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W J Crump

Publications and source records attributed to W J Crump.

At least 19 recordsLinked to original sources
PubMed1996

An application of telemedicine technology for otorhinolaryngology diagnosis.

Applications of interactive video communications for providing remote telemedicine consultations are under study. Most of these applications use "off the shelf" medical peripheral devices that are not specifically designed for telemedicine examinations. This study reports a field trial of the telemedicine instrument pack (TIP), a small self-contained unit under development by the National Aeronautics and Space Administration for use in spaceflight. Patients with otorhinolaryngology problems were selected from a primary care practice and examined with the TIP by a technician under the direction of a remote consultant. The equipment proved adequate for examination of the posterior nose, hypopharynx, and larynx. Examinations of the ear and oropharynx with the TIP were not optimal, suggesting a need for further modifications of this prototype unit.

Adult↗
PubMed1995

A telemedicine primer. An introduction to the technology and an overview of the literature.

The examination of patients by telemedicine is currently experiencing a resurgence of interest, perhaps spurred by the increase in activity in managed care and major technologic advances. The history and recent publications show rapid change in the areas of interactive video and store-and-forward equipment, available communications media, and medical peripherals. Several existing demonstration projects serve as practical examples of the potential of telemedicine systems. Important research and clinical care issues and opportunities for constituency building await participation by primary care physicians.

Humans↗
PubMed1995

The medical school without walls: who will be the faculty?

To involve community physicians as medical school faculty, a survey was completed to establish the needs of 64 community physicians participating in a third-year family medicine clerkship. We received 48 responses that indicated issues of practice regulation, training office staff, and local continuing medical education were highest priority needs. The 27 respondents in rural areas placed more emphasis on issues of referral/consultation, recruiting of physician associates, and faculty development. As a result of the survey, The University of Texas Medical Branch at Galveston has implemented a comprehensive strategy to address the stated needs, with special emphasis on a rural health initiative. This strategy includes a special program for faculty to provide rural practice coverage technical assistance for practice management, a rural communications network, faculty development, and provider recruitment. The goal of this strategy is to continue developing the "medical school without walls."

Clinical Clerkship↗
PubMed1992

Hyperemesis, hyperthyroidism, or both?

Nausea and vomiting are common during pregnancy and, when severe enough to require intervention, may develop into the syndrome known as hyperemesis gravidarum. When the diagnosis of hyperemesis is considered, a careful search for secondary causes is necessary. The list of secondary causes includes hyperthyroidism, a relatively uncommon condition during pregnancy. Because many of the signs and symptoms of hyperthyroidism are common, and thyroid function tests are more difficult to interpret during normal pregnancy, making the diagnosis of hyperemesis gravidarum is a challenge. The decision to treat or to await spontaneous resolution depends on the severity of the illness and the likelihood of the presence of true Graves' disease. The case summarized here demonstrates these issues, and includes treatment options for hyperemesis-associated hyperthyroidism.

Adult↗
PubMed1988

Reflux esophagitis. Diagnosis, pathophysiology, and management.

Reflux esophagitis is a common disorder in which esophageal inflammation is caused by the reflux of gastric contents. The diagnostic approach includes documentation that reflux is present, that the patient's symptoms are caused by the reflux, and that esophageal mucosal damage has occurred. Therapy is guided by the current multifactorial pathophysiology model, which includes efficacy of the antireflux mechanism, volume of gastric fluid, potency of refluxed material, esophageal clearance, and tissue resistance factors. Although recurrences are common, treatment with life style changes supplemented with combinations of liquid antacids, H2 blockers, sucralfate, bethanechol, and metoclopramide is usually effective.

Diagnosis, Differential↗
PubMed1988

Postdate pregnancy in a network of community hospitals: management and outcome.

The outcome of 116 postdate pregnancies managed by 14 family physicians in small community hospitals is compared with the outcome of term gestations in the same setting. The postdate pregnancies in this relatively unselected population showed an increase in incidence of macrosomia and fetal heart rate abnormalities similar to those reported from referral centers. The increases in incidence of meconium staining and low Apgar scores reported previously were not found. The postdate patients had more frequent induction, augmentation, and amniotomy, as well as a significant increase in primary cesarean section, decreased use of epidural anesthesia, and fewer assisted deliveries. These data suggest that the community physicians were attaining a favorable outcome in the postdate pregnancy by an active approach to induction and management of labor combined with abdominal delivery of the macrosomic infant showing evidence of fetal distress.

Apgar Score↗
PubMed1987

Bishop score and labor duration: a new look.

The Bishop score determined on admission was correlated with labor duration in this group of 770 patients delivered of infants in community hospitals. The total score correlated well with duration of latent-phase labor in primiparas and multiparas, but not with active phase in either parity group. We recommended the Bishop score as a useful predictor of latent-phase duration to facilitate decisions in management of labor.

Female↗
PubMed1987

The Alabama Perinatal Outcome Project: some methodological issues.

As practice networks are built to facilitate the study of unselected patient populations, special advantages and problems of these systems are emerging. The Alabama Perinatal Outcome Project is an example of such a network which has been functioning for over three years. Key methodological questions of sample selection, completeness and reliability of data, and research definitions have been addressed in the initial phase of the project. The evolution of an approach to these methodological issues and some preliminary data are presented for consideration by those designing practice networks.

Adult↗
PubMed1986

The postdate pregnancy. When to wait, when to induce labor.

The postdate pregnancy is a common and difficult problem for the physician, who must decide between risking premature delivery by inducing labor and waiting so long that post-maturity complications may be present. A normal contraction stress test with a postdate pregnancy is reassuring, and artificial labor promoted by an inducible cervix or an abnormal contraction stress test should attain the best result for both mother and baby.

Female↗