Obstacles to Claiming Permanence and Injury-Relatedness for “Posttraumatic” Headache

2009 ◽  
Vol 14 (3) ◽  
pp. 3-6
Author(s):  
Robert J. Barth
Keyword(s):  
Complete Recovery ◽  
World Health ◽  
Related Factors ◽  
Posttraumatic Headache ◽  
Sixth Edition ◽  
Causative Relationship ◽  
Short Period ◽  
The One ◽  
Health Organization ◽  
Subjective Reports

Abstract “Posttraumatic” headaches claims are controversial because they are subjective reports often provided in the complex of litigation, and the underlying pathogenesis is not defined. This article reviews principles and scientific considerations in the AMAGuides to the Evaluation of Permanent Impairment (AMA Guides) that should be noted by evaluators who examine such cases. Some examples in the AMA Guides, Sixth Edition, may seem to imply that mild head trauma can cause permanent impairment due to headache. The author examines scientific findings that present obstacles to claiming that concussion or mild traumatic brain injury is a cause of permanent headache. The World Health Organization, for example, found a favorable prognosis for posttraumatic headache, and complete recovery over a short period of time was the norm. Other studies have highlighted the lack of a dose-response correlation between trauma and prolonged headache complaints, both in terms of the frequency and the severity of trauma. On the one hand, scientific studies have failed to support the hypothesis of a causative relationship between trauma and permanent or prolonged headaches; on the other hand, non–trauma-related factors are strongly associated with complaints of prolonged headache.

Sixth Edition: the New Standard

2008 ◽  
Vol 13 (1) ◽  
pp. 1-12
Author(s):  
Christopher R. Brigham ◽  
Robert D. Rondinelli ◽  
Elizabeth Genovese ◽  
Craig Uejo ◽  
Marjorie Eskay-Auerbach
Keyword(s):  
Review Process ◽  
Peer Review Process ◽  
World Health ◽  
International Classification Of Functioning ◽  
Revision Process ◽  
Sixth Edition ◽  
Impairment Ratings ◽  
Health Organization ◽  
Impairment Severity

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, was published in December 2007 and is the result of efforts to enhance the relevance of impairment ratings, improve internal consistency, promote precision, and simplify the rating process. The revision process was designed to address shortcomings and issues in previous editions and featured an open, well-defined, and tiered peer review process. The principles underlying the AMA Guides have not changed, but the sixth edition uses a modified conceptual framework based on the International Classification of Functioning, Disability, and Health (ICF), a comprehensive model of disablement developed by the World Health Organization. The ICF classifies domains that describe body functions and structures, activities, and participation; because an individual's functioning and disability occur in a context, the ICF includes a list of environmental factors to consider. The ICF classification uses five impairment classes that, in the sixth edition, were developed into diagnosis-based grids for each organ system. The grids use commonly accepted consensus-based criteria to classify most diagnoses into five classes of impairment severity (normal to very severe). A figure presents the structure of a typical diagnosis-based grid, which includes ranges of impairment ratings and greater clarity about choosing a discreet numerical value that reflects the impairment.

The Historical Development of Burden of Treatment Compliance

2014 ◽  
Vol 19 (5) ◽  
pp. 13-15
Author(s):  
Stephen L. Demeter
Keyword(s):  
Internal Medicine ◽  
Treatment Compliance ◽  
World Health ◽  
International Classification Of Functioning ◽  
Sixth Edition ◽  
Burden Of Treatment ◽  
Specific Goal ◽  
Surrogate Measure ◽  
Health Organization

Abstract A long-standing criticism of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) has been the inequity between the internal medicine ratings and the orthopedic ratings; in the comparison, internal medicine ratings appear inflated. A specific goal of the AMA Guides, Sixth Edition, was to diminish, where possible, those disparities. This led to the use of the International Classification of Functioning, Disability, and Health from the World Health Organization in the AMA Guides, Sixth Edition, including the addition of the burden of treatment compliance (BOTC). The BOTC originally was intended to allow rating internal medicine conditions using the types and numbers of medications as a surrogate measure of the severity of a condition when other, more traditional methods, did not exist or were insufficient. Internal medicine relies on step-wise escalation of treatment, and BOTC usefully provides an estimate of impairment based on the need to be compliant with treatment. Simplistically, the need to take more medications may indicate a greater impairment burden. BOTC is introduced in the first chapter of the AMA Guides, Sixth Edition, which clarifies that “BOTC refers to the impairment that results from adhering to a complex regimen of medications, testing, and/or procedures to achieve an objective, measurable, clinical improvement that would not occur, or potentially could be reversed, in the absence of compliance.

