摘要:

Metalworking is the constructive sculptural application of various technologic processes for producing art from ferrous and nonferrous metals. Self-employed artists and their workplaces are not protected by governmental agencies. We describe the techniques involved in metalworking processes and discuss the physical trauma and medical syndromes associated with each process, as well as safety, prevention, and treatment aspects of the basic syndromes.

ISSN:0038-4348    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

An incidental saccular intracranial (berry) aneurysm is not an uncommon finding at autopsy. Rupture of such an aneurysm can produce severe neurologic deterioration and death, often without warning. Morbidity and mortality can be reduced in some patients with early surgical intervention. Familial aggregation of cerebral aneurysms occurs frequently enough to warrant screening of family members to diagnose an asymptomatic berry aneurysm. We review the etiology, clinicopathologic features, and natural history of berry aneurysms and aneurysm rupture, as well as the various screening methods. A careful examination of the cerebral vessels should be routine in every postmortem examination, regardless of the cause of death.

ISSN:0038-4348    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Mechanisms for point of care glucose determinations have changed significantly since first introduced approximately 20 years ago. Such tests are now commonly done in acute and chronic care hospitals, as well as in physicians' offices and patients' homes. Although basically reliable, there are a number of potential problems with glucose determination by these methods that may not be considered by physicians interpreting these tests. This is a brief review of such problems, especially in the acute care setting.

ISSN:0038-4348    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Fibrin glue is composed of two separate solutions of fibrinogen and thrombin. When mixed together, these two solutions mimic the final stages of the clotting cascade to form a fibrin clot. Because the resulting fibrin patch is a good medium for microbial growth, the addition of antibiotics to one of the components of fibrin glue has been shown to reduce postoperative infections. Seventeen different antibiotics have been investigated in vitro. Of the 17, cefotaxime, mezlocillin, gentamicin, neomycin, and polymixin B, when added to fibrin glue, can decrease the rate of clot formation or the strength of the resultant fibrin clot. Further work is necessary to characterize the effect the addition of antibiotics has on the rate and strength of fibrin clotting and to determine what effect low systemic levels of antibiotics might have on antibiotic resistance patterns.

ISSN:0038-4348    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Collaboration of health care professionals is likely beneficial in modifying patient behavior in the treatment of hyperlipidemia. The purpose of this study was to determine whether limited instruction and demonstration of collaborative management of hyperlipidemia in a continuing medical education (CME) would change physicians' office practices, as determined 1 year later by questionnaire. Collaborative practice was defined as physicians working with other allied health care professionals as a team to increase patients' medication compliance and other behavioral outcomes. A 19-credit hour CME Lipid Disorders Training Program (LDTP) was offered emphasizing the collaborative approach to hyperlipidemia patient management. Physicians (n=196) were surveyed 1 year after LDTP. The response rate was 52.5%, nonrespondents were similar in locations. About 51% of respondents reported increased collaborative practice; of these respondents, 68% reported saving time, 78% reported improved patient outcomes, 76% improved office efficiency, and 90% increased patient satisfaction. According to self-reporting by these physicians, increased collaboration practices after attending the LDTP course led to improved patient outcomes.

ISSN:0038-4348    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Forty percent of all long-term care hospitalization days are accounted for by patients with schizophrenia. New approaches to managing this disorder are needed, including improved efficacy and better tolerability to enhance compliance with treatment. Sertindole hydrochloride is a novel antipsychotic medication soon to be available in the United States and Canada. As part of multisite phase II and III studies, we studied effects of this medication in five patients with chronic schizophrenia and examined the side effect profile. With more than 30 patient-months of exposure, sertindole treatment was not associated with neurologic side effects and was well tolerated in all patients studied. No evidence of hematologic abnormalities was found. Serial electrocardiograms revealed slight increases in QTc that were not considered clinically significant and did not lead to discontinuance of treatment. While data from larger samples are needed, in this small population sertindole hydrochloride was tolerated well with no evidence of acute neurologic side effects associated with traditional treatments for schizophrenia. Individuals with schizophrenia may benefit from enhanced compliance with treatment and a possible reduction in hospitalizations in the future.

ISSN:0038-4348    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Fixation of femur fractures in children and adolescents is becoming widely accepted because of the lower chance of iatrogenic infection and prohibitive cost of inhospital traction and spica cast care. Interlocking nails, which have dramatically improved adult femur fracture care, have posed problems, such as injury to the greater trochanteric apophysis and osteonecrosis of the femoral head. We reviewed a series of five stable femoral shaft fractures treated with Ender nails in children from 9 to 17 years of age. No serious complications (eg, leg length inequality) occurred. Follow-up averaged more than 3 years. Complete healing, with return to preinjury activity levels, occurred within 11 weeks on average. Decreased hospitalization, low cost of implants, less potential damage to growth centers, and decreased blood loss and operative time suggest this procedure has merit. Attention to operative technique diminishes previously reported complications attributed to Ender nails.

ISSN:0038-4348    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

BackgroundAmong AIDS case reports from rural and small town areas of the United States, rates are higher in the South than in any other part of the country.MethodsFor this study, we analyzed AIDS surveillance statistics from the state of Alabama for trends, distributions, and populations affected. We aggregated Alabama AIDS surveillance data in 5-year intervals—1981 to 1985,1986 to 1990,1991 to 1995—and made comparisons based on geographic area of residence of people diagnosed with AIDS.ResultsOf the 3,558 cases of AIDS reported in Alabama in the period 1981 to 1995, 86% were men and 14% were women. Among women, 69.7% were black and 29.1% were white. Among men, 48.4% were black and 50.9% were white. We compared these figures with 1995 Alabama population estimates of 26.2% black, 73.7% white, and <1% another race. The rates for black women and white women increased 170-fold and 23-fold, respectively, from the 1981 to 1985 period to the 1991 to 1995 period. For the same periods, case rates for black men and white men increased more than 80-fold and 50-fold, respectively. Black women showed a rise per 100,000 population—from 0.3 (1981 to 1985) in both northern and southern Alabama to 37 in northern Alabama and 64 in southern Alabama (1991 to 1995).ConclusionBlack women are at disproportionately high risk, particularly in the southern counties of Alabama. HIV is increasingly prevalent in rural and small town communities in Alabama and is more often transmitted heterosexually than it has been previously.

ISSN:0038-4348    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Five unexplained second trimester fetal deaths occurring in a 3-month interval were evaluated to determine whether the fetal demise was associated with maternal infection due to parvovirus B19. One fetus was markedly hydropic, a classic finding of fetal infection; no gross anomalies were present in the other four. Liver specimens from all five fetuses showed viral inclusions by light microscopy, supporting the presence of fetal parvovirus B19 infection. None of the five women had a history of parvovirus infection, but serum samples from all of them were positive for IgG to parvovirus. We conclude that maternal parvovirus B19 infection is associated with fetal demise during the second trimester and that hydropic changes may be absent, necessitating careful evaluation of tissue from the dead fetus.

ISSN:0038-4348    

出版商:OVID    

年代:1997

数据来源: OVID