We examined the rates of postoperative complications and mortality, as recorded in a hospital discharge registry for State Washington years 1986 through 1988, patients who had an operation on lumbar spine. When malignant lesion, infection, or fracture are excluded, there were 18,122 hospitalizations procedures spine, 84 per cent which involved herniated disc spinal stenosis. The morbidity mortality during hospitalization, well charges, increased with ages patients. rate was 18 seventy-five...

Study Design. Physicians were surveyed regarding their beliefs about treatment efficacy for patients with low back pain. Objective. To document physician the of specific treatmets and extent to which these correspond current knowledge. Summary Background Data. Little is known pain treatments. Methods. A national random sample 2897 physicians mailed questionnaires that asked 1) treatments they would order hypothetical 2) believed effective Responses compared guidelines suggested by Quebec...

To determine success and complication rates for lumbar spinal fusion surgery, predictors of good outcomes, whether improves laminectomy specific low back disorders.English-language journal articles published from 1966 through April 1991, identified MEDLINE searching (spinal plus limiting terms), bibliography review, expert consultation.Articles were selected only if they reported at least 1 year follow-up data enabling the classification clinical outcomes as satisfactory or unsatisfactory 30...

OBJECTIVE : To study temporal trends and geographic variations in the use of surgery for spinal stenosis, estimate short‐term morbidity mortality procedure, examine likelihood repeat back after surgical repair. DESIGN Cohort based on Medicare claims. SETTING Hospital care. SUBJECTS All beneficiaries 65 years age or older who received a lumbar spine operation stenosis 1985 1989 were followed through 1991 (10,260 patients from cohort 18,655 cohort). MAIN OUTCOME MEASURES Two outcomes measured:...

Background and Purpose Falls are a major health problem in the elderly community; however, questions regarding incidence, risk factors, provider response to falls exist. The purpose of this study was examine incidence falls, associated care costs, among Medicare beneficiaries. Participants participants were 12,669 respondents Current Beneficiaries Survey (MCBS). Methods Categories number (none, one, recurrent) injury type (medically injurious versus not medically injurious) created from...

In this study, the influence of 8 dimensions physical environment on mobility in older adults with and without disability was measured. This done order to identify environmental factors that contribute disability.Subjects were 36 ((> or = 70 years age) who recruited from 2 geographic sites (Seattle, Wash, Waterloo, Ontario, Canada) grouped according level function (physically able [ability walk 1/2 mile (0.8 km) climb stairs assistance], physically disabled).Subjects observed videotaped...

Background and Purpose. We surveyed physical therapists about their attitudes, beliefs, treatment preferences in caring for patients with different types of low back pain problems. Subjects Metbods. Questionnaires were mailed to all 71 employed by a large health maintenance organization western Washington random sample 331 other licensed the state Washington. Results. Responses received from 293 (74%) surveyed, 186 these claimed be practicing settings which they treat who have pain. Back was...

Regional variations in lumbar spinal fusion rates suggest a poor consensus on surgical indications. Therefore, complications, costs, and reoperation were compared for elderly patients undergoing surgery with or without fusion. Subjects Medicare recipients who underwent 1985, 4 years of subsequent follow-up. There 27,111 eligible patients, whom 5.6% had fusions. Mean age was 72 years. Patients complication rate 1.9 times greater than those The blood transfusion 5.8 greater, nursing home...

Abstract Background and Purpose. This study looked at adherence, factors affecting to a prescribed home exercise program (HEP) in older adults with impaired balance following discharge from physical therapy. Subjects. The subjects were 556 (≥65 years of age) who discharged therapy during the period 2000 2003. Methods. A survey was developed determine participation HEP. Univariate logistic regressions identified specific barriers motivators that associated Results. Ninety percent respondents...

Excessive pain during medical procedures performed in unanesthetized patients is frequently reported, but can be reduced with virtual reality (VR) distraction. Increasing the person's illusion of going into world may increase how effectively VR distracts pain. Healthy volunteers aged 18-20 years participated a double-blind between-groups design. Each subject received brief baseline thermal stimulus, and same stimulus again minutes later either Low Tech or High provided subjective 0-10...

