RESUMO
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.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Internato e Residência/organização & administração , Medicina do Trabalho/educação , Competência Clínica , Feminino , Humanos , Masculino , Saúde Ocupacional , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , West VirginiaAssuntos
Aberrações Cromossômicas/diagnóstico , Amplificação de Genes , Genes Recessivos , Distrofias Musculares/diagnóstico , Reação em Cadeia da Polimerase , Biópsia , Aberrações Cromossômicas/genética , Deleção Cromossômica , Transtornos Cromossômicos , Diagnóstico Diferencial , Eletromiografia , Humanos , Masculino , Pessoa de Meia-Idade , Músculos/patologia , Distrofias Musculares/genética , Aberrações dos Cromossomos Sexuais/diagnóstico , Cromossomo XRESUMO
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.
Assuntos
Carbono/efeitos adversos , Pneumoconiose/etiologia , Eletrodos , Humanos , Estados UnidosRESUMO
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.
Assuntos
Genes Recessivos , Miotonia/genética , Adolescente , Adulto , Idoso , Temperatura Baixa , Coma Diabético/complicações , Feminino , Fenoterol/efeitos adversos , Heterozigoto , Humanos , Hipotireoidismo/complicações , Masculino , Miotonia/etiologia , Distúrbios Nutricionais/complicações , Propranolol/efeitos adversos , Estresse Fisiológico/complicaçõesAssuntos
Aconselhamento Genético , Distrofias Musculares/genética , Miotonia Congênita/genética , Distrofia Miotônica/genética , Adolescente , Adulto , Teorema de Bayes , Criança , Pré-Escolar , Aberrações Cromossômicas/diagnóstico , Transtornos Cromossômicos , Creatina Quinase/sangue , Feminino , Genes Dominantes , Genes Recessivos , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , Diagnóstico Pré-Natal , Cromossomo XAssuntos
Esclerose Lateral Amiotrófica/genética , Grânulos Citoplasmáticos , Adulto , Esclerose Lateral Amiotrófica/complicações , Esclerose Lateral Amiotrófica/patologia , Córtex Cerebelar/patologia , Núcleos Cerebelares/patologia , Feminino , Humanos , Corpos de Inclusão , Bulbo/patologia , Córtex Motor/patologia , Neurônios Motores , Neurofibrilas , Paralisia Respiratória/etiologia , Coloração e RotulagemAssuntos
Distrofias Musculares/genética , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Contratura , Feminino , Genes Dominantes , Genes Letais , Genes Recessivos , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Distrofias Musculares/classificação , Linhagem , Aberrações dos Cromossomos SexuaisAssuntos
Miotonia Congênita/patologia , Distrofia Miotônica/patologia , Paralisias Periódicas Familiares/patologia , Retículo Sarcoplasmático , Adolescente , Adulto , Biópsia , Criança , Feminino , Humanos , Masculino , Microscopia , Microscopia Eletrônica , Pessoa de Meia-Idade , Músculos/patologiaAssuntos
Antropologia , Genética Médica , Citogenética , Genética Populacional , Humanos , Crescimento DemográficoAssuntos
Ataxia Cerebelar/genética , Cerebelo/patologia , Adolescente , Adulto , Fatores Etários , Idoso , Ataxia Cerebelar/classificação , Criança , Feminino , Genes Dominantes , Humanos , Masculino , Pessoa de Meia-Idade , Linhagem , Ponte/patologia , Medula Espinal/patologia , Núcleos Vestibulares/patologiaRESUMO
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.
Assuntos
Ataxia Cerebelar/genética , Espasticidade Muscular/genética , Adolescente , Adulto , Fatores Etários , Ataxia Telangiectasia/epidemiologia , Ataxia Cerebelar/classificação , Criança , Pré-Escolar , Consanguinidade , Complicações do Diabetes , Feminino , Ataxia de Friedreich/complicações , Genes Dominantes , Genes Recessivos , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Espasticidade Muscular/classificação , Linhagem , Cromossomos SexuaisRESUMO
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