PubMed Health⌕ Search

Biomedical subjects

D Schlager

Publications and source records attributed to D Schlager.

13 recordsLinked to original sources
PubMed1997

Ultrasound detection of foreign bodies and procedure guidance.

As emergency physicians become familiar with the use of ultrasonography, this safe procedure will likely become a standard technique having multiple uses in the emergency department. Ultrasonography assists in foreign body localization and retrieval and is potentially important in applications, such as reliable endotracheal tube placement, visualization of ingested medication, vascular access, and drainage of collected fluids.

Drainage↗
PubMed1996

Safety of imaging exploding bullets with ultrasound.

STUDY OBJECTIVE: To evaluate the safety of using ultrasound to image exploding bullets that have not detonated. METHODS: We evaluated various types of exploding bullets using ultrasonography at various depths with various transducers and using standard radiography. RESULTS: None of the unexploded bullets subjected to ultrasonography or standard radiography exploded. CONCLUSION: Our results suggest that evaluation of exploding bullets with ultrasonography is safe.

Explosions↗
PubMed1995

Evolutionary perspectives on paranoid disorder.

Certain subtypes of DD may represent abnormal forms of previously well-characterized, content-specific behaviors that represent evolved adaptations to challenges of social interaction and mating. Such rare delusional states may be manifestations of an adaptive hypersensitivity to important environmental threats or opportunities, or may be a byproduct of behavioral misfiring triggered by unfamiliar environmental cues or perceptions.

Adaptation, Psychological↗
PubMed1995

Gender differences in presentation of chronic major depression.

The authors examine gender differences in presentation of illness in 96 males and 198 females with DSM-III-R chronic major depression (i.e., major depression of at least 2 years' duration). Women were found to have increased severity of illness as measured by Hamilton Rating Scale for Depression (HAM-D), Beck Depression Inventory (BDI), and Clinical Global impressions (CGI) scores. Symptom comparisons revealed that women experience more psychomotor retardation than men. Women reported increased functional impairment on the Social Adjustment Scale-Self-Report (SAS-SR), particularly in the areas of marital and family adjustment. Men were more likely to have a history of alcohol and substance abuse/dependence. These findings represent the first systematic study of gender differences in a chronic depressive population.

Adult↗
PubMed1994

A prospective study of ultrasonography in the ED by emergency physicians.

The objective of this study was to examine the use of limited, goal-directed, two-dimensional ultrasound studies performed by emergency physicians and to assess the frequency, variety, and accuracy of their readings. A 1-year prospective study was performed by using an emergency department (ED) ultrasound machine with a 3.5-mHz mechanical oscillating sector transducer and a 5.0-mHz vaginal transducer. In a series of proctoring sessions, radiologists trained emergency physicians to do limited, goal-directed ultrasonography. Laser print ultrasonograms were collected from all ED ultrasound examinations performed during a 1-year period and were compared with either formal ultrasonograms performed in the radiology department, the patient's hospital record, or both. Sensitivity, specificity, and positive predictive value (PPV), as well as negative predictive values (NPV), were calculated. The setting was a 104-bed community hospital with an ED volume of 25,000 patients annually, and patients whom the emergency physician believed needed ultrasound studies in the ED were entered. ED ultrasonography was performed in 167 patients by 14 physicians during a 1-year period. For 132 patients who completed formal follow-up, the overall diagnostic accuracy of interpretations of ED ultrasonograms yielded a sensitivity of .95, specificity of .98, PPV of .99, and NPV of .89. Eleven categories of ultrasound use were reported. The three studies most commonly performed were for gallbladder disease (53%), intrauterine pregnancy (28%), and abdominal aortic aneurysms (7%). Accuracy of ED gallbladder ultrasonograms for 65 patients showed a sensitivity of .86, specificity of .97, PPV of .97, and NPV of .85.(ABSTRACT TRUNCATED AT 250 WORDS)

California↗
PubMed1993

Seasonal variations of current symptoms in a healthy population.

Among a large workplace population interviewed over a year, current symptoms were assessed using the Hopkins Symptom Checklist (HSCL). Variation in symptoms by date of assessment was observed among the 314 women but not the 1556 men. Among women, symptoms were greatest during late autumn and winter, and significant inverse correlations were found between available daylight at the time of assessment and standard symptom dimensions of anxiety and somatisation, as well as an expanded mood scale more inclusive of depressive symptoms within the check-list. The amplitude of the seasonal effect was such that the prevalence of female 'cases', as defined by HSCL criteria, was twice as high during winter than during the rest of the year. The data are consistent with a role for light-dark exposure in eliciting or synchronizing annual mood rhythms. The sex-by-season interactions may contribute to the sex differences in overall prevalence of depression.

Adult↗
PubMed1991

Ultrasound for the detection of foreign bodies.

