Biomedical subjects

J K Coryell

Publications and source records attributed to J K Coryell.

3 recordsLinked to original sources

PubMed1986

Disability, disease duration, and rehabilitation service needs in multiple sclerosis: patient perspectives.

The purpose of this study was to determine the medical, psychologic, social, and vocational needs of individuals with multiple sclerosis (MS) and to evaluate these needs with respect to age, disease duration, sex, and disability level. Individuals with MS in western Washington state were asked to participate by responding to a mailed questionnaire. Six hundred fifty-six completed the questionnaire of more than 250 variables covering symptoms, diagnosis, adjustment, service use and service need were found in this population. Medical needs, with the exception of bladder management and physical therapy, appeared well met. However, counseling and vocational needs appeared less well met. The perceived need for most medical and community services was correlated with increasing disability as might be expected. However, the need for vocational and psychologic services was not related to the level of disability but to the age of the patients and the recency of MS diagnosis.

Activities of Daily Living↗

PubMed1984

Symptomatic fatigue in multiple sclerosis.

Symptomatic fatigue has not been investigated previously in a multiple sclerosis population. Potential subjects were the 78% of 656 individuals with multiple sclerosis who indicated in a previous study that they experienced symptomatic fatigue. Three hundred nine subjects (60%) returned a follow-up questionnaire on symptomatic fatigue. Ninety percent described fatigue as "tiredness or the need to rest," but 43% of them indicated that "sleepiness" was part of the symptomatology. In 48% fatigue made other MS symptoms worse. Fatigue tended to occur in the late afternoon and evening. It occurred almost daily for more than 66% of the subjects. In 47% of the subjects fatigue usually subsided within a few hours; in other subjects occurrences were of variable length (40%) or lasted between 6 and 24 hours (8%). Ninety percent said that fatigue was worse at warmer environmental temperatures. Fatigue was worse for 83% after "vigorous exercise" and for 64% after "moderate exercise" although 15% reported that moderate exercise helped to reduce fatigue. Meditation, some drugs, and cooling with water reduced fatigue in a majority of the small proportion of the population trying these techniques. A planned daily schedule of activity and rest seemed to be a partially effective response to symptomatic fatigue for the majority of subjects studied.

Adult↗

PubMed1981

Multiple sclerosis: early prognostic guidelines.

To determine tentative early prognostic indicators in multiple sclerosis (MS), literature dealing with MS prognosis and rehabilitation, the records of University of Washington MS Clinic patients, and the opinions of directors of MS Clinics throughout the United States were reviewed. From a review of more than 200 books and articles, as well as MS clinic records, 13 indicators were identified. Characteristics reported as indicating a relatively good prognosis were: 35 years of age or less at onset, current ambulatory ability, monosymptomatic onset, sudden appearance of symptoms, initial remission within 1 month, most recent but less than 2 months, little or no residual deficit after each exacerbation, absence of extensor plantar reflexes and cerebellar signs at initial examination, optic neuritis or other sensory symptom as the sole presenting symptom, absence of initial motor symptoms and pyramidal and cerebellar signs minimal 5 years after onset. The 30 MS clinic directors responding to the survey felt that useful indicators, in order of their usefulness, were: current ambulatory ability, minimal pyramidal and cerebellar signs 5 years after onset, good remission of initial symptoms, prompt resolution of initial symptoms, age 35 or less at onset, only 1 symptom occurring during the 1st year, sudden appearance of initial symptoms, brief duration of the most recent exacerbation, and absence of cerebellar signs at initial examination. In addition to identifying tentative early prognostic indicators, this paper also outlines a simple method of quantifying the level of disability and outlines typical disease courses and rehabilitation service needs in MS.

Adult↗