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At least 667 records · Page 37Linked to original sources
PubMed1993

Sonography of the shoulder in patients with tears of the rotator cuff: accuracy and value for selecting surgical options.

OBJECTIVE: The management of patients with signs and symptoms referable to the rotator cuff depends on the presence of cuff injury and the size of the tear. Treatment options include conservative nonsurgical management for patients with an intact or partially torn cuff, arthroscopic decompression of the coracoacromial space for those not responding to nonsurgical management, and a range of surgical techniques to repair full-thickness tears. This study was designed to determine whether sonographic evaluation with classification of the extent of cuff injury is accurate for purposes of treatment planning. SUBJECTS AND METHODS: Preoperative sonography of the rotator cuff was performed on 225 patients, and findings were classified into intact, partial tear, small full-thickness tear, large full-thickness tear, and massive tear groups. Surgical correlation with the predicted sonographic classification was provided by arthroscopic inspection or open surgery. RESULTS: The sonographic findings were surgically confirmed for 206 (92%) of the 225 patients. More extensive cuff injury was encountered during surgery than had been predicted sonographically in 11 patients (5%); less extensive injury than predicted was found during surgery in eight patients (4%). CONCLUSION: Our results show a high correlation between the sonographic classification of rotator cuff injury and the surgical findings. The selection of appropriate treatment programs can be reliably based on the sonographic classification.

Adult↗
PubMedDate not supplied

Cardiovascular conditioning in individuals with diabetic retinopathy.

The benefit of exercise for individuals with diabetes mellitus and high-risk complications of retinopathy has been questioned. Thirty-nine individuals with diabetes and visual impairment completed a 12-wk rehabilitation program that included cardiovascular conditioning. Pre- and postprogram assessment of exercise training in 30 subjects included a graded stress test with a bicycle ergometer. There were improvements in exercise tolerance as measured by the work load achieved (from 248 +/- 27 to 303 +/- 31 kilopond meter [kpm], P less than .05). There was a trend toward improvement in METS achieved (from 3.3 +/- 0.2 to 3.8 +/- 0.3, P = .06). There was no correlation of improvement in exercise tolerance with improvements in glycemic control, lipoprotein balance, and change in body weight. Individuals with diabetic retinopathy may be given the option of entering cardiovascular training programs with appropriate modifications to fit specific needs.

Adult↗
PubMed1996

Acquisition of high-risk behavior by African-American, Latino, and Caucasian middle-school students.

The purpose of this study was to measure the stages of acquisition of selected high-risk health behaviors in 768 randomly selected 7th- and 8th-graders in a Florida school district. Specific high-risk health behaviors included use of alcohol, tobacco, and drugs, fighting and weapon carrying, and suicide ideation. Analysis indicated few behaviors that were significantly different when African-American and Latino students were compared with Caucasian students. The most weapon carrying was reported by Latinos. Fewer Caucasian students than their minority peers used inhalants. Knowledge of stages of acquisition among small diverse samples may assist school personnel to intervene during the inculcation process with appropriate responsive programs.

Adolescent↗
PubMed1988

Computerized posturography, a development of the measuring system.

A computerized posturography system is composed of a custom made strain gauge force platform and it utilizes commercially available amplifiers. The body sway response signals are digitized for the calculation of the following parameters by a computer: average velocity of body sway, mean value for fore-aft and lateral body sway, and maximal amplitude of body sway. Calf muscles were exposed to vibration to disturb the postural control. The program contains appropriate filters to remove transient and quantification noise.

Humans↗
PubMed1989

The classification of low back pain.

The majority of patients with low back pain offer no objective clinical findings on which to make a diagnosis on the basis of physical examination. Therefore a diagnostic categorization of complaint based on duration and location is proposed. The justification for this organization is the assumption that the majority of back pain is secondary to deterioration within the disc. Thus the appropriate treatment program is focused at methods designed to find the pain source, and look to the health of the disc. It is on this basis that various treatment approaches for the nine classifications are proposed.

Back Pain↗
PubMed1997

Postoperative management following carpal tunnel release surgery: principles of rehabilitation.

