The indwelling ureteric stent: a 'friendly' procedure with unfriendly high morbidity.
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Catheters, Indwelling↗
Biomedical subjects
R G Stone
Publications and source records attributed to R G Stone.
Evaluation of daily living tasks: the home care advantage.
Occupational therapists working in home care have an advantage over those working in other settings because they can observe the influence of the naturalistic context on task performance. However, to use this advantage, therapists working in home care must use an evaluation approach that enables them to capture the client-task-context transaction. In this article, we discuss the ability of four "evaluation approaches"--norm-referenced, criterion-referenced, dynamic, informal--to provide information about the client-task-context transaction that therapists need in order to plan effective intervention. The potential of each approach for identifying clients' performance problems, suggesting etiologies, determining rehabilitation potential, and guiding intervention is analyzed, and the appropriateness of each approach for application in the home is appraised. This analysis highlights the utility of combining the criterion-referenced and dynamic assessment approaches for use in home care. A sequential process for integrating these two approaches is provided, and the proposed outcomes to be obtained from this process are identified.
Activities of Daily Living↗
Guidelines for privileges in arthroscopic surgery.
This report sets forth flexible guidelines to be used by hospitals or surgery centers to define privileges in arthroscopic surgery. The Arthroscopy Association of North America recognizes that the completion of a residency program, fellowship training, or hands-on workshop does not, per se, guarantee competence in arthroscopic surgery. The demonstration of an applicant's technical and motor skills by direct observation is a vital component of the credentialing process. Threshold criteria of state licensure, completion of surgical residency training, documentation of prior experience, and existing orthopaedic surgical privileges are defined. Levels of complexity of arthroscopic procedures are divided as basic and advanced.
Arthroscopy↗
Educating entry-level occupational therapy students in gerontology.
The need for gerontic occupational therapists is increasing as the number of elders increases. The practice of including gerontologic content in occupational therapy entry-level curricula is relatively new. This article provides a rationale for including gerontologic content in entry-level occupational therapy curricula and presents the results of a brief survey conducted in November 1990 of all accredited and developing entry-level professional occupational therapy programs in the United States. Seventy-one percent of the entry-level programs responded. All of the responding programs included some gerontologic content in their curricula, and 82% of the responding programs indicated that the amount of gerontologic content in the required curriculum had increased in the past 5 years. Other gerontologic elements examined were courses offered and topics included in entry-level curricula, textbooks used, and gerontic fieldwork requirements.
Clinical Competence↗
Long-term assessment of arthroscopic meniscus repair: a two- to six-year follow-up study.
The functions of the meniscus and subsequently the importance of meniscus preservation are well known. Thirty-one of 105 patients who underwent (closed) arthroscopic meniscus repair between 1982 and 1986 using an inside-out technique previously described were studied. Evaluations were based on The Hospital for Special Surgery knee rating system. Eighty-eight percent of the study population had a good-to-excellent outcome at an average 4.1 years follow-up. Most of these patients had no Fairbank changes on follow-up radiographs. Factors affecting outcome were analyzed. From this series, the at-risk factor for failure of meniscus repair is chronicity of injury (lasting longer than 2 weeks). Factors not noted to significantly influence results in this series include (a) age of the patient; (b) sex of the patient; (c) rim width up to 6 mm from the synovial meniscal junction; and (d) anterior cruciate ligament insufficiency. History of a reinjury and noncompliance with the postoperative rehabilitation protocol may also adversely influence results, but this is difficult to prove.
Adolescent↗
The posterior medial complex disruption.
Seventy-five patients with 86 complex tears of the medial meniscus posterior horn (posterior medial complex disruptions) treated by arthroscopic partial meniscectomy were contacted for evaluation of their functional results. Forty-five patients returned for physical and radiographic examination 1 to 6 years after surgery. Condylar chondromalacia was significantly higher in patients waiting to undergo surgery over 6 months from the onset of their symptoms (94%) than those waiting less than 6 months (40%) (P = .0001). Patients were classified into phases based on preoperative x-rays and the operative presence of condylar chondromalacia. Satisfactory results were seen in 87% of phase 0 and phase 1 patients, 50% of phase 2 patients, and 32% of phase 3 patients. Phase classification provided significant data for prognostication of satisfactory results (P = .0001). With advancing age, presence of preoperative x-ray changes, the articular cartilage damage may compromise the results. Most patients in this study exhibited clinical improvement suggesting some benefit from the mechanical washout, if not the meniscectomy.
