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S Schechter

Publications and source records attributed to S Schechter.

At least 19 recordsLinked to original sources
PubMed2000

Measuring our nation's diversity: developing a common language for data on race/ethnicity.

During the 4-year period 1993 through 1997, the Office of Management and Budget (OMB) undertook a comprehensive review of the statistical standards that are used throughout the federal government to gather and publish data on race and ethnicity. The primary objective of this review was to ensure that our standards provide a common language that reflects the increasing diversity of the US population and maintains our ability to monitor compliance with civil rights laws. The review culminated with the October 1997 issuance of OMB's "Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity." In this article, we describe key aspects of the process that was undertaken to review and revise the 1977 standards. We also attempt to dispel some myths and misunderstandings that have been associated with these standards.

Censuses↗
PubMed1999

Management of uncomplicated acute diverticulitis: results of a survey.

PURPOSE: A survey was conducted to document current medical treatment of patients with uncomplicated acute diverticulitis. METHODS: A survey was mailed to 667 fellows of The American Society of Colon and Rectal Surgeons certified by the American Board of Colon and Rectal Surgery. Queries were based on a clinical scenario of a patient with uncomplicated diverticulitis. RESULTS: Three hundred seventy-three surveys (56 percent) were returned completed. The majority (66 percent) chose an abdominal computed tomographic scan as the initial diagnostic test. One-half used a single intravenous antibiotic with second-generation cephalosporins (27 percent) and ampicillin/sulbactam (16 percent) being the most common. Oral antibiotics given at discharge were ciprofloxacin (18 percent), amoxicillin/clavulanate (14 percent), metronidazole (7 percent), and doxycycline (6 percent). Combinations chosen were ciprofloxacin/metronidazole (28 percent) and metronidazole/trimethoprim sulfamethoxazole (6 percent), whereas 21 percent chose a variety of other antibiotics. The majority (74 percent) prescribed oral antibiotics for 7 to 10 days. Dietary recommendations at discharge were low residue (68 percent), regular (21 percent), and high residue (10 percent). Half of those surveyed believed avoidance of seeds and nuts were of no value. Follow-up examinations chosen included sigmoidoscopy and barium enema (29 percent), colonoscopy (25 percent), sigmoidoscopy (17 percent), barium enema (13 percent), and other (16 percent). Sixty-five percent of colon and rectal surgeons claim to handle more than half of their patients with uncomplicated diverticulitis on an outpatient basis. CONCLUSION: Variations in the management of uncomplicated sigmoid diverticulitis are noted among colon and rectal surgeons, especially in terms of antibiotic choice, discharge instructions, and follow-up outpatient studies. The survey results are compared with the conclusions reached in The American Society of Colon and Rectal Surgeons practice parameters. Documentation of practice pattern variation may serve as an educational tool for physicians to improve their quality and cost of medical care. Consideration should be given to better publicize already existing American Society of Colon and Rectal Surgeons practice parameters for this common entity.

Acute Disease↗
PubMed1997

The proper use of self-report questions in effective measurement of health outcomes.

Outcomes research often relies on the use of general population survey data. The recent efforts to employ cognitive science theory in the development of data collection instruments has led to the establishment of new questionnaire design research methods. Intensive cognitive techniques are used in laboratory interviews to develop and pretest self-report survey questions with the goal of reducing non-sampling response error. This article presents the theoretical and applied approach used in the cognitive laboratory to study the ways people respond to surveys, and offers guidelines for improving self-report survey questions.

Cognition↗
PubMed1996

Synchronous colon carcinomas: molecular-genetic evidence for multicentricity.

BACKGROUND: The synchronous presentation of multiple colonic adenocarcinomas is an unusual, but well-recognized event accounting for approximately 2-11% of these neoplasms. Synchronous tumors may have a different biology and prognosis than solitary tumors. Evidence based on measurement of DNA ploidy suggests that a significant percentage of synchronous tumors have a common clonal origin, probably resulting from translumenal metastasis. METHODS: Fifteen synchronous colorectal cancers (30 tumors) were examined for histologic differences as well as genetic mutations. p53 gene abnormalities were detected by polymerase chain reaction (PCR) followed by single-strand conformation polymorphism analysis. Ki-ras mutations were detected by PCR followed by oligonucleotide-specific hybridization. RESULTS: p53 gene mutations were detected in 12 of 30 tumors. In only one case was the same p53 mutation present in both tumors from one patient. Similarly, Ki-ras mutations were observed in 9 of 30 tumors. Concordant Ki-ras mutations were observed in only one case, which was also concordant for p53 mutation. CONCLUSION: Because p53 and Ki-ras mutations tend to occur fairly early in tumor development, it seems likely that cases discordant for p53 and Ki-ras mutations represent independently developing tumor foci. Taken together, these findings strongly suggest that the great majority of synchronous colonic adenocarcinomas arise as independent neoplasms and their worsened prognosis is not a result of unusually early metastatic spread.

Adenocarcinoma↗
PubMed1994

Computerized tomographic scan-guided drainage of intra-abdominal abscesses. Preoperative and postoperative modalities in colon and rectal surgery.

