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Biomedical subjects

M B Miller

Publications and source records attributed to M B Miller.

At least 91 records · Page 5Linked to original sources
PubMed1990

[Significance of visual-scanning Doppler detection in the diagnosis of early stages of cardiac insufficiency in patients with ischemic heart disease].

A method was developed for visual monitoring myocardial structures in the mode of continuous Doppler location by using a commercial Soviet device. The method proposed measures the velocity of mobility of well-defined cardiac structures. Clinical examinations showed that myocardial contractile abnormalities could be detected earlier by visual-prospecting Doppler echocardiography than by routine Doppler location and echocardiography. The IVth standard location position is the most informative in the detection of impaired contractility. When the Doppler echocardiogram in the first additional position is analyzed, the appearance of P wave may serve as a reliable criterion for diminished myocardial contractility.

Adult↗
PubMed1988

Ventilation-perfusion scan in the acutely ill patient with unilateral hyperlucent lung.

A patient with a unilateral hyperlucent lung with acute respiratory complaints is presented. A ventilation-perfusion scan was performed to rule out pulmonary embolism. The perfusion scan ( [99mTC]MAA) showed peripheral perfusion defects in the hyperlucent lung. The ventilation study (133Xe) demonstrated peripheral ventilatory defects on the single breath image in the hyperlucent lung, the filling in of these on the equilibrium view, and diffusely delayed washout in the affected lung. These findings were suggestive of the Swyer-James syndrome and critical in excluding the numerous other causes of unilateral hyperlucent lung, which are discussed. The importance of the ventilation-perfusion study (and particularly the ventilation scan) in the patient with unilateral hyperlucent lung and acute respiratory symptoms is stressed. In addition, a discussion of the Swyer-James syndrome is included.

Aged↗
PubMed1982

Hyperthyroxinemia in patients with acute psychiatric disorders.

Thyroid function tests were measured in 645 patients admitted to an acute psychiatric disorders unit. Thirty-three percent had elevated serum thyroxine (T4), and 18 percent had an elevated free T4 index (FTI). Serum triiodothyronine (T3) was low, normal, or minimally elevated in 77 patients, with a high initial free T4 index. Twenty-two patients with an initial elevation of their free T4 index were serially followed (study group). Serum T4, free T4 index, and free T4 fell in every patient: serum T4 from 13.95 +/- 1.93 micrograms/dl (mean +/- standard deviation: SD) to 9.33 +/- 2.4 micrograms/dl (p less than 0.001); free T4 index, from 6.15 +/- 0.83 to 3.79 +/- 1.1 (p less than 0.001); free T4, from 2.43 +/- 0.65 mg/dl to 1.38 +/- 0.35 ng/dl (p less than 0.001). Serum T3 was initially normal or low, and then fell in 17 patients, and rose in five. Serial testing of thyrotropin-releasing hormone (TRH) demonstrated both flat and normal responses in patients with a variety of psychiatric diagnoses and at varying stages of thyroid disease activity.

Acute Disease↗
PubMed1976

Errors and omissions in diagnostic records on admission of patients to a nursing home.

The primary and secondary diagnoses for 100 geriatric patients consecutively admitted to a nursing home were reviewed for accuracy and omissions. Primary diagnoses were identified as the direct basis for nursing home admission. Other physical, biochemical or behavioral disorders requiring continued therapeutic care were identified as secondary diagnoses. A comparison was made of the diagnosis offered by the referring physician and the diagnosis as determined by the medical staff of the nursing home immediately after admission. In 64 percent, the secondary diagnoses were either lacking or inaccurate. The extraordinarily inadequate medical performance with respect to identifying the primary clinical and therapeutic problems of the chronically ill aged was remarkably consistent, regardless of the source of the patient's referral, whether from a general or psychiatric hospital, a private home, or another nursing home. The results of this study revealed a significant degree of unpreparedness and malaise in some members of the medical profession concerning the care of the chronically ill aged, particularly when such patients demonstrate behavioral disorders superimposed upon physical disease. Failure to identify the patient's needs through diagnosis must result in poor, inadequate or inappropriate treatment programs.

Aged↗
PubMed1975

Iatrogenic and nurisgenic effects of prolonged immobilization of the ill aged.

The kinesio, phychopathologic and psychosocial effects of prolonged immobilization of the ill aged are outlined. The iatrogenic (physician-induced) and nurisgenic (nurse-induced) factors related to such functional disabilities are described. Illustrative case histories are given. The syndrome is reversible. Thus physicians and nurses have a continued responsibility to support a sustained rehabilitation program for these patients. The biochemical effects of prolonged inactivity indicate that immobilization of the elderly patient results in adverse physical and psychologic phenomena.

17-Ketosteroids↗