Biomedical subjects
Publications and source records attributed to K Schultz.
A 7-year-old gypsy girl developed venous and arterial thromboembolism. In this case AT III deficiency of hereditary nature was demonstrated as the cause of thromboembolism.
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A total of 6 children underwent primary ureterosigmoidostomy diversion between 1972 and 1979. Despite preoperative testing of rectal competence all 6 children now experience rectal leakage. Behavioral biofeedback has been used in a 7-year-old boy who had learned to isolate and to contract the perineal muscles appropriately by 12 months of followup. The incidence of incontinence has been reduced from 15 to 5 per cent of the total hours recorded. The amount of waking hours in which the patient is wet has decreased from 31 to 6 per cent. Satisfaction of the child and parents is high.
We conducted a six-month, randomized, double-blind trial of lecithin therapy in early-onset Alzheimer's disease. We hypothesized that such therapy would retard the progression of the clinical and neuropsychological manifestations of this illness. Of the 73 referred patients, 37 met strict requirements for diagnosis and compliance. The 21 placebo and 16 lecithin-treated patients (mean age 63 years) had a comparable degree of severity of dementia (mean Clinical Dementia Rating 1.6). Lecithin therapy produced an increase in mean plasma choline levels from a baseline of 15.9 to 28.8 nmol/ml. Patients were evaluated by the physician using clinical assessments (CDR, Lawton ADL and other rating scales) and by the neuropsychologist who determined the outcome of therapy on a battery of tests (Mini Mental State Examination, Wepman Aphasia Screen, Verbal Fluency Test, Verbal Selective Reminding Test and Spatial Memory Test). Only 6 (37.5%) of the 16 lecithin-treated patients were considered by the neurologist to be clinically stable or improved as compared to 12 (57.1%) of the 21 patients given placebo (difference -19.6%, 95% confidence limits of -51% to 12%). The neuropsychologic scores showed no differences in the stability of the dementing process over time between the lecithin-treated (50.0%) and placebo (47.6%) groups. On the basis of these clinical and neuropsychological findings, it appears that lecithin alone has no important therapeutic effect in early-onset Alzheimer's disease.
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Skin temperature from three recording sites (web dorsum and two digital sites) on one hand were compared over a 30-minute period during which room temperature was raised from 66 degrees to 80 degrees F causing skin temperatures to range from 78.5 degrees to 92.3 degrees F. The web dorsum remained significantly warmer than either digital site at the lowest skin temperatures; no significant inter-site differences were seen as skin temperature gradually increased. These findings imply that none of the three sites is more advantageous than the others when recording hand temperature values around or above 85 degrees F. However, at the lower levels of skin temperature, there is a "floor" below which the web dorsum is no longer a sensitive indicator. More generally, basic data of this type provide a necessary but often absent foundation for routine practice of clinical biofeedback.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The case of a 7-year-old boy born with exstrophy of the bladder is presented. Biofeedback and behavioral therapy were employed in the treatment of anal incontinence, which occurred following ureterosigmoidostomy diversion. After 19 treatment and follow-up sessions over a period of 12 months, there was significant decrease in fecal/urinary incontinence. The patient was soiled 29% of waking hours over the first 4 weeks of treatment. This figure dropped to 9.7% over the last three sessions. Subjective satisfaction of parent, child, and teachers was high. These gains were maintained over a 12-month follow-up period. Given the design of the present study, it is not possible to determine whether the biofeedback per se had a specific treatment effect. The case demonstrates the usefulness of a broad-based behavior therapy in the management of fecal/urine soiling, which is a frequent, refractory complication of ureterosigmoidostomy.
Work hardening, presented in this paper as a "new" service for the industrially injured, is actually well grounded in the traditional models and practices of occupational therapy. From the profession's early roots in industrial therapy to the development of a variety of programs for the industrially injured through the 1950s and 1960s, the historical and philosophical bases of occupational therapy support the use of work as an evaluative and therapeutic medium. What is actually new is the adoption of terminology, technology, and a program format that fits in with the needs of consumers in the 1980s. Recent developments that created the need for the specialized services that occupational therapists are uniquely qualified to provide include growth of private sector vocational rehabilitation, changes in workers' compensation laws, and increasing costs of vocational rehabilitation. This paper describes work hardening in its present form. A case example is given that demonstrates how work hardening can be a cost-effective and time-saving bridge which spans the gap between curative medicine and the return to work.
Variables related to both the process and the outcome of neonatal intensive care were studied to compare care given during the day (0901-2100 hours) with that at night (2101-0900 hours). At night, intravenous infiltrations occurred more often, and the tidal volume of respirator-treated infants was verified less often. Blood pH values less than 7.20, excluding values within 12 hours of admission, were recorded more often and in more patients at night. During a 12-month period, there were significantly more deaths among infants less than 1,500 gm during the night than during the day. The deterioration of infants at night may result in part from current nursery staffing practices.
Patients with primary carcinoma of the base of the tongue or direct invasion from contiguous areas were examined clinically and with ultrasound, and in some cases with computed tomography (CT), xerography, and polytomography. In all cases, multiple biopsy specimens were obtained. Utrasonography was better than the other imaging methods in delineating disease extent in the tongue itself, while CT and tomography were more useful in evaluating the retropharyngeal and lateral pharyngeal regions. It is suggested that ultrasound be used in the initial evaluation of such patients.
Blood glucose, blood lactate, plasma free fatty acids, plasma alpha-amino nitrogen, plasma free amino acids and blood urea nitrogen were measured in 15 hypothermic preterm infants (mean rectal temperature: 34.5 +/- 0.28 degrees C) during a 2-hour 'warming-up' period following admission to our neonatal intensive care unit. Hypothermia was associated with lactacidemia and hyperalaninemia. The increase in body temperature of the infants resulted in the decrease of lactacidemia and hyperalaninemia. Normal levels of other metabolites remained unchanged.
The transverse diameter of the chest and heart was measured in 745 newborn infants after birth asphyxia. Both diameters showed a good correlation with birth weight. The great individual variations of the measurements were due to different degrees of birth asphyxia observed in the infants and to their different responses to compensate asphyxia. A wet lung and an increased transverse diameter of the chest (above the 90th percentile) indicate a good, and a decreased transverse diameter of the chest (bellow the 10th percentile) indicate a bad prognosis for survival. The cardiomegaly usually disappears after the first 12 hours of life, but in some cases it persists for more than 5 days, depending on the severity of birth asphyxia.