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Biomedical subjects

J C Perrin

Publications and source records attributed to J C Perrin.

At least 19 recordsLinked to original sources
PubMed1992

Use of a polyethylene body jacket to prevent feeding tube removal in an agitated patient with anoxic encephalopathy.

UNLABELLED: Maintaining a feeding tube in place in the agitated patient following a traumatic brain injury or anoxic encephalopathy is a familiar problem. However, a survey of the literature employing the MEDLINE system provided no solutions. This case study of a 36-yr-old patient with anoxic encephalopathy illustrates a new method of preventing feeding tube removal using a modified polyethylene body jacket. The patient had repeatedly pulled out his gastrostomy tube despite the use of four-way restraints, a posey, behavior modification and anti-psychotic medications at levels near sedation. A polyethylene jacket with an S-shaped tunnel for feeding tube exit was constructed to cover the abdomen. FINDINGS: 1) The patient was unable to disturb the feeding tube. 2) The recessed design of the jacket's tunnel did not traumatize the feeding tube or obstruct fluid flow. 3) Nursing staff encountered no problems in placing or removing the orthosis. 4) Skin integrity was maintained. 5) The orthosis did not interfere with therapies.

Adult↗
PubMed1992

Beaumont Lifestyle Inventory of Social Support. Can it predict disposition prior to an inpatient rehabilitation admission?

Predicting which rehabilitation patients will ultimately be discharged to a nursing home is a difficult task because methods used to evaluate preexisting home environment and quantify social support have been inadequate. To address this problem, the Beaumont Lifestyle Inventory of Social Support (BLISS) was developed. This questionnaire examines the family's willingness to care for, supervise and provide financial assistance to the patient. Organized into 10 weighted questions, BLISS results in a maximum score of 12. A prospective study was conducted to determine the correlation of the BLISS score with discharge disposition. Prior to rehabilitation admission, continuing care coordinators administered the BLISS to an involved family member of each patient. After 6 months, all BLISS forms were scored and compared with discharge disposition. Seventy-nine patients were included in this study and six (7.6%) were discharged to nursing homes. Comparison of BLISS scores obtained in patients discharged home versus nursing home revealed averages of 9.3 and 4.0, respectively (P less than 0.0006). These findings indicate that BLISS can quantify a patient's social situation and provide a predetermination of the social factors that lead to nursing home discharge. Consequently, BLISS will be a useful screening tool during the rehabilitation selection process.

Activities of Daily Living↗
PubMed1991

Hereditary coproporphyria: an imitator of multiple sclerosis.

Hereditary coproporphyria can cause both peripheral neuropathy and central nervous system abnormalities. There are several similarities between multiple sclerosis and hereditary coproporphyria that are probably due to the central nervous system dysfunction present in both. This report describes a 62-year-old man with a five-year history of progressive paraparesis initially diagnosed as multiple sclerosis. Supporting evidence for the diagnosis of a demyelinating disease included three oligoclonal bands in the patient's cerebral spinal fluid, a prolonged visual evoked response bilaterally, abnormal sensory evoked potentials, and an area of increased signal in the posterior cervical cord suggestive of demyelination that was demonstrated on magnetic resonance imaging (MRI). Features atypical for multiple sclerosis were hypoactive deep-tendon reflexes, electromyographic evidence of peripheral neuropathy, and severe constipation. Elevated urine porphyrins and decreased levels of coproporphyrinogen oxidase confirmed the correct diagnosis of hereditary coproporphyria. The patient improved after being placed on a high-carbohydrate diet. Although central demyelination is known to occur in patients with porphyria, delayed evoked potentials and MRI abnormalities have not been previously reported.

Diagnosis, Differential↗
PubMed1989

Pediatric rehabilitation. 1. General principles and special considerations.

This self-directed learning module addresses core concepts in the assessment of any child with disability, including physical growth and development, evolution of reflexes, and cognitive and personality development. It is a section of the chapter on pediatric rehabilitation for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation. The rehabilitation perspective is emphasized, especially as it changes to accommodate the developing child, with a focus on specific chronic disorders such as respiratory disease, congenital heart disease, and malignancy. These types of disorders serve as a model for the management of problems that require special medical, rehabilitative, and psychosocial consideration.

Child↗
PubMed1989

Pediatric rehabilitation. 2. Brain damage causing disability.

This self-directed learning module addresses rehabilitation issues in the child with brain damage. It is a section of the chapter on pediatric rehabilitation for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation. In addition to the motor manifestations, intellectual, social, and emotional impairment are addressed. Problems vary with developmental stage. Emphasis is on the etiology, severity, and combination of deficits in order to develop a plan of management, including physical, occupational, and speech therapy, recreational and social milieu, and family and community resources.

Brain Damage, Chronic↗
PubMed1989

Pediatric rehabilitation. 3. Disorders of the spinal cord: spinal cord injury, myelodysplasia.

