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PubMedDate not supplied

The measured effect of taping on combined foot and ankle motion before and after exercise.

The Inman ankle machine was modified to determine plantarflexion, dorsiflexion, inversion neutral, eversion neutral, plantarflexion inversion, and plantarflexion eversion before taping, immediately after taping, and with tape after a 2.5- to 3-hour football practice. The previously uninjured feet and ankles of 16 college-age football players were used. All were tape by the same method. A single-tailed paired-sample t-test was done to determine the minimun amount of restriction that could be expected for each motion after the exercise period. Ninety percent confidence intervals between untaped versus taped preexercise, untaped versus taped postexercise for all motions were determined. Inversion neutral, plantarflexion inversion, and eversion neutral had an average residual restriction after exercise of 50%, or greater than the initial restriction prior to exercise. plantarflexion, dorsiflexion, and plantarflexion eversion loosened significantly greater than 50%.

Ankle↗
PubMed2003

Improved recursive algorithm for light scattering by a multilayered sphere.

An improved recurrence algorithm to calculate the scattering field of a multilayered sphere is developed. The internal and external electromagnetic fields are expressed as a superposition of inward and outward waves. The alternative yet equivalent expansions of fields are proposed by use of the first kind of Bessel function and the first kind of Hankel function instead of the first and the second kinds of Bessel function. The final recursive expressions are similar in form to those of Mie theory for a homogeneous sphere and are proved to be more concise and convenient than earlier forms. The new algorithm avoids the numerical difficulties, which give rise to significant errors encountered in practice by previous methods, especially for large, highly absorbing thin shells. Various calculations and tests show that this algorithm is efficient, numerically stable, and accurate for a large range of size parameters andrefractive indices.

Journal Article↗
PubMed2001

Unusual freshwater near-drowning syndrome in a hospitalized postlobectomy patient.

Near-drowning syndrome depends on the duration of submersion, the amount of fluid aspirated, and the severity of hypoxia. We report a case in which a patient developed ARDS shortly after undergoing a left upper lobectomy and a chest wall resection for a lung carcinoma. On further investigation, the ARDS was caused by near-drowning in a basin of freshwater: the patient's face was submerged by the patient's companion as part of a cultural tradition of trying to clean his lung. We believe that this case presents the etiology of freshwater near-drowning syndrome due to an ethnogenic practice not previously reported.

Aged↗
PubMed1999

Factors affecting the number of teats in pigs.

The factors that affect the number of teats in pigs are of interest for both biological and practical reasons. Previous work indicates that there is a genetic component, principally from the dam. The proportion of males in a litter appears to be related to the anogenital distance of the gilts in the litter, possibly as a result of the intrauterine position effect. The present study investigated whether litter size, litter sex ratio, anogenital distance, crown-rump length, distance from base of skull to base of tail, and the number of teats on the dam and boar affected the number of teats on gilts. Stepwise multiple regression on litter mean values (adjusted r2 = 0.178) indicated that two factors were significant: the number of teats on the dam (standard coefficient 0.311) and the proportion of males in the litter (standard coefficient -0.282). A greater number of teats on the dam and a lower proportion of males in the litter resulted in a greater number of teats on the gilt. When the analysis was run using individual gilts as the independent units (adjusted r2 = 0.073), the number of teats on the dam (standard coefficient 0.207), the proportion of males in the litter (standard coefficient -0.135), and the weaning weight of the gilt (standard coefficient 0.083) were all significant predictors of the number of teats. This evidence suggests that teat number in female pigs is related to the proportion of males in the litter.

Androgens↗
PubMed2003

Sexual behavior patterns and HIV risks in bisexual men compared to exclusively heterosexual and homosexual men.

