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18 recordsLinked to original sources
PubMed1977

Malignant tumors of the intestine: a review of 37 cases.

Malignant tumors of the small bowel are rare but carry a grave prognosis. Thirty-seven cases from the Tumor Registries of Brooke Army Medical Center. Fort Sam Houston, Texas, and Fitzsimons Army Medical Center, Denver, Colorado, were retrospectively studied. Twenty-nine males and eight females ranging from five to 86 years were included in the combined series. Thirteen carcinoid tumors, eight adenocarcinomas, seven lymphosarcomas, five leiomyosarcomas, two reticulum cell sarcomas, one liposarcoma, and one mesenchymal cell sarcoma were found. Symptoms included intermittent crampy abdominal pain, intestinal obstruction, intestinal bleeding with anemia, and weight loss. The diagnosis was made on the basis of the clinical picture in addition to physical findings and pertinent x-ray contrast studies. The overall survival rate was 25%. The treatment of choice is surgical extirpation of the tumor whenever possible followed by appropriate adjunctive modalities.

Adenocarcinoma↗
PubMed1976

Newborn Country USA.

"Newborn Country USA" describes a concept for a regionwide, integrated perinatal care system that serves a population of more than four million. How the four sectors of the Denver Regional Perinatal Center - The Children's Hospital, Denver, Denver General Hospital, Fitzsimons Army Medical Center, and the University of Colorado Army Medical Center - interact as a regional resource, relate to 223 hospitals in portions of 10 states, and assist in serving a portion of 70,000 live births in 1976 are reported.

Child Health Services↗
PubMed1978

The management of high-risk obstetric transfer patients.

Regionalization of perinatal care has demonstrated a definite improvement in perinatal mortality and morbidity. It has been shown that it is optimal to have high-risk neonates transferred in utero to tertiary perinatal care centers. In 1976 there were 1622 deliveries at Fort Carson Army Hospital, and 100 perinatal transfers to Fitzsimons Army Medical Center, including 73 in utero transfers and 27 neonatal transfers. An in-depth study of the obstetric management of in utero and neonatal transfers produced guidelines for the aggressive management of high-risk obstetric patients.

Adult↗
PubMed1993

Sleep apnea in male patients with the fibromyalgia syndrome.

PURPOSE: Fibromyalgia is a common pain syndrome that is often associated with sleep disturbances. The most characteristic pattern noted on formal sleep study is alpha-wave intrusion on delta-wave sleep. This nonrestorative sleep pattern may be endogenous, or caused by any of a number of sleep disturbances. Our goal was to determine the frequency of sleep apnea and its relationship to a nonrestorative sleep pattern in our patients with fibromyalgia syndrome. PATIENTS AND METHODS: All new fibromyalgia patients seen in the Rheumatology Clinic at Fitzsimons Army Medical Center were screened using history and physical examination for suspicion of sleep apnea. When this condition was suspected, the patients underwent formal polysomnography to delineate any sleep disturbance. RESULTS: Four of 92 women, and 13 of 25 men with the new diagnosis of fibromyalgia syndrome underwent polysomnography. Of the women, 2.2% (2 of 92) had significant sleep apnea at formal evaluation; both were obese and had obstructive findings. In contrast, 44% (11 of 25) of the men had significant sleep apnea. CONCLUSIONS: Sleep apnea is not a significant cause of fibromyalgia symptoms in females. In male patients with fibromyalgia, sleep apnea was observed in a large percentage. Fibromyalgia may be a marker for occult sleep apnea in males.

Adult↗
PubMed1977

An analysis of air transport results in the sick newborn II. Antenatal and neonatal referrals.

The neonatal intensive-care unit at Fitzsimons Army Medical Center admits approximately 350 infants each year. At least half of these infants are referred, and, since 1973, there has been a steady increase in antenatal referrals. In 1975, in utero referrals exceeded neonatal referrals. The entire perinatal population of two referring hospitals was retrospectively evaluated in order to compare neonatal and in utero transfers. The neonatal transfers had higher-than-predicted mortality rate, while the in utero referrals had not only lower-than-predicted mortality rate, but the survivors had a shorter hospital stay. The combined neonatal/perinatal regionalization program resulted in a perinatal mortality rate of eight and 7.6 per 1,000 births in the two hospitals during the study period.

