scholarly journals Bupropion overdose as a clinically significant confounder of the neurological examination

2020 ◽  
Vol 13 (2) ◽  
pp. 108-113
Author(s):  
Ranier Reyes ◽  
Stephen Figueroa
Keyword(s):  
Neurological Examination ◽  
Clinically Significant

Clinical Update: Evaluation of Low Back Pain

2001 ◽  
Vol 6 (1) ◽  
pp. 3-10, 12
Author(s):  
True Martin ◽  
Christopher R. Brigham ◽  
Charles N. Brooks
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Sensitivity And Specificity ◽  
Clinical Evaluation ◽  
Neurological Examination ◽  
Deep Tendon Reflex ◽  
Low Back ◽  
Diagnostic Studies ◽  
Disc Herniations ◽  
Clinically Significant

Abstract This article provides an overview of the neurological examination and diagnostic studies commonly used in the evaluation of low back pain, information that is essential for both clinical assessment and impairment rating in the AMA Guides to the Evaluation of Permanent Impairment. Clinical evaluation begins with a careful review of medical records. After taking a thorough history, the physician performs the physical examination, including neurological testing, on the patient. The clinical evaluation also determines data needed for impairment evaluation. Neurological examination helps distinguish among the various types of pathology suggested by the history, but to some extent the neurological examination lacks sensitivity and specificity and only about two-thirds (69%) of patients with documented L4-L5 or L5-S1 disc herniations demonstrated weakness or deep tendon reflex changes. To maximize information from the evaluation, physicians routinely test for nonorganic physical signs. Isolated positive signs have no clinical or predictive value, and only a score of three or more positive signs is considered clinically significant. Further, these tests were not designed to detect malingering. Used in isolation, the history, neurological examination, and various diagnostic studies do not have the necessary sensitivity and specificity to diagnose and identify the structural pathology responsible for lumbar radiculopathy. Integrating these components into a logical, unbiased evaluation, physicians usually can perform an accurate assessment.

EM of human atherosclerosis: Aortic fatty streaks with transitional lesion features

1992 ◽  
Vol 50 (1) ◽  
pp. 622-623
Author(s):  
K. Florian Klemp ◽  
J.R. Guyton
Keyword(s):  
Foam Cell ◽  
Cell Formation ◽  
Processing Technique ◽  
Foam Cell Formation ◽  
Tissue Preparation ◽  
Electron Microscopic ◽  
Extracellular Lipid ◽  
Electron Microscopic Cytochemistry ◽  
Human Atherosclerosis ◽  
Clinically Significant

The earliest distinctive lesions in human atherosclerosis are fatty streaks (FS), characterized initially by lipid-laden foam cell formation. Fibrous plaques (FP), the clinically significant lesions, differ from FS in several respects. In addition to foam cells, the FP also exhibit fibromuscular proliferation and a necrotic core region rich in extracellular lipid. The possible transition of FS into mature FP has long been debated, however. A subset of FS described by Katz etal., was intermediate in lipid composition between ordinary FS and FP. We investigated this hypothesis by electron microscopic cytochemistry by employing a tissue processing technique previously described by our laboratory. Osmium-tannic acid-paraphenylenediamine (OTAP) tissue preparation enabled ultrastructural analysis of lipid deposits to discern features characteristic of mature fibrous plaques.

Supervision: A Case Study

1977 ◽  
Vol 8 (4) ◽  
pp. 256-263
Author(s):  
Roberta Chapey ◽  
Geraldine Chapey
Keyword(s):  
Organizational Communication ◽  
Behavioral Changes ◽  
Personal Problems ◽  
Clinically Significant

Occasionally, it is the responsibility of a supervisor to help a staff speech clinician resolve professional and or personal problems that interfere with the delivery of quality services. To deal with this situation, the supervisor must be equipped with the techniques and procedures for effective organizational communication. This article presents a case study in which a speech clinician demonstrated irresponsibility in various job areas. The supervisor’s philosophy and the procedures used in managing these problems are presented. The behavioral changes suggest that the supervisor’s interventive procedures were clinically significant and warrant further investigation.

