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Biomedical subjects

Robert L Bratton

Publications and source records attributed to Robert L Bratton.

7 recordsLinked to original sources
PubMed2005

Tick-borne disease.

Tick-borne diseases in the United States include Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, tularemia, babesiosis, Colorado tick fever, and relapsing fever. It is important for family physicians to consider these illnesses when patients present with influenza-like symptoms. A petechial rash initially affecting the palms and soles of the feet is associated with Rocky Mountain spotted fever, whereas erythema migrans (annular macule with central clearing) is associated with Lyme disease. Various other rashes or skin lesions accompanied by fever and influenza-like illness also may signal the presence of a tick-borne disease. Early, accurate diagnosis allows treatment that may help prevent significant morbidity and possible mortality. Because 24 to 48 hours of attachment to the host are required for infection to occur, early removal can help prevent disease. Treatment with doxycycline or tetracycline is indicated for Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, and relapsing fever. In patients with clinical findings suggestive of tick-borne disease, treatment should not be delayed for laboratory confirmation. If no symptoms follow exposure to tick bites, empiric treatment is not indicated. The same tick may harbor different infectious pathogens and transmit several with one bite. Advising patients about prevention of tick bites, especially in the summer months, may help prevent exposure to dangerous vector-borne diseases.

Animals↗
PubMed2004

Accuracy of detecting irregular cardiac rhythms via telemedicine.

We evaluated the accuracy of an electronic stethoscope in the detection of irregular cardiac rhythms. Ten patients with either normal sinus rhythm or atrial fibrillation previously documented by electrocardiogram (ECG) were recruited from a local retirement community. Six senior family medicine resident physicians were asked to assess the cardiac rhythms of the subjects as either regular or irregular, in both a telemedical and an in-person examination. An ECG was obtained simultaneously as the gold standard. Forty-five of the 60 in-person assessments were correct, as were 49 of the 60 telemedicine assessments. The difference was not significant. Physician confidence in telemedical examination did not affect the accuracy of examination. The results of this study suggest that telemedicine-directed auscultation of patients may be just as successful as inperson examination for the detection of cardiac arrhythmias.

Aged↗
PubMed2002

Effect of "ionized" wrist bracelets on musculoskeletal pain: a randomized, double-blind, placebo-controlled trial.

OBJECTIVE: To assess objectively the perceived benefits of wearing an "ionized" wrist bracelet to treat muscle or joint pain. SUBJECTS AND METHODS: This study was performed at the Mayo Clinic in Jacksonville, Fla, in 2000 and 2001. In a randomized, double-blind design, 305 participants wore an ionized bracelet and 305 wore a placebo bracelet for 4 weeks. For each location where pain was present at baseline, participants rated the intensity of pain. Follow-up ratings were made after 1, 3, 7, 14, 21, and 28 days of wearing the bracelet. Two primary end points were defined for evaluating efficacy. The first was the change at 4-week follow-up (day 28) in the pain score at the location with the highest baseline value (maximum pain score). The second was the change at 4-week follow-up in the sum of the pain scores for all locations. RESULTS: Analysis of the data showed significant improvement in pain scores in both groups, but no differences were observed between the group wearing the placebo bracelet and the group wearing the ionized bracelet. CONCLUSION: The finding that subjective improvement in pain scores was equivalent with ionized and placebo bracelet use questions the benefit of using an ionized bracelet. New treatments in alternative medical therapy must be shown to be effective through vigorous, unbiased, objective testing before physicians acknowledge potential benefits or recommend these treatments to patients.

Adolescent↗
PubMed2002

Aspergillosis related to long-term nasal corticosteroid use.

Aspergillus is a ubiquitous mold that can cause several types of symptomatic infections: allergic aspergillosis, typically in young atopic patients; aspergillomas (often referred to as fungus balls); and invasive aspergillosis, typically seen in debilitated or immunocompromised patients. We describe an 85-year-old woman who was not immunocompromised but had invasive aspergillosis of the paranasal sinus that resulted in unilateral headache and retrobulbar optic neuropathy. After extensive differential diagnostic examination, we concluded that the condition was possibly related to the long-term use of nasal corticosteroids (fluticasone propionate aqueous nasal spray). Surgical removal of solid masses of Aspergillus organisms followed by extended treatment with antifungal agents resulted in a favorable outcome.

Administration, Topical↗