[Erythromycin sensitivity of Shigella flexneri and S. sonnei].
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Anti-Bacterial Agents↗
Biomedical subjects
K Homa
Publications and source records attributed to K Homa.
Development of CPR security using impact analysis.
The HIPAA regulations will require that institutions ensure the prevention of unauthorized access to electronically stored or transmitted patient records. This paper discusses a process for analyzing the impact of security mechanisms on users of computerized patient records through "behind the scenes" electronic access audits. In this way, those impacts can be assessed and refined to an acceptable standard prior to implementation. Through an iterative process of design and evaluation, we develop security algorithms that will protect electronic health information from improper access, alteration or loss, while minimally affecting the flow of work of the user population as a whole.
Algorithms↗
Translation of the glenohumeral joint in patients with anterior instability: awake examination versus examination with the patient under anesthesia.
Fifty patients with a clinical diagnosis of traumatic anterior shoulder instability underwent bilateral shoulder translation testing while both awake and under anesthesia. Each patient was examined by 2 surgeons following guidelines developed by the American Shoulder and Elbow Surgeons. A single translation grade was established for anterior, posterior, and inferior directions. A comparison of means was performed with a paired t test. The mean anterior translation grade was significantly higher on the affected side when compared with that of the unaffected side both during awake examination and during examination with the patient under anesthesia (EUA). Ipsilateral comparison revealed significantly greater translation for both affected and unaffected shoulders in anterior, posterior, and inferior directions during EUA than during awake examination. Side-to-side comparison of posterior and inferior translation was similar for both awake examination and EUA. Clinical translation testing was helpful in the diagnosis of anterior shoulder instability. Side-to-side differences were subtle while awake and more apparent during EUA. The usefulness of awake translation testing for traumatic anterior instability was not clearly demonstrated; however, EUA provides helpful information to confirm the direction and degree of instability.
Adult↗
Comparative injury rates of uninjured, anterior cruciate ligament-deficient, and reconstructed knees in a skiing population.
To evaluate the risks of skiing after anterior cruciate ligament injury with or without reconstruction, we performed a 3-year study of 5646 skiers employed by a large ski resort. All skiers underwent knee ligament examinations before entering the study. The participants were divided into three groups based on whether they had never had an anterior cruciate ligament injury (N = 4748), were unilaterally deficient of the ligament (N = 138), or had undergone a unilateral reconstruction of the ligament at least 1 year before (N = 274). The rates of knee injuries requiring evaluation by a physician or time off work were calculated. The results of the reconstructed knees were further evaluated to determine whether ligament repair with semitendinosus/gracilis or patellar tendon autograft had a higher injury rate. Compared with knees with intact anterior cruciate ligaments, ligament-deficient knees had a 6.2-times higher rate of injuries, and knees in which the ligament had been reconstructed had a 3.1-times higher rate. The differences between each of the three groups were significant. Injuries to ligament-intact knees were less severe, with 13% requiring surgery, while 39% of the injuries in the ligament-deficient and 41% of the injuries in the reconstructed-ligament knees required surgery. The rates of injury for the graft types were not significantly different, but skiers with a semitendinosus/gracilis tendon autograft were significantly more likely to rupture their graft than skiers with a patellar tendon autograft.
Absenteeism↗