Standardization of Factor VIII – IV. Establishment of the 3rd International Standard for Factor VIII: C Concentrate

1983 ◽  
Vol 50 (03) ◽  
pp. 697-702 ◽  
Author(s):  
T W Barrowcliffe ◽  
A D Curtis ◽  
D P Thomas
Keyword(s):  
Factor Viii ◽  
High Purity ◽  
Collaborative Study ◽  
World Health ◽  
Current Standard ◽  
Two Stage ◽  
International Standard ◽  
One Stage ◽  
The One ◽  
Health Organization

SummaryAn international collaborative study was carried out to establish a replacement for the current (2nd) international standard for Factor VIII: C, concentrate. Twenty-six laboratories took part, of which 17 performed one-stage assays, three performed two-stage assays and six used both methods. The proposed new standard, an intermediate purity concentrate, was assayed against the current standard, against a high-purity concentrate and against an International Reference Plasma, coded 80/511, previously calibrated against fresh normal plasma.Assays of the proposed new standard against the current standard gave a mean potency of 3.89 iu/ampoule, with good agreement between laboratories and between one-stage and two- stage assays. There was also no difference between assay methods in the comparison of high-purity and intermediate purity concentrates. In the comparison of the proposed standard with the plasma reference preparation, the overall mean potency was 4.03 iu/ampoule, but there were substantial differences between laboratories, and the two-stage method gave significantly higher results than the one stage method. Of the technical variables in the one-stage method, only the activation time with one reagent appeared to have any influence on the results of this comparison of concentrate against plasma.Accelerated degradation studies showed that the proposed standard is very stable. With the agreement of the participants, the material, in ampoules coded 80/556, has been established by the World Health Organization as the 3rd International Standard for Factor VIII :C, Concentrate, with an assigned potency of 3.9 iu/ampoule.

Reflections on FDA and WHO recommendations concerning clinical trials

1989 ◽  
Vol 4 (2) ◽  
pp. 117-122 ◽  
Author(s):  
J.-F. Dreyfus ◽  
D. Cremniter ◽  
J.D. Guelfi
Keyword(s):  
Clinical Trials ◽  
Drug Users ◽  
Objective Evaluation ◽  
World Health ◽  
Measuring Instruments ◽  
New Techniques ◽  
The Usa ◽  
The One ◽  
Health Organization

SummaryWe are still confronted by numerous different nosographic models and problems concerning the objective evaluation of patients progress during treatment. It is interesting to consider the consequences of this situation in psychiatry which still involves a relative diversity of practical methods used in clinical trials. The recommendations of the USA Food and Drug Administration, on the one hand, constitute a highly structured and precise reference. The World Health Organization, on the other hand, promulgates general recommendations resulting from a compromise designed to satisfy the greatest number of clinicians.Despite the apparently diverse principles and the different practical methods they propose, both those sets of recommendations have been useful in inspiring clinicians to reflect upon these different methodological approaches. The qualities of the inclusion criteria used in the study of patients and the sensitivity of the different measuring instruments have allowed psychotropic drug users as well as producers to recognize the need for a certain rigour in clinical trials.The FDA and WHO guidelines have certainly improved the quality of clinical trials in psychopharmacology. However, they also represent a source of resistance to innovation.A series of consensus meetings to first reconcile US and European points of view and later to include new techniques in the recognized sets of methods would therefore be helpful.

scholarly journals From Syphilis to Autism, How the Anti-Vaccination Movement of Today is an Echo of the Past

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Kayleigh Beaveridge
Keyword(s):  
Personal Narratives ◽  
World Health ◽  
Statistical Characteristics ◽  
Vaccine Hesitancy ◽  
Vaccine Preventable Diseases ◽  
Vaccination Rates ◽  
The World ◽  
The One ◽  
Health Organization ◽  
The 19Th Century