STUDY OBJECTIVE: To determine the ability of an emergency physician to detect a variety of foreign bodies in an experimental model using a portable ultrasound device. DESIGN: Ten pieces of beef were sliced into cubes approximately 6 cm on each side. Six different groups of foreign bodies were examined: gravel, cactus spine, glass, metal, wood, and plastic. An independent observer placed the objects in a random fashion into the beef cubes. One hundred twenty observations were made using sets of ten beef cubes at a time. Five foreign bodies were placed into each set of ten beef cubes. INTERVENTIONS: A blinded emergency physician used a portable ultrasound with a 7.5-MHz transducer to determine the presence or absence of a foreign body in each cube. MEASUREMENTS AND MAIN RESULTS: Ultrasound detected 59 of 60 foreign bodies, including all cubes of meat embedded with gravel, cactus spine, plastic, metal, and wood. Glass was detected nine of ten times. Of the 60 cubes of meat with no foreign bodies, one false-positive was recorded. This yielded sensitivity, specificity, positive predictive value, and negative predictive value of 98%. Positive determinations by ultrasound were significantly greater in the meat cubes with foreign bodies compared with the control group with no foreign bodies (P less than .001 by chi 2). Although the subset of glass foreign bodies had one false-positive and one false-negative, it was not significantly different in comparison with the other groups (P greater than .05 by chi 2). CONCLUSION: Ultrasound has promise as a diagnostic tool for the detection of a variety of foreign bodies. Further clinical studies using ultrasound for the detection of foreign bodies are warranted.

Emergencies↗
PubMed1990

Efficacy of brief, intense light exposure for treatment of winter depression.

A high-intensity fluorescent lighting system, tilted downward toward the head, and emitting negligible levels of ultraviolet radiation, was tested under two random crossover protocols in winter-depressed patients: 30-minute sessions at (a) 3,000 lux vs. 10,000 lux in early morning, and (b) morning vs. evening sessions at 10,000 lux. Judgment of clinical remission was based jointly on relative and absolute score improvements on a Structured Interview Guide for the Hamilton Depression Scale--Seasonal Affective Disorder Version (SIGH-SAD) and a set of supplementary atypical-vegetative items. Data are presented for 24 subjects who showed relapse upon withdrawal. An overall remission rate of 75 percent was found for morning light at 10,000 lux. The rates for evening light (25%) and 3,000 lux morning light (19%) were significantly lower. The remission rate for morning light treatment of 10,000 lux for 30 minutes approximately equalled 2,500 lux treatment for 2 hours (data from our earlier studies), suggesting a reciprocity between dosing dimensions of intensity and duration. No pathological changes were revealed by ophthalmological examinations given after 2 to 6 weeks of daily treatment.

Affect↗
PubMed1979

Antigen E content of pollen from individual plants of short ragweed (Ambrosia artemisiifolia).

A study was conducted to ascertain how much variation in allergenic potency of ragweed pollen occurs among individual plants and different plant populations in a restricted geographic area. Seeds of the short ragweed (Ambrosia artemisiifolia) were collected from 38 different sites in Champaign County, Ill. Plants from these seeds were grown under similar conditions, and antigen E (AgE) was determined on pollen samples harvested from individual plants. The populations from various sites in Champaign County differed by as much as severalfold with respect to mean AgE values. There were statistically significant differences among population means, although large variations occurred among plants within populations. Further research was conducted to learn whether the level of AgE was determined by genetic factors within the plants. Genetic regulation was indicated by the finding that 3 plants which had unusually low levels of pollen AgE all produced offspring with significantly lower mean AgE levels than those of control plants.

Antigens↗
PubMedDate not supplied

Winter depression and functional impairment among ambulatory primary care patients.

This study of primary care patients sought to estimate the prevalence of and functional impairment associated with winter-seasonal depression. Three hundred three patients visiting a primary care clinic in January or February were assessed for seasonal patterns of health change, current DSM-III-R major depressive disorder (MDD), and current functional status. Approximately 9% of patients met criteria for MDD with winter-seasonal pattern, and an additional 29% reported seasonal mood changes without meeting criteria for current MDD. Multivariate analysis revealed that the functional impairment associated with such winter seasonality exceeded that associated with any of the common chronic medical conditions measured, and that such dysfunction was evident even in the absence of a diagnosable depressive disorder (MDD). Winter-seasonal pain was reported by one quarter of the overall sample and by half of those with current MDD, supporting preliminary reports that pain may be a common presenting symptom in seasonal affective disorder. The findings suggest that efforts at detection and treatment of such syndromes in primary care settings would be justified.

Adolescent↗
PubMedDate not supplied

Emergency burn treatment in Denmark.

Historically, burn treatment in Denmark has included several unique elements. Current Danish treatment includes prolonged tap water irrigation of burns, which largely replaces the use of narcotics for pain control in both the inpatient and outpatient settings. Burns on hands and feet are dressed for maximum mobility. Other burns are left open. Mortality is 10% to 15% below expectations.

Adult↗