Objective. The hemolytic uremic syndrome (HUS) consists of anemia, thrombocytopenia, and renal failure. HUS is often precipitated by gastrointestinal infection with Shiga toxin–producing Escherichia coli characterized a variety prothrombotic host abnormalities. In much the world, E O157:H7 major cause HUS. can be categorized as either oligoanuric (which probably signifies acute tubular necrosis) or nonoligoanuric. Children failure during generally require dialysis, have more complicated...

Back surgery rates are rapidly rising in the United States. This is usually elective, so patient preferences important treatment decision.The objective of this study was to determine impact on outcomes and surgical choices an interactive, diagnosis-specific videodisk program for informing patients about choices.This a randomized, controlled trial at 2 sites comparing interactive video plus booklet with alone.Elective candidates (n = 393) included 171 herniated disks, 110 spinal stenosis, 112...

OBJECTIVES: To examine the relationship between characteristics of physical environment and mobility disability in community‐living older persons. DESIGN: Cross‐sectional study conducted on three groups community‐dwelling adults. SETTING: Community‐dwelling people Seattle, Washington, Waterloo, Ontario, Canada. PARTICIPANTS: Fifty‐four adults (≥70) were recruited from two geographic sites grouped according to level function (elite, physically able, disabled). MEASUREMENT: Subjects reported...

Objectives: To examine the prevalence of and clinical markers associated with mobility limitations in Medicare Current Beneficiary Community Survey (MCBS) respondents. Design: Cross‐sectional analysis a community survey. Setting: Community. Participants: Twelve thousand seven hundred sixty‐nine respondents from 2001 MCBS, aged 65 older. Measurements: Four questions MCBS were used to create four levels limitation: none, mild, moderate, severe. Sampling weights calculate estimates means...

To describe a set of complex walking tasks (CWTs) that can be used to evaluate mobility and characterize age- sex-specific performance on these tests.A population-based study persons living in the Chianti geographic area (Tuscany, Italy).Community.One thousand two hundred twenty-seven (aged 20-95) selected from city registries Greve Bagno Ripoli Italy).Gait velocity (m/s) was measured during 13 tests (Walking InCHIANTI Toolkit (WIT)) examine ability under range conditions distances. Other...

Falls in people with multiple sclerosis (MS) are a serious health concern, and the percentage of who restrict their activity because concerns about falling (CAF) is not known. Mobility function accumulated impairments associated fall risk older adults but stroke have been studied MS.The purposes this study were: (1) to estimate MS report falling, CAF, restrictions related CAF; (2) examine associations these factors status; (3) explore status mobility number impairments.A cross-sectional...

A challenge in the engineering of auto-adjusting prosthetic sockets is to maintain stable operation control system while users change their bodily position and activity. The purpose this study was test stability a socket that automatically adjusted size fit. Socket release during sitting conducted between bouts walking.Adjustable with sensors monitored distance liner were fabricated. Motor-driven panels microprocessor-based walking target sensed distance. Limb fluid volume recorded...

The diseases and virulence genes associated with Shiga toxin-producing Escherichia coli (STEC) are characterized incompletely. We analyzed, by polymerase chain reaction, 82 STEC isolates collected prospectively in Montana profiled illnesses patient chart review. All E. O157:H7 contained stx2-group genes, as well eae, iha, espA, ehxA; 84% stx1. Non-O157:H7 less frequently stx1 (P=.046), stx2 (P<.001), iha espA (P=.039 for both), were isolated often from patients treated emergency departments...

Abstract Objective . This study examined patterns of diagnostic test use for patients with low back pain. Three specific questions were addressed: 1) What tests do physicians recommend 3 common types pain? 2) Do in various specialties differ the they would order? and 3) How appropriate are physicians' choices tests, based on current medical knowledge expert recommendations? Methods A stratified national random sample 2,604 8 was mailed questionnaires asking about order hypothetical acute...

Mobility, specifically community walking, is important, but often limited among survivors of stroke. The factors that influence the recovery walking are not clearly understood.The purpose this research was to examine mobility disability following stroke, specifically: (1) association between subjective and objective measures participation in (2) personal walking.A cross-sectional study design used.Fifty community-dwelling aged 50 79 years, were enrolled study. Participation measured...