Aircraft↗
PubMed1985

Management of the mildly abnormal Pap smear: a conservative approach.

Follow-up and management of the mildly abnormal Pap smear has been the subject of controversy in the medical literature. At Fitzsimons Army Medical Center, patients with initial Pap smears reported as "inflammatory atypia" or mild dysplasia were treated with specific therapy for vaginitis and/or cervicitis. Follow-up smears were performed 6 to 8 weeks later. Of the above groups, 80 and 58%, respectively, were negative on repeat smear. A third group of patients with Pap smears reported as consistent with human papillomavirus (HPV) were not treated but had repeat smears performed at 6 to 8 weeks. Of these, 76.4% reverted to normal. The results of the colposcopically directed cervical biopsies obtained on patients with persistently abnormal smears are reported. These findings support a conservative plan for follow-up of mildly abnormal Pap smears.

Biopsy↗
PubMed1977

Surgical management of pectus deformities.

We analyzed the long-term results in 87 patients who had pectus deformities repaired at Fitzsimons Army Medical Center during the period 1953 to 1975. Seventy-one patients had operations for correction of pectus excavotum; 16 had pectus carinatum deformities repaired. A variety of surgical techniques was used in these patients. Our findings show that in excavatum deformities the best results were obtained by removing all deformed cartilage, mobilizing the sternum, using an anterior osteotomy, and stabilizing the chest with a metal strut (which was removed after one year). For carinatum defects, the Ravitch procedure has produced good results. We are encouraged to be more aggressive in advocating repair of the deformities, not only for cosmetic results but because the patients seem to feel healthier both physically and mentally after repair. For these reasons we advocate operation for pectus deformity as any age.

Adolescent↗
PubMed1982

Invasive aspergillosis of the hand.

Aspergillosis is a fungal infection which may disseminate from the lung to bone, meninges, heart, or other organs. It is commonly found in patients with debilitating disease and those undergoing chemotherapy. A 6-year-old boy, seen at Fitzsimons Army Medical Center while being treated for acute monomyelocytic leukemia, developed invasive aspergillosis of the hand, requiring resection of the central three rays. This rare presentation of the disease required radical surgery to control its local manifestations and to prevent widespread dissemination.

Amputation, Surgical↗
PubMed1986

The effect of social support and the work environment upon burnout among nurses.

Burnout among hospital-based nurses appears to be a serious problem affecting the delivery of health care. Findings from previous empirical research indicate that burnout among these nurses results from reactions to adversities inherent in the hospital work environment, and that burnout can lead nurses to change jobs and/or abandon the practice of nursing. This paper presents and discusses research findings on the effects of various aspects of the hospital work environment on burnout among nurses, and, in addition, evaluates the effects of social support in reducing and/or mitigating the relationship between negative aspects of the work environment and burnout. A multiple regression approach is employed to test the hypothesized model. The data were collected from a sample of nurses (n = 310) employed at Fitzsimons Army Medical Center (FAMC), Aurora, Colorado. The major determinants of burnout were found to be low job enhancement (autonomy, task orientation, clarity, innovation, and physical comfort); work pressure; and lack of supervisor support, along with the interaction term involving the combined effects of job enhancement and supervisor support. These predictors, in conjunction with demographic and job-related variables explained 53% of the variance in emotional exhaustion, a central component of the burnout syndrome.

Burnout, Professional↗
PubMed1982

Urease testing of mycobacteria with BACTEC radiometric instrumentation.

A total of 140 mycobacterial isolates from patients treated at Fitzsimons Army Medical Center or the National Jewish Hospital and Research Center and from animal specimens submitted to the National Veterinary Services Laboratory were tested by using a urease procedure modified for use with a BACTEC model 301. Mycobacterial suspensions were prepared by using Middlebrook 7H10 Tween broth. Of the 98 mycobacteria isolates which were urease positive utilizing standard methodology, all were positive using the radiometric procedures. Similarly, all 42 urease-negative isolates were also negative employing the new methodology. Although maximum radiometric readings were observed at 48 h, all positive strains were readily identified 24 h after inoculation without sacrificing either test sensitivity or specificity. Thus, urease testing of mycobacteria, using the modified BACTEC radiometric methodology, was as sensitive, as specific, and more rapid than conventional methods.

