Biomedical subjects
Publications and source records attributed to C Crosby.
1. Music, a universal language with many purposes, can be used in the health care setting to aid in stress reduction and anxiety. 2. When used in the psychiatric setting, music can elicit emotion and affect behavior change. 3. Nurses in the psychiatric setting can include music in a group session that evokes thoughts, feelings, and memories for the clients.
BACKGROUND: The impact of community resettlement on the quality of life of people with long-term psychiatric disorders, is evaluated in a longitudinal study. METHOD: A repeated measures design was used to examine the sensitivity of an adapted version of Lehman's Quality of Life Interview in evaluating change. Completed interviews were carried out with 29 of the original cohort at one year post-discharge. The relationship between quality of life and ratings of client functioning is explored. RESULTS: Significant changes in the objective quality of life indices include improved living conditions (F = 40.00, P < 0.001), higher levels of social contact (F = 29.52, P < 0.01) and increased leisure activities (F = 4.57, P < 0.05). Apart from increased satisfaction with living situation (F = 6.94, P < 0.01), there were no significant changes in the subjective indices. Ratings of psychiatric state and social functioning did not significantly correlate with global quality of life at one year post-discharge. CONCLUSIONS: Concerns in relation to the sensitivity of life satisfaction ratings in evaluating programme interventions are raised.
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We report a prospective study of 245 open digital fractures of the hand in 201 patients. Management followed clear guidelines set out in protocol. The incidence of infection (2.04%) and non-union (2.45%) was low. Proximal phalangeal fractures and comminuted fractures did worst and associated significant soft tissue injuries had a particularly deleterious effect on the outcome. A classification based on the different soft-tissue components involved is proposed. In fractures associated with simple lacerations or isolated digital nerve injury only, one can expect about 40% good results and about 25% poor results. Where extensor tendon injury or extensive skin loss are also present, there will be approximately 18% good results and 50% poor results. If there is also injury to the flexor tendon or more than one component of significant soft-tissue damage, about 80% will be poor and good results are rare.
A prospective study of fifty-two fresh traumatic unstable fractures of the proximal or middle phalanges of the hand in forty-seven patients was reviewed. All the fractures were fixed with A.O. miniature screws and plates. The overall results were not satisfactory and complications were frequent. Only 26.9% of the fractures had good results. Fractures associated with significant soft tissue injuries had very poor results. When the present series was compared with a comparable group of fractures fixed with Kirschner wires, there was no significant improvement in the results. The unsatisfactory outcome of this group of unstable fractures may be largely due to the frequent association with poor prognostic factors.
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The development of an internationally accepted system of assessment of results after flexor tendon repair is important. In a prospective study of ninety-five digits, gross discrepancies were demonstrated between five popular methods of assessment: Buck-Gramcko, linear measurement, Grossman, American Society for Surgery of the Hand, and Strickland. The relative merits of each systems were studied and modifications for the Buck-Gramcko system are suggested.
A splint for controlled active motion after flexor tendon repair is described. It incorporates a single core-coated elastic band passing around a palmar pulley and attached proximally to a spring wire. Its mechanical properties were tested against six other systems. The tension in various systems all rose near full extension. However, the palmar pulley, the spring wire, and the elastic band each could lower the tension significantly. When the bending moments at the interphalangeal joints were measured, all systems produced a peak during the latter part of extension. With the palmar pulley, spring wire, and elastic band, the rise was minimal and in fact, the bending moments diminished near full extension. Initial results in 28 flexor tendon repairs using this splint showed less flexion contracture when compared with 78 flexor tendon repairs using a standard rubber band anchored at the wrist.
We report a prospective study on 284 digital fractures of the hand in 235 patients. Management followed clear guidelines set out in a protocol. Important factors in the selection of the treatment method were, acceptable alignment, functional stability, and associated "significant" soft tissue injuries. "Functionally" stable fractures treated by free mobilization had satisfactory results. Unstable fractures treated by splints or Kirschner wire fixation produced unsatisfactory results. "Open fracture," "comminuted fracture," and "associated significant soft tissue injuries" were identified as unfavorable prognostic factors. The anatomic site of the fractures was not important in determining the final outcome. About 15% of the displaced fractures became functionally stable after closed reduction and their results were comparable with the undisplaced fractures. About 30% of the patients had various degrees of difficulty after they returned to work. About 14% of the patients eventually changed their jobs because of their residual disability.
We tested the precision and accuracy of the AccuLevel Phenobarbital Test, which reports whole-blood (fingerstick) results in plasma equivalent values, and compared these values with plasma results obtained using established methods. We conclude that the assay is precise, reliable, accurate for single tests, and is appropriate for use in offices, outpatient settings, and emergency rooms.
The results of a multicenter, double-blind, placebo-controlled clinical trial of the efficacy and safety of progabide (PGB) in the treatment of partial seizures are presented. This study was performed with a number of rigorous controls not usually present in clinical trials. These included uniform co-medication in which all patients received only phenytoin and carbamazepine; concentrations of these two drugs were maintained within narrow, predefined concentration ranges. There was no statistically significant difference between PGB and placebo in seizure frequency and seizure duration for most of the analyses performed. One patient was withdrawn from the study because of hepatotoxicity. PGB was associated with a significant inhibition of phenytoin but not carbamazepine clearance. The results of this study indicate that PGB was not a potent antiepileptic drug in this population of persons with intractable epilepsy.
Molecular weights of all hemocyanin aggregates which can be homogeneously isolated have been measured by sedimentation equilibrium. The larger aggregates, which are the ones present under physiological conditions, are, to a very close approximation, integral multiples of a 4.4 x 10(6)-dalton, 60 S species. Dissociation of the 60 S species at high pH gives heterogeneous samples in which the smallest species has a molecular weight of 300,000. The smallest subunit which can be produced in denaturing solvents also has a molecular weight of 300,000.
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