OBJECTIVE: To compare patterns of sexual behavior among bisexual, heterosexual and homosexual men. MATERIAL AND METHODS: A household probability survey was carried out in Mexico City in 1992-1993 using the national health surveys sampling frame. Information from 8,068 men was obtained; however, the main analysis of this paper refers only to men sexually active in the previous 5 years. RESULTS: Bisexuals reported more prevalent anal intercourse with women (16% vs. 3%, p = 0.01), and more sexual encounters with female sex workers than exclusive heterosexuals (10% vs. 4%; p = 0.04). Bisexuals used condoms more often with sex workers than did heterosexuals (p = 0.01). Most of the bisexuals (79%) did not engage in anal receptive or insertive intercourse with males in the previous year, practicing instead oral insertive sex or only masturbation; 35% of homosexuals did not report practicing anal sex. Bisexuals who engaged in anal intercourse had less anal receptive behavior than homosexuals (13% vs. 60%, p < 0.01); of these, due to condom use, only 7% of bisexuals and 18% of homosexuals had unprotected anal receptive sex in the last intercourse with a male. CONCLUSIONS: Bisexuals practice less risky sexual behavior with males than exclusive homosexuals. This finding may imply that bisexual men in Mexico are an ineffective epidemiological bridge for HIV transmission. The English version of this paper is available too at:http://www.insp.mx/salud/index.html.

Adolescent↗
PubMed2001

Identification, cellular and subcellular distribution of 21 and 72 kDa proteins (tuberalins?) secreted by specific cells of the pars tuberalis.

The cell types of the pars tuberalis (PT) are the follicular cells, the pars distalis cells and the so-called PT-specific cells. The latter are distinct endocrine cells displaying melatonin receptors. Although the nature of the secretory product(s) of the PT-specific cells has not yet been clarified, the function of these cells has started to be unfolded. For practical reasons, previous authors have designated the, as yet, unidentified PT hormone(s) as tuberalin(s). PT-specific cells synthesise the common alpha subunit of the pars distalis glycoprotein hormones, and it has been suggested that tuberalin would correspond to the beta chain of a specific glycoprotein secreted by these cells. The aims of the present investigation were to identify the compounds secreted by the specific cells of bovine PT, and to establish their cellular and subcellular distribution. For this purpose, proteins secreted into the culture medium of PT explants were separated by electrophoresis and used to raise antibodies. Two of these proteins, with an apparent molecular mass of 21 and 72, generated antibodies (Ab-21 and Ab-72) that differentially immunoreacted with PT-specific cells. These two antibodies were used for immunoblotting of conditioned medium and of PT explants, and for light and electron microscopy immunocytochemistry. In immunoblots, Ab-21 reacted with compounds of 21, 22, 47 and 52 kDa, whereas Ab-72 revealed a compound of 72 kDa only. Ab-72 immunoreactive material corresponded to a protein, here designated as tuberalin I, secreted by a small population of PT-specific cells (type 2 cells), and stored in 140 nm secretory granules. Immunoreactive tuberalin I was missing from bovine pars distalis and from rat PT. The predominant population of PT-specific cells (type 3 cells) secreted and stored, within 280 nm secretory granules, an Ab-21 immunoreactive protein, here designated as tuberalin II. All cells of rat PT immunoreacted with Ab-21. In the cells of bovine and rat PT, immunoreactive tuberalin II was mostly confined to a paranuclear spot; this spot also bound wheat germ agglutinin and reacted with an antibody against the alpha chain of glycoprotein pars distalis hormones. It is suggested that tuberalin II would correspond to the beta chain of a specific glycoprotein secreted by type 3 PT-specific cells. In bovine PT, the cells displaying immunoreactive tuberalins I and II did not react with any of the antibodies against pars distalis hormones.

Animals↗
PubMed1998

Teaching medical ethics to orthopaedic surgery residents.