Adult↗
Arthroscopic review of meniscal repair: assessment of healing parameters.
The purpose of this study was to demonstrate what can be learned by repeat arthroscopy of meniscal repairs with regard to documenting healing, determining reasons for failure to heal, and discovering the fate of nonabsorbable suture material. The study involved 14 patients with 16 repairs who had repeat arthroscopy an average of 7.5 months after repair. Nonabsorbable suture was used in 14 of the repairs. Eleven repairs were done arthroscopically, and five were open. Charts and videotapes of both procedures were reviewed. Results showed 56% of repairs had healed, 25% had partially healed, and 13% had not healed. This is unusually slanted toward bad results for meniscal repair because the knees were usually rearthroscoped due to continued or recurrent problems. Most of the approximately 200 original patients were not symptomatic enough to warrant or submit to rearthroscopy. No damage to articular surfaces was found due to use of nonabsorbable sutures. These sutures become completely or partially incorporated into the meniscus. Meniscal repairs at risk for healing problems were set apart by an analysis of those cases with healing problems, including repairs of multiple longitudinal tears, tears greater than 40 mm in length, and tears in unstable knees. It should be emphasized that these conclusions only suggest a trend. Numbers are too few for statistical significance.
Adolescent↗
A technique of arthroscopic suture of torn menisci.
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Adolescent↗
Meniscal repair. An arthroscopic technique.
Repair of a longitudinal peripheral meniscal tear permits salvage of this structure in a high percentage of cases. In previous reports an arthrotomy was used to accomplish this repair; in this paper an arthroscopic technique is presented. The potential risks are significant and include damage to the peroneal nerve and popliteal vascular structures, failure of meniscal healing and the usual complications of arthroscopy. The procedure is recommended only for the advanced arthroscopist who is advised first to establish clearly by cadaver dissections the anatomical relationships.
Arthroscopy↗
Evaluation of sciatic nerve compromise during total hip arthroplasty.
Sciatic nerve function was monitored intraoperatively by somatosensory evoked potentials (SEP) in 50 patients during total hip arthroplasty. There were 12 instances of temporary nerve compromise in ten patients: three during acetabular preparation due to retraction, one due to reamer contact, six during femoral reaming due to positioning, and two during trial reduction due to inadequate shortening of the femoral neck. The technique for monitoring, causes, and incidence of nerve compromise during total hip arthroplasty are discussed. SEP monitoring may be especially useful in revision surgery.
Aged↗
Peripheral detachment of the menisci of the knee: a preliminary report.
1. Anterior central detachments do satisfactorily as outlined. 2. However, if synovial meniscal detachments can be subluxed into the tibiofemoral junction, they should be sutured to their synovial ligamentous beds. 3. Both types of peripheral detachment coexist frequently with other intra-articular derangements, which are usually minor except when the anterior cruciate ligament is involved.
Adolescent↗
AOTA Human Resources Project. The education study.
This article is the second in a series describing the American Occupational Therapy Association's Human Resources Project. The project, comprised of several interrelated studies, is aimed at identifying the supply of occupational therapists and assistants in the United States as of December 1973, and at describing the projected requirements for their services. The present report describes the initial phase of the Education Study, the objective of which is to define the total supply of occupational therapy manpower, regardless of membership status in the AOTA.
Accreditation↗
Search for Jovian hectometric continuum radiation.
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Journal Article↗
Simultaneous multiple-modality therapy for tension headaches and neck pain.
Eighty-one patients suffering from neck pain and tension-type headaches were treated by the application of a unique physical therapy device combining transcutaneous electrical nerve stimulation (TENS), traction, massage, vibration, and acupressure applied to the forehead, posterior cervical spine, and scapula. The device employed eight silver silicone electrodes for modality application. Its safety and effectiveness were assessed by evaluating patients before and after treatment. No complication ensued. Statistical analysis of visual analog scales for neck pain and headache yielded p values < 0.0001. Analysis of fibromyalgia neck and shoulder trigger points with three controls gave nonsignificant results. Conclusions were that 1) the device is safe and effective as judged by subjective patient input and 2) fibromyalgia trigger points are unaffected by the treatments. More objective measures are needed to provide evidence of efficacy.
Acupressure↗