The Journal of the Oklahoma State Medical Association
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We show that in benign aging, normally functioning elders have minor neurobehavioral deficits in activities of daily living, and in their neurologic, motor and sensory status; hearing is peripherally and centrally impaired. Also, depression appears in 25%. Gentle physical exercise improves mobility, prevents falls, diminishes pain, wards off depression, reduces mortality, and increases cerebral blood flow and cognition. ⋯ We describe dementia, giving tables to identify it and distinguish it from depression, and cite some reversible dementias. We report the accepted clinical inclusion criteria and exclusion criteria for this disease. We show, also with tables, the staging of severity of both dementia and Alzheimer disease as mild, moderate, or severe.
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J Okla State Med Assoc · Apr 1995
Right diaphragmatic paralysis following orthotopic liver transplantation.
Although most postoperative complications of liver transplantation are well known and their pathophysiology is reasonably understood, right diaphragmatic dysfunction occurring after liver transplantation remains an unappreciated complication. To evaluate the incidence and mechanisms responsible for such injury, a group of 48 liver transplant patients were studied prospectively. Partial right diaphragmatic paralysis was found in 11 (23%), complete paralysis was found in 10 (21%) and the remaining 27 patients had normal diaphragmatic motion (56%). ⋯ Right diaphragmatic injury was found to be a common postoperative complication of liver transplantation. Moreover, it was found to have a clinically significant effect upon the postoperative course of these patients, often necessitating a prolonged ICU stay and prolonged ventilatory support. Although the exact mechanism responsible for its occurrence remains speculative, careful attention to operative technique particularly in the dissection of the upper cava and careful closure of the bare area of the diaphragm, may reduce the frequency of this untoward complication.
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J Okla State Med Assoc · Dec 1994
ReviewGastrointestinal problems experienced in an intensive care unit.
Medical emergencies involving the gastrointestinal tract include bleeding, abdominal pain, diarrhea, toxic megacolon, pancreatitis, and hepatic failure. Each can be a cause for admission to an intensive care unit or occur de novo in a patient hospitalized in such a unit. The clinical presentation, management, and consequences of these varied gastrointestinal problems seen in an intensive care unit are presented followed by a recommended course of action.
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Removing nail polish and prosthetic nails from operating room (OR) personnel prior to scrubbing and from patients prior to hand surgery is recommended but not practiced in many hospitals. There is concern that nail polish can act as a vehicle for the transfer of infectious agents. This study was designed to determine the incidence of microbiological flora of nail polish in a clinical setting.
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J Okla State Med Assoc · Sep 1994
ReviewUnderstanding mechanical ventilation: patient monitoring, complications, and weaning.
Mechanical ventilation can provide life saving support to critically ill patients with respiratory failure. The implementation of appropriate monitoring techniques and an awareness of potential complications can increase the safety of mechanical ventilation. ⋯ Determining patient suitability for extubation is an inexact science. The physical examination during a spontaneous breathing trial and the use of the rapid shallow breathing index can assist the clinician in the difficult decision as to the timing of extubation.