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Biomedical subjects

C Muller

Publications and source records attributed to C Muller.

At least 163 records · Page 9Linked to original sources
PubMed1990

[Postoperative wound infection: a preventable complication?].

Postoperative wound sepsis carries high morbidity and additional costs. Its incidence can be reduced by appropriate measures. Continuous infection surveillance is able to reduce the overall infection rate. Besides the basic rules, as care for asepsis, atraumatic surgical technique and careful haemostasis, numerous prophylactic measures are proposed, only part of measures are proposed, only part of them relying on convincing experimental or clinical evidence. Some of these measures are discussed according to the commonly accepted classification of wounds.

Humans↗
PubMed1989

Primary medical care for elderly patients. Part I: Service mix as seen by an expert panel.

A survey of six geriatric experts concerning the normative role content of physicians providing primary care for the elderly emphasizes the importance of distinguishing reversible and irreversible components of a patient's problems and of conducting multidimensional functional assessments. Appreciation of the role of the environment in maintaining functional capacity should be inculcated in practitioners treating the elderly. Medicare payment methods should recognize that the elderly require more professional time for adequate care, and should address transportation needs.

Aged↗
PubMed1989

Primary medical care for elderly patients. Part II: Results of a survey of office based clinicians.

Evidence of the degree of fit between the special needs of the elderly and the service mix and payment level of ambulatory services offered under the Medicare program is presented in this second part of a two-part study of geriatric office care. Results from interviews with a focus group of 60 practicing clinicians, incorporating diversity of geography and practice setting, are described and compared with the view of geriatricians. Between 30 and 57% of the clinicians are aware of negative effects of Medicare's benefit structure on specific aspects of their practice.

Health Services Needs and Demand↗
PubMed1989

[Can recurrent reflux disease following fundoplication be prevented by adding a vagotomy?].

Recurrent reflux disease is one of the main problems after fundoplication. Reducing gastric acid secretion by adding a vagotomy could theoretically be of beneficial value in controlling reflux. The clinical results of 109 patients were assessed 10 to 20 years after combined fundoplication and vagotomy for primary reflux disease. Indication for an additional vagotomy was severe reflux disease or increased gastric acid output in 56 and coexistent ulcer disease in 53 patients. Data from 64 patients (59.6%) were analyzed. Results were as follows: 17.2% had persistent or recurrent reflux disease, 9.5% needing medical treatment. The results were similar with different types of vagotomy: 18.5% and 14.8%, respectively for truncular vagotomy and pyloroplasty (27 pts.) 17.9% and 7.4%, respectively for selective gastric vagotomy and pyloroplasty (28 pts.), and 11.1% and 0%, respectively for proximal gastric vagotomy (9 pts.). Compared with the results after fundoplication alone, an additional vagotomy does not seem to prevent recurrent reflux disease.

Adolescent↗
PubMed1989

[The contribution of computerized tomography to the diagnosis of diffuse pulmonary lymphangiomyomatosis. Apropos of a case].

The authors report a case of lymphangiomatosis (LAM) proven histologically in a 49 year old female. This case benefitted from very detailed CT-scanning (IDM) with characteristic images obtained from the thorax and bilateral renal tumours suggestive of angiomyolipomas. This association seems to be quasi-pathognomic of the disease. The discovery at CT-scanning of cerebral calcification raises a possible connection of LAM with Bourneville's tuberous sclerosis. This CT-scanning study has several points of interest: the early diagnosis of pulmonary lesions which are under evaluated by standard radiography; a complete inventory of the possible localisations of the disease; it enables a possible diagnosis in very frail patients in whom a lung biopsy would be a risk; an ability to assess further progress as there also exists a good correlation between the extent of the disease assessed by TDM and the disturbance in pulmonary function.

Drug Therapy, Combination↗
PubMed1988

[Long-term results following fundus plication. Symptoms after 10 to 20 years].

10 to 20 years (median 15.1 years) after fundoplication for primary reflux disease, 257 patients were asked to complete a questionnaire concerning their symptoms. Data of 163 patients (64.3%) were analyzed. Results were as follows: 21.4% of the patients had persistent or recurrent reflux symptoms, about half (9.8%) needing medical treatment. Adverse side effects of fundoplication were frequent (dysphagia in 28.2% and gas-bloat in 50.3%). Using the Visick classification criteria we found Visick grade I and II in 75.5%, grade III in 17.2%, and IV in 7.4%.

Follow-Up Studies↗
PubMed1988

Medicaid: the lower tier of health care for women.

Being poor in the United States means being exposed to the Medicaid system, whose characteristics, as determined by both federal and state policy, affect access to health care. This paper examines those aspects of the Medicaid system which have a disparate impact on women because they are overrepresented in certain social strata, as well as some aspects which affect the ability of both sexes to utilize the health care system. Owing to the problems of women in society, women make up two-thirds of the Medicaid clientele. Thus the burdens created by the limitations of Medicaid are a significant gender issue. Policies regarding AFDC coverage and pregnancy particularly concern younger women, many of whom have problems related to marriage, childbirth, and absence of economic support from fathers which place them at risk for poverty. Regulations as to income and assets of elderly persons requiring long-term care are among the policies that affect older women whose spouses have become disabled. Mandating less restrictive eligibility standards and coverage during transition of Medicaid clients to work would help address the twin problems of inferiority and uncertainty with regard to health care.

Age Factors↗
PubMed1988

Fluctuations in intra-ocular pressure with sleep: I. Time course of IOP increase after the onset of sleep.

Ten normal subjects slept over a series of four nights for time periods of 30 minutes, 1, 2 and 4 hours. Intra-ocular pressure (IOP) measurements were made using a non-contact tonometer before and after sleep. The subjects showed a significant increase in IOP of 3.45 mm Hg after 30 minutes of sleep and a further IOP increase thereafter to 6.41 mm Hg above baseline. Such increases in IOP after sleep in normal subjects suggest that glaucoma patients and those suspected of having glaucoma should be monitored overnight to assess their IOP control mechanisms.

Data Interpretation, Statistical↗
PubMed1988

[Plasmacytoma of the mediastinum. A new case].

We report the case of a 61-year old man in whom ablation of a hilar tumour enabled us to diagnose a mediastinal plasmacytoma. Plasmacytomas are rarely found in the mediastinum and sometimes evolve towards myelomas. The best treatment seems to be surgery combined with radiotherapy. The effectiveness of chemotherapy against this tumour is questionable.

Humans↗
PubMed1987

Treatment of mesenteric infarction.

Eighty-one cases of mesenteric infarction documented by angiography, laparotomy or autopsy were reviewed to assess the cause of the persistently high mortality. Thirty-seven patients (46 per cent) were felt to have inoperable lesions and were treated by supportive care only, while forty-four (54 per cent) underwent bowel resection and/or revascularization. Of these 44 patients 20 (45 per cent) survived, 14 (32 per cent) died of an early recurrence of infarction and 10 (23 per cent) died of an unrelated cause. In view of the high recurrence rate in the early postoperative period, treatment must prevent the causes of persistent or recurrent ischaemia such as vasoconstriction and reperfusion tissue damage. On the basis of recent clinical and experimental research we suggest that treatment should include routine angiography with selective perfusion of vasodilators through the superior mesenteric artery, pharmacological prevention of ischaemic and reperfusion tissue damage before surgery, and postoperative anticoagulation.

Adult↗