PubMed Health⌕ Search

Biomedical subjects

A Axer

Publications and source records attributed to A Axer.

48 records · Page 3Linked to original sources
PubMedDate not supplied

[Psychiatric rehabilitation in a secure treatment setting].

Working with severely mentally ill persons within the locked environment of a secure residential treatment facility presents a provocative challenge in attempting to establish a rehabilitative program. The author describes the mission, goals and methods of one of Oregon's newly organized facilities for "hard to place" former state hospital patients. The value of teaching the residents self-control is emphasized. Clinical vignettes illustrate how the staff involve the residents in real-life tasks, apply natural consequences to problem behaviors, and make attempts at minimizing the potential sources of confrontation.

Commitment of Persons with Psychiatric Disorders↗
PubMedDate not supplied

Recurrent Legg - Calve - Perthes' disease. A case report.

This is a report of the fifth known case of recurrent Legg--Calve--Perthes' disease. Roentgenograms of the hips after the first avascular episode, at the age of 3 years and 6 months resemble to a certain extent, Dysplasia Epiphysealis Capitis Femoris.

Child↗
PubMedDate not supplied

Osteoid osteoma of the proximal femur simulating spinal root compression.

In a 6 1/2-year-old boy and a 9 1/2-year-old girl, spinal root compression was suspected on the basis of muscle wasting and weakness, diminished deep tendon reflexes, and severe pain, all in a radicular distribution. However, extensive and invasive neuroradiologic evaluation failed to demonstrate compression of spinal roots. Only several months later was the correct diagnosis of osteoid osteoma reached. In one patient, the tumor was removed and on histologic examination groups of unmyelinated nerve fibers were found near the center of the tumor nidus, generally surrounding small arterioles. In the other patient parental consent was not given for the operation. The symptoms gradually subsided, although the typical radiologic features of the tumor went unchanged. The presence of unmyelinated autonomic nerve fibers in the nidus of osteoid osteoma may explain the severe pain commonly experienced by the patients. The spinal origin of such fibres can account for the radicular syndrome, while the localization of pain and sensory findings remote from the tumor site might be explained by a mechanism similar to that responsible for "referred pain."

Child↗
PubMedDate not supplied

Arthroscopy of the knee under local anesthesia and controlled pressure-irrigation.

One hundred and forty-two arthroscopies under local anesthesia, using "high pressure" irrigation-suction technique were carried out in 137 patients. With this technique the duration of the examination was shortened, the endoscopic field of vision was enlarged (posterior horn of the menisci could be visualized in most patients), the manipulation of the scope inside the joint cavity was easier and safer. More patients could have been examined during one session. The arthroscopic accuracy verified at 51 operations, was 90.5%, which is an improvement on our previous experience with arthroscopy under general anesthesia, with tourniquet and the routine " drip" technique.

Adolescent↗
PubMedDate not supplied

Indications for femoral osteotomy in Legg-Calvé-Perthes disease.

A group of children with Legg-Calvé-Perthes disease (LCPD) who underwent femoral osteotomy were analyzed to define further those most likely to respond favorably to this procedure. Treatment was directed to removal of the protruded, flattened, and damaged osteochondral head segment--as delineated by arthrography--from the damaging influence of the lateral acetabular lip and to expose the head to the molding influence of the acetabulum during weight-bearing and motion. This containment of the head was achieved by employing femoral varus-derotation (and sometimes extension) osteotomy. "Reversed" and "open" wedge techniques were also used to minimize limb shortening. Overall results were 83% satisfactory and 17% unsatisfactory according to Mose's criteria. Operation is recommended in the early clinical and radiologic stage of the disease, when favorable biologic and biomechanical effects may be anticipated. In the late stages of LCPD, osteotomy may be used as a salvage procedure in painful and deformed hips, while still maintaining a passive range of motion. An expectant approach can be adopted in children less than 4 years of age, but undue delay in operation, if femoral head protrusion is demonstrated by arthrography, may compromise the final results.

Child↗
PubMedDate not supplied

[Training in preventing assaultive behaviors for psychiatric professionals].

Dangerous behaviors in psychiatric institutions constitute major clinical and administrative problems. Staff competency in dealing with assaultive patients is an important factor in reducing institutional violence. One of the training programs for mental health staff working with dangerous patients is called Professional Assault Response Training (PART). PART is a product of several years of experience accumulated by the group of California authors in their efforts at designing a safe and effective approach in responding to various dangerous behaviors. PART principles guide staff in 1) de-escalating dangerous incidents through verbal crisis interventions; 2) avoiding or minimizing the risk of minor physical injury through evasion; 3) preventing serious bodily harm through the use of manual restraint. The importance of maintaining self-control by staff is reinforced throughout the entire course as a crucial professional skill. Other PART principles include identifying realistic treatment expectations for assaultive patients, proper physical mobility and emotional balance of staff, recognizing warning signals of impeding danger, using reasonable force to match response to the level of dangerousness. The PART training explores various theoretical explanations of violence (legal model, stress model, environmental model, communication model, developmental model, basic needs model and common-sense model). Verbal interventions which are a cornerstone of the PART approach are matching specific motives of threatening behavior--fear, frustration, manipulation and intimidation. Physical interventions taught in the course (evasion and manual restraint) include only techniques which can be used safely and which are not pain inducing. Finally, the PART training also assists staff in properly documenting assaultive incidents.

Aggression↗