Biomedical subjects
Publications and source records attributed to R L Iverson.
Summary recommendations for a core curriculum in intensive care unit administration and management are presented for inclusion in critical care medicine fellowship training programs. Attention is focused on program content and teaching formats that may be adapted to various educational priorities.
Septic shock may occur in otherwise normal individuals but is frequently a fatal sequel to infection in the elderly, the diabetic, or the debilitated patient. Mortality rates range from 40 to 95 per cent depending both on host factors and on the speed of initiation of appropriate therapy. The complexities of shock pathophysiology and biochemistry are elusive, but certain hemodynamic derangements are clearly described and create obvious therapeutic imperatives. Correction of the supply-dependent phase of oxygen consumption is the cornerstone of supportive therapy. Survival is primarily dependent on the rapid delivery of the appropriate antibiotics, surgical drainage and debridement of any infected tissues or abscesses, and aggressive volume resuscitation at the very time early sepsis is diagnosed. Septic shock is a medical emergency.
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Voice evaluations of 1481 children were conducted in a rural community school system. One hundred and four children were identified as having vocal qualities that differed perceptually from normal upon initial evaluation by two speech pathologists. From a rescreening several months later, 65 children were presented to an ENT specialist for examination. Eighty-eight percent of these children had their larynx examined by the physician. Of this group, 82% were male, with 35% of all the cases showing bilateral vocal nodules and 28% with bilateral vocal fold thickening. Only a small percentage of children displayed mucoid nasal secretion, redness of arytenoids or granulation of the pharyngeal wall. The results suggest that a team approach including medical and behavioral management is most beneficial for children with voice deviations.
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