Bacteriological Techniques↗
PubMed1975

Pulmonary melioidosis. Observations in thirty-nine cases.

During the 6-year period from 1965 through 1970, 39 patients with pulmonary melioidosis were treated at Fitzsimons Army Medical Center. Although this is a disease with a well-defined endemic area that does not include the United States, cases will no doubt continue to be seen in this country. These cases may result from acute infection in the endemic area, with subsequent travel to this country, or from delayed reactivation of a latent infection acquired months or years earlier. Given the potential for occurrence of this disease in the United States, continued awareness by the medical profession is important. The typical patient with subacute or chronic pulmonary melioidosis presents with fever, productive cough, weight loss, and a history of visiting an endemic area sometime in the past. Chest radiographs disclose upper lobe infiltrates and/or cavitation, suggesting granulomatous disease. With careful bacteriologic examination, sputum cultures are positive for Pseudomonas pseudomallei, which is susceptible to tetracycline, chloramphenicol, sulfonamides, and kanamycin. The titer of the indirect hemagglutinating antibodies will almost always be greater than 1:40. Most patients respond to therapy with tetracycline alone of in combination with chloramphenicol. Occasionally, a patient may require surgical intervention; if so, ideally the sputum should be negative, and a lobectomy, rather than segmentectomy, should be performed.

Adult↗
PubMed1999

Urinary incontinence among female soldiers.

A self-administered questionnaire was developed to assess the prevalence of urinary incontinence among active duty female soldiers. The questionnaire also addressed basic demographic information, including height, age, weight, and the subjects' present and past military activities. Adaptive measures that the soldiers commonly used to continue exercising and perform their duties were also explored. Seven hundred thirteen questionnaires were handed out to female soldiers at Fort Lewis (Washington), Fort Benning (Georgia), and Fitzsimons Army Medical Center (Colorado) during preparation for physical fitness tests. Of the 563 soldiers (79%) who returned completed questionnaires, 31% indicated that they commonly experienced urinary incontinence during duty and/or training to the extent that it interfered with job performance, hygiene, or was socially embarrassing. Thus, urinary incontinence is a pervasive problem among female soldiers.

Activities of Daily Living↗
PubMed1993

Patient acceptance of an information sheet about cardiopulmonary resuscitation options.

OBJECTIVE: To determine initial patient acceptance of a cardiopulmonary resuscitation/do-not-resuscitate orders (CPR/DNR) information sheet intended to facilitate early discussion of CPR preferences. DESIGN: Attitudinal survey of adults after reading a CPR/DNR information sheet. SETTING: Inpatient wards and outpatient clinics of a tertiary care military teaching hospital. PATIENTS: 230 English-reading, mentally competent, volunteer patients (95%) of 243 eligible patients completed questionnaires. Mean age was 51.5 +/- 17 years; 122 (53%) patients were men; 103 (45%) were inpatients. Self-reported diagnoses were: cancer, 42 (18%); HIV disease, 22 (10%); other medical conditions, 87 (38%); pre- and postoperative cases, 35 (15%); and unknown, 44 (19%). RESULTS: 56% of the patients had previously thought about CPR options. 10% of the patients had actually discussed preferences with their physicians. 90% of the patients desired discussion with their physicians and other health care providers. 91% of the patients reported feeling better or no change after reading the information. 78% of the patients agreed that the information sheet would be helpful in discussing their preferences and most thought the information should be routinely given to all patients. CONCLUSIONS: Written information about CPR options was perceived as helpful and acceptable to most patients surveyed. Since a few patients initially reported feeling worse after reading the CPR/DNR information sheet, written information should not be used alone but may facilitate initial communication and discussion.

Adolescent↗