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PubMed1994

Rehabilitation of oropharyngeal swallowing disorders.

Patients with oropharyngeal swallowing disorders can be rehabilitated through a program of radiographic assessment to define the patient's anatomic or physiologic swallowing disorder(s), followed by use of carefully selected compensatory and/or therapeutic strategies. Compensatory strategies are designed to eliminate symptoms of swallowing disorders, i.e., aspiration and inefficient swallow, and include postural changes, enhancement of sensory input, changes in food characteristics (viscosity, temperature, taste), modifications in volume and speed of food presentation, and intraoral prosthetics. Therapeutic strategies are designed to change swallow physiology and include range of motion exercises, sensory motor integration procedures and swallow maneuvers. The effects of many of these procedures can be assessed during the radiographic diagnostic procedure, once the patient's oropharyngeal anatomy and swallowing physiology have been defined. In general, swallowing assessment should be completed as soon as the patient is identified as dysphagic, and an appropriate rehabilitation plan initiated.

Deglutition↗
PubMed1995

Anxiety disorders in children and adolescents.

Anxiety disorders are common in children and adolescents and may be associated with significant suffering, disruptions of normal psychosocial and academic development, disruption of family functioning, and increased utilization of medical services. They are frequently chronic disorders. Effective early interventions for children and adolescents with anxiety disorders may reduce or eliminate potentially life-long suffering and impairment.

Adolescent↗
PubMed1995

Cognitive-behavioral body image therapy for body dysmorphic disorder.

Body dysmorphic disorder (BDD) is a distressing body image disorder that involves excessive preoccupation with physical appearance in a normal appearing person. Prior case reports of behavior therapy were encouraging, but no controlled evaluation of behavior therapy or any other type of treatment had been conducted. In the present study, 54 BDD subjects were randomly assigned to cognitive behavior therapy or no treatment. Patients were treated in small groups for eight 2-hour sessions. Therapy involved modification of intrusive thoughts of body dissatisfaction and overvalued beliefs about physical appearance, exposure to avoided body image situations, and elimination of body checking. Body dysmorphic disorder symptoms were significantly decreased in therapy subjects and the disorder was eliminated in 82% of cases at posttreatment and 77% at follow-up. Overall psychological symptoms and self-esteem also improved in therapy subjects.

Adult↗
PubMed1975

[Clinical results of the functional bite analysis. II. Co-determining factors for the therapeutic results].

In the present study the influences of type and duration of complaints, findings, therapeutic method, duration of therapy and patient cooperation on the prognosis of temporo-mandibular joint disorders were analyzed. The elimination of occlusal interferences may be regarded as causal therapy in the large majority of temporo-mandibular joint disorders. In these cases a very good and long-term rate of success may be achieved by the method of selectively grinding-in the teeth according to A. Lauritzen.

Humans↗
PubMed1992

Red blood cell uridine sugar nucleotide levels in patients with classic galactosemia and other metabolic disorders.

While dietary galactose restriction eliminates the life-threatening complications of classic galactosemia, central nervous system and ovarian disease are still evident in these patients, despite milk restriction. Because of the possibility that reduced tissue levels of uridine diphosphate galactose (UDPgalactose), the product of the deficient enzyme, galactose-1-phosphate uridyltransferase, are the cause of these unexplained complications, we have measured the concentration of red blood cell (RBC) uridine sugar nucleotides in these patients, comparing their values not only with those of normal subjects, but also with those of children who have other metabolic disorders. RBC UDPgalactose and uridine diphosphate glucose (UDPglucose) levels were measured by high-performance liquid chromatography (HPLC) in 35 control subjects, 24 galactosemic patients, and 19 patients with inborn errors of amino acid, organic acid, or ammonia metabolism. The last group of patients served as dietary controls, as they were all on special low-protein diets that restricted milk intake. The mean levels of UDPgalactose in galactosemic children and adults were 38% and 54% lower, respectively, than the levels in normal children and adults. While only six of 19 galactosemic children had levels below the 95% confidence limit for normals, four of five galactosemic adults had levels of UDPgalactose in the low range. The mean UDPgalactose level in children with other metabolic diseases who were on a low-milk diet was also reduced by 38%, with a mean not significantly different from galactosemics. Compared with normal adults, the level of UDPglucose in galactosemic adults was also reduced by 29%, with three of five affected adults having UDPglucose values below the 95% confidence limit.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

American Nurses Association position statement on elimination of manual patient handling to prevent work-related musculoskeletal disorders.

In order to establish a safe environment for nurses and patients, the American Nurses Association (ANA) supports actions and policies that result in the elimination of manual patient handling. Patient handling, such as lifting, repositioning, and transferring, has conventionally been performed by nurses. The performance of these tasks exposes nurses to increased risk for work-related musculoskeletal disorders. With the development of assistive equipment, such as lift and transfer devices, the risk of musculoskeletal injury can be significantly reduced. Effective use of assistive equipment and devices for patient handling creates a safe healthcare environment by separating the physical burden from the nurse and ensuring the safety, comfort, and dignity of the patient.

