PubMed Health⌕ Search

Biomedical subjects

A G Adler

Publications and source records attributed to A G Adler.

At least 19 recordsLinked to original sources
PubMed1991

Alcoholism. Are you missing the diagnosis?

Early diagnosis of alcoholism requires exploration of the impact of alcohol on the patient's life. The disease cannot be readily detected simply by asking questions about the quantity of alcohol consumed. Few physical findings are present until late in the disease, and laboratory tests for alcoholism are neither sensitive nor specific when used alone. Use of screening questionnaires should be part of routine office practice. Elderly alcoholics are difficult to identify and need special consideration. Effective therapy is available if alcoholism is detected early.

Aged↗
PubMed1991

Seven-pathogen tricuspid endocarditis in an intravenous drug abuser. Pitfalls in laboratory diagnosis.

Polymicrobial endocarditis is being reported with increasing frequency in drug abusers. However, the full extent of infection may be unrecognized with routine blood culture techniques because of the overgrowth of more fastidious organisms by other pathogens. This report documents an intravenous drug abuser with the first reported case of tricuspid valve endocarditis involving seven pathogens, discusses pitfalls of routine blood cultures and examines the role of the laboratory in microbiologic diagnosis.

Adult↗
PubMed1991

Clinic attendance and glycemic control. Study of contrasting groups of patients with IDDM.

OBJECTIVE: To assess factors associated with attendance at a specialized clinic for diabetes care. RESEARCH DESIGN AND METHODS: Adults with insulin-dependent diabetes mellitus (IDDM) in poor (HbA1 greater than or equal to 12%) versus good (HbA1 less than or equal to 10%) control and with no known complications comprised the study group. RESULTS: Infrequent attenders were in worse glycemic control than regular attenders (chi 2 = 6.60, P less than or equal to 0.01) and held health beliefs that downplayed the importance of getting advice from physicians (P less than or equal to 0.002) or providing opinions to physicians about what might be done to improve their health (P less than or equal to 0.001). CONCLUSIONS: Because infrequent attenders are more likely to be in poor glycemic control and thus at greater risk for diabetic complications, engaging them in regularly supervised treatment has important personal and public health implications. Additional studies are needed to understand why some diabetic patients limit their contact with medical providers and to develop more effective strategies for reversing this process. Initial findings from this study suggest that patient beliefs about the doctor-patient relationship may influence clinic attendance.

Adult↗
PubMed1990

Neutropenia in adults. What is its clinical significance?

Neutropenia remains a diagnostic and therapeutic challenge to primary care physicians. The clinical significance of neutropenia must always be interpreted within the context of the individual patient's presentation. Physicians who have an appreciation of the pathophysiologic mechanisms that produce neutropenia and familiarity with the commonly encountered clinical disorders can successfully evaluate and treat these conditions.

Adult↗
PubMed1990

Crack abuse. Do you known enough about it?

Crack use has increased dramatically because the drug is cheap, highly addictive, and easy to use. As a result, an increased frequency of cocaine-related medical problems has been noted. The effects of crack abuse on fetal outcome and neurobehavioral development are becoming more apparent. In addition, the role of crack use in furthering transmission of sexually transmitted diseases has been documented, and the implications for AIDS transmission have been speculated on. Crack use enhances social disorganization, particularly in poor urban areas, where increased child abuse, neglect, and prostitution are common. Ever present are the financial incentives to increase the number of crack users. Cocaine was once considered a drug for the elite, rich, and famous. Crack clearly has changed that notion.

Cardiovascular System↗
PubMed1990

Psychological characteristics of adults with IDDM. Comparison of patients in poor and good glycemic control.

This study was conducted to evaluate selected psychosocial characteristics of contrasting groups of patients with insulin-dependent diabetes mellitus (IDDM), i.e., patients with persistently poor versus good glycemic control. Patients with chronic poor control reported feeling physically best at higher blood glucose levels than patients with good control. They also reported a higher threshold for physical symptoms caused by hyperglycemia without any difference in threshold for hypoglycemic symptoms. No differences between groups were found in level of diabetes knowledge, self-esteem, or psychiatric symptomatology. This study suggests that poorly controlled adult patients have underlying perceptions of hyperglycemic symptoms and physical well-being that distinguish them from patients with well-controlled diabetes. The design of this study does not allow for determination of the causal direction in this relationship. Although these patient reports about glycemic and physical symptoms may be post hoc justifications or unreliable beliefs, they also may be accurate perceptions of physical symptom experiences and therefore could influence their self-care activities with resulting chronic problems in glycemic control. Further research is needed to assess the validity of these observations and their possible role in long-term regulation of glycemia.

