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Biomedical subjects

D K Wagner

Publications and source records attributed to D K Wagner.

At least 55 records · Page 3Linked to original sources
PubMed1985

Spinal cord aspergillus invasion--complication of an aspergilloma.

Acute paraplegia developed in a 53-year-old man with pulmonary aspergilloma because of contiguous extension of Aspergillus infection to the epidural and subdural spaces and spinal cord. Histopathologic findings of the spinal cord showed Aspergillus hyphae penetrating the myelin sheath and myelomalacia, predominantly in the anterior and lateral columns. To the authors' knowledge, there have been no previous descriptions or illustrations of spinal cord involvement and the pathologic changes caused by Aspergillus infection.

Abscess↗
PubMed1985

Long-term intravenous antibiotic therapy in chronic osteomyelitis.

Because the optimal treatment of chronic osteomyelitis is not well established, we studied the efficacy of prolonged (three months or more) outpatient intravenous antibiotic therapy via a Hickman catheter. Seventeen patients were entered into our protocol (13 with chronic osteomyelitis, three with chronic septic arthritis, and one with subacute osteomyelitis). Pseudomonas aeruginosa was the most common bone isolate, followed by Staphylococcus aureus. Most patients had polymicrobial isolates. Patients were followed up with clinical examinations, serial measurements of erythrocyte sedimentation rate, and scans using technetium Tc 99m medronate and gallium citrate Ga 67. Of the ten patients with chronic osteomyelitis who completed therapy, eight were considered cured. After further follow-up, three of the cured patients had recurrences requiring additional therapy.

Adult↗
PubMed1981

Use of antibiotics in the initial management of soft tissue hand wounds.

A prospective, randomized study was undertaken to determine the efficacy of prophylactic antibiotics in the treatment of various types of soft tissue hand wounds. A total of 394 patients were randomly assigned to one of two treatment groups, those receiving cephalexin (250 mg orally q.i.d. x 5 days), and the control group receiving no antibiotic. Patients were followed closely during the healing phase of their wounds. There was no statistical difference in the incidence of infection in the two groups.

Adolescent↗
PubMed1980

Interdisciplinary training: hospital dental general practice/emergency medicine.

The interaction between the residency training program in hospital dental general practice and emergency medicine at The Medical College of Pennsylvania is discussed. The contribution by the emergency medicine resident to the training of the dental resident and the role of the dental resident in the education of the emergency medicine resident are described in detail. Methods for enhancing this unique relationship between two departments are presented.

Communication↗
PubMed1978

Pharyngeal gram stains in the treatment of sore throats.

The use of the direct pharyngeal Gram stain for diagnosis of group A beta-hemolytic streptococcal pharyngitis was evaluated. Seventy-five consecutive out-patients presented with pharyngitis (or high fever in infants) were studied with pharyngeal cultures and Gram stains. Gram stains were read as either positive, negative, or indeterminate for streptococcal pharyngitis. When these predictions were correlated with the resulting culture growth of group A beta-hemolytic streptococci, the predictive value of a throat smear Gram stain was found to be significant (p less than 0.005). There were two false positives and three false negatives. Approximately one third of the smears were in the indeterminate category. Although the Gram stain of a pharyngeal smear was found to be less sensitive than the routine throat culture, the ability to obtain inexpensive rapid microbiological information suggests that the Gram stain can be used as a quick screening procedure.

Adolescent↗
PubMed1977

Emergency medicine as an academic discipline.

Because of an explosive increase in the use of emergency rooms in hospitals across the country, many hospitals have found it expedient to employ full-time emergency physicians. The demand for emergency physicians has prompted the development of training programs in emergency medicine in academic medical centers. The first such training program was instituted at The Medical College of Pennsylvania in 1970. The 32 current programs in the nation are filling a real need in providing manpower for hospital emergency rooms. With the increasing identification and distribution of emergency physicians, there has been an attempt to develop emergency medicine as a distinct discipline and to establish its legitimacy in the structure of academic medical centers. A variety of problems must be addressed to clarify the role of emergency medicine in the academic setting.

Curriculum↗
PubMed1977

The continuing emergency care clinic: improving patient compliance with follow-up care.

Traditionally, emergency patients have been noted for high rates of noncompliance with appointments in outpatient clinics for follow-up care. S study of cases referred for follow-up care at the outpatient clinic of The Medical College of Pennsylvania showed that less than 20% of the patients kept their appointments. To cope with this problem, a Continuing Emergency Care (CEC) clinic was established on the assumption that a change in structural environment could change noncompliance behavior patterns. The clinic is a small unit near the emergency department, separate from the larger hospital outpatient clinic area. Patient compliance data were collected on each case referred to the CEC clinic during a three-month period. Findings showed a threefold increase in appointment compliance over the previous study in which referrals were made to the hospital clinics.

Appointments and Schedules↗
PubMed1977

The research component in the development of emergency medicine as a specialty.

The development of emergency medicine as a separate medical specialty involves several major processes, including professional identification, delineation of the dimensions of the specialty, development of a body of knowledge, and creative investigative activities. Residents in emergency medicine offer a potential source of expertise that could be utilized in the development of such research activities. However, for a variety of reasons routine research has not been part of current resident education. One example of a methodology for programmatic research development in emergency medicine is identified in this paper through the establishment of a nonclinical health services research position. The effect of having staff to assist in the development and analysis of research projects has contributed to building a body of knowledge specific to emergency medicine and creating a sense of professional identity among graduate trainees.

Emergency Medicine↗