Biomedical subjects

Arthur A Rodriquez

Publications and source records attributed to Arthur A Rodriquez.

3 recordsLinked to original sources

PubMed2005

Predictors of prescriptions for management of fatigue among veterans with multiple sclerosis.

OBJECTIVE: To determine predictors of fatigue-modifying medication use. DESIGN: Cross-sectional cohort. SETTING: Veterans Health Administration (VHA) facilities. PARTICIPANTS: Veterans with multiple sclerosis (MS) in the VHA in the northwestern United States from 1995 to 2000. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: A self-administered survey distributed by mail sought information from veterans with MS about demographics, symptoms, barriers to care, and disease characteristics. The variables were compared with prescriptions for fatigue-modifying medications during the study period. RESULTS: Of 1032 patients, 451 (44%) completed the survey, and 306 (68%) reported moderate or high fatigue levels. Only 40% of the 306 were prescribed fatigue-modifying medications. Those using specialized fatigue services or who received care at tertiary centers were more likely to receive fatigue treatments. Patient-perceived barriers to accessing care and other patient characteristics were not associated with prescription rates. CONCLUSIONS: Fatigue is undertreated among veterans with MS. However, there is considerable variability in the provision of fatigue care. Interventions to improve the quality and uniformity of fatigue care are warranted.

Adult↗

PubMed2004

Whiplash: pathophysiology, diagnosis, treatment, and prognosis.

We have reviewed the literature relevant to pathophysiology, diagnosis, treatment, and prognosis of whiplash-associated disorder (WAD) since 1995 and provided a brief summary of literature pertaining to forces action on the head and neck during a motor vehicle accident. The scope of the current review is confined to the Quebec guidelines for WAD grades 1-3 but excludes grade 4 (neck complaints and fracture or dislocation). After excluding papers without scientific data and single case reports or case series with fewer than 20 patients, articles were reviewed for methodological quality. The diagnosis remains clinical. No imaging, physiological, or psychological study provides specific diagnostic criteria. In the acute period up to 2 weeks, soft collars or rest and work-leave do not shorten the duration of neck pain. Sick leave is reduced by high-dose methylprednisolone given within 8 h of injury, but confirmatory studies examining the cost-benefit relationship are needed. In the first 6 months, active as opposed to passive treatment results in improved outcomes. Specific exercise strategies have not been studied. For those with symptoms lasting more than 6 months, percutaneous radio-frequency neurotomy can provide pain relief for many months in those responding to blind local anesthetic facet blocks. Intra-articular corticosteroids are ineffective. Uncontrolled trials suggest that multimodal rehabilitation programs result in improved overall function. The overall prognosis for recovery has varied considerably across studies. Such variability is likely due to differences in case identification methods and whether outcome is assessed in terms of symptoms or the receipt of financial compensation for injury. The impact on prognosis of both collision- and patient-related factors is also reviewed.

Humans↗

PubMed2003

Botulinum toxin for spasmodic dysphonia.

Botulinum toxin is the accepted method of managing SD and has given most patients with adductor SD the ability to develop satisfactory vocal function. Results have been less satisfactory in abductor SD. Management is accomplished best with a team approach. The physiatrist with experience in EMG and botulinum toxin usage can be a prominent member of this team.

Anti-Dyskinesia Agents↗