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Biomedical subjects

H Wellman

Publications and source records attributed to H Wellman.

15 recordsLinked to original sources
PubMed2005

Welding related occupational eye injuries: a narrative analysis.

OBJECTIVE: To determine the activities and circumstances proximal to a welding related occupational eye injury, a hybrid narrative coding approach derived from two well developed classification systems was developed to categorize and describe the activity, initiating process, mechanism of injury, object and/or substance, and the use of protective eyewear from the narrative text data reported for each injury. METHODS: Routinely collected workers' compensation claims over a one year period (2000) were analyzed from a large US insurance provider. An index term search algorithm of occupation, incident, and injury description fields identified 2209 potential welding related eye injury claims. After detailed review of these claims, 1353 welders and 822 non-welders were analyzed. RESULTS: During 2000, eye(s) as the primary injured body part accounted for 5% (n = 26 413) of all compensation claims. Eye injuries accounted for 25% of all claims for welders. Subjects were mainly male (97.1%) and from manufacturing (70.4%), service (11.8%), or construction (8.4%) related industries. Most injuries were foreign body (71.7%) or burn (22.2%) and 17.6% were bilateral. Common activities include welding (31.9%) and/or grinding (22.5%). Being struck by an airborne object occurred in 56.3% of cases. Non-welders showed similar patterns except that burns (43.8%) were more frequent and more often initiated by another worker (13.9%). CONCLUSIONS: Narrative injury text provides valuable data to supplement traditional epidemiologic analyses. Workers performing welding tasks or working nearby welders should be trained to recognize potential hazards and the effective use of proper safety equipment to prevent ocular injury.

Accidents, Occupational↗
PubMed2001

Surveillance of work-related carpal tunnel syndrome in Massachusetts, 1992-1997: a report from the Massachusetts Sentinel Event Notification System for Occupational Risks (SENSOR).

BACKGROUND: This surveillance study was undertaken to target efforts to prevent work-related carpal tunnel syndrome (WR-CTS) and to assess physician case-reports as a source of surveillance data. METHODS: Physician case-reports and workers' compensation disability claims were used to document patterns of WR-CTS in Massachusetts from March 1992 to June 1997 by age, gender, industry, occupation, and calendar year. Characteristics of cases identified through the two data sources were compared. RESULTS: 4,836 cases of WR-CTS were ascertained; 6% were identified by both data sources. Whereas the two sets of cases were similar with respect to age and occupation categories, physician-reported cases were more likely male and employed in manufacturing. The number of compensation claims filed by women declined over time, and a substantial number of cases under age 25 years were identified. Manufacturing workers had the highest rates; the highest numbers of cases were employed in hospitals, grocery stores, and the insurance industry. Several technical/administrative support occupations likely to use video display terminals had both high rates and frequencies. CONCLUSION: WR-CTS is a significant public health problem. Physician reports are useful in understanding problem magnitude and targeting specific establishments for intervention but are currently of limited use in targeting specific industries and occupations.

Administrative Personnel↗
PubMed1998

FDG-PET and MRI in temporal lobe epilepsy: relationship to febrile seizures, hippocampal sclerosis and outcome.

OBJECTIVE: To correlate the volumetric head magnetic resonance imaging (MRI) and fluorodeoxyglucose-positron emission tomography (FDG-PET) scan findings with the history, intracarotid amobarbital procedure, pathology, and outcome in patients with medically refractory temporal lobe epilepsy. MATERIAL AND METHODS: Thirty-eight patients with temporal lobe epilepsy treated surgically following a comprehensive presurgical evaluation. Follow-up ranged from 12 to 44 months. RESULTS: Volumetric MRI showed ipsilateral hippocampal atrophy in 29 (76%), and PET scan showed ipsilateral temporal hypometabolism (PET-TH) in 31 (81.5%) of patients. Eighty-three percent of those patients with hippocampal sclerosis on MRI (MRI-HS) had ipsilateral PET-TH. Sixty-six percent of patients with MRI-HS had a history of prolonged febrile convulsions or a childhood febrile illness accompanied by convulsions, and 77% of patients with MRI-HS had pathologically proven hippocampal sclerosis (HS). Ninety percent became seizure free or had rare seizures. CONCLUSION: FDG-PET scans and head MRIs were complementary; 95% of patients had either MRI-HS or temporal hypometabolism. MRI-HS correlated with a history of febrile seizures and pathologically demonstrated hippocampal sclerosis. Ninety-three percent of patients had focal functional deficits on the epileptogenic side. Concordance between PET temporal hypometabolism and MRI-HS correlated with better outcome.

Adolescent↗
PubMed1997

Practical operation of a biaxial goniometer at the wrist joint.

