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Biomedical subjects

C Warshaw

Publications and source records attributed to C Warshaw.

7 recordsLinked to original sources
PubMed2006

Spinal cord injury in a 14-year-old male secondary to cervical hyperflexion with exercise.

STUDY DESIGN: Case report. OBJECTIVES: To present an interesting case of a 14-year-old male with acute paresis of upper extremities and progressive difficulty with lower extremities. The patient is a competitive wrestler and was performing his daily abdominal workout 'sit-ups' with hands interlocked behind his head. During the end and immediately following his abdominal workout, he felt progressive weakness in his upper extremities. He was rushed to the hospital within an hour and seen in the emergency room and admitted to the neurology service for a presumed thromboembolic event. SETTING: New York, USA. RESULTS: The patient was negative for any hematologic disease or coagulopathy. Magnetic resonance imaging was negative for any mass effect on the spinal cord and neurological examination revealed bilateral upper extremity paraparesis 3/5 and lower extremity spasticity and propioceptive dysfunction. The patient was treated with corticosteroids and rigid collar, follow-up examination at 3 months revealed resolution of symptoms. DISCUSSION/CONCLUSION: The pathophysiology of central cord syndrome is thought to be primarily secondary to a hyperextension injury, which causes buckling of the ligamentum flavum and increasing spinal cord diameter which leads to cord compression. This syndrome is more commonly seen in the spondylotic elderly. This case involves a teenager with normal canal diameter; however, combining aggressive exercise with extreme cervical hyperflexion, one can plausibly account for an acute ischemic event or repetitive microinjury to the spinal cord.

Adolescent↗
PubMed1997

Intimate partner abuse: developing a framework for change in medical education.

Addressing domestic violence presents unique challenges for individual physicians and for the institutions that shape medical education and practice. In addition to the need to acquire new knowledge and skills, clinicians must confront the feelings and social beliefs that shape their responses to patients, develop new frameworks for understanding complex social issues, and generate collaborative models for working in partnership with community groups. Educators, in turn, must provide training experiences that foster the development of those understandings and skills, institutional structures that support their integration into routine practice, and faculty who model nonabusive behaviors in all aspects of training and medical care. Expanding traditional medical paradigms to address the multiple dimensions of abuse can lay the groundwork for such a process. In addition, students need to be encouraged to develop awareness of the larger social forces that affect all of our lives and health, and to recognize their potential roles as community members in ending domestic violence. This article offers suggestions for changes in the structure of medical education as part of generating a health care system contribution to ending abuse in this society. Creating a model for fostering nonabusive relationships at individual and institutional levels within the health care system can provide a paradigm for transforming the conditions under which abuse is tolerated.

Adaptation, Psychological↗
PubMed1995

A model curriculum for mental disorders and behavioral problems in primary care.

Changes in the health care delivery system will increasingly emphasize the role of the primary care physician in diagnosing and treating mental disorders and behavioral problems. This increasing emphasis points to the need for more systematic definition of the knowledge and skills that future primary care physicians will need for effective delivery of mental health services. The model curriculum described in this paper represents the efforts of a multidisciplinary Task Force to describe basic training objectives for the psychiatric education of future primary care physicians.

Clinical Competence↗
PubMed1995

Violence victims' perception of functioning and well-being: a survey from an urban public hospital walk-in clinic.

This study assessed the health perceptions of self-reported violence victims in an urban minority population attending a walk-in clinic by using an anonymous, 1-week, cross-sectional survey. The Medical Outcome Study Short-Form (MOS SF-20) was used to assess functioning/well being, including the dimensions of physical functioning, role functioning, social functioning, mental health, health perceptions, and pain. Health perception main scores were calculated for each of the six health dimensions in the following four groups: patient-victims, patient-nonvictims, visitor-victims, and visitor-nonvictims. Odds ratios (OR) were calculated to assess the association of violence victimization and functioning/well-being. The mean scores of health status were consistently better among nonvictims for all of the six health concepts measured; patients who were victims showed lower mean scores than nonvictim patients. A similar pattern also was found in visitors' health status scores when victims were compared to nonvictims. The strongest association was found between violence victimization and mental health, and the least association was between the pain score and violence victimization. This study showed a substantial association between poor health and violence victimization in the patient population studied. Intervention is needed to prevent and decrease violence in order to minimize the impact of violence on the health of victims.

Chicago↗
PubMedDate not supplied

Domestic violence: changing theory, changing practice.

Despite widespread recognition of domestic violence as a public health problem, many clinicians still have difficulty integrating routine intervention into their day-to-day practice. This is in part because domestic violence raises a distinct set of challenges for both providers and the institutions that shape clinical practice. Domestic violence is a complex social problem rather than a biomedical one; addressing it means asking clinicians to step beyond a traditional medical paradigm to confront the personal feelings and social beliefs that shape their responses to patients and to work in partnership with community groups committed to ending domestic violence. In addition, addressing domestic violence raises important challenges to the health care system itself-to its theoretical models, to the nature of medical training, and to the rapidly changing structure of clinical practice. If we truly want to play a role in preventing domestic violence, rather than just treating its consequences, we must work together to transform both the individual and social conditions that create and support this kind of violence in the first place.

Attitude of Health Personnel↗