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Background and Aim: Longer residual limb lengths provide an increased lever arm. Longer residual limbs may produce increased joint moments; the two may be correlated. These correlations have not been evaluated in transfemoral amputees during transitional movements. Correlations between residual limb length and involved side joint moment could contribute to justification supporting maximal residual limb length preservation. This study investigated possible correlations between hip or knee moment and residual limb length.Technique: Hip and knee joint moments were determined while 21 transfemoral amputees performed sitting and standing movements and then evaluated for correlation with residual limb length.Discussion: Residual limb length was not correlated with either knee or involved side hip moments during sit to stand or stand to sit. Conversely, weak inverse correlations (p < 0.05) existed between sound hip moment magnitude and residual limb length. These correlations suggest that in community ambulating transfemoral amputees, longer residual limb length could decrease sound hip kinetic burden during transitional movement. Beyond correlations between residual limb length and sound hip transitional movement kinetics, there are other considerations in determining residual limb length during amputation.Clinical Relevance: This study examines relationships between lower limb joint moments and residual limb length related to sit-to-stand and stand-to-sit activities. The results have implications for amputation surgery and rehabilitation. [ABSTRACT FROM AUTHOR]

To improve the functionality of our Maternal Record System (MARS), we reviewed the clinical problems entered into the MARS database from approximately 2800 patient records and interviewed representative clinicians about their use of the Clinical Comments and Problem List sections of MARS. Problems were assigned a unique term that corrected for spelling, spacing, synonyms, and abbreviation variations. Analysis of these terms suggested design changes that would increase the number of unique entries into the Problem List, including (1) modifications in the automated problem entry functions within MARS and (2) integration of the Problem List and Clinical Comments sections. Copyright © 2003 by Aspen Publishers, Inc. [ABSTRACT FROM AUTHOR]

Offers information on narcolepsy. Signs and symptoms; Causes; Diagnosis of narcolepsy; Drugs used for treating narcolepsy and cataplexy; Antidepressants effective in controlling cataplexy in many patients.

The article focuses on attention-deficit/hyperactivity disorder (ADHD). It states that ADHD, which in the United States affects perhaps 3% to 7% of young school-age children and 4% of all adults, is the most common neurobehavioral disorder diagnosed in school-age children. Although the cause of ADHD is unknown, research has identified several characteristic neurophysiologic abnormalities, including atypical metabolism of norepinephrine and epinephrine and reduced glucose metabolism by brain cells. Studies of twins suggest a strong genetic component. Environmental factors associated with ADHD include complications of pregnancy and delivery, such as low birth weight and in utero exposure to drugs or toxins.

The article presents information on easing the heartbreak of psoriasis. Although usually mild and manageable with treatment, psoriasis can also be severe and disabling. Patients may he embarrassed by visible lesions and withdraw from social contacts. Lesions result from abnormal skin proliferation. Unsightly psoriasis lesions can cause stigmatization and social isolation. But with appropriate treatment, most patients can enjoy healthy skin and a normal life. INSET: The many faces of psoriasis.

The James H. Quillen Veterans Affairs Medical Center, the medical institution currently know as James H. Quillen Veterans Affairs Medical Center (VA), situated at Mountain Home in Johnson City, Tennessee, is very different from its modest beginnings 100 years ago, as of October 2003. Today the medical center stands as a visionary and leader in the health care industry. This article focuses on work done by this medical institution in past 100 years. This comprehensive care medical facility serves more than 25,000 veterans in its four-state service area. Since 1995, the VA has moved to an outpatient model of care and increased its patient load by 109% while decreasing the cost per patient and the number of employees providing these services. The quality of VA health care compared with private sector best practices far exceeds the norm while the VA provides care to an older and more medically complex population.

Discusses the advantages of, and nursing care involved in, tangential excision of hand burns. Definition of tangential excision; Advantages and drawbacks of tangential excision; Procedures involved in tangential excision of hand burns; Nursing challenge in tangential excision; Nursing care involved when discharging patients who undergone tangential excision.

Offers tips and advice on how to make foreign nurses adapt to the work environment in the United States. Helping foreign nurses to adjust to the American pace by including them in unit activities; Encouraging foreigners to participate in American holidays and celebrations while still observing their own traditions.

The article provides information about the myths and facts of dwarfism. According to the myth, dwarfism is a developmental disorder characterized by mental retardation and shortened life expectancy. However, based on facts, dwarfism is defined as a genetic condition or medical complication resulting in adult height of 4 feet 10 inches. In addition, most people experiencing dwarfism has normal intellect and life expectancy.

The article presents the myths and facts about dysgraphia. It is a fact that having bad handwriting does not indicate a person has dysgraphia, a neurologic disorder which impairs written expression. It is also a fact that dysgraphia is a learning or developmental disorder. On the other hand, it is a myth that slender or small writing instruments lead to dysgraphia.

The article discusses several ways in documenting dental disorders to manage oral health of a patient. The author mentions that a dentist can use dental nomenclature in explaining these dental disorders in narrative notes. He mentions that graphics and drawings are also useful in creating anatomic diagram of the condition of the teeth.

The article provides information about dystonia. According to the author, the belief that dystonia is an acquired neuromuscular disorder is a myth, since dystonia is a term that describes involuntary movement disorders characterized by sustained, repetitive muscle contractions. He added that it is also a myth that the skeletal muscle relaxants are the drugs of choice for treating dystonia since its treatment depends on the origin and type of dystonia.

The article provides information on multiple endocrine neoplasia type 1 (MEN1). Myth about MEN1 is that it is a common disorder. The truth about MEN1 is that it is also called Wermer's syndrome, a rare inherited disorder of the endocrine glands affecting 3 to 20 people of 100, 000. It is believed that pituitary gland is the endocrine gland most often affected by MEN1, but the truth is parathyroid glands are the most affected.