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R Phelps

Publications and source records attributed to R Phelps.

46 records · Page 3Linked to original sources
PubMed1985

Multiple family therapy: current status and critical appraisal.

This article provides an updated review and synthesis of the research and clinical literature dealing with multiple family therapy as an identifiable treatment approach. Major emphasis is placed on the literature published since an earlier comprehensive review (63). It is concluded that multiple family therapy is a viable and promising treatment modality, yet one that in clinical practice remains underused, conceptually underdeveloped, and poorly differentiated from other treatment approaches. Recommendations are made and pathways are identified that may promote the further growth and development of the approach.

Adolescent↗
PubMed1984

Inflammatory abdominal aortic aneurysm: report of six cases.

Six cases of inflammatory aneurysm of the abdominal aorta are described. All patients were male, aged 59 to 80 years, and five had symptomatic atherosclerotic cerebrovascular or cardiovascular disease. In three the diagnosis of inflammatory aneurysm was suggested preoperatively on the basis of computed tomographic or ultrasonographic scanning. On gross examination the aneurysm wall was about 1 cm thick and included an inner narrow layer of atherosclerotic plaque, which was contiguous with the outer thick fibroinflammatory component. Microscopically, this component consisted of fibroblasts and collagen, which entrapped fat, nerves, and lymph nodes and was infiltrated by lymphocytes and plasma cells. Plasma cells, lymphocytes, and fibroblasts predominated in four patients, while two showed abundant dense collagen with fewer inflammatory cells and fibroblasts. There was associated vasculitis, predominantly phlebitis, in three. Inflammatory aneurysms represent a distinct group of abdominal aortic aneurysms.

Aged↗
PubMed1981

Psychiatric risk factors in the pregnant diabetic patient.

One hundred pregnant diabetic patients have been prospectively studied in the first large-scale systematic evaluation of emotional behavior and psychosocial factors influencing psychiatric behavior in the pregnant diabetic patient. A Psychiatric Risk Scale including ten weighted medical and psychosocial factors has been developed to identify patients at high risk for psychiatric illness or poor compliance. This scale significantly increases the data base of classic "neglector" characteristics described by Pederson in 1965. Early identification of psychiatrically high-risk patients in concert with brief relevant psychodynamic exploration offers the potential of more directed care to a subset of patients at increased risk for poor perinatal performance.

Adolescent↗
PubMedDate not supplied

The Dacron ligament prosthesis in anterior cruciate ligament reconstruction. A four-year review.

We studied 40 patients who underwent reconstruction for chronic anterior cruciate ligament deficiency with a Dacron ligament prosthesis using a modified MacIntosh over-the-top technique, augmented with iliotibial band. Thirty patients had undergone at least 1 prior surgical procedure on the affected knee, but only 7 patients had previous anterior cruciate ligament reconstruction. All patients were followed for a mean of 47.5 months. The results at final followup demonstrated an average side-to-side arthrometer difference of 1.0 mm. The Lysholm score improved from 65 preoperatively to 89 at the end of the review; the Tegner activity level score improved from 3 to 5. Objectively, 75% of the patients had a negative Lachman test result and 95.1% of the subjects had negative or trace pivot shift results at review. Mild knee pain was still present with day-to-day activity in 87.7% of the patients. Complications occurred in 27.5% of patients, including five who had implant ruptures and two who had their grafts removed. Synovitis was a significant problem. Based on our failure criteria, 47.5% (19) of the subjects had failed results. In this study, radiologic evidence of tracer separation greater than 1 cm was a criterion of failure. With inclusion of tracer separation, the failure rate increased to 60.0% (24). Multiple previous surgeries of any type had an adverse effect on results. Damage to secondary stabilizers in these cases increased failure rate. Based on the high complication and failure rates, and relatively poor end result in this retrospective review, we cannot recommend this procedure.

Adolescent↗