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Biomedical subjects

R L Blake

Publications and source records attributed to R L Blake.

At least 19 recordsLinked to original sources
PubMed1994

Patterns of comorbidity in elderly patients with multiple sclerosis.

This study explored the prevalence of comorbid conditions in hospitalized patients with multiple sclerosis (MS) who were 65 years of age or older. Using 1989 data from the Quality of Care Medicare Provider Analysis and Review (MEDPAR) file, hospitalized MS patients were compared with respect to discharge diagnoses to an age- and sex-matched group of hospitalized patients without MS. As expected, the following discharge diagnoses were more common (P < 0.05) for MS patients: urinary tract infection, pneumonia, septicemia and cellulitus. In contrast, MS patients were less likely (P < 0.05) to have discharge diagnoses of acute myocardial infarction, heart failure, hypertension, angina pectoris, cerebrovascular disease, diabetes mellitus and chronic obstructive pulmonary disease. Possible explanations include under-reporting of certain comorbid conditions on discharge records of MS patients, a protective effect of MS or its treatment, reduced prevalence of risk factors, disproportionate mortality in younger MS patients with comorbidity and the benefits of medical surveillance.

Aged↗
PubMed1992

Limb length discrepancies.

Examining for a possible limb length discrepancy is an important part of the podiatric biomechanical examination. The authors present a review of the literature pertaining to the definition of and examination for a limb length discrepancy. They present a typical rationale for lift therapy in the treatment of this pathology.

Anthropometry↗
PubMed1992

The os trigonum syndrome. A literature review.

The os trigonum syndrome, a musculoskeletal ankle disorder causing posterior ankle pain, is an entity that may present as numerous disorders. To accurately diagnose and treat the syndrome, its anatomy, origin, nomenclature, and biomechanics must be thoroughly understood. For this purpose, a review of recent literature is presented.

Adult↗
PubMed1992

Extrinsic rearfoot posts.

The addition of an extrinsic rearfoot post to an orthotic device allows the podiatric practitioner to modify the function of the device. Specifically, rearfoot posts are used to allow for a more inverted heel position at contact, to provide greater resistance to abnormal frontal plane motion of the calcaneus and to provide for motion for shock absorption. The authors present nine prescription variables that each provide for a specific functional change to be incorporated into the orthotic device.

Adult↗
PubMed1992

Inflammation on the cervical Papanicolaou smear: the predictive value for infection in asymptomatic women.

BACKGROUND: The clinical significance of inflammation on the cervical Papanicolaou (Pap) smear of asymptomatic women is unknown. This study assessed the possible association between inflammation on Pap smears with the presence of cervical/vaginal pathogens. METHODS: A questionnaire was given to 290 asymptomatic women seen for routine gynecologic examination, including Pap smear, in a primary care setting. The women were tested for the presence of Candida species, Trichomonas vaginalis, Gardnerella vaginalis, Neisseria gonnorrhoeae, and Chlamydia trachomatis. RESULTS: Recovery of Chlamydia and Trichomonas was more frequent in women with inflammation on Pap smear than in women without inflammation, but the positive predictive value of inflammation was only 7% for Chlamydia and 14% for Trichomonas. Seventy-one percent of the women with inflammation had no evidence of any of the organisms. After a 6-month follow-up period, women with inflammation on Pap smear were no more likely than their matched counterparts without inflammation to return for a clinic visit with symptoms of vaginitis. CONCLUSIONS: In this study, inflammation on Pap smear had a relatively low predictive value for the presence of vaginal pathogens in asymptomatic women.

Adult↗
PubMed1991

Salicylate poisoning from enteric-coated aspirin. Delayed absorption may complicate management.

Acute salicylate poisoning with enteric-coated aspirin may result from accidental ingestion, a suicide attempt, or a complication of long-term therapy. Because absorption of enteric-coated aspirin is delayed, use of the Done nomogram to determine toxicity may lead to underestimating the severity of the poisoning. Treatment options include induction of emesis or diuresis, gastric lavage, administration of activated charcoal, and surgery.

Adolescent↗
PubMed1991

Foot orthosis for the severe flatfoot in sports.

