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At least 1,099 records · Page 61Linked to original sources
PubMed1992

Stress related workers' compensation claims: recommendations involving records release.

1. The cost of stress claims is predicted to cripple the workers' compensation system, where stress claims are burgeoning and the average payout is twice that of a typical injury. The major reason to release medical records in a stress claim is to determine the validity of the claim arising from the job. 2. Occupational health nurses are frequently asked by the courts to reveal personal client information and may not be protected by the "nurse-client relationship" or "privileged communication." Politically, very little interest has been shown in restricting disclosure of private information. 3. Both ANA and AAOHN have adopted strong positions about safeguarding privacy. Legally, the ultimate responsibility for wrongful acts committed by the nurse falls on the individual nurse. 4. The most important reason to guard confidential health information is the basic tenet of the nurse-client relationship in which personal matters are held in confidence. To break this trust is to jeopardize the ability to provide optimal client care, which is the essence of nursing.

Confidentiality↗
PubMed1963

Toxoplasmosis. The protean manifestations of the condition and their significance in pregnancy and in newborn infants.

Toxoplasmosis is a relatively common and generally mild parasitic infection which can, however, produce fatal and crippling complications under certain conditions - particularly when a human fetus or a newborn infant is infected. In this instance, the infection is the result of a spread of the acquired disease which may occur in the mother in the last six months of pregnancy. Although the infection of adults can be dangerous and fatalities have been reported, the danger to the nervous system, eyes and other structures of the newborn infant can be devastating-blindness, brain damage and mental deficiency, particularly as the result of an obstruction to the flow of circulating cerebrospinal fluid within the brain. This report covers a number of differing features of the disease which have been described separately by other authors in specialty journals and in the foreign literature. If present, these signs should suggest toxoplasmosis, particularly in pregnancy, in the newborn infant and in still-born infants. Early diagnosis is of paramount interest in view of the poor response which may be obtained in the treatment of subacute and chronic phases of the illness. Difficulties in diagnosis stem from the manifestations of toxoplasmosis which closely resemble the symptoms of other infectious diseases. The clinical laboratory diagnosis is made by the isolation of the organism or by the demonstration of immune protein in the patient's serum.

Adult↗
PubMed1963

SOME OBSERVATIONS ON MYOCARDIAL REVASCULARIZATION.

Since 1929 various surgical procedures have been devised to revascularize the ischemic heart to provide it with blood from extracoronary sources. A comparative study has been carried out in 80 mongrel dogs over a two-year period to evaluate the relative merits of cardio-omentopexy, left atrial pulmonary artery anastomosis and the Ivalon sponge operation. The Ivalon sponge procedure proved to be most effective in relieving artificially produced myocardial ischemia. The procedure has subsequently been carried out in two patients with crippling angina pectoris, and a complete relief of symptoms has been achieved in both.

Angina Pectoris↗
PubMed1992

Use of alkaline calcium salts as phosphate binder in uremic patients.

In order to prevent aluminum toxicity induced by the association of aluminum phosphate binder with 1 alpha(OH) vitamin D3 derivatives and the use of deferoxamine with its own hazards to diagnose and treat this toxicity, we have shown in 1982 that it was possible to replace the iatrogenic association of aluminum phosphate binder with 1 alpha OH vitamin D derivatives by oral calcium carbonate taken with the meals in order to bind phosphate and correct the negative calcium balance. This led to the disappearance of the crippling aluminic osteomalacia and adynamic bone diseases in our center. The effectiveness of CaCO3 without 1 alpha(OH)D3 derivatives in the control of hyperparathyroidism in dialysis patients has been proven by the appearance in four patients of our dialysis population of an histological idiopathic adynamic bone disease associated with relative hypoparathyroidism, and by the finding that more than 50% of our dialysis population treated by this sole treatment have plasma concentration of intact PTH below twice the upper limit of normal (that is, the threshold above which only significant histological osteitis fibrosa is observed). Besides the compliance problem, the limit of CaCO3 is the occurrence of hypercalcemia which occurs in about 8% of the measurements. Since calcium acetate binds twice as much phosphate for the same dose of elemental calcium as CaCO3, its use has been recommended. However, clinical experience has shown that in spite of the fact that half the dose of calcium element given as acetate does actually control predialysis plasma phosphate as well as CaCO3, the incidence of hypercalcemia is not decreased, probably because calcium availability at the alkaline pH of the intestine is much greater with Ca acetate. When hypercalcemia is frequent (and not explained by autonomized hyperparathyroidism, adynamic bone disease, overtreatment with vitamin D, granulomatosis or neoplasia) it is necessary either to decrease the dose of calcium and complete the necessary binding of phosphate by adding small doses of Mg(OH)2 or Mg carbonate, provided the dialysate Mg is decreased to 0.2 to 0.35 mmol/liter to prevent hypermagnesemia or to decrease the dialysate calcium (DCa) concentration. The decrease of DCa can be made either just when hypercalcemia occurs or on a systemic basis according to the amount of CaCO3 used and to the necessity of associating 1 alpha(OH) vitamin D3 derivatives.(ABSTRACT TRUNCATED AT 400 WORDS)

