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81.
Seymour Diamond 《Postgraduate medicine》2013,125(5):272-273
The treatment of pain concerns every practitioner. This article is one of a series alerting the physician to recent trends and theories in the management of a common problem. 相似文献
82.
Seymour Diamond 《Postgraduate medicine》2013,125(6):184-188
The treatment of pain concerns every practitioner. This article is one of a series alerting the physician to recent trends and theories in the management of a common problem. 相似文献
83.
Molly A. Rose Christine Arenson Pamela Harrod Robyn Salkey Abbie Santana James Diamond 《Journal of community health nursing》2013,30(4):193-202
A 1-group pretest–posttest design to assess for changes in outcomes at 10 weeks and 6 months was the method used to evaluate the standardized 6-session Chronic Disease Self Management Program (CDSMP) with low income, urban African American older adults. Participants included 153 older adults (primarily African American) with 1 or more chronic health conditions. Classes were provided in the community at senior citizen centers, senior housing, and churches. Significant improvements were noted in selected areas at 10 weeks and 6 months after the program completion. The CDSMP was feasible and well-received with the older adults who participated in the study. 相似文献
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P.T. Diamond 《Disability and rehabilitation》2013,35(12):574-576
Purpose : This case report examines the hospital course and functional recovery of a geriatric patient with severe anaemia undergoing rehabilitation following total hip replacement. It serves to highlight the need for further study of the impact of anaemia on recovery in the rehabilitation setting as well as the importance of developing clinical guidelines for the appropriate medical management of anaemia in this patient population. Method : Single case report. Results : The course of recovery during rehabilitation in a geriatric patient with sever post-operative anaemia was notably different from other geriatric patients undergoing rehabilitation following total hip replacement. The patient demonstrated a markedly reduced tolerance for therapies and prolonged length of stay, but did not experience cardiopulmonary complications during intensive rehabilitation. Her hematocrit responded nicely to treatment with human recombinant erythropoietin. Despite a prolonged recovery period, the patient ultimately progressed well and achieved a good functional outcome. Conclusions : The impact of anaemia on functional recovery in the acute inpatient rehabilitation setting as well as the theoretical risk of increased morbidity and mortality during prescribed therapeutic exercise has not been closely examined in the literature. Further study is indicated to examine the implications for anaemia on functional recovery and cardiopulmonary complications during rehabilitation. General guidelines should be developed for the management of anaemia in the rehabilitation setting. 相似文献
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Alternative referent standards for cardiac normality. Implications for diagnostic testing 总被引:1,自引:0,他引:1
A Rozanski G A Diamond J S Forrester D S Berman D Morris H J Swan 《Annals of internal medicine》1984,101(2):164-171
The radionuclide ventriculographic exercise response was evaluated in three patient populations representing alternative referent standards for cardiac normality: patients with normal coronary arteriograms, healthy volunteers, and uncatheterized patients with a low probability of coronary artery disease. Disease probability was determined by Bayesian analysis of age, sex, symptoms, and the results of cardiac fluoroscopy, exercise electrocardiography, or thallium scintigraphy. A wide range of ventriculographic responses was noted in the 62 catheterized normal patients; 21 (34%) had an abnormal ejection fraction response and 22 (35%) had an abnormal wall motion response. In contrast, the ejection fraction and wall motion responses were normal in the 9 volunteers. In 90 patients (18 catheterized and 72 uncatheterized) who had low disease probability (less than 1%), abnormal responses were rare; the ejection fraction response was abnormal in only 7% and the wall motion response was abnormal in 8%. Thus, these three populations are not equivalent referent standards of normality. Volunteers and patients with low disease probability provide too strict a standard, and their use can overestimate test specificity; catheterized normal patients, on the other hand, provide too lenient a standard, and their use can underestimate test specificity. 相似文献
89.
Ethanol reduces bone formation and may cause osteoporosis 总被引:10,自引:0,他引:10
INTRODUCTION: The etiology of ethanol-associated osteopenia is not fully understood. In order to define the role of ethanol in the pathogenesis of hepatic osteodystrophy, we compared two groups of alcoholic patients with histologically established alcoholic liver disease. PATIENTS AND METHODS: Twenty-eight patients currently drinking ethanol ("drinkers") and 12 claiming not to have consumed any ethanol for at least six months ("abstainers") were enrolled in the study. In addition, 35 non-alcoholic control subjects without clinical or biochemical evidence of liver disease were also studied. Bone mineral density and various biochemical and hormonal values were measured in each subject; iliac crest biopsies were taken under local anesthesia in the patients and under general anesthesia in the control subjects. RESULTS: Forearm bone mineral densities, spinal bone mineral densities, and iliac crest cancellous bone areas were significantly lower in the alcoholic patients compared with control subjects (p less than 0.01 for all measurements), but these values did not differ between the drinkers and the abstainers. The drinkers, however, had significantly less osteoblastic activity than the abstainers, as assessed by dynamic bone histomorphometry (p less than 0.001). Serum bone Gla-protein concentrations were higher in the abstainers than in the drinkers (p less than 0.001). No differences were seen relating to histologic parameters of bone resorption, although the alcoholic patients who had lower serum free testosterone concentrations than the control subjects also had higher urinary hydroxyproline excretion rates. CONCLUSION: These data suggest that ethanol may be responsible for osteoblastic dysfunction resulting in diminished bone formation and reduced bone mineralization. 相似文献
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