{"title":"Characteristics of alleged malpractice.","authors":"S Fink, T K Chaudhuri","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77458,"journal":{"name":"Virginia medical quarterly : VMQ","volume":"124 4","pages":"220-1"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20270799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"50th annual J. Shelton Horsley Lecture. Gains and losses in the modern diagnosis of abdominal pain.","authors":"H H McGuire","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77458,"journal":{"name":"Virginia medical quarterly : VMQ","volume":"124 1","pages":"14-7"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19971070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Telemedicine. Gift from the gods or pandora's box?","authors":"C E Dalton","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77458,"journal":{"name":"Virginia medical quarterly : VMQ","volume":"123 3","pages":"162-6"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19725148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Periodic limb movements of sleep and the restless legs syndrome are not diagnoses but rather an indication that there is some CNS disturbance and are associated with an ever-growing number of conditions. They are very common, exist in many forms and are often overlooked by physicians. It is the author's opinion that they are parts of what has been called an akathisia syndrome in the most severe situations and may include the same mechanisms that underlie attention disorders, chronic fatigue syndrome and "sun-downing." They are likely parts of a syndrome caused by dysfunction in a complex brainstem center. This center's normal function is to maintain a smooth electrical template on which discrete neuronal impulses sculpture the rich repertoire we recognize as sensory and motor function awake and to effect a smooth "switching" mechanism allowing sleep to occur without motor and sensory input invading consciousness (awakening). While the DA-ergic CNS pathways have been thought to be the primary neurotransmitter involved, the opioids secondary, there is mounting evidence that the situation is far more complicated, that many neurotransmitter, including stimulating and inhibiting amino acids, play a part. These patients agonize with their indisposition but can be helped by various treatments. Treatment alleviates not only the distress caused by the symptoms but also the devastating insomnia and excessive daytime sleepiness associated with it.
{"title":"Periodic limb movements of sleep and the restless legs syndrome.","authors":"D C Williams","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Periodic limb movements of sleep and the restless legs syndrome are not diagnoses but rather an indication that there is some CNS disturbance and are associated with an ever-growing number of conditions. They are very common, exist in many forms and are often overlooked by physicians. It is the author's opinion that they are parts of what has been called an akathisia syndrome in the most severe situations and may include the same mechanisms that underlie attention disorders, chronic fatigue syndrome and \"sun-downing.\" They are likely parts of a syndrome caused by dysfunction in a complex brainstem center. This center's normal function is to maintain a smooth electrical template on which discrete neuronal impulses sculpture the rich repertoire we recognize as sensory and motor function awake and to effect a smooth \"switching\" mechanism allowing sleep to occur without motor and sensory input invading consciousness (awakening). While the DA-ergic CNS pathways have been thought to be the primary neurotransmitter involved, the opioids secondary, there is mounting evidence that the situation is far more complicated, that many neurotransmitter, including stimulating and inhibiting amino acids, play a part. These patients agonize with their indisposition but can be helped by various treatments. Treatment alleviates not only the distress caused by the symptoms but also the devastating insomnia and excessive daytime sleepiness associated with it.</p>","PeriodicalId":77458,"journal":{"name":"Virginia medical quarterly : VMQ","volume":"123 4","pages":"260-5"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19873654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Responding to a health care fraud investigation. A practice guide.","authors":"G M Luce, J J Graham","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77458,"journal":{"name":"Virginia medical quarterly : VMQ","volume":"123 4 Suppl","pages":"9-13"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20544128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The overall prevalence of an elevated lead level in the UVa pediatric clinic population (5.7%, > or = 10 micrograms/dL; 1.1%, > or = 15 micrograms/dL) was lower than that reported by Bronson and Renier (Duluth, Minnesota) (8.2%, > or = 10 micrograms/dL, and 2.6%, > or = 15 micrograms/dL), Pirkle and colleagues (National Health and Nutrition Examination Survey III (9.0%, > or = 10 micrograms/dL) and Norman and associates (North Carolina) (20.2%, > or = 10 micrograms/dL; 3.2%, > or = 15 micrograms/dL; 1.1%, > or = 20 micrograms/dL). The results are similar to those reported by the city of Denver (3% and 1%, respectively). None of the children had a level > or = 25 micrograms/dL, a level found in 2.1/1000 children in Massachusetts, or a level > or = 45 micrograms/dL, the level recommended for chelation therapy in asymptomatic children. In view of the base cost of universal lead screening ($33/test) in the UVa laboratories and the lack of an increased prevalence of lead poisoning in the children in the UVa clinic, clinic personnel favor screening only those children who have a positive response to any of the risk assessment questions, but in particular, the question "does your child live in or visit frequently a house built before 1960?"
{"title":"Lead screening in the general pediatric clinic.","authors":"M E Gutgesell","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The overall prevalence of an elevated lead level in the UVa pediatric clinic population (5.7%, > or = 10 micrograms/dL; 1.1%, > or = 15 micrograms/dL) was lower than that reported by Bronson and Renier (Duluth, Minnesota) (8.2%, > or = 10 micrograms/dL, and 2.6%, > or = 15 micrograms/dL), Pirkle and colleagues (National Health and Nutrition Examination Survey III (9.0%, > or = 10 micrograms/dL) and Norman and associates (North Carolina) (20.2%, > or = 10 micrograms/dL; 3.2%, > or = 15 micrograms/dL; 1.1%, > or = 20 micrograms/dL). The results are similar to those reported by the city of Denver (3% and 1%, respectively). None of the children had a level > or = 25 micrograms/dL, a level found in 2.1/1000 children in Massachusetts, or a level > or = 45 micrograms/dL, the level recommended for chelation therapy in asymptomatic children. In view of the base cost of universal lead screening ($33/test) in the UVa laboratories and the lack of an increased prevalence of lead poisoning in the children in the UVa clinic, clinic personnel favor screening only those children who have a positive response to any of the risk assessment questions, but in particular, the question \"does your child live in or visit frequently a house built before 1960?\"</p>","PeriodicalId":77458,"journal":{"name":"Virginia medical quarterly : VMQ","volume":"123 3","pages":"190-1"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19725097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Walter Reed.","authors":"R S Brown","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77458,"journal":{"name":"Virginia medical quarterly : VMQ","volume":"123 3","pages":"156-7"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19725147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Telemedicine in use. The Medical College of Virginia, The Powhatan Correctional Center and the Blackstone Family Practice Center.","authors":"C L Hampton, P E Mazmanian, M J McCue, R S Krick","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77458,"journal":{"name":"Virginia medical quarterly : VMQ","volume":"123 3","pages":"167-70"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19725149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
W P Rennert, W S Hayes, G J Hauser, W G Tohme, D J Reese
{"title":"The role of telemedicine in triage decisions for pediatric emergency patients.","authors":"W P Rennert, W S Hayes, G J Hauser, W G Tohme, D J Reese","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77458,"journal":{"name":"Virginia medical quarterly : VMQ","volume":"123 3","pages":"171-2"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19725150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Increasing access to medical information. Changing communication patterns in southside Virginia.","authors":"P E Mazmanian, R A Banks, P Self, C Hampton","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77458,"journal":{"name":"Virginia medical quarterly : VMQ","volume":"123 3","pages":"176-8"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19725152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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