The objectives of this study were (a) to determine errors in wrist angle measurements from a commercially available biaxial electrogoniometer and (b) to develop a calibration routine in order to correct for these errors. Goniometric measurements were collected simultaneously with true angular data using a fixture that allowed wrist movement in one plane while restricting motion in the orthogonal plane. These data were collected in two sets of trials: flexion/extension with radial/ulnar deviation restricted, and radial/ulnar deviation with flexion/extension restricted. During these trials, we studied discrete 30 degrees increments of forearm rotation. The results showed the expected cross talk and zero drift errors during forearm rotation. The application of mathematical equations that describe the effect of goniometer twist resulted in significant error reduction for most forearm rotations. The calibration technique employs both a slope and a displacement transformation to improve the accuracy of angular data. The calibration technique may be used on data collected in the field if forearm rotation is measured simultaneously with the goniometer data.

Calibration↗
PubMed1990

Predictors of bone mass in perimenopausal women. A prospective study of clinical data using photon absorptiometry.

STUDY OBJECTIVE: To determine whether clinically available data on risk factors are adequate to identify perimenopausal women with either low or high bone mass. DESIGN: Cross-sectional observational study of a cohort of perimenopausal women (mean age, 50.8 years). SETTING: Community volunteers in a university hospital. SUBJECTS: One hundred twenty-four white volunteers established as perimenopausal by history and serum concentrations of estrogens and follicle-stimulating hormone. MEASUREMENTS AND MAIN RESULTS: Models were constructed to predict bone mass in the radius, lumbar spine, and hip using risk factors (age, height, weight, calcium and caffeine intake, alcohol and tobacco use, and urinary markers of bone turnover). Although highly significant predictive models were developed for all skeletal sites, none of the models correctly identified more than 70% of women with low bone mass at any site. However, for the radius, a model was constructed that never overestimated bone mass by more than 0.10 g/cm. A small subgroup (7%) with short stature, low body weight, low calcium intake, and who were heavy smokers always had low radial bone mass. Using these models, about 30% of our population could be assessed without bone mass measurements. Predictions for the spine and femur were less efficient, suggesting that direct measurements are required if therapy decisions are to be based on bone mass at these sites. CONCLUSIONS: Risk factors for osteoporosis are of limited use in identifying women with low bone mass around the time of menopause. Measurements of bone mass are probably necessary if the risk for osteoporosis is to be the basis for deciding on estrogen replacement therapy.

Absorptiometry, Photon↗
PubMed1989

Young children's attribution of action to beliefs and desires.

When and how children understand beliefs and desires is central to whether they are ever childhood realists and when they evidence a theory of mind. Adults typically construe human action as resulting from an actor's beliefs and desires, a mentalistic interpretation that represents a common and fundamental form of psychological explanation. We investigated children's ability to do likewise. In Experiment 1, 60 subjects were asked to explain why story characters performed simple actions, such as looking under a piano for a kitten. Both preschoolers and adults gave predominantly psychological explanations, attributing the actions to the actor's beliefs and desires. Even 3-year-olds attributed actions to beliefs and false beliefs, demonstrating an understanding of belief not evident in previous research. In Experiment 2, 24 3-year-olds were tested further on their understanding of false belief. They were given both false belief prediction and explanation tasks. Children performed well on explanation taks, attributing an anomalous action to the actor's false belief, even when they failed to predict correctly what action would follow from a false belief. We concluded that 3-year-olds and adults share a fundamentally similar construal of human action in terms of beliefs and desires, even false beliefs.

Adult↗
PubMed1986

Left ventricular function in tricuspid atresia: a radionuclide study.

Left ventricular function was evaluated by radionuclide angiocardiography in patients with tricuspid atresia before and after the Fontan operation. Ejection fraction was 0.54 +/- 0.13 in 29 patients without the Fontan procedure and 0.56 +/- 0.14 in 14 postoperative patients. Group means were not statistically different, but both were less than normal values for the institution (p less than 0.001). Function did not correlate significantly with age or aortic oxygen saturation. Serial studies demonstrated little change in eight of nine patients examined over 1 to 3 years preoperatively. From the preoperative group of nine patients with abnormal ejection fraction, three underwent surgery, with two survivors. Although 5 of 14 patients had abnormal systolic function after the Fontan operation, only 1 was symptomatic. Depressed response to isometric exercise was found in two patients with a normal ejection fraction at rest. Group systolic function after Fontan surgery did not correlate significantly with age at surgery but all patients were operated on at more than 5 years of age. Of seven patients studied both preoperatively and postoperatively two had an increase and three a decrease in ejection fraction. The trend in these seven studied serially after surgery was toward early improvement in ejection fraction. This study shows variability in left ventricular performance in patients with tricuspid atresia before and after surgery. Individuals undergoing the Fontan procedure after 5 years of age do not necessarily have an increase in ejection fraction over preoperative values, and may even have a decrease. Serial improvement over early postoperative results may be expected, without significant deterioration, during the next 1 to 3 years.

