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Biomedical subjects

D Berg

Publications and source records attributed to D Berg.

At least 127 records · Page 7Linked to original sources
PubMed1994

Genetic linkage evaluation of twenty-four loci in an eastern Canadian family segregating Darier's disease (keratosis follicularis).

BACKGROUND: Darier's disease (keratosis follicularis) is known to have a genetic cause as evidenced by its autosomal dominant transmission in families. The gene causing this disease has not been discovered. OBJECTIVE: During an ongoing linkage study of schizophrenia, a family segregating Darier's disease was found. This family is being studied in an attempt to locate prospective regions that may contain the Darier's disease gene. METHODS: Two genetic strategies are being employed: (1) testing candidate genes for the disorder and (2) scanning the entire genome with polymerase chain reaction-based microsatellite markers. RESULTS: Thirty-nine marker systems located on chromosomes 1, 2, 4, 5, 6, 9, 11, 12, 16, 17, 22, X, and Y have been genotyped. Slightly positive lod scores were achieved between six markers and Darier's disease. The remaining 33 markers were nonsegregating or indeterminate, or revealed an obligate recombinant. CONCLUSION: Linkage analysis can lead to localization of the gene causing Darier's disease. In these preliminary studies low positive lod scores were obtained, potentially pointing to the chromosomal location of the Darier's disease gene.

Chromosome Mapping↗
PubMed1994

[Increased mortality in home delivery].

103 current publications on perinatal mortality of home delivery (HD) have been investigated concerning their possible usage for statistics. Only few could meet the necessary statistical requirements. All publications which were in favour of home delivery showed statistical faults; therefore, they cannot give clear evidence of advantages and disadvantages of HD. The group of the described HD (approximately 85,000 home deliveries) were compared with a statistically comparable group of hospital deliveries. The risk for children to die during or after birth is between 3 and 23 times higher for home-born children than for those born in hospitals. The rate of unexpected incidents during delivery, where transport to hospital was required, is about 11%; this corresponds to the rate of unexpected incidents in hospitals. In home delivery, it is not possible to provide obstetrical operative interventions. The frequency of operatively terminated deliveries is about 40% in the group of secondarily transferred patients. The Netherlands have about 30% home deliveries; their perinatal mortality rate (0.96%) is the highest of all comparable high-developed countries (Germany: 0.6%). Considering the necessary safety of the child, home delivery is irresponsible.

Cross-Sectional Studies↗
PubMed1994

Development, implementation, and evaluation of an advanced physical diagnosis course for senior medical students.

PURPOSE: To develop, implement, and evaluate a new course curriculum designed to increase senior medical students' knowledge, psychomotor skills, interpretative abilities, and clinical utility regarding physical examination techniques. METHOD: From February 1991 through February 1993, 53 fourth-year students at the Medical College of Wisconsin participated in a one-month elective, Advanced Physical Diagnosis (APD), which was taught by faculty members of the Division of General Internal Medicine. The APD course included the following modules: (1) organ-specific didactic and interactive practice sessions; (2) physical-examination-based case conferences; and (3) professorial rounds, consisting of rounds on inpatient medical services and the use of professional patients, i.e., outpatients with specific, incontrovertible physical findings. An objective structured clinical examination (OSCE) was developed to evaluate the examination skills of the APD students. A pre- and post-course OSCE format was used with both the APD students and a control group of students rotating on the general medicine ward service. In addition, the APD students evaluated their own skills in physical examination and evaluated the course and each of its components by anonymously completing an extensive end-of-course survey. RESULTS: The pre-course OSCE detection rate of incontrovertible physical findings was similar between the control and APD students (Mantel-Haenszel chi 2 = 2.4, p > .1); the post-course OSCE showed significant improvement in the detection rates for the APD students compared with the control students (Mantel-Haenszel chi 2 = 45.8, p < .0001). The APD students felt strongly that the course had improved their physical examination skills and highly recommended the elective to their colleagues. CONCLUSION: Both the OSCE results and the students' self-assessments indicate that the pilot curriculum for the APD course improved the students' physical examination skills. The curriculum can be expanded and also exported to other institutions. Such a course may help promote and refine the use of physical diagnosis in the delivery of quality, timely, and cost-efficient health care.

Clinical Competence↗
PubMed1994

The Behavioral and Attitudinal Modification Project (BAM): a failed experiment using a classical experimental research design in a closed institutional setting for drug addicts.

Failure in program implementation and related research within closed institutional settings has long been a source of discouragement for correctional administrators and correctional researchers. This paper describes an attempt to implement an innovative treatment program, The Experimental Behavioral and Attitudinal Modification Project, within a civil addict treatment facility to enhance treatment effectiveness. It documents the major obstacles to correctional program innovation and research which ultimately brought about disruption, complacent cooperation, and other implementation problems leading to a project shutdown. It also attempts to place in theoretical perspective the reasons behind implementation failures, particularly as they relate to innovations in treatment and the use of classical experimental designs in closed institutional settings. The article is adapted from the executive summary of the final report to the funding agency. Researchers working to facilitate the effective reintegration of drug-using offenders into society should take heed from this research project, originally implemented in 1970, as a study in FAILURE as apropos today as it was over two decades ago.

