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D Baer

Publications and source records attributed to D Baer.

At least 19 recordsLinked to original sources
PubMed1999

["I am tired"].

Explore the source record for details and available documents.

Anxiety↗
PubMed1998

Phaeohyphomycosis caused by Phaeoacremonium inflatipes.

Phaeoacremonium inflatipes, one of three species previously classified as strains of Phialophora parasitica, was identified as the causal agent of a subcutaneous infection of the left foot of an 83-year-old woman from South Carolina. The patient had a granulomatous growth over the anteromedial aspect of her left foot. It was surgically excised, which led to complete healing without complications. Tissue sections of the excised mass stained with hematoxylin and eosin and Gomori's methenamine silver strains showed many septate hyphal elements of various lengths, some exhibiting brownish pigment in the cell walls of the hyphae. Portions of the tissue, when cultured, yielded many colonies which were initially glabrous, off white becoming velvety, greyish brown on aging. Microscopically, their hyphae were septate, branched, and phaeoid and bore lateral and terminal, erect, septate conidiophores. The conidiogenous cells (phialides) were terminal or lateral, mostly monophialidic, subcylindrical to spinelike in shape, and constricted at their bases and bore funnel-shaped, inconspicuous collarettes at their tips. The conidia were subhyaline, oblong, and ellipsoid to allantoid.

Aged↗
PubMed1997

Stanford-Kaiser Permanente G1 study for clinical stage I to IIA Hodgkin's disease: subtotal lymphoid irradiation versus vinblastine, methotrexate, and bleomycin chemotherapy and regional irradiation.

PURPOSE: We have demonstrated that a relatively mild chemotherapy regimen, vinblastine, methotrexate, and bleomycin (VBM), and involved-field radiotherapy (IFRT) could substitute for extended-field radiotherapy in patients with favorable Hodgkin's disease (HD) who have been laparotomy-staged. The purpose of this study is to determine if VBM and regional radiotherapy can substitute for extended-field radiotherapy in favorable clinical stage (CS) I and II HD. PATIENTS AND METHODS: Seventy-eight patients with favorable CS I to II HD were randomly assigned to subtotal lymphoid irradiation (STLI) or VBM chemotherapy and regional radiotherapy. Randomization was stratified on the basis of age, sex, number of Ann Arbor sites, histology, and institution. Patients were evaluated for freedom from progressive HD, survival, and toxicity. Results were compared with the predecessor trial in pathologically staged patients. RESULTS: With a median follow-up period of 4 years, the rate of freedom from progressive HD was 92% (95% confidence interval [CI], 88% to 96%) for patients treated with STLI and 87% (95% CI, 81% to 93%) for patients treated with VBM and regional radiotherapy. Six of seven patients who relapsed are alive and in remission following successful second-line therapy. CONCLUSION: Given the caveat of a small number of patients, the results of extended-field radiotherapy and VBM and regional radiotherapy are comparable with a median follow-up period of 4 years. VBM serves as a paradigm to reduce late effects in favorable early-stage HD. We do not advocate its routine use in clinical practice, but instead encourage participation in clinical trials with the objective of maintaining efficacy while reducing toxicity in CS I and II HD.

Adult↗
PubMed1997

Cost of care for cancer in a health maintenance organization.

The direct costs of medical care for cancer are examined at Kaiser Permanente (KP) in Northern California. Use data from July 1987 through June 1991 were obtained from KP automated files for all 21,977 KP patients in the Bay Area SEER registry with cancer at one of seven cancer sites. Medical charts were reviewed for a stratified sample of 886 patients. Costs were estimated for initial, continuing, and terminal care, and for all person time within 15 years of diagnosis, by stage at diagnosis. From diagnosis until death or 15 years, long-term costs attributable to cancer were as follows: breast, $35,000; colon, $42,000; rectum, $51,000; lung, $33,000; ovarian, $64,000; prostate, $29,000; and Non-Hodgkin's Lymphoma (NHL), $48,000. The utilization and cost results reported here may be useful in assessing the cost-effectiveness of cancer prevention and control programs, in adjusting capitation rates and budgets, and in estimating the aggregate medical care costs attributable to cancer.

