Biomedical subjects

D E Wagner

Publications and source records attributed to D E Wagner.

17 recordsLinked to original sources

PubMed1995

Efficacy of once daily extended-release theophylline in decreasing the use of inhaled beta 2-agonists in stable, mild-to-moderate asthma patients.

BACKGROUND/OBJECTIVE: The purpose of this study was to determine whether the addition of extended-release theophylline to the daily treatment regimen of inhaled beta 2-agonist users would result in decreased use of beta 2-agonist while maintaining similar efficacy for treatment of asthma. METHODS: This was a single-blind, multicenter (six sites) study. Sixty-one patients with a history of mild-to-moderate asthma treated with inhaled beta 2-agonist were randomized to treatment with Theo-24 (anhydrous extended-release capsules) plus inhaled beta 2-agonist or placebo plus beta 2-agonist. Patients kept daily symptom diaries, measured peak flow rates, recorded puffs of inhaled beta 2-agonist, and adverse events during a 4-week treatment period. RESULTS: Fifty-five patients were included in the efficacy analysis. The primary efficacy variable in this study was the mean number of puffs (adjusted for baseline differences) of beta 2-agonist inhaled per day. In this study, the addition of theophylline to the daily regimen of inhaled beta 2-agonist for 4 weeks significantly reduced the total daily dose of inhaled beta 2-agonist at weeks 3 and 4 of treatment compared with placebo. The differences were significant at the P < .05 level. For patients in the theophylline group, the number of puffs decreased from an unadjusted mean of 9.81 at baseline to an adjusted mean of 6.78 after 4 weeks of treatment compared with 9.91 at baseline and 8.17 for the placebo group. There were no unexpected or serious adverse events. CONCLUSIONS: In this study, the addition of once daily, extended-release theophylline to the daily regimen of inhaled beta 2-agonist for 4 weeks significantly reduced the total daily dose of inhaled beta 2-agonist at weeks 3 and 4 of treatment compared with placebo, while maintaining acceptable asthma symptom scores.

Administration, Inhalation↗

PubMed1992

Health Care Plan's Nurse Advice System.

Staff model HMO's expend great effort in handling member phone calls. Health Care Plan, Inc. has developed a computer program to aid phone room nurses in their documentation and decision making processes. The Nurse Advice system has been successfully implemented in six of eight medical centers. By providing real-time access to patient clinical data, the quality of care and service is improved.

Decision Making, Computer-Assisted↗

PubMed1990

The pros and cons of a mass-media colorectal screening program.

Saint John's Hospital Cancer Center attempted an extensive colorectal screening project encompassing some 34,000 square miles with a population of 13,000,000. Even though our response was encouraging, it still fell far short of expected participants. We found the media played an invaluable role; for as the television coverage diminished, so did the number of kits returned for processing. We wonder if, perhaps, we spread ourselves "too thin." Perhaps the screening program should be more regionally based among community hospitals? Should our targeting be re-directed; ie., towards retirement communities and homes? Is the use of colorectal screening kits truly a cost-effective method of healthcare delivery? These questions can only be answered through further participation of community cancer centers nationally. It is our hope that through continued testing, screening programs will become more refined and productive, ensuring the highest standards of medical care provided to our communities.

California↗

PubMed1989

Listeria spp. found on fresh market produce.

From October 1987 to August 1988, 1,000 tests were conducted on 10 types of fresh produce from two Minneapolis area supermarkets to detect Listeria spp. The produce included broccoli, cabbage, carrots, cauliflower, cucumbers, lettuce, mushrooms, potatoes, radishes, and tomatoes. The vegetables were tested by the Food and Drug Administration method for isolation of Listeria spp., with the addition of LiCl-phenylethanol-moxalactam agar in the last 280 tests; 8.6 and 11.4% of these tests were positive by modified McBride and LiCl-phenylethanol-moxalactam agars, respectively. Listeria monocytogenes was isolated from cabbage, cucumbers, potatoes, and radishes; L. innocua was isolated from cucumbers, lettuce, mushrooms, potatoes, and radishes; L. seeligeri was isolated from cabbage and radishes; and L. welshimeri was isolated from cucumbers, potatoes, and radishes. The isolates were of various serotypes; however, the L. monocytogenes isolates were predominantly serotype 1 (82%). Only potatoes (25.8% positive) and radishes (30.3% positive) showed significant amounts of L. monocytogenes contamination.