Hearing Aid Gain Usage by Children

1989 ◽  
Vol 20 (2) ◽  
pp. 149-152 ◽  
Author(s):  
Kenneth W. Berger
Keyword(s):  
Hearing Aid ◽  
Appreciable Difference ◽  
Significant Difference ◽  
Clinically Significant

Hearing aid gain usage by two groups of children was examined. No appreciable difference was noted between the groups, nor was there a clinically significant difference between gain usage by these children as compared with a sample of adult hearing aid wearers.

Tools & Resources: Impairment and Disability Web Sites

1999 ◽  
Vol 4 (6) ◽  
pp. 5-6
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Interpersonal Relationships ◽  
Web Sites ◽  
Outpatient Psychotherapy ◽  
Obsessive Compulsive ◽  
Not Otherwise Specified ◽  
Cluster B Personality Disorders ◽  
Clinically Significant ◽  
And Behavior

Abstract Personality disorders are enduring patterns of inner experience and behavior that deviate markedly from those expected by the individual's culture; these inflexible and pervasive patterns reflect issues with cognition, affectivity, interpersonal functioning and impulse control, and lead to clinically significant distress or impairment in social, occupational, or other important areas of functioning. The AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, defines two specific personality disorders, in addition to an eleventh condition, Personality Disorder Not Otherwise Specified. Cluster A personality disorders include paranoid, schizoid, and schizotypal personalities; of these, Paranoid Personality Disorder probably is most common in the legal arena. Cluster B personality disorders include antisocial, borderline, histrionic, and narcissistic personality. Such people may suffer from frantic efforts to avoid perceived abandonment, patterns of unstable and intense interpersonal relationships, an identity disturbance, and impulsivity. Legal issues that involve individuals with cluster B personality disorders often involve determination of causation of the person's problems, assessment of claims of harassment, and assessment of the person's fitness for employment. Cluster C personality disorders include avoidant, dependent, and obsessive-compulsive personality. Two case histories illustrate some of the complexities of assessing impairment in workers with personality disorders, including drug abuse, hospitalizations, and inpatient and outpatient psychotherapy.

Abstract #615: Hispanic People Achieve Clinically Significant Weight loss with Liraglutide 3.0 Mg for Weight Management

2015 ◽  
Vol 21 ◽  
pp. 121
Author(s):  
Patrick O’Neil ◽  
W. Timothy Garvey ◽  
J. Michael Gonzalez-Campoy ◽  
Pablo Mora ◽  
Rafael Violante Ortiz ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Management ◽  
Significant Weight Loss ◽  
Hispanic People ◽  
Clinically Significant

Behavioral and emotional differences between children of divorce and children from intact families: Clinical significance and mediating processes *This study is part of a dissertation () supported from the German research community.

2002 ◽  
Vol 61 (1) ◽  
pp. 5-14 ◽  
Author(s):  
Andreas Schick
Keyword(s):  
Self Esteem ◽  
Research Community ◽  
Children Of Divorce ◽  
Group Differences ◽  
Significant Group ◽  
Intact Families ◽  
Divorce Adjustment ◽  
Theoretical Assumptions ◽  
German Research ◽  
Clinically Significant

The following study is based on a sample of 241 9-13-year-old children (66 children from divorced parents, 175 children from non divorced parents). They were examined for differences regarding anxiety, self-esteem, different areas of competence, and degree of behavior problems. With a focus on the children’s experiences, the clinically significant differences were examined. Clinically significant differences, revealing more negative outcomes for the children of divorce, were only found for social anxiety and unstable performance. The frequency of clinical significant differences was independent of the length of time the parents had been separated. The perceived destructiveness of conflict between the parents one of four facets of interparental conflict in this study functioned as a central mediator of the statistically significant group differences. The children’s perception of the father’s social support was a less reliable indicator of variance. Further studies should try to make underlying theoretical assumptions about the effects of divorce more explicit, to distinguish clearly between mediating variables, and to investigate them with respect to specific divorce adjustment indicators.

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