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F A Meier

Publications and source records attributed to F A Meier.

At least 37 records · Page 2Linked to original sources
PubMed1986

Throat cultures and rapid tests for diagnosis of group A streptococcal pharyngitis.

This article reviews the use of diagnostic tests to guide management of adults with sore throats. Pharyngitis due to group A beta-hemolytic streptococci represents the major diagnostic concern in these patients. Organisms other than group A streptococci can cause pharyngitis, but their clinical importance and their diagnostic tests have not yet been established. For many years, physicians have used routine throat cultures to diagnose group A streptococcal pharyngitis. Rapid tests have recently been introduced that detect the group A streptococcal antigen on throat swab specimens. Because both tests have high sensitivity and specificity, the choice of tests may depend on test turnaround time. Rapid tests should improve management by decreasing both short-term morbidity and inappropriate use of antibiotics.

Antigens, Bacterial↗
PubMed1985

Development of a computerized infectious disease monitor (CIDM).

At the LDS Hospital in Salt Lake City, an interface was developed between the microbiology laboratory computer system and the HELP integrated central hospital computer system. The HELP system includes medical information from most clinical care support areas. The microbiology data are translated from the laboratory computer file structure to a hierarchical data structure on the HELP system. A knowledge base was created with the help of infectious disease experts, and became part of a Computerized Infectious Disease Monitoring system (CIDM). The knowledge base is automatically activated when specific microbiology data are entered into a patient's computer file (data driven), thus decisions are made automatically with no additional effort required of medical personnel. The CIDM was designed to inform infectious disease personnel when a patient has one of the following conditions: a hospital-acquired infection, an infection at a normally sterile body site, an infection due to a bacteria with an unusual antibiotic sensitivity pattern, an infection for which the patient is not receiving an antibiotic to which the offending bacteria is sensitive, an infection that could be treated with a less expensive antibiotic, an infection which is required by law to be reported to state and national health authorities, and those patients receiving prophylactic antibiotics longer than is medically indicated. All of the microbiology data are now extensively reviewed by nurses and physicians from terminals at nursing stations or intensive care units. The CIDM is currently being used for hospital-acquired infection surveillance at LDS Hospital.

Anti-Bacterial Agents↗
PubMed1984

Locating community residents with chronic airway obstruction. A comparison of four strategies.

In the course of establishing and evaluating a patient education program, we compared 4 strategies for locating patients with chronic obstructive airway disease (COAD): (1) search of hospital discharge records (HOSP), (2) referral by physicians (MD), (3) an advertising campaign (AD), and (4) a respiratory symptom questionnaire mailed to households (QUEST). Of 1,834 persons assessed, 923 (50%) had airway obstruction; 43% of the confirmed cases (396 of 923) reported no previous diagnosis of COAD. The HOSP strategy accounted for 75 assessments (4%) and 63 confirmed cases (7%), MD produced 352 assessments (19%) and 247 cases (27%), AD generated 475 assessments (26%) and 204 cases (22%), and QUEST resulted in 932 assessments (51%) and 409 cases (44%); MD was the least expensive strategy ($17.00/case). The mailed questionnaire located the largest number of cases not previously diagnosed.

Advertising↗
PubMed1983

Intracranial metastases due to prostatic carcinoma.

From 1973 to 1982, 189 patients were treated at the Dartmouth-Hitchcock Medical Center for Stage C or D prostatic carcinoma. In eight of these cases (4.2%), there was clinical or pathological evidence for intracranial metastases. The condition of subdural neoplastic spread, not from contiguous bone, was identified in five cases, two of which were suspected before death. Four of these five patients were thrombocytopenic or pancytopenic at the time of the diagnosis. Intraparenchymal brain metastases were identified in six cases. Cerebellar, temporal bone, cavernous sinus, and splenium infiltration by tumor were unusual findings in individual cases. The results of chest x-rays and respiratory status were poor predictors of lung metastases in four of five patients on whom autopsies were performed. This article describes the spectrum of radiographic and pathologic findings of intracranial prostatic carcinoma, and suggests that the likely mechanism of brain metastasis in these cases is by the dural veins and Virchow-Robin spaces.

Adenocarcinoma↗
PubMed1983

Reye's syndrome. A review from the forensic viewpoint.

Reye's syndrome, encephalopathy and fatty change in the liver and other viscera, typically occurs suddenly in infants and children recovering from a viral illness, particularly influenza or varicella. Its rapid clinical course may suggest a drug-related insult and the differential diagnosis includes a variety of toxins. There are grounds for suspicion that exogenous substances--including aspirin--may be cofactors with recent viral illness in the syndrome's pathogenesis. For these reasons, medical examiners may be called upon to rule the diagnosis in or out, to assess the possibility of direct toxic injury, or to document presence or absence of possible cofactors. With these tasks in mind, this review summarizes the diagnostic, pathologic, and laboratory findings of Reye's syndrome and considers the roles of viral infection, heritable predispositions, and exogenous toxins in its causation. It singles out salicylate treatment for special considerations as a possible cofactor, and concludes with a suggested approach to the forensic medical investigation of possible cases of Reye's syndrome.