Introduction: The anti-vaccination movement has led to decreased vaccination rates and increased vulnerability to vaccine-preventable diseases in the general population. In order to better understand the anti-vaccination movement of today, the anti-vaccination movement that emerged in the 19th century is examined and measured against the one observed in the 20th century. Discussion: Though the population of the 19th and 20th centuries differ in many regards and our knowledge of vaccine and immune mechanisms are far greater; the anti-vaccination movement seen today stands on the same pillars as that of the 1800s with the sentiment of fear at its core. Though the façade of these pillars has been altered to suit the world today, both movements exploited the influence of prominent public figures, maintained false associations with dire vaccine consequences and emphasized these through the use of visual media, repetition and personal narratives. The persistence of the anti-vaccination movement lies largely in the use of personal stories which are more impactful and memorable then the statistical characteristics of scientific study. Conclusion: The pro-vaccination movement must respond to the tactics used by the anti-vaccination movement and create accessible, understandable and equally impactful communication strategies in order to prevent the spread of misinformation and counter the efforts of the current anti-vaccination movement. Relevance: Vaccine hesitancy was listed amongst the top 10 global health threats in 2019 by the World Health Organization. In order to shift the negative rhetoric surrounding vaccines, the anti-vaccination movement of today and its historic roots need to be understood.

scholarly journals Guidelines on controlling latent tuberculosis infection to support tuberculosis elimination

2021 ◽  
Vol 23 (1) ◽  
pp. 28-36
Author(s):  
P Godoy
Keyword(s):  
Treatment Guidelines ◽  
Latent Tuberculosis ◽  
Homeless People ◽  
Risk Groups ◽  
World Health ◽  
Sufficient Evidence ◽  
Short Treatment ◽  
Short Period ◽  
Latent Tb Infection ◽  
Health Organization

Objectives: Latent TB infection (LTBI) affects 25% of the world’s population. As long as this reservoir exists, the elimination of TB will not be feasible. The Assembly of the World Health Organization adopted the “Global End TB” strategy for the elimination of TB in 2014. The objective of this review is to present strategies for risk groups that are candidates for the detection and treatment of LTBI. Material and method: There is sufficient evidence of screening in: immunocompromised people (HIV-infected, biological therapies, alternative renal therapy, organ transplantation), recent immigrants, inmates in prison, people injecting drugs and homeless people, and workers from at-risk settings. Tests to diagnose LTBI include tuberculin skin test (TST) and gamma release assay interferon (IGRA). There is no reference test and the choice of one or the other will depend on logistical considerations, such as avoiding injection (TST) or not needing a second visit (IGRA). Treatment of LTBI is based on the use of isoniazide and rifampicin in short period of 3 or 4 months, using associations of rifampicin and isoniazide or rifampicin alone. Discussion: Given the estimated high prevalence of LTBI, renewed efforts are required to reduce the number of people with LTBI that includes a registration and monitoring system to observer progress, increased testing, and the use of short treatment guidelines.

Emergence of a High-Grade Sarcoma in a Recurrent Meningioma: Malignant Progression or Collision Tumor?

2011 ◽  
Vol 135 (7) ◽  
pp. 935-940
Author(s):  
Buge Oz ◽  
Melike Pekmezci ◽  
Reza Dashti ◽  
Kutlay Karaman ◽  
Cengiz Kuday ◽  
...  
Keyword(s):  
Malignant Transformation ◽  
Neurofibromatosis Type ◽  
Collision Tumor ◽  
World Health ◽  
Malignant Neoplasms ◽  
High Grade ◽  
Multiple Meningiomas ◽  
Short Period ◽  
High Grade Sarcoma ◽  
Health Organization

Abstract Anaplastic meningiomas that resemble sarcomas often reveal clues to their meningothelial differentiation or develop in a plausible setting that confirms their meningothelial origin. Malignant mesenchymal neoplasms without obvious evidence of meningothelial differentiation or origin are more likely to be true primary or metastatic sarcomas. Because of their clinical and biological differences, it is important to distinguish anaplastic meningioma from a sarcoma. We present a 67-year-old woman with multiple meningiomas, who developed a high-grade spindle cell tumor 6 months after the resection of a World Health Organization grade I meningioma. It was not clear whether this tumor represented a malignant transformation of meningioma or a primary sarcoma. Malignant transformation of a meningioma is exceptional within this short period and a coexisting sarcoma and meningioma are equally uncommon. Even though these malignant neoplasms are rare in general, they appear to be more prevalent in patients with multiple meningiomas including those with neurofibromatosis type 2.