Aluminum↗
PubMed1992

[Foreign body aspiration in childhood].

Damage to the airways and lung parenchyma from aspiration is a common clinical problem with diagnostic and therapeutic challenges. The insult may be acute or chronic. The amount of concentration, chemical composition, and size of particles vary, and the lesion produced may be reversible or irreversible. Death may be immediate or late. Recovery may be complete, or crippling pulmonary disease may follow. In this review is reported on the aspiration of foreign bodies or liquids into the respiratory tract. Specialty: in infancy, esophageal foreign bodies may cause mainly respiratory symptoms. Adequate diagnosis and therapy are discussed.

Child↗
PubMed1964

CHILDREN WITH EPILEPSY. A STUDY OF THEIR NEEDS IN CALIFORNIA.

The 1959 California Legislature directed the State Department of Public Health to conduct a study of the needs of California children with epilepsy and to determine the costs and feasibility of including medical services to such children under the Crippled Children Services program. A demonstration program of services was provided in Contra Costa and San Bernardino counties. Under these programs, children suspected of having epilepsy were referred for specialists' examinations, tests and recommendations for treatment. Private physicians provided the largest portion of a total of 236 referrals. Children referred were found to have complex medical, social and educational problems, and to be in need of comprehensive diagnostic and treatment services. About half of the children had mixed epilepsy and over one-third had focal seizures. Two-thirds had at least one other major additional handicap. At the time of referral one-fifth of these children had one or more seizures daily.Through specialized care and medications provided under this project, 58 per cent of those with seizures became seizure free, and an additional 24 per cent showed a considerable reduction of seizure frequency. This project provided a practical method of obtaining information necessary for program planning and has also demonstrated the value of such a program in helping private physicians to meet some of the multiple problems presented by these children.

California↗
PubMed1964

AORTIC VALVULAR REPLACEMENT: CLINICAL EXPERIENCE WITH 13 CASES.

Acquired aortic disease is now currently corrected by total prosthetic replacement of the aortic valve. Aortic valve replacement was performed in 13 cases at the Montreal Heart Institute in 1963. In the first four cases, Bahnson aortic leaflets were used; in the remaining nine, the Starr-Edwards semirigid aortic valve prosthesis. The surgical technique employed is described. There were two operative deaths and two late deaths. The results have been excellent in all of the survivors but one. They have returned to full-time activities and four of them to strenuous physical work. It is the contention of the authors that aortic valve replacement is a surgical procedure with acceptable risks, offering hope for a near-normal life to patients crippled by severe aortic valvular lesions.

Aorta↗
PubMed1964

THE MUSHROOM CROWD: SOCIAL AND POLITICAL ASPECTS OF POPULATION PRESSURE.

The meaning of population pressure is discussed and, with the help of a formula, its five main components (people, rate of increase of people, food-producing acreage, protein nutrition and industrialization) are analyzed.Factors which have eased population pressure in the past are considered under the headings of political violence (war and genocide), natural disaster (famine and disease), and social action (increased local protein supply, emigration, industrialization and birth control).Birth control is the first prerequisite to an easing of population pressure; the effectiveness of the Japanese and the Indian programs is discussed.The crippling burden of preventable disease, shown to be a major obstacle to the development of sophisticated industries, presents a challenge to Western medical men who so far have done little to meet it.

Agaricales↗
PubMed1964

THE SPECIAL ORTHOPEDIC HOSPITAL--PAST AND PRESENT.

