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Biomedical subjects

D E Meier

Publications and source records attributed to D E Meier.

86 records · Page 5Linked to original sources
PubMed1984

Marked disparity between trabecular and cortical bone loss with age in healthy men. Measurement by vertebral computed tomography and radial photon absorptiometry.

To define age-related changes in bone mineral content in normal men, we measured radial (proximal and distal) and vertebral bone mineral content in 62 men aged 30 to 92 years. Radial bone mineral content (largely cortical bone) was measured by single photon absorptiometry, and trabecular vertebral content (T12, L1 to L3) by computed tomography. Radial bone mineral content fell gradually (2% to 3.4% per decade) with age, but vertebral trabecular content fell more rapidly (12% per decade). Body size was not associated with the rate of bone loss from the distal radial and vertebral sites, but men with lower surface areas lost bone more rapidly at the predominantly cortical proximal radial site. The fact that radial cortical bone mineral content falls much less rapidly than vertebral trabecular content with age and is also associated with surface area indicates that trabecular and cortical bone compartments may be independently modulated. Age-related bone loss should not be considered a homogeneous process.

Adult↗
PubMed1982

Parietal cell vagotomy in a surgical training program.

Parietal cell vagotomy was performed in 48 patients at the Parkland Memorial Hospital and the Dallas Veterans Administration Hospital between April 1977 and January 1981. The maximum follow-up time was 50 months and the average was 28 months. Seventy-five percent of the patients were followed for more than 1 year. There were no operative deaths. Four patients (8.3 percent) had persistent postoperative side effects including two documented ulcer recurrences (4.2 percent). Acid secretion studies were reviewed to characterize the longterm effect of parietal cell vagotomy. These studies demonstrated marked postoperative reductions in gastric acid secretion. The results of this study suggest that with the simplified technique described in this paper, parietal cell vagotomy can be performed with minimal mortality and morbidity by surgical residents under direct staff supervision.

Adolescent↗
PubMed1982

Management of asymptomatic patients following stab wounds to the chest.

A patient with stab wounds to the chest may have negative physical findings, and normal radiologic examinations and still develop delayed pneumothorax or hemothorax. The frequency and time intervals of these complications have not been established. One hundred ten asymptomatic patients with chest stab wounds were prospectively studied. All patients had normal chest radiographs on initial evaluation. Ten patients (9%) developed a delayed pneumothorax or hemothorax. Careful radiologic examination using inspiratory and expiratory chest films revealed all positive findings by 6 hours postadmission. Asymptomatic patients with chest stab wounds can be safely managed without hospitalization.

Adolescent↗
PubMed1981

Vertebral artery trauma: acute recognition and treatment.

Vertebral artery injury is uncommon and may be initially unrecognized. Sequelae of vertebral artery injury include arteriovenous fistulae and pseudoaneurysms that may appear months after injury. The incidence of the sequelae is unknown. Cervical angiography used in the routine evaluation of a patient with penetrating neck trauma readily demonstrates vertebral artery injuries. This series of 13 cases demonstrates the low morbidity associated with the treatment of isolated vertebral artery injuries. A technique for proximal and distal ligation of the vertebral artery is presented. Its use is recommended in the treatment of any patient with vertebral artery injury who has a normal contralateral vertebral artery and no demonstrable extracranial branches from the vertebral artery to the spinal cord.

Humans↗
PubMed1981

Missile embolus to the lung associated with a corotid-jugular arteriovenous fistula.

Missile embolization to the pulmonary artery is rare. The diagnosis is suspected if a missile is seen on radiograph in a lung field without hemopneumothorax or pulmonary contusion. Treatment of the injury and embolic sites is indicted. We report a case of missile embolization to the lung associated with a carotid-jugular arteriovenous fistula.

Adult↗
PubMed1981

Appendicitis in a barium-filled appendix.

