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Biomedical subjects

J E Hicks

Publications and source records attributed to J E Hicks.

35 records · Page 2Linked to original sources
PubMed1989

Prosthetics, orthotics, and assistive devices. 1. General concepts.

This self-directed learning module highlights the general concepts and new advances in the area of orthotics and prosthetics. This general overview is part of the chapter on prosthetics, orthotics, and assistive devices for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation. This section contains essential information on spinal, lower and upper limb orthotics, lower and upper limb prosthetics, juvenile prosthetics, kinesiology, motion analysis, and assistive devices such as canes and crutches. This article establishes a foundation on which the second, third, and fourth articles of this chapter will build. The three articles to follow review newer developments in specialized seating and assistive devices, prosthetics, and the orthotic management of selected disorders.

Adult↗
PubMed1989

Prosthetics, orthotics, and assistive devices. 2. Specialized seating and assistive devices.

This self-directed learning module discusses topics in specialized seating, mobility devices, augmented communication, and adaptive equipment. Development, perceptual-motor, and cognitive factors are addressed in regard to appropriate prescription, training, and follow-up. It is part of the chapter on prosthetics, orthotics, and assistive devices for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation.

Adult↗
PubMed1989

Prosthetics, orthotics, and assistive devices. 3. Prosthetics.

This self-directed learning module highlights new advances in prosthetics. It is part of the chapter on prosthetics, orthotics, and assistive devices for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation. This section contains information regarding conventional and myoelectric upper limb prosthetics, above-knee (AK) socket designs and materials, and foot and ankle systems. New advances that are covered in this section include the narrow medial-lateral AK socket, the flexible AK socket, and new prosthetic foot and ankle systems. Proper understanding and clinical application of this technology is essential for the optimal prosthetic rehabilitation of the amputee.

Artificial Limbs↗
PubMed1989

Prosthetics, orthotics, and assistive devices. 4. Orthotic management of selected disorders.

This self-directed learning module presents core information and new advances in the orthotic management of problems of the runner and of patients with neurovascular foot ulcers or arthritis. Additional topics covered include a comprehensive approach to positioning and splinting for burns and tone-reducing orthoses for spasticity management. It is part of the chapter on prosthetics, orthotics, and assistive devices for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation.

Adult↗
PubMed1989

Functional and psychosocial effects of multimodality limb-sparing therapy in patients with soft tissue sarcomas.

We have documented functional and psychosocial changes in patients with extremity soft tissue sarcomas who have undergone multimodality limb-sparing treatments. In 88 patients, parameters related to economic status, sexual activity, pain, limb function, and global quality of life (QOL) were recorded prior to surgery and every 6 months postoperatively. Changes from the preoperative assessment for every parameter were analyzed in each patient. Six months after surgery, there was a decrease in employment status, sexual activity, and in limb function in a significant number of patients. At 12 months, these decreases were still evident. Despite these changes, global QOL measured by a standardized test showed at least some improvement in a significant proportion of patients at 12 months. These findings highlight the difficulty in defining QOL. It could not be ascertained if radiation therapy and/or chemotherapy were causative factors in specific changes because of the small numbers of patients in each subgroup. However, among 60 patients with high-grade sarcomas, significant wound problems developed in 10 of 33 who received postoperative radiation therapy in combination with adjuvant doxorubicin and cyclophosphamide chemotherapy compared with one of 27 patients who received adjuvant chemotherapy alone (P = .016). Also, among high-grade sarcoma patients with 12-month follow-up, six of 19 patients who received radiation therapy and chemotherapy developed joint contractures compared with zero of 15 patients who received chemotherapy alone (P less than .04). The combination of postoperative radiation therapy and chemotherapy appeared to be associated with significantly more tissue-related injury in patients with high-grade sarcomas compared with chemotherapy alone.

Adolescent↗
PubMed1989

The failure of intravenous cyclophosphamide therapy in refractory idiopathic inflammatory myopathy.

Eleven patients with idiopathic inflammatory myopathy refractory to treatment with corticosteroids and other immunosuppressive agents were treated with monthly intravenous cyclophosphamide (0.75-1.357 g/m2). Six patients completed a full course of 7 infusions at which point only one patient met predefined criteria for improvement in both strength and function. Five had modest improvement in strength but did not meet the criteria for improvement. All patients have subsequently required treatment with other medications. Major complications observed during therapy included serious infections in 2 patients (streptococcal endocarditis and disseminated Mycobacterium avium intracellulare) and death in one patient in which the contribution of cyclophosphamide cannot be excluded. We conclude that intravenous cyclophosphamide as used in our study cannot be recommended for the treatment of patients with refractory inflammatory myopathy.

Adult↗
PubMed1986

Cervical motion assessment: a new, simple and accurate method.

Accurate assessment of head motion can be a useful tool in clinical studies. Since the head moves on a combination of axes in the cervical spine, evaluation of neck motion is difficult. Assessment of cervical mobility is further complicated because of inadequate reference points on the head from which to measure. Hence, numerous methods for approximating cervical range have been devised. These methods include visual estimation, radiographic analysis, schematography, photography, and a variety of goniometer devices. Disadvantages of these techniques are lack of accuracy and objectivity, radiation exposure, expense, time consumption, and equipment availability. To measure cervical mobility, a standard gravity goniometer with spirit level and head adapter was used, which allowed stabilization. The gravity goniometer can be obtained in a variety of sizes at most hardware stores. The head adapter consists of a wood block into which an arc is carved and elastic straps suspended for securing on the head. The reliability of this instrument was tested and compared to the universal goniometer, and correlation coefficients were determined. When two experienced examiners used the universal goniometer to assess cervical motion, significant intraclass correlation coefficients (ICC) were found with three of the six criteria measures (p less than 0.05). When one experienced and one novice examiner used the gravity goniometer with head adapter, highly significant ICC values were found for all six criteria measures (p less than 0.01). A single experienced examiner comparing both instruments on the same subjects produced significant ICC values in four of the six criterion measures (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Cervical Vertebrae↗
PubMed1985

Rehabilitative rheumatology content in current rehabilitation medicine training programs.