Pioneer orthopedic institutions established in Europe in the late 18th and early 19th centuries, and in the U.S.A. in the second half of the 19th and the first decade of the 20th century, can trace their ancestry in ideas back to the practice and teachings of Hippocrates. Experience in treatment of great numbers of injured soldiers in the First World War opened a new era in reconstructive surgery of the locomotor system.After the Second World War, in advanced nations the pattern of crippling diseases showed a spectacular change. Problems that justify the existence of large special orthopedic hospitals are, in children, the more complex congenital deformities, cerebral palsies, and the increasing number of injuries due to hazards of modern life; in the adult, the reconstructive surgery of trauma and of arthritis.In modern orthopedic hospitals physicians have joined orthopedic surgeons in the study of the natural history of the various forms of arthritis. These centres provide facilities for biomechanical research and postgraduate training which acute general hospitals cannot offer.

Adult↗
PubMed1965

TYPEWRITER CONTROL FOR AN APHASIC QUADRIPLEGIC PATIENT.

New equipment was developed to enable an aphasic quadriplegic patient to communicate with other people. The patient was completely quadriplegic except for slight movement in the right hand and minimal movement of the left fingers. The equipment translated Morse code, which the patient had to learn, into either (1) a visual display to communicate with visitors, or (2) an electric typewriter input to permit correspondence. This case demonstrates how properly applied research can yield results of value in ameliorating the lot of patients with major physical afflictions or crippling illnesses.

Aphasia↗
PubMed1992

The treatment of reflex sympathetic dystrophy syndrome: current concepts.

Reflex sympathetic dystrophy syndrome is the currently accepted term for a disorder that has previously appeared in the literature under a confusing array of designations: causalgia, Sudeck's atrophy, algoneurodystrophy, shoulder-hand syndrome, etc. The disorder, which was first described in 1864, is characterized by pain, swelling, limited range of motion with associated signs of vasomotor instability, trophic skin changes and patchy bone demineralization. It appears as an exaggerated response of an extremity to injury: trauma, infection, phlebitis or numerous other lesions. In 35 per cent of the RSDS patients, no precipitating event can be identified. The rational treatment of these patients should be based on a thorough understanding of its pathogenesis. While the optimal management is still controversial, there is a consensus that the best results will be achieved if treatment is started early and adapted to the clinical stage of the disease. The role of physical therapy is still debatable. Sympathetic interruption, corticosteroids, calcitonin, beta-blocking agents and more recently bi-phosphonates have been advocated. Proper management may result in the prevention of crippling sequelae.

Analgesics↗
PubMed2003

The Vienna heritage of Iowa orthopaedics.

Strong traditions of basic research, clinical innovation, teaching and integrating science and evaluation of outcomes into clinical practice have characterized University of Iowa orthopaedics for ninety years. These traditions were brought to Iowa City from Vienna when Iowa City was a town of fewer than 10,000 people in a sparcely populated rural state. In the last third of the 19th century, surgeons at the University of Vienna, led by Theodore Billroth (1829-1894), helped transform the practice of surgery. They developed new more effective procedures, analyzed the results of their operations, promoted the emergence and growth of surgical specialties and sought understanding of tissue structure, physiology and pathophysiology. Their efforts made Vienna one of the world's most respected centers for operative treatment, basic and clinical research and surgical education. Two individuals who followed Billroth, Eduard Albert (1841-1900) and Adolf Lorenz (1854-1946) focussed their research and clinical practice on orthopaedics. Their successes in the study and treatment of musculoskeletal disorders led one of their students, Arthur Steindler (1878-1959), a 1902 graduate of the Vienna Medical School, to pursue a career in orthopaedics. Following medical school, he worked in Lorenz's orthopaedic clinic until 1907 when he joined John Ridlon (1852-1936) at the Chicago Home for Crippled Children. In 1910, Steindler became Professor of Orthopaedics at the Drake Medical School in Des Moines, Iowa, and, in 1913, John G. Bowman, the President of the University of Iowa, recruited him to establish an orthopaedic clinical and academic program in Iowa City. For the next third of a century he guided the development of the University of Iowa Orthopaedics Department, helped establish the fields of orthopaedic biomechanics and kinesiology and tirelessly stressed the importance of physiology, pathology and assessment of the outcomes of operations. From the legacy of Billroth, Albert and Lorenz, Arthur Steindler created an internationally recognized center for orthopaedic care, research and teaching in Iowa City.

Austria↗
PubMed1992

Ocular leprosy.