American Nurses' Association↗
PubMedDate not supplied

[The specific features of the development of iodine deficiencies in children living under environmental pollution with fluorine compounds].

Natural iodine deficiency and ambient air pollution with fluorine compounds were examined for their combined influence on the prevalence and severity of iodine-deficiency disorders. The excess intake of fluorine was shown to increase the incidence of thyroid diseases and to lower anthropometric indices in children. The preventive measures performed to eliminate iodine-deficiency disorders under intensive ambient air pollution with fluorine compounds were found to be insufficiently effective.

Air Pollution↗
PubMed1976

Pharmacokinetics of diazepam in disordered liver function.

The plasma elimination curves of diazepam following intravenous administration of 10 mg were studied in nine patients with cirrhosis of the liver and four patients without liver disease. The data were analyzed according to a two compartment model. The mean biological half-life (T/2) of diazepam was increased five-fold in patients with cirrhosis compared to the controls (164 hours vs. 32.1 hours). The plasma clearance of diazepam could be correlated neither with a quantitative measure of liver function, as estimated by galactose elimination capacity, nor to semiquantitative measures of liver function, such as serum albumin and prothrombin. It is suggested that the plasma clearance of diazepam is an inaccurate index of its rate of hepatic metabolism due to the complex kinetics of the drug.

Adult↗
PubMed2002

[Paracervical non-caries defects].

The aim of the study was the description of origin and treatment of paracervical, non-caries defects. Dental plaque is involved in the formation of caries defects, while those of non-caries origin are produced due to the action of mechanical and chemical factors. The treatment consists in wide fluoride prophylaxis (elimination of causes) and in the application of mineralization procedures and restoration of missing dental tissue using modern dental highly-adhesive materials. At the same time occlusion disorders and parafunctions are eliminated.

Dental Prophylaxis↗
PubMed2002

[Secondary recurrent hepatitis in ventricular arrhythmia].

INTRODUCTION: A major episode of hepatic cytolysis, rapidly regressive and occasionally recurrent, evokes a bilary or toxic pathology. We report an exceptional case in which several episodes of cytolysis were secondary to a paroxystic cardiac rhythm disorder. OBSERVATION: A 44 year-old woman was hospitalized 3 times during 4 months for episodes of asthenia and rapidly regressive cytolysis. Lithiasic, viral, metabolic, autoimmune and toxic causes were eliminated. A cardiac rhythm disorder was revealed during the last two episodes and diagnosis was made of intermittent and asymptomatic ventricular tachycardia, secondary to arryhthmogenic right ventricular dysplasia, and was confirmed on the electrocardiogram, cardiac scan and magnetic resonance imaging. Treatment of the cardiac rhythm led to the absence of further relapse. COMMENTS: In our patient, the clinical and chronological imputability appeared highly probable. The responsibility of perturbed cardiac rhythm in the genesis of an ischemic hepatopathy is classical, but little documented. Our observation confirms that severe unexplained cytolysis requires systematic search for a cardiac rhythm disorder, even in the absence of a known or symptomatic cardiopathy.

Adult↗
PubMed2004

Use of health care services and costs of psychiatric disorders among National Health Insurance enrollees in Taiwan.

The National Health Insurance (NHI) database in Taiwan was used to detect the use of health care services and the costs of psychiatric disorders among NHI enrollees. Data were analyzed for 126,146 enrollees. Four categories were used for enrollees: no psychiatric disorder, a minor psychiatric disorder, a major psychiatric disorder without catastrophic illness registration, and a major psychiatric disorder with catastrophic illness registration (which eliminates copayments). Compared with enrollees with a minor psychiatric disorder, those with a major psychiatric disorder, either with or without catastrophic illness registration, had higher use and costs of mental health care services. Compared with enrollees without a psychiatric disorder, those with a minor psychiatric disorder or a major psychiatric disorder without catastrophic illness registration had higher use and costs of non-mental health care services. Both the mental and general health care of persons with psychiatric disorders are important.

Databases, Factual↗
PubMed1994

[Assessment of intrapulmonary ventilation disorders in children with bronchial asthma using the nitrogen elimination technique].