Aflatoxins↗
PubMed1982

Environmental causes of cancer death.

People increasingly look to the forensic autopsy as a way of determining whether a particular cancer death was environmentally caused. The forensic pathologist must be diligent pursuing evidence that links potential environmental causes to cancer but must also educate the public providing reassurance that most cancers are not due to industrial pollution. Cigarette smoking and various life-style factors appear to account for more cancers than do man-made environmental contaminants. Assessing the possibility that a cancer death is due to a specific environmental agent requires extensive information. First, one must obtain an accurate history of lifetime occupational and environmental exposures. Second, one must analyze this information in view of epidemiologic data on the cancer risks associated with each exposure. Finally, one should seek to document through the autopsy that exposure to a potentially harmful agent actually occurred. The carefully done forensic autopsy can alert the public to dangerous conditions and can provide individuals a basis for recovery in court for damages due to harmful exposures.

Environment↗
PubMed1981

The "iron screen": modification of standard laboratory practice with data analysis.

Multivariate analysis was applied to iron deficiency anemia to generate an efficient sequence of diagnostic laboratory tests. A three step diagnostic system--serum ferritin level and mean corpuscular volume as a screen in all patients, followed by serum iron level and total iron binding capacity in some patients, and by erythrocyte sedimentation rate in a few patients--was constructed using a previously validated data reduction system. When compared to bone marrow iron stores, this system was found to have 96 per cent accuracy. In one year of clinical trial the "iron screen" classified 396 of 416 patients in a hospital setting. This sequential strategy shows how clinical laboratory data can be utilized to render diagnoses of defined probability.

Anemia, Hypochromic↗
PubMed1981

Fatal peritonitis following IUD-associated salpingitis.

Previous reports have implicated the Dalkon shield intrauterine device (IUD) in septic second trimester abortion and maternal death from sepsis. In the case reported here, Fusobacterium necrophorum, a rarely pathogenic vaginal anaerobe, gained access to the uterus in a woman wearing a Dalkon shield and caused acute parametritis, overwhelming peritonitis, systemic sepsis, and death. It is well known that IUDs can contribute to the development of serious pelvic infections, and in this case it is possible that the Dalkon shield was the cause of the ascending infection into the uterus.

Adult↗
PubMed1979

Serum-ferritin.

Explore the source record for details and available documents.

Anemia, Hypochromic↗
PubMedDate not supplied

Evaluation of two ELISA's for detecting Chlamydia trachomatis from endocervical swabs.

Two enzyme immunoassays (EIAs) detecting Chlamydia trachomatis from endocervical swabs, Syva MicroTrak (MT) and Abbott Chlamydiazyme (CZ), were compared with a tissue culture (TC) standard. Initially, 8% (100 of 1250) of specimens were TC positive, yielding sensitivities of 94% (94 of 100) for MT and 79% (79 of 100) for CZ with identical 98% specificities (1129 of 1150 for MT and 1130 of 1150 for CZ). Discrepant specimens were retested by both EIAs and assayed for elementary bodies (EBs) by a fluorescent antibody test. After discrepancy analysis, 9.5% (118) of 1240 patients were either TC or EB positive, yielding sensitivities of 94.1% for MT (111 of 118) and 79.7% for CZ (94 of 118) with identical specificities of 100% (1122 of 1122). These results indicate that the MT is significantly more sensitive (p less than 0.05, McNemar test) than CZ in detecting C. trachomatis from endocervical swabs.

Adolescent↗
PubMedDate not supplied

Hyperviscosity syndrome in paraproteinemia. Managed by plasma exchange; monitored by serum tests.

Clinical and laboratory indices of hyperviscosity were studied in three patients presenting with this complication of paraproteinemia. Serum viscosity correctly predicted the presence of clinical hyperviscosity syndrome in patients with stable hemoglobin and albumin concentrations. Serum viscosity also correlated with total protein and paraprotein levels. A simple exponential model proved not only to describe the kinetics of blood viscosity during plasma exchange but also to predict protein concentration at symptomatic recovery. Construction of such a protein-viscosity curve helps manage by plasma exchange patients with paraproteinemia who develop hyperviscosity syndrome.

Blood Viscosity↗
PubMedDate not supplied

Meningitis due to Neisseria mucosa: case report and review.

Neisseria mucosa is a species of gram-negative cocci that has a characteristic mucoid, adherent colonial morphology and includes pigmented and nonpigmented morphotypes. The ability of N. mucosa to reduce nitrates distinguishes it from other Neisseria species. N. mucosa is part of the normal human nasopharyngeal flora and infrequently causes human infections, including meningitis. We report a unique case of a patient with a cerebrospinal fluid shunt infection due to N. mucosa and review five other reports of cases of meningitis caused by this organism. Seven additional previously reported cases of presumed N. mucosa meningitis have been excluded from this review on the basis of the current criteria for identification of the organism. In the reports of established cases, female infants and children who often had predisposing conditions predominate. Although the outcome for such patients has been favorable, no clinical or laboratory findings are helpful in distinguishing meningitis due to N. mucosa from that due to other bacteria.

Adult↗