Adult↗
PubMed1990

Eye surgery in the elderly.

The overall risk of eye surgery is quite low, and surgery can generally be performed in all but the sickest patients. Ambulatory eye surgery is now the rule rather than the exception and is generally well tolerated under local anesthesia. It is important for the consultant to remember those conditions that will increase morbidity and appropriately inform the ophthalmologist and anesthesiologist.

Age Factors↗
PubMed1989

Pulmonary aspiration. The three syndromes.

Pulmonary aspiration of oropharyngeal secretions, inert fluids and/or particulate material, or gastric contents produces three distinct clinical syndromes. Optimum management, although largely supportive, requires that the clinician understand the clinical presentation and course of each syndrome. Prevention is the primary goal. Early recognition of high-risk patients coupled with prompt institution of simple preventive measures can reduce the incidence and severity of these syndromes.

Humans↗
PubMed1987

Perioperative management of the ophthalmology patient.

The overall risk of eye surgery is quite low, and it can generally be performed in all but the sickest patients. Ambulatory eye surgery is becoming more and more frequent, with improvement in surgical techniques and changes in reimbursement schedules. For most patients it seems quite safe. However, there are a number of specifics, reviewed previously, regarding the eye patient with which the consulting physician should be familiar.

Eye Diseases↗
PubMed1986

Management of perioperative hypertension using sublingual nifedipine. Experience in elderly patients undergoing eye surgery.

Sublingual nifedipine was administered perioperatively to 19 elderly (age, greater than or equal to 60 years) patients undergoing ophthalmologic surgery. All of the patients had blood pressures exceeding 200 mm Hg systolic or 110 mm Hg diastolic, and 18 of the patients had both. Average (mean +/- SD) systolic blood pressure fell from 224.9 +/- 13.9 mm Hg to 154.6 +/- 19.0 mm Hg, while average diastolic blood pressure was reduced from 121.5 +/- 12.2 mm Hg to 78.1 +/- 10.6 mm Hg. Mean time to onset of response to nifedipine was 9.47 +/- 3.9 minutes, while the maximum antihypertensive response occurred in 35.3 +/- 10.2 minutes. A prompt antihypertensive response was obtained without any serious side effects. To our knowledge, this is the first reported study demonstrating the efficacy and safety of using sublingual nifedipine for the management of perioperative hypertension.

Aged↗
PubMed1986

Cardiac dysrhythmias associated with ophthalmic atropine.

Atropine sulfate, a mydriatic and cycloplegic agent, is frequently used in patients undergoing glaucoma surgery. Trabeculectomy with peripheral iridectomy is the most common glaucoma surgery performed to decrease intraocular pressure and preserve vision. Systemic absorption of ophthalmic atropine does occur and may result in toxic and adverse side effects. Cardiac dysrhythmias are one of the major adverse reactions. This case study reviews three patients who had a trabeculectomy for glaucoma and received ophthalmic atropine. One patient received both systemic and ocular atropine. Two patients developed atrial fibrillation and one a supraventricular tachycardia. Two patients required admission to a cardiac intensive care unit for management of the dysrhythmia and a third reverted to normal sinus rhythm spontaneously. The cardiac effects of ophthalmic atropine should be considered in the preoperative and postoperative assessment of patients with dysrhythmias.

Absorption↗
PubMed1984

Immobilization hypercalcemia in acute spinal cord injury treated with etidronate.

Hypercalcemia developed in a 30-year-old C5 quadriplegic six months after he received a gunshot wound in the cervical spine. Short-term treatment consisted of fluids and diuretics, but conventional drug therapy for long-term maintenance of normocalcemia was not effective. A regimen of etidronate disodium was then instituted, which resulted in normocalcemia. When use of this drug was discontinued at intervals during the therapy, the hypercalcemia recurred. The patient's condition was maintained on the etidronate regimen until full mobilization occurred, at which time the drug therapy was discontinued and normocalcemia persisted. This case represents, to our knowledge, the first reported success with the use of etidronate in the treatment of hypercalcemia in the immobilized patient with acute spinal injury.

Acute Disease↗