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Biomedical subjects

M S Frank

Publications and source records attributed to M S Frank.

At least 55 records · Page 3Linked to original sources
PubMed1991

Somatic complaints in childhood tic disorders.

Twenty-six children diagnosed with chronic tic disorders (18 with Gilles de la Tourette syndrome and 8 with chronic motor tic disorder) were studied for unexplained physical complaints. Compared to normal controls, an excess of somatic complaints was found in the tic disorders group; this was similar to an excess of somatic complaints in a mixed psychiatric clinic group. Medication produced no significant effect on somatic complaints for patients in the tic and psychiatric clinic groups. Within the tic disorders group, no significant correlation was found between the increased somatic complaints and the severity of anxiety, dysphoria, or movement disorder.

Adolescent↗
PubMed1990

Computer facilitation of the resident selection process.

A personal computer software system has been designed and implemented to facilitate the numerous complex tasks involved in the resident selection process. The computer tracks the status of each candidate, monitors each application for incomplete documentation, generates personalized correspondence, computes and maintains a scoring system based on evaluation by each Resident Selection Committee member, and provides various data printouts (eg, list of candidates by medical school; persons granted an interview; and ranking lists). Developed with the intent to share with the academic community, the system improves organization and accuracy, and notably decreases time spent by administrative assistants and staff members in the resident selection process.

Computer Systems↗
PubMed1990

Patient-initiated mobile mammography: analysis of the patients and the problems.

Patient initiation of mammographic screening is one method of increasing compliance with screening mammography guidelines. A low-cost screening project using a mobile van was developed at the University of Alabama at Birmingham. Analysis of the first 2,099 patients revealed that the participants were generally white (92%), more likely to have had a previous mammogram than the norm (33% in this study vs 19% in a 1986 Gallup survey), and relatively high-risk (30% having a breast cancer risk factor). The cancer detection rate was 6.2 per 1,000 women screened, with a biopsy rate of 1.3% and a positive predictive value of 48%. More than half the cancers detected were in situ lesions or invasive carcinomas smaller than 1 cm. Our results suggest that low-cost mobile mammographic screening can operate at appropriate levels of sensitivity and specificity and is well accepted by participants. Such projects require considerable preliminary planning, significant financial and time commitment by the physicians involved, and meticulous follow-up. A mammography management software system was developed to facilitate tracking of patients for routine and diagnostic follow-up studies and rapid communication of results. Although most follow-up studies and biopsies were done in the community, resistance in the medical community was significant and is perhaps the greatest impediment to such screening endeavors.

Adult↗
PubMed1989

Atenolol-associated cholestasis.

Atenolol, a beta 1-selective beta-adrenergic receptor-blocking agent, is frequently used for the treatment of hypertension and angina pectoris. We report our experience with a patient who developed cholestatic hepatitis related to the initiation of therapy with atenolol with prompt resolution of symptoms and biochemical abnormalities upon discontinuation of this medication. A review of the literature failed to demonstrate any prior report of atenolol-associated hepatic injury. Although rare, because of the common use of atenolol, clinicians should be aware of this potential adverse effect.

Aged↗
PubMed1987

Metastatic calcification of the heart and lungs in end-stage renal disease: detection and quantification by dual-energy digital chest radiography.

Metastatic calcification of the lung and heart can cause severe cardiopulmonary compromise and death. Although it is found in most end-stage renal disease patients at autopsy, it is only rarely detected during life. Using a prototype dual-energy digital chest radiographic unit, we measured calcium content (mg/cm2) over the lung and heart in 32 hemodialysis patients. Pulmonary calcium content was significantly greater in these patients than in sex-matched control subjects (men, 230 +/- 43 [mean +/- standard error] vs 166 +/- 7, p less than .05; women, 168 +/- 19 vs 110 +/- 7.5, p less than .001). Abnormal values were detected by dual-energy radiography in 44% of patients (vs 9% of patients studied by conventional radiography). Cardiac calcium content was also significantly greater in the hemodialysis patients than in the control subjects (259 +/- 14 vs 184 +/- 8, p less than .05). Metastatic calcification was significantly correlated with elevated phosphate and calcium-phosphate product levels. Patients with significantly elevated pulmonary calcium content had evidence of restrictive lung disease by functional testing. There was an inverse correlation between elevated cardiac calcium content and ejection fraction. We conclude that dual-energy digital radiography allows premortem diagnosis of metastatic visceral calcification and is more sensitive than current techniques.