This self-directed learning module provides review and references for the basic concepts of, and highlights new advances in, disorders of the spinal cord in children. It is a section of the chapter on pediatric rehabilitation for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation. For spinal cord injury, only data pertinent to the pediatric age group are discussed. Myelodysplasia is presented in detail to include genetic implications, early intervention, long-term management planning, psychosocial impact, and quality-of-life considerations.

Child↗
PubMed1989

Pediatric rehabilitation. 4. Disorders of the motor unit.

This self-directed learning module addresses diagnostic and rehabilitation issues in children with the most common disorders of the motor unit. It is a section of the chapter on pediatric rehabilitation for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation. Conditions occurring only in infancy or childhood and differences in diagnostic and rehabilitation approaches as compared with those used in adults are highlighted.

Child↗
PubMed1989

Pediatric rehabilitation. 5. Joint and connective tissue diseases.

This self-directed learning module presents pertinent information about rehabilitation management of specific joint and connective tissue diseases affecting children. This section highlights juvenile rheumatoid arthritis, Lyme disease, rheumatic fever, hemophilia, dermatomyositis, polymyositis, systemic lupus erythematosus, and other forms of arthritis. It is a section of the chapter of pediatric rehabilitation for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation.

Child↗
PubMed1989

Pediatric rehabilitation. 6. Musculoskeletal and soft tissue disorders.

This self-directed learning module highlights advances in evaluation and treatment of congenital and acquired musculoskeletal disorders in the child. It is a section of the chapter on pediatric rehabilitation for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation. This section contains information on alterations of limb structure and gait, scoliosis, torticollis, sports injuries and overuse syndromes, and unexplained pain in children.

Arm Injuries↗
PubMed1987

Paraparesis in a child with a herniated thoracic disc.

Herniated thoracic disc after minor trauma, causing paraparesis in an 11-year-old boy, proved difficult to diagnose. Myelogram and computer tomography of the thoracic spine appeared normal, but magnetic resonance imaging demonstrated a small herniation at T4-T5. Disc material adherent to the dura was found at laminectomy. The child made progressive recovery preoperatively and postoperatively and was able to ambulate in parallel bars with a left knee-ankle-foot orthorsis at the time of discharge from the hospital.

Child↗
PubMed1983

Pregnancy and the herniated lumbar disc.

During the last decade, five pregnant patients with symptoms and signs of a herniated lumbar disc were identified among a series of 48,760 consecutive deliveries at William Beaumont Hospital, an incidence of 1:10,000. In all cases, clinical evaluation and electromyography complemented conservative treatment during the final stage of pregnancy. Each patient was delivered by cesarean section. Large lumbar disc herniations in each case were subsequently identified by myelography. In all five cases, lumbar laminectomy was successful in facilitating the eventual resolution of the signs and symptoms of the radiculopathy. Although the mechanical and postural stresses of pregnancy have been cited as predisposing causes of a herniated lumbar disc, this study suggests otherwise. Lumbosacral vertebral disc ruptures of pregnancy, while relatively rare, should nevertheless be recognized early, distinguished from other causes of lumbosacral gestational plexopathy, and promptly treated.

Adult↗
PubMed1978

Congenital synostosis of the knee.

Three congenital synostoses of the knee occurred in 2 patients. Complete bony epiphyseal fusion was present on the radiographs. This condition is a failure of joint formation in the early mesenchymal stage at 4--5 weeks gestation and appears as connected cartilaginous cell masses which later ossify. Involvement of other joints has been reported in the literature, but these may be the first documented cases of the condition in knee joints.

Child↗
PubMed1977

A heritable syndrome of craniosynostosis, short thin hair, dental abnormalities, and short limbs: cranioectodermal dysplasia.

Five children are reported with dolichocephaly (with sagittal suture synostosis in three), sparse, slow-growing, fine hair, epicanthal folds, hypodontia and/or microdontia, short span, brachydactyly and brachypodia, and narrow thoraces. Radiologic abnormalities were noted chiefly in the skull, chest, and limbs. Intelligence was normal. The pattern of inheritance is compatible with an autosomal recessive trait.

Abnormalities, Multiple↗
PubMed1977

An autosomal dominant midline cleft syndrome resembling familial holoprosencephaly.

We have detected a previously unrecognized autosomal dominant syndrome characterized by: mental retardation, microcephaly; craniofacial anomalies including cleft lip and anterior cleft palate, hypotelorism and antimongoloid slant; skeletal anomalies, notably of the foot and spine; and chronic constipation. Despite similarities to familial holoprosencephaly, this disorder appears to be a distinct entity. Incomplete penetrance and variable expressivity accompany transmission of the abnormal allele through four generations of a large kindred. Three of the four affected males survived past 20 years of age; the fourth is an infant. All three affected females died very early in infancy.

Abnormalities, Multiple↗