Adolescent↗
PubMed1986

Role of radionuclide shunt studies in management of infants and children.

The utility of radionuclide-shunt quantitation in children was assessed by examination of the outcome of 128 patients who underwent shunt study over a two-year period. The possibility of cardiac catheterization was eliminated in 87. Fifty of these had undergone previous cardiac catheterizations, which suggested the necessity for further invasive study or surgery; after radionuclide evaluation, 28 were shown to have had enough spontaneous closure of the defect to cancel planned surgery, 12 were scheduled for surgery without repeat catheterization, and ten had nuclear rather than catheterization estimates of residual shunting following surgical repair of septal defects. Thus, radionuclide shunt study provides a relatively noninvasive technique to quantitate left-to-right shunts, supplementing or supplanting cardiac catheterization in the management of infants and children with such lesions.

Adolescent↗
PubMed1984

Scintigraphic and X-ray arthrographic diagnosis of femoral prosthesis loosening: concise communication.

In order to determine loosening of femoral components of conventional total hip arthroplasties, a comparison of radionuclide (RA) and radiographic arthrograms (XA) was performed. The hips of 29 patients were studied with radiographic contrast and intraarticular Tc-99m sulfur colloid. The XAs were positive for loosening in 10/29 studies, whereas the RAs were positive in 19/29 studies. In five of ten in which both studies were positive, the RA showed femoral prosthesis loosening more clearly than the XA. By surgical follow-up, there were four false-negative XAs . Our data suggest that the RA is valuable in determining femoral component loosening.

Adult↗
PubMed1982

High-contrast film copying for thallium 201 cardiac image processing.

To evaluate the usefulness of high-contrast film copying as an economical means of enhancing contrast in thallium 201 cardiac images, stress and rest studies of 47 patients with and 19 patients without coronary artery disease were evaluated. A total of 66 sets of four different image formats were independently interpreted by five observers. The analysis of the receiver operating characteristic curves suggested that the high-contrast film copies were superior to their original analog images and comparable with computer-processed images in diagnostic yield. It appears that contrast enhancement by simple film copying can improve the accuracy of 201Tl image interpretation.

Coronary Disease↗
PubMed1982

Single-photon emission computed tomography (SPECT) for assessment of hepatic lesions.

Single-photon emission computed tomography (SPECT) and conventional scintigraphy were compared in 130 patients examined to assess hepatic involvement in malignant disease. Transmission computed tomography (TCT) served as the reference method against which SPECT and conventional scintigraphy were compared. The sensitivity of SPECT was calculated for lesions grouped according to diameter as well as location. The Bayesian theorem was used to assess the reliability of both SPECT and conventional scintigraphy. SPECT identified only 52% of lesions with a diameter of 1.5-2.0 cm. It was also shown that the sensitivity of SPECT was lowest for small lesions in the middle third of the liver. A comparison of the final diagnosis demonstrated that SPECT had greater sensitivity, specificity, and accuracy than conventional scans, and is superior at low disease prevalence. At high disease prevalence, SPECT has a lower rate of false negatives. SPECT appears to be the superior imaging modality for evaluation of the liver in malignant disease.

Bayes Theorem↗
PubMed1979

Primary aldosteronism: diagnosis, localization, and treatment.

New diagnostic techniques have enhanced the detection of primary aldosteronism. However, the response of blood pressure after operation in unilateral and bilateral adrenal disease is different. We have compared four localizing techniques--adrenal venography, adrenal isotopic scanning, a modified adrenal venous sampling for steroid measurements, and the anomalous postural decrease in plasma aldosterone concentration--in 51 patients with primary aldosteronism, all of whom had undergone operative confirmation. Adrenalectomy resulted in normal blood pressure in 59%, improvement in 25%, and no change in 16%. Correct localization of the lesion was obtained in 47% by the adrenal isotopic scan, in 66% by adrenal venography, and in 91% by the modified adrenal venous hormone technique despite four false-positives. Of the 26 patients with an anomalous postural decrease in plasma aldosterone, 88% had a unilateral lesion.

Adenoma↗
PubMedDate not supplied

Central nervous system angioendothelosis. A treatable multiple infarct dementia.

CNS neoplastic angioendothelosis is a treatable primary proliferative disorder of the endothelial cells of blood vessels characterized by a clinical neurological picture of multiple infarct dementia and an inordinate amount of local cerebral edema, so striking that it may simulate primary or metastatic central nervous system tumor. The malignant cells remain within the lumen of the vessels and rarely if ever metastasize or occur in peripheral blood. There is remarkable improvement in symptoms by treating with high dose steroids. Antimetabolites and irradiation are suggested means of additional treatment.

Aphasia↗