The patient with an unsatisfactory result following carpal tunnel release is fortunately the exception rather than the rule. The vast majority of appropriately selected and treated patients will recover uneventfully without the need for extensive therapy. Although uncommon, the dissatisfied patient presents an extremely difficult management problem. Inasmuch as there are a number of factors that may potentially contribute to a poor result, failure to recognize and treat excessive edema and stiffness in the early postoperative period are responsible for a significant percentage of poor results. Patients with a poor result present with three basic signs or symptoms, which may occur in combination or alone. These signs and symptoms include excessive edema, stiffness, and hypersensitivity. If left untreated, these are the patients who will go on to develop persistent median nerve symptoms, stiffness, and possibly even reflex sympathetic dystrophy or sympathetically mediated pain. If identified early and placed in an appropriate therapy program, most of these patients will receive the proper treatment and will ultimately be satisfied with their result. The author presents here a protocol for the postoperative management of the patient who has undergone carpal tunnel release surgery, with emphasis on the recognition and treatment of those patients at risk for a poor result.

Journal Article↗
PubMedDate not supplied

Electro-audio-visual method for diagnosis and treatment.

This method can be applied to the non-drug treatment of diseases. It provides an exact evaluation of the healing effect by keeping the acupuncture point from overload. This method is realized by a bistable/monostable square wave oscillator. The electrical pulses for the treatment of the acupuncture point are delivered from the noninverted oscillator output. Their electrical parameters: frequency, pulse duration, rise time and coefficient of filling depend on the constantly changeable biophysical parameters of the acupuncture point, such as complex skin impedance (z), and total infrared skin thermal emission (te). Pulses from the inverted oscillator output are provided to the acoustic and visual channels. In the acoustic channel, the pulses are controlled only by amplitude. The visual output channel pulses apply to the amplitude- frequency circuit, where an amplitude-frequency analysis is performed. The output pulses of three electrical filters (low, middle and high frequency), control three sources of light, respectively red, green, and blue. Three colors blend on the white screen, as the color picture is modulated by the two biophysical parameters of the acupuncture point. These parameters are in a constant dynamics. The audio channel output information is delivered to the audio-information gate of the patient, reaching the Central Nervous System (CNS). The video channel output information is applied to the video-information gate and then to the patient's CNS, preparing it for appropriate therapeutical programs.

Acupuncture Points↗
PubMed2003

Circadian rhythm of surfactant protein A, B and C mRNA in rats.

BACKGROUND: All organisms have developed an internal timing system capable of reacting to and anticipating environmental stimuli with a program of appropriately timed metabolic, physiologic and behavioral events. The alveolar epithelial type II cell of the mammalian lung synthesizes, stores, and secretes a lipoprotein pulmonary surfactant, which functions to stabilize alveoli at low lung volumes. METHODS: The authors investigated the diurnal variation of surfactant protein A, B and C mRNA accumulation. The diunal variation on gene expression of surfactant protein A, B and C was analysed using filter hybridization at 9 a.m., 4 p.m. and 11 p.m. Lung SP-A protein content was determined by double sandwich ELISA assay using a polyclonal antiserum raised in rabbits against purified rat SP-A. RESULTS: 1. The accumulation of SP-A mRNA at 4 p.m. was significantly decreased by 23.5% compared to the value at 9 a.m. (p < 0.05). 2. The accumulation of SP-B mRNA at 4 p.m. and 11 p.m. was decreased by 15.1% and 5.7%, respectively, compared to the value at 9 a.m. (p = 0.07, p = 0.69). 3. The accumulation of SP-C mRNA at 4 p.m. and 11 p.m. was decreased by 6.8% and 7.7%, respectively, compared to the value at 9 a.m. (p = 0.38, p = 0.57). 4. Total lung SP-A content at 4 p.m. and 11 p.m. was increased by 5.3% and 15.9%, respectively, compared to the value at 9 a.m. (p = 0.64, p = 0.47). CONCLUSION: These findings represent the diurnal variation of surfactant proteins mRNA expression in vivo. These results indicated that the diurnal variation of significant gene expression is observed in hydrophilic surfactant protein rather than in hydrophobic surfactant proteins.

Animals↗
PubMed2000

Health maintenance behaviors of individuals with severe and persistent mental illness in a state prison.

The purpose of this grounded theory study is to define health and health-seeking behaviors of incarcerated individuals experiencing severe and persistent mental illness (SPMI) in a state prison. The strategies used to prevent loss of control and maintain health in the prison environment were examined. Nineteen incarcerated individuals with SPMI were interviewed in a state prison. Constant comparative analysis of the data revealed that while establishing a "fit" with the core variable "loss of control" and its identified properties, differences were found in the enactment of health maintenance behaviors related to properties in the prison environment. Several of these behaviors are inconsistent with behaviors expected of individuals in a community day treatment center and reflect a need for bridging programs to facilitate entry into the "free" world. Correctional nurses and mental health providers in this system can advocate for incarcerated individuals with SPMI by developing programs that provide cost-effective intermediate care and collaborating with community health systems for continuity of care. The findings related to alcohol and drug abuse among incarcerated individuals with SPMI challenges mental health providers in both correctional facilities and community-based programs to generate appropriate and effective substance abuse treatment programs for these individuals.

