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Biomedical subjects

D R Becker

Publications and source records attributed to D R Becker.

At least 37 records · Page 2Linked to original sources
PubMed1991

Impact of programmed reading on ABSITE performance. American Board of Surgery In-Training Examination.

To test the hypothesis that a program of regular reading and discussion would result in significant improvement in the surgical database as measured by the American Board of Surgery In-Training Examination (ABSITE), we conducted a 2-year prospective study. The study group, which was comprised of 40 residents, was compared with a control group of 44 residents enrolled in the residency during the 2 years that preceded the study period. Neither reading effort nor discussion group attendance correlated strongly with ABSITE performance among first-year residents. At this level, ABSITE scores correlated best with National Board of Medical Examiners Part I scores (r = 0.699, p = 0.002). In contrast, second-year through fifth-year residents showed a cumulative improvement across the residency (80 versus 180 standard score points, p = 0.048). Individual resident improvement correlated highly with reading effort (r = 0.79, p less than 0.001). There was little measurable effect from attending discussion sessions. We conclude that the surgical database can be improved by a program of regular reading and that the magnitude of the improvement is directly proportional to the reading effort.

Educational Measurement↗
PubMed1989

Ovum transport in the rat oviductal ampulla in the absence of muscle contractility.

Ovum transport in mammalian oviducts involves two main effectors: ciliary motility and muscle contractility. To study the relative contribution of cilia to ovum transport in the rat, we blocked smooth muscle activity with isoproterenol, a beta-adrenergic agonist, and measured transport rates of surrogate ova in situ. Transport rates before isoproterenol administration were 0.04 mm/s in the cephalic ampulla and 0.03 mm/s in the caudal ampulla; rates were unchanged after administration of isoproterenol. To determine if isoproterenol affected ciliary activity, we measured ciliary beat frequency with laser-scattering spectroscopy over the effective isoproterenol dosage. Isoproterenol did not cause a significant change in ciliary beat frequency. Our results show that in the rat oviductal ampulla, ciliary motion is capable of transporting ova in the absence of muscle contractility.

Animals↗
PubMed1987

A prospective randomized study evaluating periumbilical versus infraumbilical peritoneal lavage: a preliminary report. A combined hospital study.

Peritoneal lavage has been proved to be a fairly safe and reliable diagnostic tool in evaluating blunt abdominal trauma. However, the operation is not always a simple procedure. In an attempt to determine the ease and reliability of the procedure, the authors conducted a combined hospital approach, prospectively randomizing the performance of periumbilical and infraumbilical approaches to the peritoneal lavage. To date, 53 lavages have been performed. Reliability of the procedures appears to be equal. The greatest differences in the techniques are with regard to the greater efficacy and performer acceptance of the periumbilical approach. The operative approaches are discussed in detail and literature regarding peritoneal lavage is reviewed.

Abdominal Injuries↗
PubMed1986

Sepsis due to triple lumen central venous catheters.

We prospectively studied 96 consecutive catheterizations in 65 patients who required triple lumen central venous catheters. The incidence of catheter associated bacteremia was 3.1 per cent. Staphylococcus epidermidis was the organism involved in all instances.

Catheters, Indwelling↗
PubMed1984

Malignant melanoma metastatic to the cystic and common bile ducts.

Malignant melanoma can involve any organ of the body and commonly involves the gastrointestinal tract. The first case of melanoma in the world's literature involving the cystic duct and the first in the English literature involving the common bile duct is described. This case is compared with the two cases in the world's literature with common duct involvement.

Bile Duct Neoplasms↗
PubMed1984

Gastric carcinoma after peptic ulcer surgery.

Gastric carcinoma following surgery for benign peptic ulcer disease is being increasingly reported. The authors have reviewed their experience at Saint Francis Hospital and Medical Center and Mount Sinai Hospital from 1970 to 1980 and found 319 cases of gastric carcinoma, 16 of whom had undergone previous surgical procedures for peptic ulcer disease, with an incidence of 5 per cent of gastric stump carcinoma. The average time interval for the development of gastric stump carcinoma was 17.4 years, ranging from 5 to 49 years. The average survival after the diagnosis was 4.6 months, making the prognosis uniformly poor, probably due to delayed diagnosis. Treatment modalities consisted of major and minor surgical procedures, medical therapy, and no treatment in some instances. It is recommended that all patients who undergo operations for peptic ulcers have careful long-term follow-up. Vague gastrointestinal symptoms occurring in these patients, especially 10 years or more after surgery, require endoscopy and biopsies of the gastric stump to exclude gastric stump carcinoma.

Adolescent↗
PubMed1983

The noninvasive venous vascular laboratory. A prospective analysis.

We undertook a prospective study to ascertain the accuracy of the noninvasive venous vascular laboratory in diagnosing clinically suspected deep-vein thrombosis. Of 88 patients studied with contrast venography and bilateral plethysmography, 41% had normal venograms; 15%, isolated venous thrombosis in the calf; and 44%, proximal deep-vein thrombosis. Clinical and Doppler examinations could not differentiate these three groups. The composite venous score was reliable at extreme values. By considering scores of 3.9 or less as negative, 8.0 or more as positive, and 4.0 to 7.9 as indeterminate, a suitable combination of sensitivity (75%), specificity (100%), and overall accuracy (90%) was obtained. Low-risk patients with scores of 3.9 or less should be observed. Patients with scores of 8.0 or greater can undergo anticoagulation without contrast venography, which is mandatory for patients with indeterminate venous scores and high-risk patients with scores of 3.9 or less.

Adolescent↗
PubMed1983

Splenic abscess associated with Streptococcus bovis septicemia and neoplastic lesions of the colon.

Streptococcus bovis bacteremia is known to be associated with gastrointestinal disease, especially colon lesions. Two patients are presented with a previously unreported syndrome: S. bovis bacteremia, endocarditis, colon neoplasms, and splenic abscess. In one case, the colonic lesion was occult and required colonoscopy for identification (normal barium enema). S. bovis bacteremia is an important marker for occult gastrointestinal neoplasia.

Abscess↗
PubMed1983

Management of penetrating neck injuries.

In 44 patients neck wounds penetrating the platysma were evaluated over a 5-year period. Twenty-one patients were admitted and observed; 22 patients were explored immediately. One was dead upon arrival in the emergency room. The decision to explore was based upon initial clinical evaluation using criteria of unstable vital signs, bleeding, hematoma, subcutaneous emphysema, respiratory distress, or neurologic deficits. Of the 21 patients selected for observation, none had complications or required later surgery. There was a negative exploration rate of 23%. Had all patients been explored, the negative exploration rate would have been 60%. We conclude that selective exploration, based upon careful clinical evaluation, is both safe and reasonable in cases of penetrating neck trauma.

Adolescent↗