Cases reported "Wounds and Injuries"

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1/7. Returning to work after disability.

    After a workplace injury or disability, there is a period of hardship and adjustment for the injured party as well as all stakeholders in the workers' compensation process. Ultimately, however, return to work is considered. The author reviews this often challenging exercise from the Canadian perspective and stresses the need for timely intervention, honest communication, the coordination of information and resources--and the need for flexibility. A case study on low back pain is included.
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ranking = 1
keywords = communication
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2/7. The first report of hypnotic treatment of traumatic grief: a brief communication.

    In 1813 the Dutch physicians Wolthers, Hendriksz, De Waal, and Bakker reported the hypnotic treatment of a woman suffering from traumatic grief, in which the therapist had to deal directly with the patient's spontaneous reenactments of the circumstances surrounding the death. This report, summarized in the present article, has historical value, as it is probably the first known precursor of the uncovering hypnotic approach. The original authors' views on the case are discussed, and a modern view for understanding the patient's traumatic grief and its treatment is presented.
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ranking = 4
keywords = communication
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3/7. role of dynamic CT myelography in identifying the etiology of superficial siderosis.

    The authors report three cases of superficial siderosis with a fluid-filled spinal canal cavity communicating with the subarachnoid space. The site of communication was identified with dynamic CT myelography and the defect was surgically repaired.
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keywords = communication
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4/7. Employee experiences with early return to work programs.

    Those who administer early return to work programs should be aware of the differing needs of workers who have suffered on the job injuries. Many employees are able to move through a program without problems; others are at risk for poor outcomes. Those workers most in need of assistance should an on the job injury occur are those who have relatively poor satisfaction in the job in which injury occurred, a longer period of disability due to injury, aggravation of injury while on the early return to work program, or perceptions of little support from within the company. Particular attention to certain aspects of programs (identification of workers at risk for poor outcome, design of modified jobs, and communication of concern for workers) may enhance favorable response to early return to work programs.
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ranking = 1
keywords = communication
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5/7. Report of a rare case of significant hemobilia and review of this entity.

    hemobilia, regardless of the etiology, is a serious manifestation of disease and/or injury. It is an abnormal communication of intra- or extra-hepatic bile ducts with blood vessels, and often not considered in the differential diagnosis of upper gastrointestinal hemorrhage. If appropriate treatment is delayed or omitted, the end result may be devastating. Malignant melanoma, a ubiquitous tumor, metastasizes to practically every body part. It is almost never responsible for significant hemobilia. An example of a patient with hemobilia caused by melanoma is reported and discussed.
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ranking = 1
keywords = communication
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6/7. The family meeting in critical care settings.

    A routine, carefully planned meeting with families of patients in a trauma unit or critical care setting can improve coping and enhance patient care. Even though staffs in intensive care units realize that families may profoundly influence a patient's psychologic state, or may themselves be severely stressed, few units systematically address the needs of families in crisis. Common needs of families of acutely injured patients are the need to be with the patient, to learn about his condition, to feel useful, to express feeling about the situation, and to obtain emotional support. Besides addressing these needs, a family meeting can reduce family turmoil, help dispel family-staff conflict, and provide a format for educating staff about psychologic responses to life-threatening illness. The experience with eight patients in an ICU is described, and guidelines given for family meetings. Factors assuring a successful family meeting include careful attention to leadership, timing, communication, and clear priorities.
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keywords = communication
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7/7. A comparison of shock intensity in the treatment of longstanding and severe self-injurious behavior.

    A comparison of shock intensity was conducted while treating a young woman with mental retardation and severe self-injurious behavior (SIB). Two levels of shock intensity were evaluated: 3.5 milliamps (mA) delivered via the self-injurious behavior Inhibiting System (SIBIS) and 18.5 mA delivered via the Hot Shot Power Mite. A combined reversal and multiple baseline across behaviors design was used to evaluate treatment effects. SIBIS in conjunction with differential reinforcement and extinction of self-injurious escape behavior produced minimal reductions in SIB. The Hot Shot combined with extinction of self-injurious escape behavior and reinforcement for compliance resulted in immediate and large reductions in SIB. Residential staff were trained to implement contingencies by the fourth day of treatment with excellent generalization from 30-min sessions to the natural environment across all waking hours. Continuous protective restraints were eliminated within the first month of treatment. Progress occurred in personal care, vocational training, independence, and communication. Treatment effects were maintained for approximately 6 months until a relapse occurred after home visits.
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keywords = communication
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