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Meridith B Marks

Publications and source records attributed to Meridith B Marks.

7 recordsLinked to original sources
PubMed2006

Skin problems in an amputee clinic.

OBJECTIVE: To document the type and frequency of individual residual limb skin problems among patients using a lower extremity prosthesis, including the suggested etiology and management of each type of skin problem. DESIGN: This is a 6-yr retrospective chart review of skin lesions diagnosed in patients examined in an outpatient amputee clinic at a regional, referral rehabilitation hospital in Ottawa, Canada. Skin lesions were included if they were on a lower extremity residual limb for a patient who functionally used a prosthesis. Descriptive statistics were used to analyze data. RESULTS: A total of 528 skin problems were documented in 337 lower extremity residual limbs. Ulcers, irritations, inclusion cysts, calluses, and verrucous hyperplasia were the five most common skin problems representing 79.5% of all documented skin disorders. CONCLUSIONS: This study demonstrated that a wide variety of dermatologic conditions occurred frequently in the lower extremity amputee who functionally used a prosthesis. Five types of skin problems accounted for nearly 80% of the skin lesions identified. Future studies are required to evaluate prevention and management of the most frequent skin problems.

Adult↗
PubMed2005

Dermatologic conditions associated with use of a lower-extremity prosthesis.

OBJECTIVES: To document the frequency of skin problems among lower-limb prosthesis users and to assess for factors associated with skin problems among patients using a prosthesis. DESIGN: Six-year retrospective chart review. SETTING: An outpatient amputee clinic at a regional, referral rehabilitation hospital in Canada. PARTICIPANTS: Seven hundred forty-five subjects with a total of 828 lower-extremity amputations participated. Subjects were included if they had a lower-extremity amputation and used a prosthesis for ambulation or transfers. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The presence or absence of a skin problem. Descriptive and nonparametric statistics were used to analyze data. RESULTS: Three hundred thirty-seven residual limbs (40.7%) had at least 1 skin problem. Adjusted odds ratios showed that amputation level, being employed, type of walking aid, and absence of peripheral vascular disease (as a comorbidity) were independently associated with the presence of at least 1 skin problem ( P <.05). CONCLUSIONS; Dermatologic conditions are a frequent complication for the lower-extremity amputee who uses a prosthesis. The results suggest that more active amputees have an increased risk for developing skin problems. Further study in this area is warranted.

Aged↗
PubMed2005

Failure to fail: the perspectives of clinical supervisors.

BACKGROUND: Clinical supervisors often do not fail students and residents even though they have judged their performance to be unsatisfactory. This study explored the factors identified by supervisors that affect their willingness to report poor clinical performance when completing In-Training Evaluation Reports (ITERs). METHOD: Semistructured interviews with 21 clinical supervisors at the University of Ottawa were conducted and qualitatively analyzed. RESULTS: Participants identified four major areas of the evaluation process that act as barriers to reporting a trainee who has performed poorly: (1) lack of documentation, (2) lack of knowledge of what to specifically document, (3) anticipating an appeal process and (4) lack of remediation options. CONCLUSIONS: The study provides insight as to why supervisors fail to fail the poorly performing student and resident. It also offers suggestions of how to support supervisors, increasing the likelihood that they will provide a valid ITER when faced with an underachieving trainee.

Canada↗
PubMed2003

Bone overgrowth in the adult traumatic amputee.

Bone overgrowth of the residual limb after an amputation is a well documented complication in the pediatric amputee population. Bone overgrowth can cause pain, problems with skin breakdown, and poor prosthetic fit. There have been few reports of bone overgrowth in the adult amputee. Two cases of traumatic transfemoral amputations after extensive tissue damage are presented. Both patients successfully completed an in-patient amputee rehabilitation program and achieved functional ambulation with their prostheses. However, each developed distal residual limb pain within a year after their amputations that significantly limited the amount of time they could wear their prostheses and the distance they could walk. Radiographs demonstrated additional bone growth from the residual femur into adjacent soft tissues in both patients. These case examples demonstrate that bone overgrowth should be considered in the differential diagnosis of residual limb pain in the adult amputee.

Adult↗