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Biomedical subjects

D P Mueller

Publications and source records attributed to D P Mueller.

At least 19 recordsLinked to original sources
PubMed1994

Treating oral sarcoidosis.

Oral sarcoidosis is rare and can be confused with various other lesions. Two case reports of sarcoidosis involving the lips are presented along with a discussion of sarcoidosis and treatment options.

Adult↗
PubMed1994

Brain parenchymal infection in bone marrow transplantation patients: CT and MR findings.

OBJECTIVE: The purpose of this study was to assess the MR and CT appearance of brain infection after bone marrow transplantation and to correlate the appearances with laboratory and pathologic findings. MATERIALS AND METHODS: We retrospectively reviewed the records of seven bone marrow transplant recipients with radiologic evidence of brain infection. RESULTS: Forty-one lesions were detected in seven patients with proved infectious foci outside the brain before brain infection was suspected clinically. Six patients had low total WBC or lymphocyte counts and one patient had normal total WBC and lymphocyte counts. Most lesions in patients with low total WBC or lymphocyte counts showed no appreciable edema or contrast enhancement. However, all lesions detected in the patient with normal total WBC and lymphocyte counts showed marked vasogenic edema and ring enhancement. CONCLUSION: Brain infection in bone marrow transplant recipients during immunosuppression exhibited MR characteristics different from those typically seen in immunocompetent patients. This appearance may be related to a diminished immunologic/inflammatory response.

Adult↗
PubMed1991

Older volunteers: a discussion of the Minnesota Senior Study.

We used findings from the Minnesota Senior Study to examine the theoretical and methodological difficulties of defining, coding, and analyzing data on older volunteers. This study, the first statewide survey of the needs and resources of the elderly in Minnesota in almost 20 years, found that over half (52%) of older Minnesotans do volunteer work for organizations--considerably higher than has been found in national surveys. Problems in definition and methodology, however, have confounded analyses. This paper proposes a new conceptual model for classifying volunteer roles, based on three dimensions: whether the voluntary service is "formal" or "informal"; whether the activity entails a regular or an occasional time commitment; and the nature of the service activity (person-to-community, person-to-object, or person-to-person).

Aged↗
PubMed1989

Temporal bone computed tomography in the preoperative evaluation for cochlear implantation.

High resolution computed tomography of the temporal bone is performed routinely in the preoperative evaluation for cochlear implantation. A retrospective review was performed to determine the effect of these studies. The clinical significance was determined through consultation with the referring otolaryngologist and review of the operative reports. Twelve examinations were reviewed. Abnormalities were identified in 12 of the 24 ears examined (eight of 12 patients studied). In two patients the CT examination strongly influenced the selection of the ear to be implanted. In four additional cases information felt to be useful in preoperative planning was provided. Useful information related to potential complications with the mechanical insertion of the electrode apparatus. We conclude that temporal bone abnormalities are common in the population undergoing cochlear implantation and that high resolution temporal bone CT is essential in preoperative evaluation. The CT scan should be interpreted with adequate knowledge of the operative procedure to evaluate any possible barriers to the mechanical insertion of the internal components of the system.

Cochlear Implants↗
PubMed1988

Therapists' perceptions of difficult psychiatric patients.

Psychotherapists often describe patients who present management problems as "difficult patients." This article describes a 5-factor scale to measure how therapists perceive difficult psychiatric patients. Reliability and validity evidence is presented for scales labeled Demanding, Help Rejecting, Unreachable, Dangerous, and Poor Fit. Fifty-four psychiatric outpatients identified as difficult to treat by two or more therapists were compared with 54 control psychiatric outpatients matched on age, sex, marital status, and diagnosis. Therapists rated difficult patients higher on each scale. Patients rated higher on the Demanding, Help Rejecting, and Poor Fit scales were heavier and more varied users of the treatment system than were those rated lower on these scales. The scale helps identify causes of staff dissatisfaction and inappropriate organization of services and suggests how to meet the special needs of difficult patients. Problem patients can be seen as denying the competence and authority of the mental health professional but also as central to the unique mandate of psychiatry. The reward system should more adequately support those therapists who care for the patients often avoided by others.

Ambulatory Care↗
PubMed1981

The current status of urban-rural differences in psychiatric disorder. An emerging trend for depression.

Evidence for differences in rates of psychiatric disorder by size of community is examined. Epidemiological studies reporting rates for specific diagnoses (treated and untreated) as well as those making only global assessments of psychiatric caseness are examined. An interesting trend toward higher rates of depressive disorders (excluding manic-depressive psychosis) in urban areas emerges. Differences in the availability of social support in communities in varying size is proposed as a possible explanation for this finding.

Adult↗
PubMed1978

Stressful life events and community mental health center patients.

This paper reports on the occurrence of stressful life events prior to treatment and at a follow-up timepoint in a general sample of community mental health center patients. Life events scores from the patients, at both timepoints, are compared with scores from a nonpatient sample drawn from the community. Results indicate that patients before entering treatment tend to experience more events (particularly undesirable ones that could be confounded with psychological condition) than nonpatients. The result is no longer true at the follow-up time point. Findings regarding life events and patienthood are basically the same whether all events are used (i.e., the change score) or undesirable events alone. If, however, only events judged to be unconfounded with psychological condition are considered, we find no difference between patients and nonpatients at either timepoint. Implications of the study's results for the direction-of-effect issue with respect to the stress-psychological disorder relationship are discussed.

Adolescent↗
PubMed1978

Does patient satisfaction correlate with succes?

The authors studied the relationship between patient satisfaction and success of treatment in a group of out-patients consecutively admitted to two community mental health centers in California in 1975. The study is based on patient ratings of the satisfaction with treatment and the success of treatment at the second visit, the last visit, and follow-up, as well as on therapists' ratings of treatment success at the second visit and the last visit. At both time points the therapists' mean ratings of treatment success were significantly lower than the patients'. Significant but low correlations between satisfaction and success indicate that satisfaction ratings cannot replace success ratings or other outcome indicators in assessments of quality of care.

Adult↗