Activities of Daily Living↗
PubMed1999

Hepatitis A in Latin America: a changing epidemiologic pattern.

In a multicenter study, hepatitis A virus (HAV) seroprevalence was surveyed in six countries in Latin America in which in 12,000 subjects were stratified for age. The highest rates of seroprevalence were recorded in the Dominican Republic (89.0%) and Mexico (81.0%), with lower rates in Brazil (64.7%), Chile (58.1%), Venezuela (55.7%), and Argentina (55.0%). The seroprevalence of HAV in children between 1 and 5 years of age was less than 50%, except in the Dominican Republic. In the 5-10-year-old age group, seroprevalence rates have also decreased compared with previous reports. This suggests that the epidemiology is shifting from high to intermediate endemicity, with the population susceptible to HAV infection shifting from children to adolescents and adults. Furthermore, data from Brazil, Argentina, and Mexico show that HAV seroprevalence is significantly lower in people living in medium and high socioeconomic conditions. This study suggests the need for appropriate vaccination programs to be implemented targeting children, adolescents, and adults, particularly in higher socioeconomic groups.

Adolescent↗
PubMedDate not supplied

An adolescent age group approach to examining youth risk behaviors.

PURPOSE: To investigate relationships among youth risk behaviors and demographic factors using an adolescent age group approach. DESIGN: Cross-sectional data from a randomly selected population. Risk behaviors were compared within specific demographic factors and by adolescent age groups. SETTING: Racially diverse, inner-city neighborhoods in two midwestern cities. SUBJECTS: Teenagers (n = 1350) and parents (n = 1350) of the teenagers. MEASURES: Truancy; arrested/picked up by police; weapon carrying; fighting; sexual intercourse; tobacco, alcohol, and other drug use; demographic factors; and family structure. RESULTS: Youth mean age was 15.4 (+/- 1.7) years and 52% were female; racial/ethnic characteristics were 47% White, 22% Black, 19% Hispanic, and 10% Native American. Parents' mean age was 42.2 (+/- 8.4) years and 81% were female. chi 2 analyses indicated numerous significant (p < .05) youth risk behavior differences within the demographic factors and that many of the differences varied by adolescent age group. For example, risk behavior differences within racial/ethnic groups were most profound in the middle and older age groups, whereas risk behavior differences within parent income, education levels, and family structure were most apparent in the younger age groups. Of the demographic factors, family structure was most frequently associated with the risk behaviors. CONCLUSIONS: The results generally suggest that the relationships among risk behaviors and demographic factors vary within the adolescent age groups included in this study. The results will be useful for developing age-appropriate prevention programs for youth who fit the profile for these risk behaviors. The study protocol also includes specific sampling methods that may be useful for future studies that intend to collect data from difficult-to-reach populations.

Adolescent↗
PubMed1982

The sensory history of developmentally delayed children with and without tactile defensiveness.

This study investigated whether sensory history questionnaires differentiated between developmentally delayed children with and without tactile defensiveness and, in addition, which individual items were most discriminative. Interviews were conducted with 20 mothers of developmentally delayed children regarding their children's past and present behavioral responses to tactile and other sensory stimuli. The group of mothers with tactually defensive children reported a significantly greater number of positive responses to items previously determined to be indicative of tactile defensiveness than did the mothers of children without tactile defensiveness. An individual item analysis identified 11 items as discriminating most clearly between a group of children with tactile defensiveness and a group without tactile defensiveness. Some preliminary behavioral trends and implications for the use of sensory history questionnaires in parent counseling and in planning appropriate treatment programs are presented.

Child Behavior↗
PubMed1991

Occupational therapy intervention for an adult with depression and suicidal tendencies.

A hospitalized patient with depression and suicidal tendencies was referred for occupational therapy. The patient's evaluations while hospitalized indicated a lack of social skills and unrealistic expectations concerning abilities and aspirations. A work evaluation showed high scores in artistic and people-related occupations. Treatment focused on improvement of self-image, social interaction abilities, and stress management skills that would assist the patient in obtaining and keeping a job. Increased knowledge of vocational options and selection of an appropriate training program led to a job placement that the patient has enjoyed and maintained for the past 2 years.