Adult↗
PubMed1985

Symptomatic sarcoidosis of the stomach.

A patient is presented here who had gastric sarcoidosis which was initially diagnosed as Menetrier's disease. The English medical literature comprises 19 cases with symptomatic gastric sarcoidosis, and these are reviewed. The clinical, roentgenographic, and endoscopic findings in gastric sarcoidosis are quite variable, but of the symptomatic patients, 75% present with pain and 25% with bleeding; surgery is required in 50% of patients, while of those treated with corticosteroids, 66% improve symptomatically. Endoscopic biopsies are accurate and essential in establishing the diagnosis.

Adrenal Cortex Hormones↗
PubMed1983

Pharmacotherapy of inflammatory bowel disease. Part 2. Metronidazole.

Studies have shown metronidazole to be useful in the treatment of colonic Crohn's disease, especially for perineal complications. It appears to equal sulfasalazine in effectiveness and to offer hope to patients who fail to respond to that drug. However, exacerbation of perineal disease is to be expected on discontinuation of therapy. The only troublesome side effect is paresthesia, which apparently is dose-related and not progressive. Although no studies exist showing the drug to be mutagenic, teratogenic, or carcinogenic in humans, animal and laboratory tests raise concern of this possibility. For this reason, metronidazole therapy should be stopped in two to six months if ineffective and stopped periodically when disease is controlled to see if it can be discontinued.

Crohn Disease↗
PubMed1982

Metronidazole therapy for perineal Crohn's disease: a follow-up study.

The present study of metronidazole in perineal Crohn's disease includes 26 patients, and is composed of 17 of 21 patients who were previously reported and 9 additional consecutive patients. The course of these patients was evaluated to determine if the drug could be reduced or stopped, whether or not it continued to be effective for prolonged periods, and what long-term side effects were encountered. Dosage reduction was associated with exacerbation of disease activity in all patients, but in all, the perineal manifestations of disease healed promptly when the full dosage of metronidazole was reinstituted. The drug could be successfully discontinued in only 28% of those in whom cessation was attempted; in those patients whose perineal disease worsened with cessation of therapy, rapid healing was achieved if the drug was reintroduced. Sixteen patients received metronidazole for at least 12 mo including 7 for 18-36 mo. Eight of these 16 patients, including 4 on and 4 off the drug, remain healed; the other 8 patients had advanced healing. The only major side effect observed was paresthesias. These occurred in 50% of the patients and developed in the patients at a mean of 6.5 mo after the onset of treatment. They appeared to be dose related and nonprogressive but tended to persist for prolonged periods even after discontinuance of the drug.

Adult↗
PubMed1981

Iatric submucosal hemorrhage. A pitfall of intraoperative endoscopy.

Intraoperative fiberoptic endoscopy has been recommended to identify the site of gastrointestinal hemorrhage in patients whose preoperative endoscopic and/or roentgenologic studies have been unrevealing but who require surgical intervention to control the bleeding. We report an undescribed complication of intraoperative endoscopy in such a patient.

Aged↗
PubMed1981

Metachronous carcinoma complicating Crohn's disease.

A 63-year-old woman with Crohn's ileocolitis, complicated by ileal adenocarcinoma two years previously, was admitted for examination of weight loss and fatigue. Colonoscopy demonstrated an area of flat, ulcerated mucosa in the sigmoid colon that proved to be an adenocarcinoma in the area of Crohn's colitis; a sigmoid resection and primary anastomosis were performed. Metachronous carcinoma of the large and small bowel occurred in areas involved with Crohn's disease.

