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Electromyographic biofeedback use in the treatment of voluntary posterior dislocation of the shoulder: a case study.

Voluntary posterior dislocation of the shoulder has been difficult to treat successfully. Electromyographic biofeedback is a nonoperative treatment measure that has been successfully used for this condition in three previously reported cases. The purpose of this article is to present a case history in which electromyographic biofeedback was used successfully as part of a nonoperative treatment program for voluntary posterior dislocation of the shoulder.

Adolescent↗

The role of voluntary organizations in national family planning programs.

A meeting of an expert group was held on 7-12 August 1972 in Bangkok, Thailand, to discuss existing patterns of relationships between governments in Asian countries implementing national family planning programs and the private national family planning associations. The concept of a suitable working relationship and division of labor was explored. It was felt that a nationwide program can best be administered under government leadership but that voluntary organizations should be involved to the maximum extent possible. The need for communication and coordination at all levels of planning and operation was stressed.

Family Planning Services↗

Pathology and the pathologist in the cancer program.

Cancer as one of the most important human diseases does not present as formidable a problem as infectious disease did a century ago. The diversified cancer program, combining voluntary and governmental agencies in support of research, education and coordinated teamwork in the clinical care of the patient, presents a varied although unified approach to the problem that has never before been available for the study of any single human disease. Pathology, with its applied methods from the basic sciences, has a singular role in the scientific aspect of the cancer program. Representing a new specialty in medicine and embodying an inquiring approach to the study of human disease, pathology has a leading role to play. The pathologist, assuming the new role of "pathologist-physician" brings to the clinical care of the cancer patient the most precise methods of cancer diagnosis. The "pathologist-physician" should be a pivotal member of the "clinical team" in the immediate diagnosis, care and treatment of the cancer patient.

Humans↗

Posterior subluxation of the glenohumeral joint.

Twenty-four patients who had posterior subluxation of the glenohumeral joint were assigned to one of two groups on the basis of the severity of the symptoms. The sixteen patients in Group I, who had less severe symptoms, were treated with a physical therapy program that was based on exercises to strengthen muscles. The eleven patients in Group II (three of whom had no success with physical therapy when they were originally in Group I) had a posterior capsulorrhaphy, with or without a bone block. According to an over-all rating, Group I had a rate of success of 63 per cent, and Group II had a rate of success of 91 per cent. The patients who had more severe ligamentous laxity were not more likely to fail either of the treatment programs. Although voluntary subluxation may be a subtle but important indicator of underlying emotional difficulties, it appears that, in the patient who is emotionally stable, the ability to voluntarily subluxate the shoulder posteriorly is not associated with a negative prognosis for either non-surgical or surgical treatment. Patients who have moderately disabling posterior subluxation of the shoulder should be treated with an intensive program that is designed to strengthen muscles. Patients who have symptoms that are severely disabling or who have had no success with non-operative treatment should be treated with posterior capsulorrhaphy. When the posterior aspect of the glenoid is severely deficient and when the posterior portion of the capsule or the infraspinatus tendon is attenuated, a bone block should augment the reconstruction.

Adolescent↗

Psychological defenses and control of AIDS.

The well known psychological defenses of avoidance, repression, and denial against the knowledge that one has, or might have, a fatal disease used by a high percentage of individuals, must be considered in control programs for the human immunodeficiency virus (HIV). Current programs of education, voluntary testing, and counseling do not consider this defense mechanism and may therefore provide inadequate control. Compulsory HIV testing programs and development of an "HIV Parole" system may be needed if the current HIV epidemic worsens.

Acquired Immunodeficiency Syndrome↗

Description and evaluation of a canine volunteer blood donor program.

