1/14. An integrated physiotherapy/cognitive-behavioural approach to the analysis and treatment of chronic whiplash associated disorders, WAD.PURPOSE: The aim of this paper was to describe a model for an integrated physiotherapy/cognitive-behavioural approach in the analysis and treatment of chronic WAD patients, as well as to evaluate the effectiveness of this approach in three experimental single case studies. METHOD: Three patients with a diagnosis of chronic WAD were included in the study. Psychological and physical functional analyses were used to describe the problem areas and as a basis for the management of WAD. A programme including learning of basic and applied skills, generalization, and maintenance was carried through. RESULTS AND CONCLUSION: The results showed that functional behavioural analyses can be useful in physiotherapy for structured patient assessment and in planning of treatment. It was also shown that physiotherapy integrated with cognitive behavioural components decreased the patients' pain intensity in problematic daily activities.- - - - - - - - - - ranking = 1keywords = programme (Clic here for more details about this article) |
2/14. The concept of total pain: a focused patient care study.This article considers the care of a patient admitted into a hospice environment for pain management and respite care. The concept of 'total' pain is discussed together with the need for a multidimensional assessment of pain to enable effective management to be accomplished. A multiprofessional approach to care along with inclusion of both the patient and her husband in decision making achieved the best possible quality of life for them both. A palliative care approach requires healthcare professionals to focus on the achievement of quality of life for all patients whose disease is not responsive to curative treatment. This is achieved by providing relief from pain and other distressing symptoms, including psychological, spiritual and social aspects of care, together with the acknowledgement of patient and relative autonomy. Hence, the study also exemplifies contemporary palliative care in action.- - - - - - - - - - ranking = 38.161523710432keywords = hospice (Clic here for more details about this article) |
3/14. Management of a proximal interphalangeal joint fracture dislocation with a compass proximal interphalangeal joint hinge and therapy: a case report.The purpose of this report is to describe the management of a chronic proximal interphalangeal (PIP) joint fracture dislocation in a 46-year-old computer programmer. Twenty days following injury, a right ring finger volar plate arthroplasty was performed, loose fracture fragments were excised, and a Compass PIP joint hinge was applied. The hinge was locked at 10 degrees to 15 degrees extension and held in this position for 8 days. On postoperative day 8, hand therapy was initiated. Many challenges were encountered. insurance constraints required the patient to change therapists. The device frame cracked. The patient developed a PIP joint contracture with extensor lag. Despite these obstacles, the patient achieved a successful outcome, returning to normal pain-free use with grip strength at 87% of that of the uninvolved hand. At discharge, active range of motion was 12 degrees/100 degrees at the PIP joint and 0 degrees/40 degrees at the DIP joint. Passive extension was 0 degrees. At 6 months postoperatively, active range of motion was 0 degrees/105 degrees at the PIP joint and 0 degrees/60 degrees at the DIP joint. This case demonstrates the need for closely supervised postoperative therapy that includes good communication between providers, ongoing patient education, and close monitoring of range of motion.- - - - - - - - - - ranking = 1keywords = programme (Clic here for more details about this article) |
4/14. Treatable complications of cancer patients referred to an in-patient hospice.This paper illustrates the importance of accurate diagnoses and treatments of complications in terminally ill cancer patients. The paper reports on five hospice in-patients who completely recovered from life-threatening complications; three of them had been incorrectly labeled as "imminently dying" by the referring physicians. The paper concludes that it would be beneficial for patients to receive examinations and a trial of medical treatment in their continuing treatment settings.- - - - - - - - - - ranking = 190.80761855216keywords = hospice (Clic here for more details about this article) |
5/14. chronic pain syndrome should be recognized as a separate clinical entity.chronic pain is a relatively new concept in our understanding of pain. It is rarely recognised or diagnosed as a separate clinical entity in sri lanka. Thus the extent of this problem is not known. The case histories of two patients with the chronic pain syndrome are presented, with a brief review of the theoretical aspects of chronic pain. Trends in the management of chronic pain are summarized. Unfortunately, organized treatment programmes for chronic pain are unavailable in sri lanka.- - - - - - - - - - ranking = 1keywords = programme (Clic here for more details about this article) |
6/14. Continuity of care for the cancer patient with chronic pain.The care of patients with cancer and chronic pain, often complicated and demanding, strains the resources of a single physician. Continuity of care programs, such as that developed by the Pain Service of Memorial Sloan-Kettering Cancer Center (new york), with good communication and liaison work between hospital and community, add a much needed dimension to the pain management of these patients in the home. Although continuity of care programs resemble hospice programs in philosophy, there are major differences in admission criteria: the program is not restricted to dying individuals; patients may live alone; they may receive active therapy with a focus on cure or remission; and they continue to receive their care, including pain management, within a standard medical system under the supervision of their primary physician and nurse.- - - - - - - - - - ranking = 38.161523710432keywords = hospice (Clic here for more details about this article) |
7/14. otitis media in Dar es Salaam, tanzania.To assess the prevalence of otitis media in tanzania a study was made of 3772 patients attending for the first time the ENT out-patient department of Muhimbili Medical Centre, University Hospital of Dar es Salaam. otitis media in one form or another was present in 524 patients (14 per cent). The majority reported a long history of ear discharge. hearing loss was a major complaint and was often found to be between 40-60 dB. H.L. Most patients admitted previous treatment, but otoscopy had rarely been performed. The medical profession in tanzania cannot possibly deal with the large number of cases of chronic otitis media. With the recent introduction of otorhinolaryngology into the curriculum of the medical school of tanzania it seems advisable to include otology in the programme for primary health workers.- - - - - - - - - - ranking = 1keywords = programme (Clic here for more details about this article) |
8/14. Multiform ventricular tachycardia.Electrophysiological studies were performed in three patients with chronic recurrent ventricular tachycardia (VT) associated with coronary artery disease. In each case the ventricular origin of the tachycardia was confirmed and induction of tachycardia by programmed stimulation suggested a re-entry mechanism. Multiple types of ventricular tachycardia were observed which differed in cycle length, QRS morphology, timing of local epicardial and endocardial ventricular electrograms and the use of the specialized conduction system for propagation. There was evidence of one or more re-entry circuits arising in or near previously infarcted areas, with features of cycle length alternation, change in exit points and variations in subsequent conduction through the myocardium and specialized conduction tissues. These findings suggest multiform VT can be due to a number of factors. A modified surgical approach is recommended for management of medically refractory VT when there is evidence of multiple types.- - - - - - - - - - ranking = 1keywords = programme (Clic here for more details about this article) |
9/14. Interpretive psychotherapy with chronic pain patients.patients for whom medical and surgical management has failed to relieve chronic pain were treated in a multimodal programme which included interpretive psychotherapy. Dynamic conflicts were identified in all cases and utilized in the psychotherapy and programme design. Examined in the light of ego functioning, pain that was previously considered intractible, yielded to psychological treatment. Further research is planned to identify the parts played by the different modalities and to study outcome.- - - - - - - - - - ranking = 2keywords = programme (Clic here for more details about this article) |
10/14. Response-contingent taste-aversion in treating chronic ruminative vomiting of institutionalised profoundly retarded children.Two case studies are presented describing the use of response-contingent taste-aversion procedures to treat chronic ruminative vomiting of profoundly retarded children. Each treatment programme was designed to be carried out by para-professional staff in an institutional setting. Each programme eliminated rumination, with effects maintained one to nine months following treatment. For one subject who exhibited major weight-loss prior to intervention, substantial weight-gain was also demonstrated.- - - - - - - - - - ranking = 2keywords = programme (Clic here for more details about this article) |
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