The control of excessively pronating feet in athletes can be a prolonged and frustrating experience for both the doctor and the patient. The inverted orthotic technique has previously been described for making a device that has two basic applications: to control excessive subtalar joint pronation, especially where a Root or modified Root device cannot, and to invert the entire lower limb for such problems as medial knee pain. The authors present two case histories that highlight the indications of this orthotic device for the athletic population.

Adult↗
PubMed1991

Biomechanical analysis of running with 25 degrees inverted orthotic devices.

The purpose of this study was to evaluate the effectiveness of two different rigid foot orthotic devices in controlling subtalar joint subluxation and pronation. A high-speed video analysis system was used to record, store, and analyze data from seven runners: 1) barefoot, 2) shoes only, 3) shoes and vertical orthoses, and 4) shoes with 25 degrees inverted orthotic devices. The results indicate the need for suitable studies, on a larger population group, to evaluate the effect of a variety of orthotic devices on running biomechanics.

Biomechanical Phenomena↗
PubMed1991

The myth of running limb varus.

Even though the authors believe that there are many flaws in treadmill-based video analysis, they do believe that this study shows that running limb varus is not as important a concept as previously discussed by many authors. The FootTrak system is the first system available to give biomechanical researchers the ability to document the tibia-to-vertical angle with computerized digitation. The clinician with a knowledge of biomechanics understands that functional orthotic devices are more effective on primary calcaneal motions and positions than motions and positions produced by extrinsic tibial, knee, or hip factors. Thus, functional foot orthoses tend to work better in controlling varus during running that is produced by the calcaneus, rather than the tibia.

Biomechanical Phenomena↗
PubMed1991

TL-61 versus Rohadur orthoses in heel spur syndrome.

The authors present the subjective responses of 40 patients with heel spur syndrome or plantar fascitis to orthotic treatment. Twenty patients had Rohadur orthoses and 20 patients had TL-61 orthoses. These data show no difference in the response to or problems created by either TL-61 or Rohadur orthoses. The authors recommend TL-61 as one alternative to Rohadur, now that that latter is unavailable.

Fasciitis↗
PubMed1991

Achilles tendon rupture. A protocol for conservative management.

The authors discuss surgical versus conservative management of closed Achilles tendon ruptures. They favor a conservative approach in most cases and present arguments to support this preference. They present a protocol for conservative management of closed Achilles tendon ruptures, which has been developed at the Center for Sports Medicine, Saint Francis Memorial Hospital, San Francisco.

Achilles Tendon↗
PubMed1991

Social stressors, social supports, and self-esteem as predictors of morbidity in adults with chronic lung disease.

Psychosocial correlates of morbidity and functional status were examined in 44 white adults with chronic lung disease. Demographic characteristics, functional status, stressful life changes, social supports, and self-esteem were assessed at baseline by a self-administered questionnaire. Hospital days, bed-disability days, restricted-activity days, and physician visits were then measured prospectively by mailed questionnaire over the next 6 months. There were no cross-sectional associations of psychosocial variables with demographic characteristics. Better functional status (measured by the Sickness Impact Profile) was associated with a lower 12-month life-change score (measured by the Social Readjustment Rating Scale), with stronger social supports (measured by a 13-item index), and with higher self-esteem (measured by the Rosenberg Scale). On bivariate analysis, higher life-change score predicted higher levels of all four morbidity variables; low social supports predicted increased bed days, restricted-activity days, and physician visits; and low self-esteem predicted high restricted-activity. After controlling for demographic characteristics and baseline function by multivariate analysis, low social supports continued to predict higher rates of physician visits, but the other associations of psychosocial variables with morbidity were no longer statistically significant. The results suggest that patients with weak social supports have increased use of physician services.

Adult↗
PubMed1990

Gender concordance between family practice residents and their patients in an ambulatory-care setting.

To determine whether women residents are more likely than men residents to treat female patients, the author analyzed data concerning resident-patient encounters in an ambulatory care setting from 107 family practice residents completing a university training program from 1979 through 1988. While the mean numbers of encounters for the men and women residents were similar, 70.5% of the women residents' encounters were with female patients, compared with 63.1% of men residents' encounters with female patients (p less than .0001). The women residents saw 3.6 times more female than male patients aged 13 to 20 years and 3.9 times more women than men patients aged 21 to 40. The women residents had more encounters for contraception, vaginitis, prenatal care, and health maintenance for women patients and fewer encounters for prostatic/testicular problems and health maintenance for men patients.

Adolescent↗