Flushing reaction associated with the interaction of phenelzine and clonazepam.
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Biomedical subjects
Publications and source records attributed to H March.
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Stubby prostheses offer potential advantages over conventional prosthetic devices in terms of safety, stability, and energy efficiency. Although cosmesis is compromised in the process, these short nonarticulated pylon prostheses may be a viable option to consider in bilateral A-K or knee disarticulation amputee patients under the following circumstances: (1) as a training tool to determine whether progression to full-length articulated devices is feasible; (2) as permanent prostheses for the patient whose primary need for ambulation is within his own home; (3) for the elderly bilateral amputee in whom ambulation is feasible but safety and energy efficiency are of particular importance; and (4) as a definitive device in the patient who expresses a preference for them. Two patients who have become successful users of stubby prostheses are presented to illustrate these points.
A group of 92 patients with lower limb amputations were evaluated in an effort to determine whether an appropriate clinical decision to prescribe a prosthesis could be made without using elaborate evaluation testing. The assessments were made independently by a clinic team and by an ergonomic laboratory, each applying its own criteria for predicting successful prosthetic use. The high correlation between the two areas indicated that the ergonomic laboratory made no additional contribution toward the decision to supply a patient who had no complicating features with a prosthesis. Nineteen patients had significant ST depressions during exercise testing and of these, nine died within one year. Two patients with no ST segment depressions died within one year.
The choice of suspension in below-knee prosthetics poses a problem for the clinician because cuff suspension weighs less than side-joint-thigh corset suspension but the latter offers more stability. The energy costs of one compared with the other is of prime consideration when dealing with the older person after an amputation. To determine the energy costs of cuff and side-joint-thigh corset suspension, 17 patients were selected for study. A sepcial prosthetic bucket was fabricated for each patient and designed so that the suspensions could be quickly and easily interchanged. Trials with each method of suspension were carried out before and after a training period, and the cardiorespiratory parameters were measured. After the training period all patients demonstrated less oxygen consumption, but the type of suspension did not affect energy costs.
After sublingual nitroglycerin, the ejection fraction increased at least 8 percent in 10 of 19 patients (53 percent), changed less than 8 percent in 5 of 19 patients (26 percent), and decreased at least 8 percent in 4 of 19 patients (21 percent). After sublingual nitroglycerin, 16 of 21 areas (76 percent) of hypokinesis improved, 2 (10 percent) did not change, and 3 (14 percent) became worse. After sublingual nitroglycerin, 6 of 6 akinetic areas did not change. After sublingual nitroglycerin, 2 of 3 dyskinetic areas did not change and one improved. Left ventriculography performed before and after sublingual nitroglycerin may be useful in predicting viable areas of ischemic myocardium.
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