Orthopaedic surgery residents will be faced with a variety of ethical issues when they enter clinical practice. A previous survey suggested that they lack knowledge about how to approach several types of medical ethics dilemmas. We developed a medical ethics curriculum for orthopaedic surgery residents and presented it over a one-year period to the residents in one training program. The effect of the educational intervention on the residents' knowledge of medical ethics and their ability to handle hypothetical situations was measured by comparing their responses to a questionnaire, administered before and after the intervention, with those of residents in a training program in which the intervention was not provided. The twenty-five residents at the site of the educational intervention had a mean improvement of 0.10 in the overall score, from a mean score of 0.71 on the baseline survey to a mean score of 0.81 on the follow-up survey. This improvement was significantly greater than the mean improvement of 0.02 for the thirty residents at the control site, who had a mean score of 0.72 on the baseline survey and a mean score of 0.74 on the follow-up survey (p = 0.002). Six residents who participated in the medical ethics curriculum rated it as very useful; seventeen, as somewhat useful; one, as slightly useful; and one, as not at all useful. A medical ethics curriculum can increase orthopaedic residents' knowledge of medical ethics. Whether this curriculum also will lead to behavioral changes requires additional evaluation.

California↗
PubMed2006

Spinal manipulation in physical therapist professional degree education: A model for teaching and integration into clinical practice.

Spinal manipulation for low back complaints is an intervention supported by randomized clinical trials and its use recommended by clinical practice guidelines. Physical therapists in this country and internationally have used thrust spinal manipulation at much lower-than-expected rates, despite evidence supporting its efficacy for the treatment of acute low back pain (LBP). The purpose of this clinical commentary is to describe a physical therapist professional degree curriculum in thrust spinal manipulation and outline a method of monitoring ongoing student performance during the clinical education experience. Increased emphasis on evidence-based decision making and on the psychomotor skills of thrust spinal manipulation was introduced into a physical therapist professional degree curriculum. As part of ongoing student performance monitoring, physical therapy students on their first full-time (8-week) clinical education experience, collected practice pattern and outcome data on individuals with low back complaints. Eight of 18 first-year students were in outpatient musculoskeletal clinical settings and managed 61 individuals with low back complaints. Patients were seen for an average (+/-SD) of 6.2 +/- 4.0 visits. Upon initial visit the student therapists employed spinal manipulation at a rate of 36.2% and spinal mobilization at 58.6%. At the final visit, utilization of manipulation and mobilization decreased (13% and 37.8%, respectively), while the utilization of exercise interventions increased, with 75% of patients receiving some form of lumbar stabilization training. Physical therapist students used thrust spinal manipulation at rates that are more consistent with clinical practice guidelines and substantially higher then previously reported by practicing physical therapists. Education within an evidence-based framework is thought to contribute to practice behaviors and outcomes that are more consistent with best practice guidelines.

Clinical Competence↗
PubMed1983

Follow-up of attempted suicide in Christchurch.

Ninety-eight subjects who had attempted suicide and 102 general practice controls previously interviewed were followed-up at 18-24 months. The former continued to show greater social and psychiatric disability than controls and more than one-third made repeat suicide attempts. Nevertheless, as a group, the attempted suicides showed significant improvement in mental state, and familial and interpersonal relationships, whereas controls reported little change in most measures. Persistence of suicidal ideation and repeat attempts were correlated with the diagnosis of psychosis and personality disorder and predictions about the likelihood of further suicidal activity were accurate. Although 92% of patients were referred for further treatment, 38% of these were judged to have dropped out prematurely. Completion of treatment and being in ongoing treatment were positively correlated with patients' self reports of improvement. The findings are compared to experience elsewhere and to a previous Christchurch follow-up study.

Follow-Up Studies↗
PubMedDate not supplied

Implementation of international guidelines on hypertension: the Indian experience.

The WHO-ISH Guidelines on Hypertension have been introduced in India but their implementation has not been systematically studied. The process of implementation of international guidelines involves several steps: (a) recognition of the guidelines by the national opinion makers (b) acceptance, adaptation and adoption of the guidelines by the main change agents (c) initiation of guidelines in healthcare practice by the trend setters (d) advocacy of the guidelines by the influential change agents (e) dissemination of guidelines across various levels of health care and (f) diffusion into routine health care practice. The previous WHO-ISH Guidelines had inadequate impact due to limitations at each of these levels. The implementation of the new guidelines in developing countries, such as India, requires a concerted campaign of social marketing involving partnerships of key stakeholders.