Ambulatory Care↗
PubMed1995

Transferrin saturation and risk of cancer.

The authors examined the hypothesis that relatively high levels of transferrin saturation increase the risk of cancer. They studied a cohort of prepaid health plan members whose transferrin saturation levels were measured during the period 1969-1971 and who were followed for cancer through 1990. After the exclusion of 10 percent of the subjects who received treatment for one or more of six chronic conditions or who were pregnant when the measurement was made and persons who contributed less than 5 years of follow-up, the authors were left with 38,538 persons who were followed for an average period of 17.7 years. In women, a positive association was observed between transferrin saturation and risk of stomach carcinoma (> or = 34.5% compared with < or = 20.3%: relative risk (RR) = 3.5, 95% confidence interval (CI) 0.98-12). In men, transferrin saturation was inversely associated with risk of colon and rectal carcinoma (> or = 40.7% compared with < or = 26.0%: colon, RR = 0.62, 95% CI 0.35-1.1; rectum, RR = 0.30, 95% CI 0.08-1.1) and with non-Hodgkin's lymphoma (32.1-40.6% compared with < or = 26.0%: RR = 0.31, 95% CI 0.11-0.88; no cases observed with transferrin saturation > or = 40.7%). The authors did not find evidence that the risk of epithelial cancer (all sites combined) was related to transferrin saturation level or to iron deficiency (< or = 15%) or overload (> or = 60%).

Adult↗
PubMed1995

In vitro cellulolytic activity of the plant pathogen Clavibacter michiganensis subsp. sepedonicus.

The activity of four Clavibacter michiganensis subsp. sepedonicus strains against various cellulose substrates was investigated. Sixty-seven Clavibacter michiganensis subsp. sepedonicus strains grew well on media amended with carboxymethylcellulose, 64 strains produced zones of hydrolysis. Endoglucanase activity was optimal at 37 degrees C and pH 6.0 against carboxymethylcellulose incorporated in plate assays. Zymogram and sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed the presence of a protein band corresponding to the cellulolytic activity in the molecular weight (MW) range of approximately 28,000. Protein bands in the same range were detected in five Clavibacter michiganensis subsp. sepedonicus strains. Studies on crude enzyme extracts of Clavibacter michiganensis subsp. sepedonicus strain N-1-1 revealed that p-nitrophenyl beta-D-cellobioside (pNPC) was hydrolyzed, with optimal activity at 37 degrees C and pH 7.0.

Carboxymethylcellulose Sodium↗
PubMed1992

Disturbances in the composition of plasma lipoproteins during gram-negative sepsis in the rat.

Hyperlipidemia is associated with gram-negative sepsis. In this study we characterized the plasma lipoproteins of fasted and fed septic and control rats with respect to their lipid and apolipoprotein composition. Sepsis was induced by i.v. injection of 8 x 10(7) live Escherichia coli colonies/100 g body wt. Food was removed from fasted control and fasted E. coli-treated rats after injection. Fed rats were infused intragastrically with a nutritionally complete diet for 5 days prior to E. coli treatment. 24 h after treatment with E. coli, lipid and protein concentrations of very-low-density lipoprotein (VLDL) were over 2-fold higher in the fasted E. coli-treated rats than those of the fasted control rats. This appears to be due to a decrease in the clearance of VLDL. The relative composition of apolipoprotein B-48 and apolipoprotein E were lower while that of apolipoprotein B-100 was higher in fasted E. coli-treated rats than in fasted controls. Low-density lipoprotein (LDL) and high-density lipoprotein lipids were also significantly elevated, indicating greater synthesis of these particles during sepsis and food deprivation. By contrast, VLDL-triacyglycerol from fed, E. coli-treated did not differ from that of their respective controls although the total cholesterol remained elevated. Percentages of apolipoprotein B-48 and apolipoprotein B-100 increased while apolipoprotein E contributed significantly less to the total protein of VLDL from the E. coli-treated rats compared with controls. LDL lipids were also increased. In conclusion, gram-negative sepsis leads to marked changes in the plasma lipoprotein composition which may be attributed to altered hepatic synthesis, peripheral metabolism or hepatic uptake of lipoproteins and their remnants. These in turn may be a function of the nutritional status.