Leprosy, also known as Hansen's disease, affects millions of people worldwide and is largely confined to the developing world. Although Hansen's disease is disfiguring, crippling, and even blinding in its later stages, it is not commonly lethal but gradually steals sensory input from the digits and the visual pathways. In this article, the epidemiology and pathogenesis of leprosy are reviewed, with an emphasis on ocular involvement, treatment, and prevention.

Anti-Bacterial Agents↗
PubMed2003

The health insurance crisis in the United States: lack of access and the ripple effect.

America's health care system is in crisis. Many individuals are not offered health insurance or cannot afford it, thereby increasing the number of uninsured who have no stable source of care other than the emergency room. In turn, the costs associated with those who lack health insurance ripple to providers who end up funding a proportion of uncompensated care, thereby financially crippling the bottom line. The lack of access to proper care experienced by the uninsured also has a downstream effect on the insured population, threatening the quality of and access to health care for all Americans.

Community Health Services↗
PubMed1992

Aseptic necrosis of the head of the femur among sickle cell anaemia patients in Uganda.

A number of HbSS patients presenting with aseptic necrosis of the femoral head have been seen at Mulago Hospital in Kampala, Uganda. A record review of the hospital's Sickle Cell Anaemia Clinic for the period 1985-1989 revealed that aseptic necrosis of the femoral head has been diagnosed in 2.9% (47/1611) of patients attending regularly. The largest number of diagnosed patients were in the 15-24 year old age group; peak incidence occurred in 20-24 year old women. Diagnosis in this series of patients was generally delayed and management was accordingly difficult. It is suggested that clinicians ask directly about pain in the hip of sickle cell patients rather than waiting spontaneous reporting. Such an approach may improve early detection of this potentially crippling problem.

Adolescent↗
PubMed1951

The precipitation of clinical poliomyelitis by injections.

In records of 1,321 cases of poliomyelitis in the city of Los Angeles in 1948, notation was made as to whether or not the patient had been vaccinated against smallpox or had received an injection of one kind or another in the period preceding the onset of poliomyelitis. In children under 12 years of age, the incidence of poliomyelitis was slightly higher among those who had had recent vaccination or injection than among those who had not, and the incidence of paralysis was slightly greater also. However, the disparities were not considered statistically significant. They were not wide enough to warrant withholding immunization against other serious diseases on the strength of the possibility that in so doing a slight reduction in the incidence of crippling poliomyelitis might be effected.

Child↗
PubMed1992

Prevalence of oral submucous fibrosis in the high natural radiation belt of Kerala, south India.

Oral submucous fibrosis (OSMF) is a crippling disorder which is confined almost exclusively to the Indian subcontinent. Despite its association with a significantly increased risk of cancer, the etiology is still not clear. An epidemiological assessment showed 0.4% prevalence for OSMF in Kerala, South India, which is among the highest recorded. Recently the National Tumour Registry in Trivandrum reported the highest recorded site-specific incidence rate for oral cancer (ICD 140-145) in this area. The coastal belt of the Trivandrum and Quilon districts of Kerala has a very high natural radioactivity (over 1500 mR (387 microC) per year); about 500 mR (129 microC) per year is considered to be the maximum permissible dose for populations in general. An epidemiological survey in this area and in a comparable population (without exposure to high background radiation) as a control showed that the percentage prevalence of OSMF in the study area was 0.27 and in the control area 0.32. It appears highly improbable that the OSMF in the study area was induced by high background radiation.

Adolescent↗
PubMed1992

[Maxillary prosthesis for better QOL--early setting and faster construction of maxillary prosthesis].

The maxillofacial prosthesis (MFP) is well accepted as one of the modalities to ameliolate the postsurgical crippling in the patients with maxillary malignancy. In this report, we analyzed 55 primary cases of MFP out of 100, from July, 1981 to July, 1987 in terms of the time of start after operation, and the duration and procedure of the MFP-making. MFP-making set about within 4 weeks in 35% of patients, 8 weeks in 25%, 12 weeks in 22%, and more than 12 weeks in 18%. The completion of MFP-making averaged 10 days. As a result of simplifying of MFP-making, we shortened a period requiring MFP-making within 3 days in recent 10 cases. There were no adverse effects of early wear of MFP after operation. We believe that early wear of MFP after operation improve the quality of life of patients with maxillary malignancy and considered that wear of MFP is not the completion of treatment, but is one of the procedures of treatment for the patients undergone maxillectomy.

Adolescent↗