Biomedical subjects

S A Paluska

Publications and source records attributed to S A Paluska.

5 recordsLinked to original sources

PubMed2000

Knee braces: current evidence and clinical recommendations for their use.

Methods of preventing and treating knee injuries have changed with the rapid development and refinement of knee braces. Prophylactic knee braces are designed to protect uninjured knees from valgus stresses that could damage the medial collateral ligaments. However, no conclusive evidence supports their effectiveness, and they are not recommended for regular use. Functional knee braces are intended to stabilize knees during rotational and anteroposterior forces. They offer a useful adjunct to the treatment and rehabilitation of ligamentous knee injuries. Patellofemoral knee braces have been used to treat anterior knee disorders and offer moderate subjective improvement without significant disadvantages. Additional well-designed studies are needed to demonstrate objectively the benefits of all knee braces. Knee braces should be used in conjunction with a rehabilitation program that incorporates strength training, flexibility, activity modification and technique refinement.

Braces↗

PubMed2000

Physical activity and mental health: current concepts.

Physical activity may play an important role in the management of mild-to-moderate mental health diseases, especially depression and anxiety. Although people with depression tend to be less physically active than non-depressed individuals, increased aerobic exercise or strength training has been shown to reduce depressive symptoms significantly. However, habitual physical activity has not been shown to prevent the onset of depression. Anxiety symptoms and panic disorder also improve with regular exercise, and beneficial effects appear to equal meditation or relaxation. In general, acute anxiety responds better to exercise than chronic anxiety. Studies of older adults and adolescents with depression or anxiety have been limited, but physical activity appears beneficial to these populations as well. Excessive physical activity may lead to overtraining and generate psychological symptoms that mimic depression. Several differing psychological and physiological mechanisms have been proposed to explain the effect of physical activity on mental health disorders. Well controlled studies are needed to clarify the mental health benefits of exercise among various populations and to address directly processes underlying the benefits of exercise on mental health.

Adolescent↗

PubMed2000

The comfort of family practice residents with health care of patients of the opposite gender.

BACKGROUND AND OBJECTIVES: Studies have shown that female and male residents see disproportionately few patients of the opposite gender. Such an imbalance may be detrimental to the quality of residency training. This study examined residents' levels of comfort in caring for patients of the same and opposite genders and their assessments of the adequacy of the number of same- and opposite-gender patients they saw during residency training. METHODS: Data were collected from four family practice residency programs in the Midwest. All current family practice residents at the four sites surveyed were given a questionnaire asking them to rate their perceptions of the gender distributions of their patient panels and comfort with several areas of health care, some gender specific. The questionnaire used a five-point Likert scale. RESULTS: Ninety-four surveys (83% response rate) were collected. Ninety-three percent of female residents reported seeing enough female patients, but only 54% reported seeing enough male patients. Seventy-six percent of male residents reported seeing enough male patients, but only 31% reported seeing enough female patients. More females than males (88% versus 48%) felt comfortable with women's health, but more males than females (70% versus 31%) felt comfortable with men's health. Male residents were significantly more comfortable than female residents in performing or managing prostate exams, testicular exams, and prostatitis. Female residents were significantly more comfortable with clinical breast exams and breast disease. CONCLUSIONS: Male and female residents perceive disproportionate experiences in their exposure to patients of the opposite gender. Significant differences between male and female residents were also apparent regarding their relative comfort in managing some gender-specific health care topics. These results have implications for residency education.

Clinical Competence↗

PubMed1997

Vacuum-assisted vaginal delivery.

Vacuum extraction is an effective method of operative vaginal delivery. The procedure is widely used in Europe and many developing countries as the instrument of choice for assisted vaginal deliveries and has recently gained greater acceptance in the United States. The vacuum procedure is relatively easy to learn and offers a safer, less traumatic alternative to the use of forceps or cesarean section for indicated deliveries. Advances in extractor cup design have resulted in fewer cases of neonatal and maternal trauma and improved efficacy. As with any procedure, strict attention to technique and sound clinical judgment are essential for success.

Delivery, Obstetric↗

PubMed1997

Cataract after vitrectomy in young patients.

OBJECTIVE: The purpose of the study was to evaluate the occurrence of cataract in young patients after pars plana vitrectomy. DESIGN: The authors reviewed the medical records for previtrectomy and postvitrectomy lens changes in patients younger than 30 years of age at the Kellogg Eye Center, University of Michigan. PARTICIPANTS: Forty-nine patients (50 eyes) younger than 30 years of age (mean age, 23.5 years; range, 5 months-30 years) underwent phakic vitrectomy over a 12-year period. MAIN OUTCOME MEASURES: Cataracts were categorized as posterior subcapsular, nuclear sclerotic, or cortical. Cataracts also were graded as mild (1+), moderate (2+), or severe (3+). RESULTS: In this series of young patients, vitrectomy was performed for a wide range of ocular conditions, including trauma and complicated retinal detachment. Postvitrectomy cataract developed in 29 patients (60%). Eighteen patients (36%) had visually significant cataract on long-term follow-up (mean follow-up, 29.7 months; range, 6 months-13 years). The most common cataract was posterior subcapsular (57%), followed by nuclear sclerosis (23%), a combination of both (17%), and cortical cataract (3%). Patients with gas-filled eyes had a significantly higher rate of cataract formation than patients with fluid-filled eyes (P < 0.05). CONCLUSIONS: Postvitrectomy cataracts were more common in the authors' series compared with those of previous reports on young patients. Cataracts were most often posterior subcapsular and were significantly associated with the use of intraocular gas. The occurrence of postvitrectomy cataract appears to be higher in patients undergoing vitrectomy for complex ocular conditions, regardless of age.

Adolescent↗