Guidelines as Topic↗
PubMed1994

The effect of recombinant human erythropoietin therapy on red cell expansion during autologous blood donation.

As the result of the institution of coordinated programs involving regional blood centers, hospital blood banks, information services, and physicians, preoperative autologous blood donation, a previously underutilized practice, has become a standard of care in a number of elective surgical procedures. In addition, the administration of recombinant human erythropoietin has been shown to facilitate the collection of autologous blood from patients scheduled for elective orthopaedic surgery. An analysis of the findings in a study of 263 orthopaedic surgical patients in which the relationship between autologous blood ordering, collection and storage, and subsequent blood transfusion was studied indicates that both blood ordering and blood procurement practices are significant factors with regard to allogeneic blood exposure.

Blood Donors↗
PubMed1998

Primary care groups. The cultivated commissioner.

The government's proposals for primary care groups assume GPs will be able to direct commissioning organisations more successfully than their fundholder predecessors. Under the previous system, practices incapable of managing a budget and purchasing health services were, in effect, ruled out of fundholding. Guidelines are needed specifying the skills and expertise required for membership of PCGs.

Budgets↗
PubMed1999

Military preventive medicine support: the Balkan experience.

Preventive medicine (PVNTMED) support to deployed forces is as varied as the circumstances for force deployment. The Bosnia-Herzegovina deployment of the 1st Armored Division as part of the Dayton Peace Accords Implementation Forces proved to be no exception to this premise. PVNTMED units, both in the field and at the U.S. Army-Europe support base, were challenged to provide mission support under significant mobility restrictions and in arenas of public health practice not previously thought to be of tactical significance, specifically environmental pollution. New to this operation was the deployment of a Theater Army Medical Laboratory with a mission to assist deployed PVNTMED units with the capability to rapidly diagnose infectious disease agents and provide an expanded array of environmental monitoring support. Vector-borne diseases were also a threat to health, and an innovative base camp sanitation assessment and reporting system was created to alert leaders to the risk of disease transmission to soldiers.

Bosnia and Herzegovina↗
PubMedDate not supplied

Is hospitalism new? An analysis of medicare data from Washington State in 1994.

CONTEXT: Managed care, increased disease severity, and more complex treatment options may be reasons for the recent enthusiasm for "hospitalists"--physicians who specialize in the care of inpatients. It is not clear, however, whether hospitalism is a new model for caring for inpatients or merely a new description for previously existing practice patterns. PRACTICE PATTERNS EXAMINED: The proportion of physician visits occurring in the hospital before the introduction of the term hospitalists. Five specialties were examined: family/general practice, general internal medicine, cardiology, gastroenterology, and pulmonology. DATA SOURCE: 1994 Medicare Part B claims data for beneficiaries 65 years of age and older who received all of their care in Washington State. RESULTS: For the average family/general practitioner, 10% of all Medicare visits occurred in the hospital. Corresponding figures for the other specialties were 20% for general internists, 36% for cardiologists, 38% for gastroenterologists, and 45% for pulmonologists. A substantial number of physicians devoted most of their Medicare effort to inpatient care (i.e., hospital visits > 50% of total visits). If this definition were used as a proxy for hospitalism, 4% of family/general practitioners, 10% of general internists, 20% of gastroenterologists, 29% of cardiologists, and 37% of pulmonologists would have been considered hospitalists in Washington State during 1994. On the other hand, 35% of family/general practitioners, 18% of general internists, 7% of both gastroenterologists and pulmonologists, and 4% of cardiologists did not bill Medicare for any inpatient visits and could reasonably be categorized as "officists." CONCLUSION: Physicians vary considerably in the proportion of their workload that occurs in the hospital or outpatient setting. Even before the term was coined, a considerable number of physicians were de facto "hospitalists."

Aged↗