Food Microbiology↗

PubMed1984

Primary melanoma: pitfalls in diagnostic biopsy techniques and interpretations.

A group of 235 patients with melanoma were followed for 10 years. In 25 of these patients, the initial biopsy specimen obtained by the shave, punch, or incisional technique was insufficient to determine the microscopic extent of the lesion. Guidelines for treatment of these patients include evaluation of the deepest level of tumor invasion, a clinical history of the lesion, and a careful physical examination. If any visible melanoma remains, total excisional rebiopsy should be performed before definitive treatment is begun. Of the 25 patients thus managed, recurrences developed in 3 within 2 years of initial treatment. In two patients, reexcisional surgery was carried out, and they are currently free of disease. One patient died from systemic metastases. Total excisional biopsy of lesions suspected of being melanomas is strongly recommended, and shave, punch, or incisional techniques should be avoided.

Adult↗

PubMed1983

Carcinoma of the pancreas: progress or stalemate?

Has treatment for cancer of the pancreas progressed or has a stalemate been reached? This is a difficult question to answer. Cancer of the pancreas has several unique features. First, it has been an extremely difficult tumor to study because of its anatomic location and our present invasive and non-invasive studies have failed to provide for truly early detection of this disease when cure may be possible. Second, assuming that we are able to diagnose early, radical surgical resection (our best treatment to date) still carries a substantial morbidity and mortality. The direction certainly has to be in early detection and screening in the asymptomatic patient. To date all of our therapy is directed to the patient who already has symptoms. Diagnosis prior to this stage of the disease is imperative. This would entail the use of biological and serum antibody-type screening procedures with specific tumor markers and better epidemiologic studies to identify risk factors which would aid in screening procedures. It is apparent that present day techniques in the diagnosis and directions are needed before any significant improvement in survival rates are realized.

Aged↗

PubMed1980

Incidence of salmonellae in fecal samples of production swine and swine at slaughter plants in the United States in 1978.

Nine swine slaughter plants and 19 swine production units were randomly selected for sampling from the six highest swine-producing states representing a total of 64% of the United States swine production. Three composites of 10 fresh swine fecal samples were obtained from each slaughter plant, representing three different farm sources of swine. Two composite fecal samples were collected from two different production pens from each production unit. Samples were analyzed for salmonellae. Isolated salmonellae were biochemically and serologically identified and tested for antibiotic susceptibility and resistance transfer ability. Salmonellae were recovered from swine at seven of the nine slaughter plants and 16 of the 27 composites of slaughter swine. Of the 19 production units, 3 had swine shedding salmonellae. Resistances found included streptomycin, tetracycline, and sulfadiazine. Of the 52 total isolates tested, 71% had some level of antibiotic resistance. Only 3 of 37 resistant isolated could transfer resistance under the conditions used.

Abattoirs↗

PubMed1976

A retrospective study of regional perfusion for melanoma.

Regional perfusion has been utilized in the treatment of accessible melanomas for many years. This series of 245 patients, which encompasses over ten years of experience, is presented to reevaluate the results of regional perfusions in melanomas, and perhaps to redefine the indications for such a procedure. Fifty-nine patients died from three months to over five years following the procedure, and six of the deaths were from diseases other than melanoma. The overall survival in stage I disease was 93%; stage II, 68%; and stage III, 41%. There were no survivors in stage IV. Nearly all of the recurrences and deaths from disease were seen within two years of the perfusion. These results are similar to others, and 10% to 15% better than those of conventional methods. Indications are now more definite, and include most invasive melanomas in an area accessible to perfusion technique, except in very elderly and poor risk patients, those with severe arteriosclerosis in the area concerned, and those with widespread metastases.

Chemotherapy, Cancer, Regional Perfusion↗

PubMed1976

An evaluation of bilateral breast carcinoma. Simultaneous and sequential lesions.

The detection of bilateral breast carcinoma, simultaneous or nonsimultaneous, appears to be increasing. Undoubtedly a major factor in this is the increased use of mammography and xeromammography. In a 21-year period at Saint John's Hospital and Health Center, 1,189 cases of primary breast carcinoma were treated, of which 34 (2.9 percent) were bilateral. However, from 1972 to 1974 the incidence has risen from 1.9 to 10.8 percent, with a simultaneous rise in numbers of xeromammograms made. Xeromammography should be done routinely in patients in whom carcinoma of the breast is suspected. Its use should also be an integral part of the follow-up in patients in whom mastectomy has been carried out previously.

Breast Neoplasms↗

PubMed1972