groups were assessed for prospectively collected demographic, psychosocial and work history/adjustment data. A structured clinical interview addressing socioeconomic outcomes and assessing work return, health utilization, recurrent injury and case closure was administered 1 year after discharge from the treatment program. METHODS: Consecutive patients from a regional referral center for tertiary rehabilitation treatment of chronic work-related musculoskeletal injuries were evaluated with a comprehensive biopsychosocial assessment protocol at pretreatment and posttreatment. Moreover, at 1 year after completing the program, a structural telephone interview was conducted that assessed health and socioeconomic outcomes. RESULTS: For the 1-year socioeconomic outcomes (such as posttreatment injury), the RI patients responded to rehabilitation at a level equivalent to the NRI patients. Demographic analyses revealed that RI patients, relative to NRI patients, were older, more represented by the dominant culture, had more education, had a shorter length of disability, had less severe types of injuries, had a greater rate of non-work-related health conditions, received higher disability payments, and had slightly greater job demand. The RI group also had a greater rate of pre-injury Axis I psychiatric disorders, particularly substance abuse/dependence disorders, than the NRI group. In addition, the RI group had greater job stability than the NRI group. CONCLUSIONS: The results of this study indicate that, although patients with recurrent injuries evidence differences in demographic, psychosocial and work history/adjustment differences when compared with patients with nonrecurrent injuries, their 1-year outcomes after tertiary, medically directed rehabilitation are identical. Both groups demonstrate very low rates of further work-related injuries through the first posttreatment year. Patients with recurrent injuries appear to develop skills in dealing with the workers' compensation system with a familiarity not seen in NRI patients. Of course, these results will need to be replicated in other settings to determine whether they can be generalized to the entire workers' compensation population.
Adult↗
Objective assessment of spine function following industrial injury. A prospective study with comparison group and one-year follow-up.
Objective functional capacity measurement techniques were used to guide a treatment program for a group of 66 chronic back pain patients. These patients were compared with a group of 38 chronic patients who were not administered the treatment program. Outcome data were collected by telephone survey at an average 1 year follow-up. In addition, functional capacity measures were collected for treatment group patients on admission and follow-up evaluations. Results demonstrated that the functional capacity measures collected for the treatment group improved in approximately 80% of the patients. These changes were also accompanied by positive changes in psychologic measures. In addition, at 1 year follow-up, the treatment group had approximately twice the rate of patients who returned to work, relative to the comparison group. Additional surgery rates were comparable for both groups (6% in the treatment and 7% in the comparison group), but the frequency of additional health-care professional visits was substantially higher in the comparison group. The findings suggest that quantitative functional capacity measures can give objective evidence of patient physical abilities and degree of effort and can significantly guide the clinician in administering an effective treatment program.
Adult↗
Quantification of lumbar function. Part 5: Reliability of range-of-motion measures in the sagittal plane and an in vivo torso rotation measurement technique.
Intra- and intertester reliability of a previously described technique for measurement of sagittal plane lumbar spine motion was assessed. Results demonstrated a high degree of reliability of this technique. Sagittal plane norms for men and women are also presented. In addition, a pilot study of a simple in vivo measurement method for lumbar torsion is described and tested on a group of control subjects and a group of chronic low-back pain patients.
Adult↗
Quantification of lumbar function. Part 6: The use of psychological measures in guiding physical functional restoration.
The present article reviews the use of psychologic measures in guiding a functional restoration treatment program with chronic low-back pain patients. The results of the first 134 consecutive patients completing this program are reviewed. These results demonstrate that various psychologic measures paralleled improvement in physical function. Of particular interest is the finding that various Minnesota Multiphasic Personality Inventory (MMPI) scales that were initially clinically elevated showed a significant decrease to nonelevated levels after treatment. The clinical implications of these findings are discussed, along with the important observation that one should avoid assuming that a single psychologic test can reliably be used as the sole predictor variable in clinical cases.
Achievement↗