Biomedical subjects

B A Evanoff

Publications and source records attributed to B A Evanoff.

22 records · Page 2Linked to original sources

PubMed1996

Surgeons' decision making in patients with chronic wrist pain: role of bilateral three-compartment wrist arthrography--prospective study.

PURPOSE: To determine if wrist arthrography changes surgeons' diagnoses and treatment plans for patients with chronic wrist pain. MATERIALS AND METHODS: Bilateral, three-compartment wrist arthrography was performed in 64 patients. Prospective questionnaires evaluated surgeons' diagnoses and management plans at three stages: before arthrography, after arthrography of the symptomatic wrist, and after arthrography of the asymptomatic wrist. RESULTS: Surgeons tended to plan more conservative management after receiving the results of arthrography. The number of patients for whom the reported treatment plan included surgery dropped from 28 of 64 patients (44%) to 19 of 64 patients (30%) after review of the arthrography results (P = .05). The number of patients for whom the treatment plan included treatment of any kind dropped from 55 of 64 patients (86%) to 49 of 64 patients (77%) after review of the arthrography results (P = .09). An overall change in treatment plan occurred in 29 of 64 patients (45%). CONCLUSION: Wrist arthrography influences surgeons' decision making. After reviewing the results of arthrography, surgeons tended to change treatment plans toward more conservative, less invasive treatment.

Adult↗

PubMed1993

Mortality and incidence of cancer in a cohort of Swedish chimney sweeps: an extended follow up study.

Despite 200 years of efforts to regulate safety in this occupation, chimney sweeps have increased mortality from cancer, ischaemic heart disease, and respiratory disease. Mortality and incidence of cancer were examined in a cohort of 5542 Swedish chimney sweeps employed through their national trade union at any time between 1918 and 1980. Previous studies of this cohort found increased risks of ischaemic heart disease, respiratory disease, accidental deaths, and various neoplasms. By increasing follow up, we sought to increase the power of the study and examine disease time trends. Mortality analysis was extended 7.5 years to cover the period 1951-90; cancer incidence analysis was extended six years to cover the period 1958-87. New findings include increased incidence and mortality of prostate cancer (SMR 169, 95% CI 106-256, 22 observed) and increased incidence of total haematolymphatic cancers (SIR 151, 95% CI 106-209, 36 observed). When only the most recent follow up period was analysed, previously observed risks persisted for total lung cancer (SIR 178, 95% CI 99-293), oat cell lung cancer (SIR 240, 95% CI 103-472), bladder cancer (SIR 247, 95% CI 131-422), and oesophageal cancer (Obs/Exp = 2/1.1). Mortality from ischaemic heart disease (SMR 98, 95% CI 76-123) and respiratory disease (SMR 111, 95% CI 56-199) declined during recent follow up, although significant excess mortality remained during analysis of the entire study period (ischaemic heart disease SMR 128, 95% CI 112-145; respiratory disease SMR 159, 95% CI 115-213). In analyses of the entire study period, risks of ischaemic heart disease and lung, bladder, and oesophageal cancer were adjusted for smoking; oesophageal cancer was also adjusted for use of alcohol. All risks remained significantly raised. Exposure-response analyses showed significant positive associations between duration of employment and risks for mortality from lung, oesophageal, and total cancer. Chimney sweeps remain at increased risk for cancers of the lung, oesophagus, and bladder. Our study supports a casual role for exposure to chimney soot, which contains carcinogens including polycyclic aromatic hydrocarbons. Extended follow up of this cohort now shows increased risks of prostate and haematolymphatic cancers.

Adolescent↗

PubMed1986

Reproductive hazards in the workplace: a case study of women firefighters.

Recent attention has focused on the difficulties of providing equal employment opportunities for women while ensuring reproductive health in the workplace. This paper examines the potential hazards faced by pregnant firefighters and recommends a policy that seeks a reasonable accommodation between employment and fetal and maternal health. The potential hazards faced by firefighters include physical exertion, hyperthermia, and exposure to carbon monoxide and other toxic gases. The ideal policy option for improving reproductive health is to make the workplace safe for all employees. Where this cannot be accomplished and a unique reproductive hazard exists to women during pregnancy, temporary positions should be found that remove the pregnant woman from the hazard while allowing her to continue work.

Abnormalities, Drug-Induced↗

PubMedDate not supplied

Natural history of asymptomatic rotator cuff tears: a longitudinal analysis of asymptomatic tears detected sonographically.

The purpose of this study was to examine longitudinally the natural history of asymptomatic rotator cuff tears over a 5-year period and to assess the risk for development of symptoms and tear progression. Since 1985 through the present, bilateral sonograms were done on all patients. A review of consecutive sonograms done from 1989 to 1994 revealed 58 potential patients with unilateral symptoms who had contralateral asymptomatic rotator cuff tears. Of these 58 patients, 45 (22 men, 23 women) responded to a comprehensive questionnaire and 23 additionally returned for examination and repeat sonographic evaluation. The questionnaire was based on the American Shoulder and Elbow Surgeons score and included several outcome-based questions. A physical examination was performed in a standardized fashion along American Shoulder and Elbow Surgeons guidelines. Repeat high-resolution sonograms were performed by a single experienced radiologist. Primary and repeat sonograms were then reassessed for tear size and location by two independent experienced radiologists blinded to the clinical data results. Twenty-three (51%) of the previously asymptomatic patients became symptomatic over a mean of 2.8 years. The average Activities of Daily Living score for those remaining asymptomatic was 28.5 of 30 and for those becoming newly symptomatic, 22.9 of 30 (P <.5). The mean visual analog pain score (1 = no pain) for those remaining asymptomatic was 1.1 and for the newly symptomatic patients, 4.0. Of the 23 patients who returned for ultrasound, 9 were asymptomatic and 14 symptomatic. Only 2 of the 9 patients remaining asymptomatic had progression of their tears. Overall, 9 of 23 patients had tear progression. No patient had a decrease in the size of the tear. Our results demonstrate that symptoms can develop in patients with previously asymptomatic rotator cuff tears when seen in the context of a contralateral symptomatic tear. Development of symptoms was associated with a significant increase in pain and decrease in the ability to perform activities of daily living (P <.05). There appears to be a risk for tear size progression over time.

Activities of Daily Living↗