Activities of Daily Living↗
PubMed1998

A review of balance instruments for older adults.

OBJECTIVE: The purpose of this article is to review balance instruments developed within the past 10 years that can be used in the clinic or home environment. The use of such instruments may assist in identifying older adults who are at risk for falling, a major problem that can result in impaired function and loss of independence. METHOD: Six instruments were reviewed: the Berg Balance Scale (Berg), the Clinical Test of Sensory Interaction and Balance (CTSIB), the Functional Reach Test, the Tinetti Balance Test of the Performance-Oriented Assessment of Mobility Problems (Tinetti), the Timed "Up and Go" Test (TU&GT), and the Physical Performance Test (PPT). Considered were what aspects of balance are assessed, time needed to administer the instrument, tools or equipment needed, evidence of reliability and validity, advantages and disadvantages, and the target population. RESULTS: The Berg, Tinetti, and PPT measure a variety of aspects of balance, whereas the Functional Reach, TU&GT, and CTSIB measure more narrow aspects of balance. All six instruments have been used with older adults and do not require much equipment. The instruments differ in their reliability and validity. CONCLUSION: Familiarity with balance instruments can be helpful in selecting the one most appropriate for clinical setting and clients in order to institute appropriate prevention programs, such as environmental modifications and lifestyle adaptations.

Accidental Falls↗
PubMed1997

Reflex Sympathetic Dystrophy in the Upper Extremity.

The diagnosis and treatment of pain are among the most challenging problems facing orthopaedic surgeons, and reflex sympathetic dystrophy is probably the most frustrating and difficult pain syndrome to manage. Pain, swelling, and autonomic dysfunction are cardinal signs of the condition. Although the pathogenesis is still unclear, many theories have been proposed. Because reflex sympathetic dystrophy is sympathetically mediated, diagnosis can be confirmed on the basis of response of the pain to sympathetic blockade. Treatment may include an appropriate exercise program, a-adrenergic blocking agents, mood-elevating drugs, calcium channel blockers, intravenous regional blocks, and stellate ganglion blocks. Recent additions to therapy include electroacupuncture, transcutaneous electrical nerve stimulation, and biofeedback. Prognosis is, at best, guarded with this perplexing condition, but the best response is obtained when diagnosis is made early (within the first 2 or 3 weeks after injury) and treatment is initiated during the first stage of the disease.

Journal Article↗
PubMed1992

Group A streptococcal infection in an aboriginal community.

OBJECTIVE: To determine whether group A streptococcal infection and poststreptococcal sequelae are still a significant health issue for Aboriginal communities. DESIGN: A cross-sectional survey of streptococcal carriage, infection and antibody levels. SETTING: A north Queensland Aboriginal community. PARTICIPANTS: One hundred and twenty preschool and school-aged children (2 to 12 years of age) living in the Lockhart River Community on Cape York Peninsula. RESULTS: Pyoderma was present in 43% of the children and in 76% of these culture of skin lesions grew group A streptococci. Group A streptococci also grew from 13% of throat swabs, making a total of 36% of children culture positive. Anti-streptolysin O and anti-DNAase B levels were remarkably high and increased with age. CONCLUSIONS: The evidence presented confirms a high level of group A streptococcal carriage and infection in children of the Lockhart River Community. Further investigation of this problem is warranted in other Aboriginal communities with a view to instituting appropriate control programs.

Antistreptolysin↗
PubMed2006

Sideswipe injuries to the elbow in Western Australia.

OBJECTIVE: To examine the conditions leading to sideswipe injury of the upper limb in motor vehicle accidents and to highlight the severity of these injuries. DESIGN AND SETTING: Prospective study of upper-limb sideswipe injuries in patients admitted to Royal Perth Hospital, Western Australia, between August 2003 and January 2005. PARTICIPANTS: Eleven patients sustaining sideswipe injuries to the upper limb. MAIN OUTCOME MEASURES: Accident pattern, type of injury, surgical management, complications, and functional and employment implications. RESULTS: Ten patients required open reduction and internal fixation for open fractures of the humerus, ulna and radius, and nine underwent additional surgical procedures including nerve, artery and tendon repair, and free flaps and split-skin grafting. The injury severity scores ranged from 9 to 25. The severity of injuries led to extensive functional deficits in eight patients, affecting employment prospects in seven. CONCLUSION: Appropriate educational programs, legislation and improvements in traffic conditions, especially in rural areas, as well as changes in current car design, could contribute to preventing these devastating and complex injuries.

Accidents, Traffic↗