The Council on Rehabilitative Rheumatology of the American Rheumatism Association, through the Education Subcommittee, surveyed directors of 69 approved rehabilitation medicine residency training programs to assess the nature of training in rehabilitative-rheumatology and whether the directors believed this training to be adequate. Sixty-one directors responded, with 84% of the respondents reporting a rheumatology department in their hospitals and 43% reporting a formal rotation for their residents in rheumatology. Fifty-nine (97%) reported their residents received lectures in rheumatology. Fifty-five (90%) reported lectures given by a physiatrist in the rehabilitative management of rheumatic diseases. Only 21 (34%) reported a physiatrist-attended rheumatology outpatient clinic. Fifty-one (82%) desired a closer liaison with the rheumatology department. Thirty-seven (61%) indicated their residents received adequate training on the diagnosis of rheumatic diseases, and 46 (75%) adequate training in rehabilitative management, while 59 (97%) desired a concise handbook which emphasizes the rehabilitative management of rheumatic diseases. A previous survey of 100 arthritis fellowship programs approved by the American Medical Association brought 81 responses, of which only 43% considered that their Fellows had adequate training in rehabilitative rheumatology. Physiatrists attended clinics 21% of the time and patient care rounds 19%. Ninety-four percent desired a syllabus. Both surveys indicated limited interaction between the two specialties and leads us to conclude that a rehabilitative-rheumatology handbook would be desirable, closer liaison of rehabilitation faculty with rheumatology faculty is needed to respond to individual training needs, more active participation by a physiatrist in patient care conferences may be necessary for adequate education in rehabilitative-rheumatology.

Education, Medical, Graduate↗
PubMed1984

Vertebral abnormalities associated with synthetic retinoid use.

Frequent symptoms of back and neck stiffness led to a radiographic investigation of the vertebral spine in patients receiving synthetic retinoids, isotretinoin and etretinate. X-ray examination of fifty patients with various skin disorders who received retinoids for at least 2 years were compared with seventy-two age- and sex-matched untreated patients. Differences in frequencies of defined abnormalities, which included anterior spinal ligament calcification and presence of osteophyte at two or more vertebral levels in the absence of joint space narrowing, were determined for treated and untreated patients. When the entire group of treated patients was compared with the entire group of those untreated, no statistically significant differences were observed. When only patients with basal cell nevus syndrome ( BCNS ) or basal cell carcinoma (BCC) who had never received retinoid were compared with those who received isotretinoin, the frequency of the defined abnormalities was significantly higher in the treated group (P less than 0.01). This study suggests that the ingestion of isotretinoin at mean total dose of 150,060 mg for an average of 2.9 years is associated with a statistically significant increase in developing an associated ossifying diathesis in patients with BCNS or BCC, when compared with matched, untreated controls.

Adult↗
PubMed1984

Diagnostic ultrasound: its use in the evaluation of muscle.

We describe a noninvasive quantitative way of measuring muscle with a specially-designed digital ultrasound scanner. Reliability and reproducibility of echo amplitude were determined in 16 normal male volunteers--10 runners and 6 non-runners. Echo amplitudes were recorded from the quadriceps femoris muscle. The muscle was scanned at mid-thigh in a relaxed state with 18 degrees flexion and in an isometrically contracted state with the leg in full extension. Echo amplitudes obtained in the non-runner group were: (1) mean value of the muscle in the relaxed state (174.9 +/- 30.8) and (2) mean value of the muscle in the contracted state (121.8 +/- 31.4). The difference in these values (53.1) was significant at p less than 0.05. Echo amplitudes for runners were: (1) mean value of the muscle in the relaxed state (146.6 +/- 39.2) and (2) mean value of the muscle in the contracted state (107.1 +/- 30.1). The difference in these values (39.5) was significant at p less than -0.01. The data indicate that: values of echo amplitudes are reproducible; there is a statistically significant difference in the mean amplitudes of muscle in a contracted and relaxed state; and while the difference between runner and non-runner muscle is not statistically significant (p greater than 0.1), there is a trend toward significance. Because ultrasound amplitude is a function of tissue structure, this technique may provide a noninvasive method for quantifying muscle collagen and fat.

Adipose Tissue↗
PubMed1980

A systematic technique for the identification of crash hazards in U.S. Army aircraft.

A methodology for identification of crashworthiness deficiencies in Army aircraft is discussed. The methodology provides for injury and impact data to be extracted from accident reports using a specially-developed injury coding system. Personnel injuries are costed through a technique which provides for consideration of each injury based on its relative severity as determined by medical examination. Crash injury causes are identified and ranked according to the magnitude of their effect and probability of occurrence. The technique is designed to provide recommendations as to the most urgent crashworthiness research/development/procurement efforts for consideration by aircraft systems managers and aviation research laboratories. An application of the methodology to an operational Army aircraft is shown. Results typically available are discussed. Recommendations are made as to the use of the methodology and to additional investigation aids which would improve the future identification of crash hazards.

Accidents, Aviation↗
PubMed1976

Neutropenia during high dose intravenous oxacillin therapy.

Five patients who developed neutropenia following intravenous administration of high dose oxacillin for serious Staphylococcus aureus infection are described. Neutropenia was reversible with cessation of intravenous oxacillin therapy. Two patients were continued on oral oxacillin without untoward effects.

Adolescent↗