Effective management of pain depends on sufficient knowledge of the pharmacology of analgesics, careful assessment of each patient's pain, and a change of attitude toward the use of potent opioid (narcotic) analgesics. Utilizing extensive experience and the results of studies at Memorial Sloan-Kettering Cancer Center, the author rebuts physician misconceptions, recommends strategies for 25 medication problems, and provides oral/parenteral equivalencies of the most common analgesics.
In a study of a teaching hospital's newborn records 1986-1987, the definition of severe neurological injury in Virginia's Injured Infants Act was found to be associated with neonatal death, prematurity, and a preexisting maternal condition likely to contribute to poor outcome. The incidence of severe neurologic injury did not approach the prevalence of severe mental retardation and cerebral palsy. Thus the ability of the Act to preempt litigation substantially is questionable, the authors state, and they recommend a broader definition.
When he devised a method for repairing vesico-vaginal fistulas, the great Marion Sims took notice and did likewise. For his original work in congenital deformities he was called America's first plastic surgeon. "A genius of his time," summed up an article describing his innovations in ophthalmology. He was Peter Mettauer of Prince Edward Courthouse, Virginia.
An enzymeimmunoassay test performed well in comparison with cell culture in detecting chlamydial infections among 209 women at a public health clinic, detecting 73% of the infected patients. Clinical and epidemiological criteria alone identified only 52%. The authors consider the test an essential supplement to other criteria when looking for chlamydial infection in a high risk population.
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