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Biomedical subjects

J A Combs

Publications and source records attributed to J A Combs.

6 recordsLinked to original sources
PubMed1998

Bacterial osteitis pubis in a weight lifter without invasive trauma.

Osteitis pubis is a well-known complication of invasive procedures about the pelvis which is caused by a bacterial infection. It is also now known that osteitis pubis in athletes is an inflammatory disorder rather than infectious as previously thought. It occurs in athletes who place significant repetitive stresses across the symphysis in such activities as running, race walking, gymnastics, soccer, rugby, basketball, and tennis. This case report, however, describes a weight lifter who developed a bacterially caused osteitis pubis without any invasive trauma. He was evaluated thoroughly and no other focus of infection was found. He was treated conservatively with intravenous antibiotics and physical therapy. At 3 months follow-up he had returned to his usual fitness activities without limitations. Although most osteitis pubis in athletes is inflammatory in nature, health care providers must keep an index of suspicion that an infectious etiology is possible in this population even without invasive trauma.

Cumulative Trauma Disorders↗
PubMed1997

Back pain in children and adolescents: a retrospective review of 648 patients.

Back pain in children has long been considered a serious condition with an organic cause. The staff of the Shriner's Hospital had been informally noting that diagnoses among children with back pain had been changing. We conducted a retrospective study of 648 patients with spinal disorders treated at the Shriner's Hospital for Crippled Children, Spokane Unit, between January 1991 and June 1993. The patients were divided into two groups: those with pain and those without pain. It was found that back pain with no organic cause was the primary diagnosis in 57% of the group having pain. Only one child had a diagnosis of malignancy, and there were no cases of active infection. In the group with pain, three interesting associations were found concerning psychosocial problems, disability, and litigation. It was found that the diagnoses in children with back pain treated at this referral center during the study period parallel those in the adult population with back pain.

Adolescent↗
PubMed1993

Chronic septic arthritis caused by Borrelia burgdorferi.

Chronic arthritis occurs in 10% of Lyme disease patients. A patient had chronic septic Lyme arthritis of the knee for seven years despite multiple antibiotic trials and multiple arthroscopic and open synovectomies. Spirochetes were documented in synovium and synovial fluid (SF). Polymerase chain reaction (PCR) analysis of the SF was consistent with Borrelia infection. Persistent infection should be excluded with silver stains and cultures in any patient with chronic monoarticular arthritis and a history of Lyme disease.

Adult↗
PubMed1990

Creating a healing environment.

To regain some of the principles of personalized care that were part of the foundation of nursing, Carondelet St. Mary's Health Center in Tucson, AZ, instituted a nurse case manager program in 1985. The program assigns a nurse case manager to coordinate patient and family care from an array of nursing services. Its special characteristic is a focus on home care after discharge. The basis for the program is a belief in holistic care, beginning during the hospital stay and continuing after discharge. Because the psychosocial and spiritual impact of the illness might not be felt until the client returns home, the nurse case manager concentrates on preventing or alleviating distress through a program of care, education, and service. In 1988 the center was asked to apply its program to a high-risk adolescent obstetrical group enrolled in a local health maintenance organization. The challenges for the nurses included poor nutritional status, substance abuse, unemployment, low self-esteem, and other factors precipitated by the group's socioeconomic status. By direct intervention the nurses were able to set patterns for positive adult behavior, and by the end of the program most of the clients had made considerable changes toward more successful life-styles.

Adolescent↗