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Biomedical subjects

J L Seres

Publications and source records attributed to J L Seres.

9 recordsLinked to original sources
PubMed1993

The neurosurgical management of pain: a critical review.

The historical background of neurological surgery for pain demonstrates a remarkable honesty in outcome assessment. Because of apparent concentration on technological break-throughs, the contemporary focus is less directed to socially important issues. Because of the importance of outcome management in the current political environment, it is important to return to basic principles. A more socially and economically responsible approach is desperately needed in the neurosurgical community at this time. Standardization of outcome reporting and issues of societal impact must be included to justify the real value of new technology.

Humans↗
PubMed1989

Perspectives on surgical indications. Implications for controls.

Surgical indications do not forecast outcomes as well as they should. A review of the literature demonstrates a significant rate of overutilization of coronary angiography, coronary artery surgery, cardiac pacemaker insertion, upper gastrointestinal endoscopies, carotid endarterectomies, back surgery, and pain-relieving procedures. The tendency appears to be a reduction in developing specific indications, and the evolution of a "last resort" concept. Arguments against this approach and a plea for the development of tighter focused indications are presented. Implications for cost saving and reduction in suffering are discussed.

Health Services Misuse↗
PubMed1981

Multidisciplinary treatment of chronic pain at the Northwest Pain Center.

The Northwest Pain Center is a three-week multidisciplinary day care pain management program which has been operating since 1972. Experience shows that pain problems result in excessive use of medical resources, inappropriate medication use, and possibly unnecessary surgeries. Significant depression and family disruption are common. In spite of powerful incentives that maintain pain behavior, most important being the compensation and disability systems, more than 70 percent of patients maintain objective physical gains resulting from pain center treatment. Studies attempting to differentiate long-term successes from long-term failures provide implications for treatment and evaluation strategies. Areas of need are identified in public and professional education, and necessary future research.

Ambulatory Care Facilities↗
PubMed1978

A therapeutic milieu for chronic pain patients.

Traditional means of treating chronic pain have been unsuccessful in a discouraging number of cases. Pain centers have appeared within the last few years, offering a more comprehensive view of the whole pain problem. Pain centers address pain as a multifaceted event with social, economic, physiological, and psychological representations. In addition, the pain center constructs an atmosphere that provides every opportunity for reduction of pain, while minimizing those factors that tend to encourage its expression. Such a venture calls for a multidisciplinary approach; it further demands a rather sophisticated grasp of numerous factors which do not necessarily lend themselves to discussion with a single vocabulary. This paper will attempt to describe a number of conceptual models of chronic pain and to demonstrate how each of these models is addressed therapeutically in a multidisciplinary pain center millieu.

Humans↗
PubMed1976

Results of treatment of chronic low-back pain at the Portland Pain Center.

We have evaluated 100 consecutive patients with low-back pain admitted to the Portland Pain Center. The average patient had been disabled for about 6 years, and had had an average of two surgical attempts to improve his symptoms. Most of the patients considered had open claims with their Workmen's Compensation carriers. Significant gains were demonstrated in drug reduction, general well behavior, and increased range of motion and exercise tolerance. The Pain Center setting provides a multidisciplinary approach to the treatment of chronic low-back pain. Significant increases in functional capacity are demonstrated.

Adult↗