Animals↗
PubMed1986

Managing liability risk in the office laboratory.

New technology has created new responsibilities and new risks for office practitioners who develop and use an office laboratory. Mistakes are bound to occur, but a system organized along the lines suggested is a workable way to minimize the number of mistakes and lessen the consequences of any mistakes that do occur. If a significant problem occurs and these guidelines have been ignored, it is likely they will be used as a framework for inquiry. The benefit to the physician and patient far outweighs the risk of using the new technology and procedures. Any risk is manageable because the physician has the opportunity to control the technology selected, the procedures and protocols used, and the persons involved in the testing process.

Financial Management↗
PubMed1986

Laboratory test analysis near the patient. Opportunities for improved clinical diagnosis and management.

New developments in laboratory technology have produced complex analytic systems that are simple to operate, relatively reliable, and inexpensive. These systems allow the office practitioner to perform test analyses in an office laboratory and can provide timely information useful for diagnostic and clinical management decisions. This article reviews the clinical applications and analytic systems available for use in urine analysis, blood cell analysis, determination of the sedimentation rate, coagulation testing, biochemical analysis, and bacteriologic and virologic testing. Although these analytic systems are generally designed to be used by nonprofessional laboratory staff, there is only limited information available about their reliability when used in this manner. Physicians, in bringing this technology into their office laboratories, must be cognizant of a new area of medical practice because they will now be the professionals responsible for the laboratory's function. It will be important that they develop new skills as the office laboratory directors and develop consultative relationships with laboratory professionals to ensure that the information used in patient care is both timely and reliable.

Bacteriological Techniques↗
PubMed1983

Serum unconjugated estriol concentrations before and after the oxytocin challenge test: an index of fetal well-being.

Serum unconjugated estriol concentrations before and after the oxytocin challenge test (stress test) were measured in 54 high-risk, obstetric patients. Six of the stress test results were positive, and eight were equivocal. Eleven patients demonstrated decrements in estriol of greater than or equal to 25% after stress tests, and the infants of six of these patients demonstrated perinatal morbidity. Three patients exhibited positive stress test results but had estriol concentrations which were unaltered by the stress test; all were delivered vaginally of healthy infants shortly after the stress test. The coefficient of correlation between the stress test and perinatal outcome was 0.58 (P less than 0.001). When the estriol and stress test results were combined to predict outcome, a multiple correlation coefficient of 0.71 was obtained (P less than 0.001). This increment represents a significant (P less than 0.001) and substantial (18%) improvement in the prediction of perinatal outcome. These findings indicate that the measurement of changes in estriol with the stress test significantly improves one's ability to define the fetus at risk.

Estriol↗
PubMed1980

Fetal acceleration determinations and perinatal outcome.

The importance of a laboratory test, especially when used as a screening procedure, is its ability to accurately provide information which can be used in the clinical management of patients. The fetal acceleration determination (FAD) has been utilized by many clinical obstetric services to assess the fetus at risk and to avoid the cumbersome and expensive oxytocin challenge test (OCT). In an effort to determine the usefulness of this modality in assessing the high-risk obstetric patient, a retrospective study of FADs was performed on 264 patients. All the tests were performed within one week of delivery. Fetal outcome was measured by Apgar scores, fetal morbidity and mortality and length of nursery stay. Chi square row by column contingency analysis was performed, and Bayes theorem was applied to our data to predict FAD specificity. The probability of false-positive and false-negative tests was high, and no correlation with outcome was observed. Analysis of these data indicates that the FAD is of limited value in identifying the fetus at risk.

Apgar Score↗