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Biomedical subjects

M Quan

Publications and source records attributed to M Quan.

30 records · Page 2Linked to original sources
PubMed1983

Transient ischemic attacks.

Patients with transient cerebral ischemic attacks (TIAs) are generally felt to be at increased risk for stroke. A comprehensive clinical evaluation consisting of a thorough history and physical examination, as well as adjunctive laboratory and radiologic studies, is required to substantiate the diagnosis and to identify the underlying etiology. For patients with TIAs of atherothrombotic origin, the optimal course of management is still controversial. Although surgical therapy, antiplatelet therapy, and anticoagulant therapy have all shown promise in preventing stroke, their precise roles in the management of TIAs still await further elucidation.

Aged↗
PubMed1983

Adult immunization: the medical record design as a facilitator for physician compliance.

A three-year prospective chart audit of a family practice residency program was performed to measure physician compliance in following the recommendations of an adult immunization program. Despite curriculum changes, performance self-evaluation, and reminders by faculty members to residents about the need for adult immunization, physician compliance was poor in the second year of the study. It was thought that components of the medical record might be improved to facilitate physician compliance in the adult immunization program. At the beginning of the third year of the audit, tetanus and pneumococcal vaccines were preprinted on the health maintenance inventory (HMI), but influenza was not. The chart design also was changed to put the HMI in a more prominent place. In the third year of the audit, physician compliance with tetanus and pneumococcus immunization improved significantly. The results of the chart review suggest that physician compliance with adult immunization programs can be improved with appropriate chart design.

Adult↗
PubMed1982

Ectopic pregnancy.

Ectopic pregnancy continues to be a major clinical problem and is the leading cause of death in the first trimester of pregnancy. Diagnosis can be elusive. A thorough knowledge of the clinical spectrum of this disease, as well as the diagnostic tools available to the primary care clinician, provides the opportunity for making an early diagnosis. This is essential if the morbidity and mortality of ectopic pregnancy are to be reduced.

Adult↗
PubMed1982

Asymptomatic carotid bruit.

The asymptomatic carotid bruit is not an uncommon finding in patients aged 45 years and older. The presence of such a finding has been associated with an increased incidence of stroke and cardiovascular death. The optimal evaluation and management of such patients are still unresolved. Noninvasive carotid evaluation appears to be useful for defining the degree of carotid artery stenosis and possibly in identifying a particular subset of patients at high risk for stroke. Whether patients with asymptomatic carotid bruits are best managed medically or surgically remains controversial and will require further investigation.

Carotid Artery Diseases↗
PubMed1982

Flexible sigmoidoscopy.

Flexible sigmoidoscopy became available in 1976. To date, studies comparing it with rigid sigmoidoscopy support an increase of 2.5 to six times in the flexible sigmoidoscope's ability to detect polyps, and a two- to threefold increase in detection of colonic neoplasms in the same patients. This paper summarizes the current reported results of flexible sigmoidoscopy to date and describes the instrument and procedure as done at the UCLA Family Practice Residency Program. The flexible sigmoidoscope deserves evaluation for widespread primary care application.

Colonic Neoplasms↗
PubMed1980

Termination of pregnancy by menstrual extraction.

Termination of pregnancy by means of "menstrual extraction" is a useful procedure for family physicians opting to offer this service to their patients. It is an easily performed procedure which, when compared to the presently available avenues for abortion, offers significant advantages in cost, diminished morbidity, and the opportunity for continuity of care by the primary physician. The procedure is successful in properly selected patients 99 percent of the time.

Abortion, Induced↗
PubMedDate not supplied

Doppler color flow mapping of the proximal isovelocity surface area: a new method for measuring volume flow rate across a narrowed orifice.