Adenocarcinoma↗
PubMed1980

Role of 99mTc-IDA cholescintigraphy in evaluating biliary tract disorders.

Technetium-99m IDA cholescintigraphy has provided a new, noninvasive means of visualizing biliary tract function. It has become the procedure of choice in patients with suspected acute cholecystitis because of its ability to most accurately detect functional obstruction or patency of the cystic duct as opposed to ultrasound's ability to detect only anatomic changes such as the presence of calculi or a thickened gallbladder wall. These latter findings are more important in establishing the diagnosis of chronic cholecystitis where ultrasound shares a position of prime importance with the oral cholecystogram. Tc-99m IDA cholescintigraphy has also been particularly useful in evaluating bile leaks, biliary-enteric anastomosis patency and the post-cholecystectomy patient with recurrent pain. In the patient with cholestasis, ultrasound is usually the procedure of choice since it establishes whether or not ductal dilatation is present and frequently can determine the cause of obstruction. Cholescintigraphy has played an ancillary role in many cases by demonstrating the level of partial obstruction, but it does not have the anatomic resolution to visualize the cause of obstruction. Occasionally, in the evaluation of cholestasis, cholescintigraphy has proven to be the only modality which has identified the presence of acute common duct obstruction or localized intrahepatic ductal obstruction. All in all, Tc-99m IDA cholescintigraphy has had a dramatic impact upon hepatobiliary diagnosis.

Abdominal Injuries↗
PubMed1980

Serendipity in technetium-99m dimethyl iminodiacetic acid cholescintigraphy: diagnosis of nonbiliary disorders in suspected acute cholecystitis.

Technetium-99m dimethyl iminodiacetic acid cholescintigraphy has contributed significantly to the diagnosis of acute and chronic biliary tract disorders. Yet attention should also be focused on the other structures visualized during the blood pool, hepatocyte, renal excretory, and intestinal phases of the study. Nonbiliary pathology was detected in 42 of 294 patients (14.3%) studied for suspected acute cholecystitis. The serendipitous detection of previously unsuspected abnormalities assisted in directing further work-up from suspected biliary disease and towards the real source of the patient's acute problem in 28 cases (9.5%).

Acute Disease↗
PubMed1980

Healing of perineal Crohn's disease with metronidazole.

The effect of metronidazole was studied in 21 consecutive patients with chronic unremitting perineal Crohn's disease. Drainage, erythema, and induration diminished dramatically in all patients, and complete healing was obtained in 10 of 18 patients maintained on therapy. Five others have shown advanced healing; in 2 patients the inflammation is improved, but healing is minimal. Side effects of metallic taste, dark urine, and mild gastrointestinal upset occurred in many patients. However, the dosage had to be decreased in only 4 patients and the drug discontinued in 1 patient, all because of peripheral neuropathy that proved to be reversible. In 2 other patients, metronidazole was discontinued because of poor compliance. If further experience corroborates this prompt and striking response in patients with extreme, disabling, and otherwise unmanageable disease, metronidazole will play an important role in the therapy of perineal Crohn's disease.

Adult↗
PubMed1979

Rapid and accurate diagnosis of acute cholecystitis with 99mTc-HIDA cholescintigraphy.

Technetium-99m dimethyl acetanilide iminodiacetic acid (HIDA) cholescintigraphy was performed on 90 patients with suspected acute cholecystitis. Visualization of the gallbladder established patency of the cystic duct and excluded the diagnosis of acute cholecystitis in 50 of 52 patients. Nonvisualization of the gallbladder with visualization of the common bile duct was diagnostic of acute cholecystitis in 38 patients, all subsequently proven at surgery. The observed accuracy of this procedure is 98% and specificity is 100%. The false negative rate is 5% and false positive rate is zero. Technetium-99m-HIDA has many advantages which make it the procedure of choice in evaluating a patient for suspected acute cholecystitis. It is a rapid, simple, safe examination which provides functional as well as anatomic information about the hepatobiliary system in individuals with a serum bilirubin level up to 8 mg/100 ml.

Acetates↗