Human volunteer blood donor programs are commonplace, but the concept of nonhuman animal blood banking is relatively new. Few studies exist regarding efficacy, donor screening, and safety for volunteer companion animals. This retrospective study evaluated a nonprofit, community-based canine volunteer donor program using community blood drives. Of 98 potential donors, 14 were ineligible to donate, including 4 who tested seropositive for blood-borne pathogens. Of 84 donors, 45 were Dog Erythrocyte Antigen (DEA) 1.1 positive and 39 were DEA1.1 negative. Donations totaling 143 included 29 repeat donors (35%). No serious adverse events occurred. Minor adverse events included acute donor reaction (2.8%), hematoma (4.2%), rebleeding (2.1%), and skin irritation (0.7%). Adverse event rates were comparable to data for human blood donations. A substantial fraction of donors donated multiple times, suggesting that volunteer donors and their guardians perceived the donation process to be safe and effective. This article discusses the issue of donor consent and use of the term volunteer. This study indicates that nonprofit, community-based canine volunteer donor programs for animal blood banks can be successful while maintaining high safety standards and ethical treatment of volunteers.

Animals↗

Effects of two electrical stimulation frequencies in thigh muscle after knee surgery.

The purpose of this study was to compare the effects of two protocols of electrical stimulation combined with voluntary contractions on the recovery of thigh muscles after anterior cruciate ligament (ACL) surgery. Ten sportsmen with a mean age of 26 yrs were randomly assigned into two groups: a 80 Hz stimulated group (5 patients) and a 20 Hz stimulated group (5 patients). All patients received electrical stimulation of the quadriceps femoris, five days a week, for 12 weeks, and had a standard program of voluntary contractions. Muscle and fat volumes of the thigh were assessed using MRI before surgery and after 12 weeks of rehabilitation. Quadriceps and hamstring muscle strength were evaluated by isokinetic measurements. Twelve weeks after surgery, the quadriceps peak torque deficit in the operated limb with respect to the non operated limb at 180 degrees /s and 240 degrees /s was significantly (p < 0.05) less in the 20 Hz group than in the 80 Hz group. This difference was not confirmed when comparing the pre-surgery quadriceps peak torque of the operated limb with the post-surgery one. Subcutaneous fat volume was increased for the two groups at the post-surgery test. This increase was significantly (p < 0.05) greater for the 80 Hz group. Thigh muscle volume deficit was not significantly different between the two groups.

Adipose Tissue↗

Religion, medical ethics, and transplants.

This article describes the exclusion of public expressions of religion from the history of bioethics during recent decades. It offers a proposal to include the public church for the purpose of gaining donations of vital organs for transplantation. I also include a brief discussion of theological support and practical suggestions for such a program.

Black or African American↗

Sensitivity of test strategies used in the Voluntary Johne's Disease Herd Status Program for detection of Mycobacterium paratuberculosis infection in dairy cattle herds.

OBJECTIVE: To evaluate sensitivities at the herd level of test strategies used in the Voluntary Johne's Disease Herd Status Program (VJDHSP) and alternative test strategies for detecting dairy cattle herds infected with Mycobacterium paratuberculosis. DESIGN: Nonrandom cross-sectional study. SAMPLE POPULATION: 64 dairy herds from Pennsylvania, Minnesota, Colorado, Ohio, and Wisconsin. Fifty-six herds had at least 1 cow shedding M. paratuberculosis in feces; the other 8 herds were free from paratuberculosis. PROCEDURE: For all adult cows in each herd, serum samples were tested for antibodies to M. paratuberculosis with an ELISA, and fecal samples were submitted for bacterial culture for M. paratuberculosis. Sensitivities at the herd level (probability of detecting infected herd) of various testing strategies were then evaluated. RESULTS: Sensitivity at the herd level of the testing strategy used in level 1 of the VJDHSP (use of the ELISA to test samples from 30 cows followed by confirmatory bacterial culture of feces from cows with positive ELISA result) ranged from 33 to 84% for infected herds, depending on percentage of cows in the herd with positive bacterial culture results. If follow-up bacterial culture was not used to confirm positive ELISA results, sensitivity ranged from 70 to 93%, but probability of identifying uninfected herds as infected was 89%. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that the testing strategy used in the VJDHSP will fail to identify as infected most dairy herds with a low prevalence of paratuberculosis. A higher percentage of infected herds was detected if follow-up bacterial culture was not used, but this test strategy was associated with a high probability of misclassifying uninfected herds.

Animals↗