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T Kircher

Publications and source records attributed to T Kircher.

28 records · Page 2Linked to original sources
PubMed1987

Cause of death. Proper completion of the death certificate.

Mortality statistics derived from death certificates are the only continuously collected, population-based, disease-related information available in most parts of the world, including the United States. For this reason, every effort must be made to ensure that the most specific, accurate, and complete information regarding cause of death is registered on death certificates. This article discusses identification of the underlying and immediate causes of death, the mechanism and manner of death, and completion of the medical certification section of the death certificate. Examples are given to illustrate the appropriate sequencing of casual information and the selection of the proper underlying causes of death.

Cause of Death↗
PubMed1985

The autopsy as a measure of accuracy of the death certificate.

To determine the extent of agreement on underlying cause of death between death certificates and autopsy reports, we analyzed 272 randomly selected autopsy reports and corresponding death certificates from among all such data on autopsies performed in Connecticut in 1980. In 29 per cent of the deaths, a major disagreement on the underlying cause of death led to reclassification of the death in a different International Classification of Diseases major disease category. In an additional 26 per cent, the death certificate and autopsy report agreed on the major disease category but attributed the death to a different specific disease. Deaths due to neoplasms were most accurately diagnosed, with a sensitivity of 87 per cent and a positive predictive value of 85 per cent. Deaths resulting from diseases of the respiratory or digestive system were associated with the highest rates of disagreement. Diseases most commonly overdiagnosed were circulatory disorders, ill-defined conditions, and respiratory diseases. Diseases most commonly underdiagnosed as the cause of death on the death certificate were specific traumatic conditions and gastrointestinal disorders. The autopsy remains an important method for ensuring the quality of mortality statistics.

Autopsy↗
PubMed1985

Alimentary tract ganglioneuromatosis-lipomatosis, adrenal myelolipomas, pancreatic telangiectasias, and multinodular thyroid goiter. A possible neuroendocrine syndrome.

Diffuse, alimentary tract ganglioneuromatosis-lipomatosis, bilateral adrenal myelolipomas, pancreatic telangiectasias, and a multinodular thyroid goiter were found at autopsy in a 56-year-old, white male with a history of insulin-dependent diabetes, hypertension, peptic ulcer, and remote cerebral infarction. The degree of atherosclerosis, arterionephrosclerosis, and cardiac disease found at autopsy did not correlate with the patient's history or his sudden death. The typical features of the multiple endocrine neoplasia syndrome, type II-B, were not identified. The findings in this patient may represent a variant of the multiple endocrine neoplasia complex, or a separate, previously unrecognized syndrome.

Adrenal Gland Neoplasms↗
PubMed1985

The National Autopsy Data Bank.

The National Autopsy DAta Bank was conceived by the CAP in 1975 as a central repository of pathologic, biomedical, demographic, and epidemiologic information useful for a range of scientific and research endeavors. Successful phase I and phase II pilot studies have demonstrated that central autopsy data collection is feasible and desirable. In addition, the inconsistent quality and lack of uniformity in performing and reporting autopsies has led to the establishment of new objectives. Here, the authors trace the development of the NADB, reveal what has been learned from the studies, and highlight the directions in which the project is heading.

Autopsy↗
PubMed1985

Descriptive epidemiology of the autopsy in Connecticut, 1979-1980.

Knowledge of the differences between deaths for which autopsies are performed and all deaths is pertinent to epidemiologic investigation in such areas as disease trends, chronic disease incidence, and occupationally related disease. A population-based study was undertaken to evaluate these differences for deaths in Connecticut in 1979 and 1980. Analyses for 1979 and 1980 were comparable. Of 28,440 deaths in 1980, 14% underwent autopsy. Differences by sex, race, marital status, age, underlying cause of death, and place of occurrence of death were demonstrated when decedents who underwent an autopsy were compared with all decedents. Non-white men who died at 20 to 29 years of age were the most likely group to undergo an autopsy. Proportions of autopsies, by major category of underlying cause, did not parallel the leading causes of death. Deaths due to trauma accounted for a larger proportion of all autopsies (25%) than of all deaths (6%). If a death certificate indicated a circulatory disorder or neoplasm as the cause of death, an autopsy was less likely to be performed. A disproportionately high number of autopsies were performed for deaths occurring in hospitals; the converse was true for deaths occurring in nursing-convalescent homes. We conclude that knowledge of the ways in which autopsies are biased will permit broader use of the sensitive and specific information that can be obtained from them.

Adolescent↗
PubMed1982

Isolated right ventricular infarction with massive dilation: acquired Uhl's disease?

A patient had extensive isolated right ventricular infarction, which as the result of proximal occlusion of a small right coronary artery in a dominant left circumflex coronary arterial system, with minimal left-sided disease. A healed right ventricular infarction and Uhl's disease may have similar clinical and morphologic features. The sequence of events in our patient raises the question of whether coronary artery occlusion and myocardial infarction may be associated with a parchmentlike right ventricle. Damage to the right ventricular myocardium with subsequent superimposed chamber pressures and resulting dilation may lead to morphologic features similar to the parchment heart of Uhl's anomaly.

Aged↗
PubMed1980

Silicone lymphadenopathy: a complication of silicone elastomer finger joint prostheses.

Two cases of lymphadenopathy resulting from a lymph node foreign body reaction to silicone are presented. In each case lymph node biopsy was performed because of the clinical suspicion of neoplastic disease. Histologic study in both cases revealed no evidence of malignant disease, but rather demonstrated multinucleated giant cells in reaction to irregular fragments of refractile foreign material. The foreign substance was consistent in appearance with silicone. In each case a history of long standing rheumatoid arthritis and previous joint replacement with implantation of silicone elastomer prostheses was elicited.

Female↗
PubMedDate not supplied

Leiomyosarcoma of the rectum: the military experience.

Leiomyosarcoma of the rectum is a rare neoplasm and may behave in a highly malignant manner. Our experience with a single case prompted a review of the Armed Forces Central Medical Registry (AFCMR), where six other cases were found from the total AFCMR population. Four patients were treated with abdominoperineal (AP) resection; three had local excision only. Three patients developed metastatic disease and two of those died. The authors recommend prompt wide excision (AP resection) for any case of leiomyosarcoma of the rectum.

Adult↗
PubMedDate not supplied

[Use of supportive autogenic training in multiple morbidity in geriatric psychiatry patients].

23 multimorbid, geronto-psychiatric patients, aged 60 years or older, participated in a "supportive" course of autogenic training according to Schultz. Participating in the course an average of 7 +/- 3 weeks, 17 (76%) of the subjects were able to learn the training. In general, subjects reported a better general condition after the training sessions, measured with visual analogue scales (p < 0.001). The psychopathological status improved significantly during the time of the course (BPRS: p < 0.001; GDS: p < 0.001). No significant change was found in the cognitive state (MMSE) and the statements on the "list of complaints" ("Beschwerdenliste"). The global training success was better in the psychopathological less affected than in the more severely ill (BPRS prior r = 0.64, p = 0.001, GDS prior r = 0.46, p < 0.05). No correlation was found between training success and age, number of somatic diseases, number of medication, MMSE and the "Beschwerdenliste". Autogenic training is a useful component in psychotherapeutic and psychiatric therapy for elderly multimorbid in- and outpatients. A half-open group, two therapy sessions per week, reciting the training formulae aloud, a structured, simple setting and co-therapists proved to be worthwhile.

Aged↗