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Biomedical subjects

A Sager

Publications and source records attributed to A Sager.

At least 19 recordsLinked to original sources
PubMed2001

Manual stereotactic aspiration of spontaneous deep-seated intracerebral haematomas in non-comatose patients.

Manual stereotactic aspiration was used in 46 consecutive non-comatose patients with haematomas within the basal ganglia and the results were compared with those obtained in a similar group of 39 patients who were treated purely medically in another hospital. The operation was performed in the subacute stage, and in most cases three target-points were chosen on the scan with the largest expansion of the haematoma. The haematoma was manually aspirated with a syringe device in different depths in regard to the target-points, and mean proportion aspirated was 90.2%. The level of consciousness improved markedly and GCS scores after stereotactic surgery were significantly higher than those after medical treatment (p < 0.0001). Peri-ictal mortality was significantly reduced in the surgical group and with improved levels of consciousness, the patients were suitable for further rehabilitative treatment earlier. This resulted in a significantly reduced in-patient stay. Manual stereotactic aspiration of deep-seated intracerebral haematomas in the subacute stage proved to be a simple and safe method with high efficacy.

Adult↗
PubMed2000

Prevalence and pathogenicity of retroviruses in wildcats in France.

Feline leukaemia virus (FeLV) and feline immunodeficiency virus (FIV) are frequently encountered in domestic cats (Felis catus) and in wild felids, but only FeLV has been previously identified in wildcats (Fellis silvestris). Thirty-eight wildcats, either captured alive or found dead, were sampled in eastern and central France. Nine of them (23.7 per cent) carried the FeLV p27 antigen, and three (7.9 per cent) had antibodies to FIV. There was a significant relationship between two measures of body condition and FeLV status; the FeLV-positive cats being in poorer condition than the FeLV-negative cats. The results suggest that FeLV is common in wildcats and may increase mortality in this species. The FIV-positive results constitute the first indication of a FIV-related virus in wildcats.

Animals↗
PubMed1998

An international dermatological image atlas on the WWW: practical use for undergraduate and continuing medical education, patient education and epidemiological research.

We describe the development of an image database DOIA (Dermatological OnlIne Atlas) and present several spin-off projects using images of the atlas, e.g. student education using the atlas including results of an questionnaire evaluating computer-literacy, prerequisites and interests of students for using computers and the World-Wide-Web (WWW), a patient information system and an experiment to collect epidemiological data from patients with dermatological diseases via WWW. The database, available on the WWW at http:@www.derma.med.uni-erlangen.de, contains about 3,000 clinical images covering more than 540 dermatological diagnoses. It is designed for worldwide use; international submissions are encouraged. One aim of the project is to compile an international reference for dermatological images, containing images of high educational quality and also covering conditions on different skin types and rare diagnoses which are not commonly illustrated in ordinary textbooks. All images were originally mapped to the Erlanger Diagnosis Code, which is a proprietary modified ICD-9 key, later also to the UMLS (Unified Medical Language System). In addition, images are described with keys for the location, physical attributes of the location and clinical and histopathological features of the lesion. In order to facilitate the integration of the atlas into other web-based medical resources and to allow easy access to additional information, the Erlanger Diagnosis Code was mapped to the CUIs (unique concept identifiers) of the UMLS Metathesaurus. One purpose of the UMLS is to allow conversion of terms from one controlled medical vocabulary to another, thus, mapping of our diagnosis code to the UMLS CUIs allows simultaneous search for a given diagnosis in a number of other databases and also access to our image database from other databases. Mapping was successful for 619 out of 1383 dermatological diagnosis terms. For images with these diagnoses we are able to provide a hyperlink to other databases available on the Internet, such as MEDLINE, PDQ and OMIM, with automatic retrieval using the preferred vocabulary of the respective database. By grouping all diagnoses into sets with similar morphologies we further integrated a differential diagnosis mode. In order to educate patients via the Internet, a separate patient information system has been developed, using images of the electronic atlas. As an experiment to explore the feasibility of the Internet to gather epidemiological data from patients, users are asked to complete an electronic questionnaire covering signs for atopy. We conclude that an online image atlas has multiple educational, clinical and research applications.

Computer-Assisted Instruction↗
PubMed1992

Low dose calcium administration increases mortality during septic peritonitis in rats.

Calcium is essential for normal cellular function. However, increases in cell calcium are also involved in cellular dysfunction and death by activating destructive enzymatic processes such as proteases, nucleases, and lipases. Since ionized hypocalcemia is common during sepsis, calcium is often administered in an attempt to normalize circulating levels. Previous studies using endotoxin and large amounts of calcium demonstrated increased mortality in calcium-treated animals. This study extends these preliminary data to endogenous sepsis (cecal ligation) and low dose calcium therapy. Sprague Dawley rats (n = 9 per group) had jugular catheters placed and their cecums ligated. They were randomized to an infusion of D5W at 1 ml/hr, calcium chloride at 4 mg/ml/hr (Low Ca), or calcium chloride at 6 mg/ml/hr (High Ca) for 24 hr. An additional group of animals received calcium chloride at 6 mg/ml/hr but had no surgery. Animals were followed for 24 hr survival. A separate group of animals (n = 6 per group) was prepared in a similar manner. Blood was obtained 6 hr following cecal ligation for circulating endotoxin concentrations, and animals were sacrificed. Calcium infusion increased ionized calcium levels slightly (low Ca, 1.12 +/- .06 to 1.21 +/- .09; high Ca, 1.06 +/- .04 to 1.16 +/- .05; P less than 0.05). Survival (24 hr) was 100% in the nonseptic controls and D5W septic animals, 67% in the low Ca septic group, and 44% (P less than 0.05) in the high Ca septic group.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Prior approval in the pediatric emergency room.

Managed-care plans for low-income Americans are widely promoted to improve the quality and control the cost of medical care by reducing unnecessary specialty and emergency room (ER) care through the use of primary care physicians as case managers/gatekeepers. The purpose of this study was to evaluate one element of managed care, gatekeeping prior approval, for children who use the pediatric ER of one urban public hospital. Over a 6-month period, 518 children and adolescents insured under managed-care plans that required authorization from the primary care physician to receive treatment presented to the ER. Of the 385 records reviewed for this study, the majority (87%) received their primary care at community health centers or the hospital's own outpatient clinics. Most ER visits (72%) were made when primary care sites were closed. According to nursing triage assessment, 57% presented with urgent or emergent conditions, and 26% had a history of chronic illness. Nine percent required hospitalization. Although an elaborate system for gatekeeping was established, only 13 (3%) patients' requests for ER care were denied. Of these, 3 were seen in the ER without authorization, 6 received the recommended follow-up, and 4 were not seen in follow-up. Twenty-nine participating primary care physicians (74%) and 19 ER staff (63%) responded to a survey of their experience with and attitudes toward prior approval. For a variety of reasons, the majority of primary care physicians and ER staff found the gatekeeping policies for after-hours visits burdensome and inappropriate.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed1983

Why urban voluntary hospitals close.

In this paper, we argue for the importance of understanding hospital closings and relocations. Broad descriptive data on closings, relocations, and other reconfigurations of beds in 52 large and mid-size U.S. cities are presented. The period covered is 1937 to 1980. Two contrasting outlooks on hospital closings and relocations are offered. As hypothesized, smaller and less specialized nonteaching hospitals and those located in minority neighborhoods or serving above-average proportions of minority or Medicaid-funded patients were more likely to close. A potentially more effective but more costly and less accessible system of urban health care appears to result.

Economics, Hospital↗