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Biomedical subjects

D B Haseman

Publications and source records attributed to D B Haseman.

8 recordsLinked to original sources
PubMed1994

The effect of informed consent on the level of anxiety in patients given i.v. contrast material.

OBJECTIVE: A common reason given for not obtaining informed consent before the use of IV contrast material is that the anxiety created by informing patients of potential reactions will increase the possibility of their occurring. However, the idea that this is possible is debatable, and no study of this subject has used a standardized anxiety index. Accordingly, using the State-Trait Anxiety Inventory, we assessed the anxiety level among patients about to have an IV contrast procedure and measured the effect of informing them of the risks associated with the use of contrast material. SUBJECTS AND METHODS: Approximately 2050 adult outpatients at three separate medical centers were solicited for participation in this study. Each of the 1251 patients who volunteered to participate was placed into one of six groups. The majority were patients who were awaiting the injection of either ionic or nonionic contrast material and who were or were not informed of the risks associated with the use of IV contrast material. The last two groups were generally healthy outpatients reporting for routine X-rays who were not awaiting IV contrast administration but who were informed of the risks associated with the use of ionic and nonionic contrast material. Each patient informed of the risks was asked to read a standardized consent form, and all patients completed a standardized anxiety index. RESULTS: Patients who were informed of the risks associated with IV contrast material did not have measurably increased anxiety, and they did not have an increased prevalence of adverse reactions. Indeed, the only patients who had statistically significant increased anxiety compared with the other groups were among those awaiting the injection of ionic contrast material who were not informed of the risks (p = .04). The majority (51-78%) of patients in all six groups had measurable elevated anxiety scores. CONCLUSION: We conclude that it is not justified to fail to obtain informed consent in order to avoid anxiety-induced adverse reactions to IV contrast material. The majority of patients awaiting injection of IV contrast material have measurable increased anxiety levels regardless of whether they are informed of its risks.

Anxiety↗
PubMed1990

Osteosarcomatosis.

A review of the 690 cases of osteosarcoma in the radiographic file of the Armed Forces Institute of Pathology revealed 29 cases of "osteosarcomatosis" (multiple skeletal sites of osteosarcoma). Fifteen of these patients were 18 years old and under and manifested rapidly appearing, usually symmetric, sclerotic metaphyseal lesions. The remaining 14 patients were more than 18 years old and had fewer, asymmetric sclerotic lesions. In most patients (28 of 29), a radiographically dominant skeletal tumor was seen. Pulmonary metastases occurred in the majority of patients and were detected at the same time as the bone lesions. These 29 patients were studied with regard to demographic data and skeletal distribution and radiographic appearance of their lesions. As a result of the findings, a metastatic origin from a primary dominant osteosarcoma is favored over a multifocal origin as the basis for osteosarcomatosis. Osteosarcomatosis is more commonly encountered in the mature skeleton than has been previously recognized.

Adolescent↗
PubMed1989

A digital image microscopy system for rare-event detection using fluorescent probes.

Instrumentation for rare-event analysis should be capable of reliably detecting infrequent cells (less than 1:10,000) while both excluding false-positive signals and including true positive cells found in multicell clumps. We have developed a digital image microscopy (DIM) system in which a cytospin of 2 million cells is scanned with an intensified video camera (ISIT) using an IBM PC AT microcomputer-controlled microscope stage. PASCAL software controls the stage and analyzes video input, storing the location of positive cells to magnetic disk. The user can then "replay" each positive cell under computer control for either visual confirmation or analysis using other fluorescent probes. The computer requires 24 min to scan a cytoprep of 2 million cells, while playback for visual confirmation by the user averages 5 min. Using Hoechst-33342 premarked cells seeded into bone marrow as a model system, we found that the DIM system reliably detects one target cell per million marrow cells. With appropriate immunological markers, this system will aid in evaluating bone marrow purged of tumor cells prior to transplantation and should also be useful for detection of minimal residual disease in blood or bone marrow from patients with leukemia or solid tumors.

Bone Marrow↗
PubMed1987

Multiple skeletal fibroxanthomas: radiologic-pathologic correlation of 72 cases.

Out of a series of 900 biopsy-proven cases of skeletal "fibroxanthoma" (nonossifying fibroma, fibrous cortical defect), we studied 72 patients with more than one lesion. Age, sex, coexistent conditions such as neurofibromatosis, and histologic and radiographic appearance of the lesions were evaluated. Multiple skeletal fibroxanthomas are probably more common than previously suspected. (At least 8% of the 900 patients in our archives had multiple lesions). Only a small percentage (5%) of patients with multiple skeletal fibroxanthomas had coexistent neurofibromatosis. These lesions are histologically indistinguishable from their solitary counterparts and most commonly present in the lower extremities. Four radiographic patterns were noted: clustered lesions--usually about the knee. nonclustered lesions--in opposite ends of long bones. coalescent lesions--several lesions coalescing over time. This observation has not been previously reported. emergent lesions--lesions appearing in previously unaffected bone. Familiarity with these features may obviate biopsy.

Adolescent↗