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Biomedical subjects

B W Goodman

Publications and source records attributed to B W Goodman.

9 recordsLinked to original sources
PubMed1988

Neck pain.

Six conditions cause most of the neck pain complaints seen by primary care physicians: cervical muscle strain or sprain, torticollis, acceleration injury, myofascial pain dysfunction syndrome, and cervical osteoarthritis or rheumatoid arthritis. Most of them can be diagnosed and treated by the primary care physician. Of the more unusual causes, one should not miss a clinical fracture; a herniated cervical disc, spinal cord compression from a disc, or epidural tumor; infection of the disc or the vertebral body; subluxation of the vertebral bodies; or pain referred from the chest or mediastinal structures. MRI offers new opportunity for early diagnosis of myelopathy owing to OA or RA, vertebral osteomyelitis, and metastatic involvement of cervical vertebrae.

Humans↗
PubMed1988

Family practice physicians' perceptions of the usefulness of drug therapy recommendations from clinical pharmacists.

Family practice physicians' perceptions of the usefulness and clinical outcome of drug therapy recommendations made by clinical pharmacists in a family medicine clinic were determined. For 15 weeks, pharmacists in the clinic recorded all consultations in which they made recommendations about the drug therapy of specific patients. At the time of each consultation, the pharmacists gave the physician a questionnaire designed to gauge the physician's opinion of the usefulness of the consultation. Physicians who implemented the recommendations were sent a second questionnaire and asked to indicate the extent to which the clinical pharmacist influenced their decision to implement the recommendation, the effect the recommendation had on the patient's clinical status, and the usefulness of the recommendation to the patient in ways unrelated to clinical status (such as greater patient acceptance, safety, or lower cost). Five clinical pharmacists provided 59 consultations to 33 physicians. The physicians rated 51 (88%) of the consultations as very useful, and they implemented 78 (98%) of the 80 recommended actions. Of the 56 physicians who attributed their decision to implement the recommendation to their consultation with the clinical pharmacist, 43 believed that the recommendations had improved the clinical status of the patient, and 38 believed that the recommendations were useful to patients in ways unrelated to clinical status. Physicians in a family medicine residency training program had positive perceptions of the usefulness of drug therapy recommendations made by clinical pharmacists. A majority of the physicians believed that the recommendations had a positive effect on patients' clinical status.

Attitude of Health Personnel↗
PubMed1984

Chest pain in adolescents--functional consequences.

In prospectively evaluating 100 cases of adolescents with chest pain (along with two control groups), 91 were found to have recurrent chest pain; fewer than 5 had a serious organic cause. Significantly higher school absenteeism occurred in patients with either chest or abdominal pain than in patients without pain. Adolescents with chest and abdominal pain were more likely to be high users of medical services than those with no pain. Most adolescents believed that persons their age could have attacks; 44 of those with chest pain thought their symptom was due to a heart attack. The occurrence of chest pain was not influenced by an adolescent's age, sex, race, smoking status or family structure, nor was it consistently associated with depression. Chest pain is thus a common problem of adolescence that produces considerable functional impairment not attributable to serious underlying disease.

Abdomen↗
PubMed1983

Jaw claudication. Its value as a diagnostic clue.

Jaw claudication accompanies relatively few disorders, but it may be an important presenting feature that heralds serious underlying disease. In temporal arteritis, for example, jaw claudication rather than the classic finding of unilateral lancinating headache may be the distinguishing symptom. In the case reported here, jaw claudication was a prominent symptom for five months in a black woman. Temporomandibular joint disease can produce pain similar to that of jaw claudication, as can rheumatoid arthritis involving the temporomandibular joint in the elderly. Myasthenia gravis closely mimics jaw claudication, and parotid tumors can produce similar pain. Atherosclerotic narrowing of the external carotid artery proximal to the origins of the facial and maxillary branches is a rare cause of jaw claudication. Recognition of the importance of jaw claudication can lead to early identification of the underlying disease and quick initiation of therapy to avoid serious complications.

Aged↗
PubMed1983

Adolescent chest pain: a prospective study.

One hundred adolescents with chest pain were prospectively analyzed to determine the etiology, functional consequences, and illness attributions of patients seen in a general pediatric clinic. The typical patient had frequent pain (63% had two or more episodes weekly) of moderate duration (51% of the pain lasted longer than six minutes) that had been occurring for many months (36% had pain occurring longer than 6 months). Stressful events, such as a death in the family, major illness, an accident, family separations, and school changes occurred in 31% of patients. The most frequently diagnosed condition was musculoskeletal problems (31%) including costochondritis (14%), chest wall syndrome (13%), skeletal trauma (2%), and ribcage anomalies (2%). Hyperventilation accounted for 20% of diagnoses and 5% had breast-related problems. Thirty-nine percent of patients had pain not readily classifiable. Serious underlying illness was a rare cause of chest pain, although several patients had associated organic disease not responsible for their chest pain. More than two thirds of patients restricted physical activities; more than 40% were absent from school. When patients were questioned about their understanding of their illness, 44% were afraid that they were experiencing a heart attack, 12% worried about heart disease, and 12% feared cancer. Chest pain is a prevalent problem that is usually benign but is commonly misunderstood and causes considerable dysfunction and anxiety in adolescents.

Adolescent↗
PubMed1981

Takayasu's arteritis: the relationship with tuberculosis.

A 12-year-old girl developed Takayasu's arteritis (pulseless disease) within a month of the appearance of tuberculous cervical adenitis. This unusual form of arteritis is common in Japan and Korea but has rarely been reported in individuals born in the United States. The etiology is unclear. The literature currently hypothesizes an autoimmune basis and treatment with steroids. Although a tuberculin sensitization pathogenesis has been suggested, a close temporal relationship with the onset of a tuberculous process has not previously been documented. The likelihood of uncovering tuberculin sensitivity or active tuberculosis in patients with Takayasu's arteritis is substantially higher than in the general population in all countries analyzed. The natural history of this arteritis is highly variable. The adolescent described in this paper has demonstrated complete symptomatic remission as well as return of pulses simultaneous with antituberculosis therapy.

Adolescent↗
PubMed1981

A curriculum in practical clinical skills for family medicine residents.

The teaching of practical clinical skills to medical students and residents has been traditionally taught on an unstructured basis. This has led to situations in which physicians have been expected to perform manual procedures without adequate prior exposure or instruction. As a result of this perceived deficit in training, a curriculum has been designed to prepare new family medicine residents for some of the procedures they will be expected to perform in their first year of training. These procedures include airway management and endotracheal intubation, orthopedic casting, use of outlet forceps, suturing, and cardiopulmonary resuscitation.

Airway Obstruction↗
PubMed1979

Temporal arteritis.

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Adrenal Cortex Hormones↗