Search PubMed⌕ Search

Biomedical subjects

J B Reuler

Publications and source records attributed to J B Reuler.

53 records · Page 3Linked to original sources
PubMed1979

Leptomeningeal carcinomatosis with normal CSF features.

We report two cases of leptomeningeal carcinomatosis in which CSF-positive cytologic features were present but other CSF measurements were normal--a most unusual combination. In both cases, the results of the cytologic examination led to substantial therapeutic alterations. Cytologic examination of the CSF should be performed in any case with unexplained CNS symptoms or signs, regardless of the character of the CSF.

Aged↗
PubMed1979

Pseudothrombophlebitis syndrome in the arthropathy of granulomatous colitis.

A case of pseudothrombophlebitis syndrome occurred in a young man with colitic arthropathy who was seen because of a swollen leg. The salient features of this syndrome, the difficulty in differentiating it clinically from true deep venous thrombosis, and the importance of correct diagnosis are stressed, particularly in light of the fact that patients with inflammatory bowel disease are predisposed to occlusive venous disease.

Adult↗
PubMed1978

Sternoclavicular joint involvement in ankylosing spondylitis.

Two patients with sternoclavicular joint involvement in ankylosing spondylitis are described, both of whom presented with referred pain syndromes which delayed diagnosis. The anatomy of the sternoclavicular joint and the salient features of this entity are reviewed.

Adult↗
PubMed1978

Hypothermia: pathophysiology, clinical settings, and management.

Hypothermia, defined as a core temperature less than 35 degrees C, is frequently not recognized, in part because of the inadequacy of standard thermometers. This entity has multiple causes and unique pathophysiologic consequences that complicate diagnosis and treatment. Understanding of the physiology of thermoregulation is important in light of recent advances in therapy using core rewarming. Pathophysiology, etiology and management of the hypothermia syndrome are reviewed.

Accidents↗
PubMed1978

Herpes zoster.

Herpes zoster is a disorder frequently encountered in adults. The natural history is often poorly appreciated and management is frustrating. Recent studies have critically evaluated newer therapeutic modalities. The epidemiology, clinical manifestations, complications and therapeutic alternatives of herpes zoster deserve review.

Herpes Zoster↗
PubMedDate not supplied

Back pain and epidural spinal cord compression.

The physician must have a high index of suspicion to detect SCC early in patients with malignancy. Back pain is the first symptom in almost all patients, and the diagnosis should be considered for all older patients with back pain. Asking about back pain should be a routine part of the review of systems, especially for patients with known malignancies. Clinically, it is impossible to tell whether or not a patient who has back pain and cancer has epidural SCC. Patients may be stratified as to the likelihood of SCC using the history and physical examination, but the diagnosis relies on radiographic visualization of the spinal cord. It may be acceptable to closely follow patients with normal neurologic examinations and normal plain films, but even this is controversial and includes only a minority of patients. Myelography remains the test of choice. MRI will play an increasingly important role in the future, but has not yet been systematically evaluated. The best therapeutic approach is not clear, but standard treatment is only about 50% effective in all cases. At present, radiation therapy is the treatment of choice for many patients, in particular those who are ambulatory at diagnosis. Anterior resection with vertebral body reconstruction is an exciting approach and may substantially improve the prognosis for patients who are paraparetic or paraplegic. It is important to attempt to choose for each patient the diagnostic and therapeutic options offering the best chance for comfort and preservation of function. The decision of how or even whether to treat is multifactorial and is more complicated than the determination of simply whether or not compression is present.(ABSTRACT TRUNCATED AT 250 WORDS)

Back Pain↗
PubMedDate not supplied

Teaching history-taking: where are we?

Knowledge in history-taking has increased rapidly over the last twenty years. Currently the principles to be taught include "conduct," "content," and "diagnostic reasoning." However, inattentiveness of medical schools, reluctance of busy faculty to be involved, and increasing enrollments have resulted in difficulties in teaching these skills. Studies have shown a beneficial short-term effect of teaching these materials on interview performance but it is unknown whether this effect is long-lasting. The methods for instruction include the bedside and videotape models utilizing the concept of the fifteen-minute interview technique, programmed instruction, patient instructors, and direct student feedback. Future research should focus on identifying strategies in diagnostic reasoning, developing graduated competency criteria for trainees at different levels of their education, refining methods to evaluate large numbers of students, measuring outcomes of effective training such as compliance, and comparing costs and effectiveness of various methods. In addition, there remains the need to establish an association of course directors.

Communication↗