PURPOSE: Computerized tomographic (CT) scan-guided percutaneous drainage of intra-abdominal abscesses has changed the colon and rectal surgeon's approach to preoperative and postoperative intra-abdominal infections. This study is an effort to prove the efficacy of CT scan-guided percutaneous drainage. METHODS: A retrospective study was performed on 133 patients who underwent CT scan drainage of intra-abdominal abscesses over a 6.3-year period. RESULTS: 67 patients had underlying lower gastrointestinal disease. Twenty-three of these patients (34 percent) had spontaneous abscesses and underwent drainage as a preoperative or final modality, whereas 44 patients (66 percent) were drained postoperatively. In 78 percent of patients, surgery was successfully avoided or delayed. Ten patients had acute diverticulitis associated with a large pelvic abscess. Eight patients underwent successful CT scan-guided percutaneous drainage, yielding an 80 percent success rate. Morbidity from the CT scan-guided percutaneous drainage procedure in spontaneous and postoperative groups was 0 percent and 9 percent, respectively. Mortality was 9 percent and 11 percent, respectively, and associated with an elevated Acute Physiology and Chronic Health Evaluation II (APACHE II) score. CONCLUSION: CT scan-guided percutaneous drainage of intra-abdominal abscesses is an important adjunct to colon and rectal surgery because roughly 80 percent of spontaneous and postoperative abscesses were successfully managed.

Abdominal Abscess↗
PubMed1994

Simple method for polyp retrieval during colonoscopy.

Retrieval of small polyps can often be frustrating for the skilled endoscopist. We introduce a technique of polyp retrieval that is simple and effective in yielding intact specimens for accurate pathologic examination.

Biopsy↗
PubMed1992

Recurrent breast cancer: stereotaxic localization for fine-needle aspiration biopsy. Work in progress.

The efficacy of stereotaxic localization for fine-needle aspiration biopsy in the detection of recurrent cancer manifested as calcifications on mammograms was evaluated in 43 patients that had been treated with local resection and radiation therapy. Six patients had malignant aspirates and one had an atypical aspirate; examination of the surgical specimens revealed all seven of these to be malignant. Thirteen patients underwent surgical biopsies, the results of which were malignant in seven and benign in six. The remaining 30 patients were followed up with mammography. The follow-up mammograms were obtained at 6-month intervals and demonstrated no change in appearance. On the basis of this initial experience, stereotaxic localization for aspiration biopsy offers the potential to accurately distinguish benign from malignant lesions.

Adenocarcinoma↗
PubMed1992

AIDS patients.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Invasive papillary carcinoma of the breast: mammographic appearance.

The mammographic findings in 18 patients with invasive papillary carcinoma were studied retrospectively. The mammograms of 10 patients showed a multinodular pattern, and seven patients had solitary nodules. One patient had an irregular, ill-defined mass in the retroareolar region. Two patients were found to have carcinoma in the contralateral breast, and two patients had intraductal carcinoma adjacent to the invasive papillary carcinoma. The varied mammographic features that may occur with this rare breast malignancy are discussed.

Aged↗
PubMed1987

Neonatal duodenum: fluid-aided US examination.

In 261 infants with vomiting, 11 duodenal abnormalities were diagnosed with fluid-aided ultrasound (US). These abnormalities included duodenal obstruction, malrotation with and without associated volvulus, incomplete rotation, and duodenal stenosis. US was the initial modality used in the evaluation of vomiting in these neonates and young infants. The overall sensitivity and specificity of fluid-aided US evaluation of duodenal abnormalities were 100% and 99%, respectively. (Workup bias limits the reliability of these figures.) Fluid-aided US examination of the stomach and duodenum provided a dynamic view of duodenal rotation and anatomy, and at the very least provided a method of triaging those infants who may require surgery, upper gastrointestinal series, or follow-up US to make a definitive diagnosis.

Duodenal Obstruction↗
PubMed1987

Ultrasonic "double track" sign in hypertrophic pyloric stenosis.

Ultrasound has been used in the diagnosis of hypertrophic pyloric stenosis since the first reports of its use with contact B mode scanners. Real-time imaging has allowed measurements of pyloric diameter, length, and muscle wall thickness. Wall thickness measurements taken with the pylorus in longitudinal (elongated) view improve diagnostic accuracy. Fluid aided real-time examination of 10 cases showed the ultrasound equivalent of the "double track" sign. This finding is the result of pyloric fluid compressed into smaller tracks as it is impinged upon circumferentially by the thickened circular muscle. This sign, previously seen in barium studies, although nonspecific, may prove to be a sensitive diagnostic criterion.

Female↗
PubMed1986

Renal candidiasis of the infant: ultrasound evaluation.

Sonographic diagnosis of 3 cases of renal candidiasis led to early diagnosis and treatment. Echogenic densities within a dilated pyelocalyceal system appeared to be the classic finding for obstructing candidal bezoars or candidal pyonephrosis in the premature neonate. Sonography was useful in guiding diagnostic and therapeutic percutaneous nephrostomies of very premature (900 and 750 g) infants. The ultrasonic findings of moderate echogenicity within dilated collecting systems in premature infants suggest pyonephrosis. Candidiasis should be considered as a prime cause.

Candidiasis↗
PubMed1985

Imaging of psoas muscle abscess in adolescents with Crohn's disease.

Two adolescents with psoas muscle abscesses secondary to Crohn's disease are presented. Musculoskeletal signs of hip flexion and scoliosis led to early clinical suspicion. Computed tomography and ultrasonography demonstrated the extent of involvement and allowed specific preoperative diagnosis.

Abscess↗