This manuscript describes a new method, validated in in vitro models, for quantitating volume flow rate across an orifice with Doppler color flow mapping. Flow through a narrowed orifice is characterized by the convergence of radial streamlines proximal to the orifice. In this color Doppler method, one or more isovelocity surface areas (PISA), delineated by blue and red aliasing velocity interfaces, can be identified proximal to the narrowed orifice. Volume flow rate (in milliliters per second) can then be calculated as PISA (in square centimeters) multiplied by the isovelocity of the PISA (in centimeters per second). Doppler color flow mapping was performed in in vitro models of constant and pulsatile flow through an orifice in a wall. The first proximal isovelocity surface area, with an isovelocity corresponding to the aliasing velocity, that is, one half the Nyquist sampling limit, could be identified as a blue and red color interface proximal to the orifice. Over a range of circular orifice diameters from 3 mm to 16 mm and flow rates from 0.5 to 18.7 L/min, the proximal isovelocity surface area could be imaged in two planes. This PISA was best described by a hemielliptic mathematical model with two different radii measured from long-axis and short-axis views. In the constant flow model, volume flow rate calculated from the Doppler PISA correlated well with actual volume flow rate measured simultaneously with a cylinder and stopwatch (r = 0.98, p less than 0.001, standard error of the estimate [SEE] = 0.36 L/min). In the pulsatile flow model, with jet velocities ranging from 2.6 to 7.7 m/sec and flow volume ranging from 1.0 to 10.3 L/min, calculated volume flow rate also demonstrated an excellent correlation with actual volume flow rate (r = 0.99, p less than 0.001, SEE = 0.53 L/min). Findings from these in vitro models suggest that quantification of the proximal isovelocity surface area by Doppler color flow mapping appears to be a promising technique for estimating volume flow rate across a narrowed orifice. This new color Doppler flow method may have advantages over previous Doppler methods in estimating volume flow rate in various clinical situations, for example, valvular regurgitation and shunt lesions.

Blood Flow Velocity↗
PubMedDate not supplied

Diagnosis and management of infectious vaginitis.

Vaginitis is an important gynecologic disorder that accounts for nearly 5 million office visits to physicians each year. Infectious vaginitis is the most common cause for an abnormal vaginal discharge; other possible causes include cervicitis, atrophic vaginitis, physiologic discharge, physicochemical vaginitis, and psychosomatic vaginitis. Although the history and physical examination may suggest the diagnosis, laboratory confirmation is required. The vaginal pool wet mount remains the cornerstone in the office diagnosis of vaginitis, with the "sniff" test, vaginal pH determination, and the "swab" test all playing important adjunctive roles. Metronidazole is the only effective treatment for trichomoniasis in the United States. The vaginal administration of an imidazole antifungal agent is the mainstay of treatment of vaginal candidiasis. Despite a search for alternative drug regimens, a 7-day course of metronidazole therapy remains the treatment of choice for bacterial vaginosis.

Clinical Protocols↗
PubMedDate not supplied

Pelvic inflammatory disease: diagnosis and management.

BACKGROUND: Acute pelvic inflammatory disease (PID) is a major gynecologic health problem in the United States, afflicting more than 1 million women each year and generating annual direct and indirect costs estimated at $4.2 billion. Family physicians can play an important role in the prevention, as well as diagnosis and treatment, of PID. METHODS: A MEDLINE search for articles published from 1985 to the present was made using the key words "pelvic inflammatory disease," "endometritis," "salpingitis," "tubo-ovarian abscess," "adnexitis," "pelvic abscess," "parametritis," and "oophoritis." The bibliographies of these articles and the author's personal files were also sources of information. RESULTS AND CONCLUSIONS: A number of risk factors have been linked to PID, including young age, age at first intercourse, multiple sex partners, the presence of bacterial vaginosis, vaginal douching, the use of an intrauterine contraceptive device, and a history of a sexually transmitted disease. The diagnosis of PID represents a major clinical challenge that requires a careful history and physical examination coupled with selective and knowledgeable use of the diagnostic tests and procedures currently available. Broad-spectrum antibiotics, which represent the cornerstone of therapy, must adequately cover the polymicrobial spectrum of pathogens implicated in this infection, which includes Neisseria gonorrhoeae, Chlamydia trachomatis, and specific cervicovaginal anaerobic and aerobic bacteria. The numerous sequelae associated with PID, which include infertility, ectopic pregnancy, and chronic pelvic pain syndromes, underscore the need for effective measures for preventing pelvic inflammatory disease.

Acute Disease↗