Attitude of Health Personnel↗
PubMed1993

Environmental behaviour of radionuclides deposited after the reactor accident of Chernobyl and related exposures.

Several radioecological experiences with isotopes of ruthenium, iodine, caesium and barium, obtained after the reactor accident of Chernobyl, are reported. It was found that for a wet deposition barium was the element with the highest retention on grass. The retention of caesium was lower by a factor of 1.6, retention of iodine by a factor of 2.4 and retention of ruthenium by a factor of 3.5. Former data on the caesium transport in cereals from leaves to grain were confirmed. Depending on the conditions the iodine transfer factor for milk varied between 0.002 and 0.007 d.kg-1. The caesium transfer factor for milk was (0.003 +/- 0.0006) d.kg-1 and was found to be relatively constant in the years 1986-1988. In 1991, the values were higher by a factor of 2-5. Radioecological model results of whole-body burdens in Southern Bavaria showed a reduction of the caesium ingestion doses due to countermeasures and spontaneous changes of consumption habits in the first 2 months by a factor of 5 and till the end of 1987 by a factor of 1.5. The model results agree well with the range of measured whole-body burdens. One month after the deposition, the external exposures in urban environments due to ruthenium, caesium and barium isotopes were found to be reduced by a factor of 2, compared with open lawns, in the case of iodine the reduction was even a factor of 2.5. External exposures of a population group from the Munich area were determined by thermoluminescence dosimetry. The results are in accordance with the spectral measurements of external dose rates in urban environments.

Accidents↗
PubMed1993

The impact of educational loan burden on housestaff career decisions.

The past decade has seen declining interest in primary care medicine and a dramatic increase in the cost of a medical degree. Seventy-nine percent of housestaff in an internal medicine residency program responded to a survey to determine whether medical school loan burden was related to career choice in a primary care field or specialty area. Overall mean indebtedness was $45,185 (median $40,000). Thirty-eight percent of residents with debts < $40,000 chose a career in primary care, compared with 10% with debts > $40,000 (chi square = 9.44, p < 0.01). Fourteen percent of those with debts < 40,000 and 59% with debts > $40,000 stated that financial conditions had a moderate to marked impact on their career decision making. Excessive loan burden has a significant influence on residents' career decision making and a negative influence on choosing careers in primary care internal medicine.

Adult↗
PubMed1993

[Hermaphroditism verus: clinical aspects, diagnosis and therapy in adulthood].

A 20-year old woman, who underwent an intersex operation during infancy, was presented for evaluation of the gonads because of suspected true hermaphroditism. The phenotype was female with regular menstruations. Examination revealed an ovarian tumour of 8 cm on the left side and a normal right ovary. During the operation, the tumour was revealed as an endometriosis cyst, which could be excised whilst preserving the ovarian tissue. The right gonad was an ovotestis. The testicular part was removed because of a 4% risk of malignancy. The different combinations of ovary/testis and ovotestis are described. Diagnosis and therapy of true hermaphroditism should be performed as early as possible to obtain an adequate gonadal function and an undisturbed psychosexual development.

Adult↗
PubMed1993

Infectious disorders of the skin.

Cutaneous infections are common occurrences in clinical practice. Plastic surgeons need to recognize the varied presentations of cutaneous infections because they may mimic cutaneous malignancies or be a harbinger of underlying disease. We have reviewed the diagnosis and management of some of the more common bacterial, viral, and fungal infections of the skin.

Humans↗
PubMed1993

Periparotid lupus erythematosus panniculitis. Clinicopathologic correlation of two cases presenting as primary parotid disease.

Lupus erythematosus (LE) panniculitis, also called lupus profundus, is an uncommon but well-established manifestation of both chronic cutaneous (discoid) LE and systemic LE. Although LE panniculitis characteristically may involve the face, specific parotid and periparotid involvement has not, to the best of our knowledge, been previously reported. We describe the clinicopathologic correlation of two cases of LE panniculitis that presented as apparent primary parotid parenchymal disease; one as a neoplasm, the other as parotiditis. Failure to recognize LE panniculitis resulted in prolonged periods of inappropriate therapy and significant morbidity, including an unnecessary parotidectomy. Lupus erythematosus panniculitis has well-established histologic criteria that should be considered in the differential diagnosis of an unexplained parotid mass.

Adult↗
PubMed1992

[Venous tonicity in pregnancy varicose veins].

The dilation of the femoral vein during pregnancy was analysed retrospectively in patients with unilateral severe varicose veins (group I, n = 7), mild varicose veins (group II, n = 8) and healthy pregnant women (group III, n = 3). Groups I and II employed elastic stockings as treatment, while group I additionally applied a ruscus-containing cream to the affected leg. In the healthy women, in the unaffected leg in group II and in the cream treated leg in group I, the femoral vein increased in diameter on average by 2.1 to 2.4 mm in the third term of pregnancy, while in the affected leg of group II it increased by 3.6; in group I the increase in the leg not treated with cream was about 4.5 mm. The differences in dilatation are significant (p less than 0.05). Apparently, the venous tonic action of ruscus extract can considerably reduce venous dilatation during pregnancy.

Bandages↗