Robson Classification and quality audit

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Gehanath Baral
Keyword(s):  
Cesarean Section ◽  
World Health Organization ◽  
Real Time ◽  
Perinatal Outcome ◽  
World Health ◽  
Related Factors ◽  
Quality Audit ◽  
Robson Classification ◽  
Health Organization

World Health Organization has recommended Robson Classification from baseline obstetric characters to assess, monitor and compare Cesarean Section rates by the quantity analysis. Incorporation of real time labor related factors requires quality audit for both maternal and perinatal outcome.

scholarly journals Assessment of the susceptibility status of Aedes aegypti (Diptera: Culicidae) populations to pyriproxyfen and malathion in a nation-wide monitoring of insecticide resistance performed in Brazil from 2017 to 2018

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Kauara Brito Campos ◽  
Ademir Jesus Martins ◽  
Cynara de Melo Rodovalho ◽  
Diogo Fernandes Bellinato ◽  
Luciana dos Santos Dias ◽  
...  
Keyword(s):  
Insecticide Resistance ◽  
Mosquito Control ◽  
Natural Populations ◽  
Adult Emergence ◽  
World Health ◽  
Two Generations ◽  
Wide Scale ◽  
Susceptibility Tests ◽  
The One ◽  
Health Organization

Abstract Background Chemical mosquito control using malathion has been applied in Brazil since 1985. To obtain chemical control effectiveness, vector susceptibility insecticide monitoring is required. This study aimed to describe bioassay standardizations and determine the susceptibility profile of Ae. aegypti populations to malathion and pyriproxyfen, used on a national scale in Brazil between 2017 and 2018, and discuss the observed impacts in arbovirus control. Methods The diagnostic-doses (DD) of pyriproxyfen and malathion were determined as the double of adult emergence inhibition (EI) and lethal doses for 99% of the Rockefeller reference strain, respectively. To monitor natural populations, sampling was performed in 132 Brazilian cities, using egg traps. Colonies were raised in the laboratory for one or two generations (F1 or F2) and submitted to susceptibility tests, where larvae were exposed to the pyriproxyfen DD (0.03 µg/l) and adults, to the malathion DD determined in the present study (20 µg), in addition to the one established by the World Health Organization (WHO) DD (50 µg) in a bottle assay. Dose-response (DR) bioassays with pyriproxyfen were performed on populations that did not achieve 98% EI in the DD assays. Results Susceptibility alterations to pyriproxyfen were recorded in six (4.5%) Ae. aegypti populations from the states of Bahia and Ceará, with Resistance Ratios (RR95) ranging from 1.51 to 3.58. Concerning malathion, 73 (55.3%) populations distributed throughout the country were resistant when exposed to the local DD 20 µg/bottle. On the other hand, no population was resistant, and only 10 (7.6%) populations in eight states were considered as exhibiting decreased susceptibility (mortality ratios between 90 and 98%) when exposed to the WHO DD (50 µg/bottle). Conclusions The feasibility of conducting an insecticide resistance monitoring action on a nation-wide scale was confirmed herein, employing standardized and strongly coordinated sampling methods and laboratory bioassays. Brazilian Ae. aegypti populations exhibiting decreased susceptibility to pyriproxyfen were identified. The local DD for malathion was more sensitive than the WHO DD for early decreased susceptibility detection.

scholarly journals Evaluation of the quality of life of clients with chronic ischemic pain

2011 ◽  
Vol 19 (1) ◽  
pp. 67-72 ◽  
Author(s):  
Débora Fernanda Amaral Pedrosa ◽  
Andressa Karina Amaral Plá Pelegrin ◽  
Hilze Benigno de Oliveira Moura Siqueira ◽  
Talita de Cássia Raminelli da Silva ◽  
Orlando Carlos Gomes Colhado ◽  
...  
Keyword(s):  
Quality Of Life ◽  
World Health ◽  
Physical Domain ◽  
Ischemic Pain ◽  
World Health Organization Quality ◽  
The Social ◽  
Organization Quality ◽  
The One ◽  
Health Organization

The evaluation of quality of life (QOL) faced with chronic ischemic pain involves the clients in their subjectivity and multidimensionality. This descriptive study aimed to evaluate the quality of life of clients who presented chronic ischemic pain. A total of 100 clients of hospital institutes participated in the study. The instrument used to assess pain was an 11 point numerical scale, and to assess the quality of life, the World Health Organization Quality of Life-abbreviated questionnaire. The arithmetic mean for chronic pain was 5.59±3.16 points. The means for quality of life were: in the physical domain, 44.75±16.98; in the overall domain, 50.0±22.40; in the environment, 55.06±13.51, in the psychological, 56.21±17.19 and in the social domain, 68.33±21.84. Thus, the physical domain was, among the areas analyzed, the one which presented a greater impact on the quality of life of the clients with chronic ischemic pain.

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