Fourteen cases of appendicitis developing in an appendix with prolonged retention of barium have been previously described. A 15th case is herein presented. Present reports are inadequate to determine the normal period of retention of barium in an appendix after contrast study. No conclusions can be drawn as to whether the retained barium causes appendicitis by a sequence of events or whether the retained barium merely demonstrates a previously existing abnormality in the appendix or has no pathologic significance. A patient in whom barium is retained in the appendix should, as a minimum step, be informed that appendicitis may develop and that he should consult his physician if abdominal symptoms develop. Interval appendectomy for the asymptomatic patient with prolonged retention of barium cannot be justified by the present body of case reports.

Adult↗
PubMedDate not supplied

Barriers to completion of health care proxies: an examination of ethnic differences.

BACKGROUND: Advance directives have not been uniformly used by different segments of the US population and studies have consistently shown a lower prevalence of advance directives among African Americans and Hispanics compared with non-Hispanic whites. OBJECTIVE: To examine barriers to completion of health care proxies for different ethnic groups. METHODS: One hundred ninety-seven subjects aged 65 years or older self-identified as African American (n = 65), Hispanic (n = 65), or non-Hispanic white (n = 67) attending a geriatrics and internal medicine outpatient clinic of a large New York City teaching hospital were administered a questionnaire. Questionnaires were developed to examine potential barriers to completion of health care proxies. Barriers were drawn from the literature and from focus groups. RESULTS: Significant predictors of proxy completion using logistic regression analysis included knowledge of health care proxies, availability of a health care agent, exposure to mechanical ventilation, age, and self-reported health status as fair to poor. Subjects who believed that a health care agent was irrelevant in the setting of involved family were significantly less likely to have completed a health care proxy. Although there were significant differences in the baseline completion rates of health care proxies for the 3 ethnic groups, ethnicity did not predict prior appointment of a health care agent in multivariate analysis. CONCLUSIONS: Differences in health care proxy completion rates across white, African American, and Hispanic elderly individuals in this New York City population seem to be related to potentially reversible barriers such as lack of knowledge and the perceived irrelevance of advance directives in the setting of involved family. Enhanced educational efforts of both health care personnel and patients could increase the rate of formal health care proxy appointment.

Advance Care Planning↗
PubMedDate not supplied

Exposure to 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (DDT) in relation to bone mineral density and rate of bone loss in menopausal women.

The organochlorine pesticide 2,2-bis(p-chlorophenyl)-1,1,1,-trichloroethane (DDT) and its metabolite 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (DDE) are examples of an environmental contaminant that may have hormonal properties. Bone metabolism is both estrogen- and androgen-dependent. Exposures to various environmental endocrine disrupters can affect bone metabolism in animals, but there are no published data concerning the effect of DDE exposure on bone metabolism in humans. We hypothesized that high levels of DDE would be associated with lower bone density in peri- and postmenopausal women than in premenopausal women. Study subjects were drawn from the cohort of women who had participated in the Mount Sinai Medical Center Longitudinal Normative Bone Density Study (1984-1987). We used serum samples obtained at study entry to measure DDE levels in 103 (50 black, 53 white) women (mean age = 54.5 y [standard deviation = 5 y]). Measurements of bone mineral density at the lumbar spine and radius were made at 6-mo intervals during a 2-y period. DDE concentrations were significantly (p < .001) higher in blacks (13.9 ng/ml) than in whites (8.4 ng/ml), but there was no correlation between DDE concentration and bone density at the spine (mean levels = 1.065 g/cm2 and 1.043 g/cm2 in the lowest and highest quartiles, respectively, of DDE [trend p value = .85]) or at the radius (mean levels = 0.658 g/cm and 0.664 g/cm in the lowest and highest quartiles, respectively, of DDE [trend p value = .34]). Longitudinal analyses revealed no correlation between DDE and the rate of bone loss at either bone site. Similar results were seen in race-stratified analyses, as well as in analyses in which we controlled for lactation history and other potential confounders. We found little evidence that chronic low-level DDT exposure is associated with bone density in peri- and postmenopausal women.

Absorptiometry, Photon↗
PubMedDate not supplied

Palliative care programs: what, why, and how?

Establishing a palliative care service can improve patient care and ease family concerns for patients who are hopelessly ill. For the hospital, such services can improve utilization outcomes. Take a closer look at a palliative care service operating for nearly five years at Mount Sinai Hospital in New York City.

Health Services Accessibility↗