ISSN:0894-9115    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

To plan targeted, relevant continuing medical educational activities, a study was undertaken to assess demographic data, practice patterns, and current continuing medical educational needs of former graduates of the physical medicine and rehabilitation program. A survey was sent to the 168 physicians who had completed a physical medicine and rehabilitation residency program from 1961 to 1995 and to the 34 then current residents in the program. Questions were asked regarding gender, year of completion of residency, certification, fellowships, current employment situation, size of practice community, work time distribution, and busiest areas of clinical practice. In addition, from a list of 47 topics plus "other," the respondents indicated in which topics they had a current strong interest in continuing their education. They also responded to questions about their most important considerations when deliberating about attending an educational activity, the amount of notice required regarding an upcoming course, and the preferred duration of educational activities. The response rate of former residents was 56% and of then current residents was 100%. Topics of interest to greater than half of the respondents, in descending order, were musculoskeletal/soft tissue disorders, therapeutic injections/nerve blocks, industrial medicine, back and neck pain rehabilitation, and sports-related disorders. There were significant differences on some topics based on gender, year of residency completion, academic affiliation, private practice, and ratings of residency training in that topic. The most important consideration when deciding whether to attend an educational activity was, by far, interest in topic, followed by provision of continuing medical educational credits. There are among physiatrists several differences in educational interests that challenge continuing medical education planners to determine efficient, effective ways to deliver continuing medical education to meet these needs within the financial and time constraints imposed by today's clinical practice.

ISSN:0894-9115    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Irreversible skeletal changes have been described in patients with dermatologic disorders treated with isotretinoin (Accutane), a synthetic vitamin A derivative. Although retinoids were developed to avoid toxicity associated with vitamin A, skeletal lesions and rheumatologic consequences are possible hazards of isotretinoin treatment. Enthesopathy is one of the potential musculoskeletal sequelae and is characterized by pathologic, sometimes painful changes at the insertion sites (entheses) of tendons, ligaments, and articular capsules into bone. We report a patient who was referred secondary to an extended history of bilateral hip region pain. She was subsequently found to have a greater trochanteric enthesopathy. A detailed patient history revealed past use of Accutane for cystic acne. The subsequent treatment course, including medications, corticosteroid injections, physical therapy, and activity modifications, is described and the pertinent literature is reviewed. We believe that patients who are prescribed isotretinoin should be warned about this potential pathologic condition at the initiation of treatment and that physicians who are treating patients with a history of Accutane use should be suspicious of underlying enthesopathies as the etiology behind pain of musculoskeletal origin.

ISSN:0894-9115    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

A 37-yr-old woman presented with a 7-mo history of unilateral shoulder girdle stiffness, pain, and weakness and had already been diagnosed with frozen shoulder. Physical examination revealed scapular winging and suspicious focal paralysis of shoulder girdle muscles. Subsequently, electrodiagnostic studies reported denervation of deltoid, infraspinatus, serratus anterior, and lower cervical paraspinal muscles, in addition to a prolonged long thoracic nerve latency. The history, physical examination, and cervical magnetic resonance imaging scan seemed most consistent with neuralgic amyotrophy, although the electrodiagnostic examination could be interpreted as cervical radiculopathy. Some of the difficulties in identifying neuralgic amyotrophy and distinguishing it from cervical radiculopathy are discussed herein. Historically, frozen shoulder has seemed to develop as a complication of the neuropathic process. Both neuralgic amyotrophy and frozen shoulder have a poorly understood pathogenesis, and their combined presence is presumed to be rare. Because of difficulties inherent in the physical examination of frozen shoulder, a coexistent neuropathic process may go undetected.

ISSN:0894-9115    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The objectives of this study were to develop and validate an equal-interval measure of neurologic impairment from the International Standards for Neurological and Functional Classification of Spinal Cord Injury Patients developed by the American Spinal Injury Association. These standards were used to rate impairment at admission and discharge to Model System facilities. The results demonstrate that the standards fulfill their purpose of characterizing sensory-motor impairment. Developed was a self-scoring key that rehabilitation clinicians can use to obtain a measure of severity that combines sensory and motor level ratings and completeness classifications to describe impairment more precisely and illustrate the magnitude of reductions in impairment. This measure can be used to monitor improvement over time and compare severity across individuals or groups.

ISSN:0894-9115    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1999

数据来源: OVID