ABSTRACT
CONTEXT: Occupational medicine practice has experienced a shift from larger corporate medical departments to organizations providing services for a variety of industries. Specific training needs will accompany this shift in practice patterns; these may differ from those developed in the traditional industrial or corporate medical department setting. METHODS: The West Virginia Occupational Health and Safety Initiative involves occupational medicine residents in consultation to a variety of small industries and businesses. It uses the expertise of occupational physicians, health and safety extension faculty, and faculty in engineering and industrial hygiene. Residents participate in multidisciplinary evaluations of worksites, and develop competencies in team-building, workplace health and safety evaluation, and occupational medical consulting. OUTCOME MEASURES: Specific competencies that address requirements for practicum training are used to measure the trainee's acquisition of knowledge and skills. Particular attention is paid to the acquisition of group problem-solving expertise, skills relevant to the current market in practice opportunities, and the specific career interests of the resident physician. Preliminary evaluation indicates the usefulness of training in evaluation of diverse industries and worksites. CONCLUSIONS: We offer this program as a training model that can prepare residents for the challenges of a changing marketplace for occupational health and safety services.
Subject(s)
Health Knowledge, Attitudes, Practice , Internship and Residency/organization & administration , Occupational Medicine/education , Clinical Competence , Female , Humans , Male , Occupational Health , Program Development , Program Evaluation , West VirginiaSubject(s)
Chromosome Aberrations/diagnosis , Gene Amplification , Genes, Recessive , Muscular Dystrophies/diagnosis , Polymerase Chain Reaction , Biopsy , Chromosome Aberrations/genetics , Chromosome Deletion , Chromosome Disorders , Diagnosis, Differential , Electromyography , Humans , Male , Middle Aged , Muscles/pathology , Muscular Dystrophies/genetics , Sex Chromosome Aberrations/diagnosis , X ChromosomeABSTRACT
Pneumoconiosis was diagnosed in five workers involved in the manufacture of carbon electrodes. Possible etiologies are discussed. It is generally believed that pneumoconiosis ceased to be a problem in this industry after World War II; however, the reported cases all resulted from exposures after 1940. These findings question the efficacy of recent and current engineering controls and suggest the need for further study of this industry.
Subject(s)
Carbon/adverse effects , Pneumoconiosis/etiology , Electrodes , Humans , United StatesABSTRACT
The frequency of heterozygotes of recessive generalized myotonia may be estimated at about 1/108 in the German Federal Republic. Some heterozygotes can be identified by an EMG. However, apart from this, apparently 2%--5% of heterozygotes may show minor subclinical manifestations. Sporadic cases of myotonia with late onset and a history of preceding, extremely prolonged physical stress, undernourishment, and/or prolonged cold exposure may be due to heterozygote manifestations of this otherwise recessive gene. Late onset and sporadic appearance also are features in patients with myotonia associated with hypothyroidism. One male patient displayed myotonia after a protracted diabetic coma. In cases reported in the literature where myotonia developed in association with either propranolol (beta-adrenergic blocking agent) or fenoterolhydrobromide (stimulator of beta receptors) heterozygote manifestation of recessive generalized myotonia is suggested.
Subject(s)
Genes, Recessive , Myotonia/genetics , Adolescent , Adult , Aged , Cold Temperature , Diabetic Coma/complications , Female , Fenoterol/adverse effects , Heterozygote , Humans , Hypothyroidism/complications , Male , Myotonia/etiology , Nutrition Disorders/complications , Propranolol/adverse effects , Stress, Physiological/complicationsSubject(s)
Genetic Counseling , Muscular Dystrophies/genetics , Myotonia Congenita/genetics , Myotonic Dystrophy/genetics , Adolescent , Adult , Bayes Theorem , Child , Child, Preschool , Chromosome Aberrations/diagnosis , Chromosome Disorders , Creatine Kinase/blood , Female , Genes, Dominant , Genes, Recessive , Humans , Infant , Infant, Newborn , Male , Pregnancy , Prenatal Diagnosis , X ChromosomeSubject(s)
Amyotrophic Lateral Sclerosis/genetics , Cytoplasmic Granules , Adult , Amyotrophic Lateral Sclerosis/complications , Amyotrophic Lateral Sclerosis/pathology , Cerebellar Cortex/pathology , Cerebellar Nuclei/pathology , Female , Humans , Inclusion Bodies , Medulla Oblongata/pathology , Motor Cortex/pathology , Motor Neurons , Neurofibrils , Respiratory Paralysis/etiology , Staining and LabelingSubject(s)
Muscular Dystrophies/genetics , Adolescent , Adult , Age Factors , Aged , Child , Child, Preschool , Contracture , Female , Genes, Dominant , Genes, Lethal , Genes, Recessive , Humans , Infant , Infant, Newborn , Male , Middle Aged , Muscular Dystrophies/classification , Pedigree , Sex Chromosome AberrationsSubject(s)
Anthropology , Genetics, Medical , Cytogenetics , Genetics, Population , Humans , Population GrowthSubject(s)
Cerebellar Ataxia/genetics , Cerebellum/pathology , Adolescent , Adult , Age Factors , Aged , Cerebellar Ataxia/classification , Child , Female , Genes, Dominant , Humans , Male , Middle Aged , Pedigree , Pons/pathology , Spinal Cord/pathology , Vestibular Nuclei/pathologyABSTRACT
The significance of genetics to the nosology of nervous system diseases has been shown in spastic paraplegias and spinocerebellar ataxias. At least about 60 different genetic types have been recognized to date. In most diseases, the genetic exploration and discrimination of types has been possible only by clinical, pathologic and simple genetic criteria like transmission. Further differentiation of genetic entities will be done especially through biochemical investigation.
Subject(s)
Cerebellar Ataxia/genetics , Muscle Spasticity/genetics , Adolescent , Adult , Age Factors , Ataxia Telangiectasia/epidemiology , Cerebellar Ataxia/classification , Child , Child, Preschool , Consanguinity , Diabetes Complications , Female , Friedreich Ataxia/complications , Genes, Dominant , Genes, Recessive , Humans , Infant , Male , Middle Aged , Muscle Spasticity/classification , Pedigree , Sex ChromosomesABSTRACT
Besides myotonic dystrophy some generalized myotonias exist, until now mostly diagnosed as "Thomsen's disease." It is questionable whether the dominant "myotonia congenita" is homogeneous. Surely there is at least one recessive type of generalized myotonia, which is also clinically different from Thomsen's disease. Paramyotonia congenita Eulenburg is a genetically independent type separated from paralysis periodica paramyotonia. Further diseases with myotonia and some other diseases of differential disgnostic importance with regard to myotonias are mentioned