Stratification of functional abnormalities evaluated by whole-body plethysmography in asthmatic children can be characterized into three functional groups: pulmonary hyperinflation (H: TGV > mean + 2SD), bronchial obstruction (O: Raw > mean + 2SD) and a mixed type, group M, including both abnormalities. The multibreath nitrogen washout (MBNW) offers the possibility to measure FRC and calculate the amount of trapped gases (TG = TGV-FRCMBNW). Furthermore ventilation inequalities can be estimated by mathematical analysis of the washout curve from which indexes such as the lung clearance index (LCI), the mean dilution number (MDN) and the moment ratio (m2:m0 = M-ratio) can be obtained. In 69 asthmatic children (age 5-17 y; 38 boys, 31 girls) body plethysmography and MBNW were performed in the symptom free interval. The questions were, at what extend TG are present within the different functional groups, and which parameters best describe ventilation inequalities. The group attribution was H: 23, M: 16, O: 30. The highest amount of TG was found in H (36.4 +/- 22.2% TGV), then in M (26.6 +/- 23.1% TGV) and in O (19.4 +/- 16.0% TGV). In 33/50 cases presenting with normal TGV, TG mainly was at cost of a low FRC (13 in H, 8 im M, 12 in O). In 19 cases FRC was higher than TGV (3 in H, 1 in M 15 in O). TG was closely related with LCI, MDN and M-ratio. Most pronounced ventilation inequalities were found in group M showing a correlation only with FRC, but not with TGV.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

A scale for evaluating emotional disorders in severely and profoundly mentally retarded persons. Development of the Diagnostic Assessment for the Severely Handicapped (DASH) scale.

The DASH scale was used to assess 506 profoundly and severely mentally retarded persons (247 females and 259 males). The scale, covering 13 major psychiatric disorders, consists of 83 items derived from DSM-III-R as well as previously published studies of this population. Data were collected on symptom frequency, duration and severity in individual interviews with direct-care staff. Elimination and pervasive developmental disorders were most frequent, self-injurious behaviour disorders most severe. Most symptoms had been evident for at least a year. Inter-rater reliability was generally good.

Adult↗
PubMed1989

[How does quality of life modify indications for palliative surgical measures?].

Palliative operations have the aim of eliminating tumor symptoms and functional disorders and, if possible, improving the survival time, when incurability was diagnosed. The lacking possibility of cure requires careful risk-benefit evaluation of palliative operations. In this case, the general risk of such an intervention, its effectiveness and the patient's tolerance are relevant factors in the evaluation of life quality. It is important not only to prolong the life expectancy but also to alleviate various symptoms and avoid or eliminate physical deformations and functional disorders. Although it is still difficult to quantify "life quality", it is a decisive factor in palliative surgery beside the elimination of pain and maintenance of body functions. For example to avoid an artificial anus and relieve from pain is generally more important for patients than the statistical results of marginally prolonged survival time. Extensive palliative surgery is indicated when survival time and life quality can significantly be improved, compared to other treatment modalities.

Activities of Daily Living↗
PubMed1987

Effect of gradual withdrawal on the rebound sleep disorder after discontinuation of triazolam.

Sixty volunteers with insomnia participated in a randomized, double-blind, controlled clinical trial. After an initial six nights of placebo, 30 subjects (the abrupt-withdrawal group) received 0.5 mg of triazolam nightly for 7 to 10 nights, after which they received placebo. The other 30 subjects (the tapered-dosage group) received the same initial placebo treatment, then triazolam at 0.5 mg for seven nights, at 0.25 mg for two nights, and at 0.125 mg for two nights, and then placebo. As compared with the initial placebo period, the triazolam period significantly reduced the interval before the onset of sleep (sleep latency), and it prolonged sleep duration, reduced the number of awakenings, and improved the self-rated soundness of sleep in all cohorts. In the abrupt-withdrawal group, plasma levels of triazolam were undetectable the morning after the first night of placebo substitution, and subjects reported prolongation of sleep latency (57 minutes longer than base line), reduction in sleep duration (1.4 hours less than base line), and increased awakenings (1.2 per night above base line). The symptoms of rebound sleep disorder lasted one or possibly two nights, and there was a reversion toward base line on subsequent placebo nights. In the tapered-dosage group, however, plasma triazolam levels fell gradually to zero, and rebound symptoms were decreased or eliminated. Thus, rebound sleep disorder following abrupt discontinuation of triazolam can be attenuated by a regimen of tapering.

Adult↗
PubMedDate not supplied

Acquired reactive perforating collagenosis.

Acquired perforating disorder has been recognized as an uncommon distinct dermatosis in which altered collagen is eliminated through the epidermis. Several disorders accompanied by itching and scratching were reported to be associated with reactive perforating collagenosis. A 67-year-old white woman diagnosed as acquired reactive perforating collagenosis with poorly controlled diabetes mellitus and congestive cardiac failure is presented.

Aged↗
PubMed1994

Who wants to eliminate heart disease?

Twenty-seven physicians and nine pharmacists at one University teaching hospital identified their preferred way of dying after attaining average life expectancy. Respondents' ranking of modes of dying showed high agreement (for physicians, W = 0.65, p < 10(-16)). Disease category, rapidity of death, and their interaction (ANOVA, all p < 0.0001) influenced choice. "Rapidly fatal cardiac death" was overwhelmingly preferred. Cancer and slowly fatal central nervous system disorders were rated last. Eliminating cardiovascular disease would necessarily increase the likelihood of other modes of death. If these respondents represent "informed consumers", then reducing cardiac death at normal life expectancy may be contrary to Western society's preferences.

Adult↗