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Biomedical subjects

D Wetter

Publications and source records attributed to D Wetter.

12 recordsLinked to original sources
PubMed2001

[Vacuum needle biopsy of the breast with digital stereotaxic control--initial experiences with the Mammotome in Baden].

The purpose of our study was to evaluate a stereotactic, percutaneous, vacuum-assisted breast biopsy system. The Mammotome (Biopsies) was used to perform breast biopsies in 35 of 37 patients using only one small incision. In two patients a biopsy was not possible: one lesion could not be positioned into the limited field of the digital CCD-camera. One lesion was not enough dense to be seen on digital images. Biopsies were performed because of suspicious microcalcifications (34) or nodules (3). Histology revealed 32 benign and 3 malignant lesions. We encountered 4 syncopes. Because the biopsies are performed in the sitting position, they were the cause we had to break up 2 biopsies. Relevant hematomas occurred in 4 cases. Vacuum assisted core biopsy has proven to be a safe and accurate technique for obtaining a histologic diagnosis in most patients who have screening-detected lesions; it is done at a lower cost with lower resultant morbidity to the patient compared with traditional surgical excisional biopsy. A certain learning phase must be granted.

Biopsy, Needle↗
PubMed1999

Gender differences in chronic disease risk behaviors through the transition out of high school.

BACKGROUND: Major life transitions (e.g., graduation from high school) are times when many changes occur in a person's social and physical environment. Men and women likely experience aspects of these changes differently. As a result, health-related behaviors likely change at these times with possible differences in these changes by gender. METHODS: Gender differences in the performance of chronic disease risk-related behaviors (fruit, juice, and vegetable intake; physical activity; tobacco and alcohol use; and sexual practices) through the transition out of high school (HS) were assessed in a secondary analysis of a nationally representative sample from the 1992 National Health Interview Survey-Youth Risk Behavior Survey. The survey was completed by 5881 young people aged 14 to 21 years. Regression discontinuity analysis with piecewise regression was performed. RESULTS: Statistically significant gender by transition effects were obtained for exercise/physical activity (decreases at the transition point for males), snuff use (decrease for females in HS), binge drinking and number of days drinking alcohol (increases for males at the transition point), and use of alcohol or drugs before sexual intercourse (decrease for females post HS). Fruit intake decreased for males and females and daily and heavy cigarette smoking increased during the HS years. Effect sizes were small but promising, given that the data set was not designed to test this hypothesis. CONCLUSION: These data offer evidence of differences by gender in chronic disease risk behaviors through the HS transition. Longitudinal studies are needed to assess the true nature of these differences, the tracking of these risk behaviors and their personal, social, and environmental determinants, including gender-specific determinants, that may explain these changes and inform future intervention development.

Adolescent↗
PubMed1999

Ethnic differences in cancer risk behaviors through the transition out of high school.

Differences were assessed by ethnic group in the performance of cancer risk related lifestyle behaviors through the transition out of high school. Data were obtained from a nationally representative probability sample survey, the 1992 National Health Interview Survey-Youth Risk Behavior Survey. A cross-sectional sub-sample included adolescents with an age range from high school freshmen to young adults within four years after high school. Self reported indicators of diet, physical activity, cigarette smoking, smokeless tobacco use, alcohol use, and sexual practices were the primary dependent measures. Cancer risk increased at the transition out of high school through changes in cancer related behaviors. Hispanic-American males experienced somewhat higher risks after the transition for chewing tobacco and snuff. African Americans experienced somewhat higher risks after the transition for physical activity, chewing tobacco, and number of sexual partners. Further research needs to verify these findings with longitudinal designs, assessment of tracking of behaviors through the transition, and of the ecological, social and psychosocial correlates that may explain why these changes occurred.

Adolescent↗
PubMed1996

Current approaches in smoking cessation.

This review highlights the necessity of smoking cessation as a cornerstone of cancer prevention. We briefly review the literature linking smoking to various forms of cancer, the benefits of smoking cessation for cancer patients, and the Agency for Health Care Policy and Research Smoking Cessation Clinical Practice Guideline. Also provided is an update on controlled smoking cessation studies published between March 1995 and February 1996.

Antidepressive Agents↗
PubMed1994

Predicting smoking cessation. Who will quit with and without the nicotine patch.

OBJECTIVE: To identify predictors of smoking cessation success or failure with and without transdermal nicotine patch treatment. DESIGN: Two independent randomized, double-blind, placebo-controlled studies using the nicotine patch assessing outcome at the end of treatment and at 6-month follow-up; each study used a different mode of adjuvant counseling. PATIENTS: Subjects were daily smokers (> or = 15 cigarettes per day), aged 21 to 65 years with expired air carbon monoxide levels of at least 10 ppm, and motivated to quit. Eighty-eight subjects participated in study 1, and 112 subjects participated in study 2. INTERVENTION: Study 1 consisted of 8 weeks of 22-mg nicotine patch therapy with intensive group counseling. Study 2 consisted of 4 weeks of 22-mg nicotine patch therapy and 2 weeks of 11-mg nicotine patch therapy with brief individual counseling. MAIN OUTCOME MEASURES: The prediction of smoking cessation (at end of treatment and after 6 months) based on pretreatment and intratreatment measures in smokers using active or placebo nicotine patches. RESULTS: Pretreatment markers, such as the Fagerstrom Tolerance Questionnaire score, number of cigarettes smoked per day, years smoked, expired air carbon monoxide level, or baseline blood nicotine and cotinine levels, showed no consistent relationship with successful smoking cessation across both studies. Of the intratreatment markers examined, withdrawal severity and nicotine replacement levels also were not consistently predictive of cessation success. However, any smoking during the second week of treatment was a consistent and powerful predictor of failure at the end of treatment and after 6 months. Among active nicotine patch patients who smoked at all during week 2 after quitting, 83% and 97% (studies 1 and 2, respectively) were smoking at 6-month follow-up. Conversely, abstinence during the second week of treatment predicted successful smoking cessation. Among active nicotine patch patients who were totally abstinent during week 2 after quitting, 46% and 41% (studies 1 and 2, respectively) were abstinent at 6-month follow-up. Of all nicotine patch patients in both studies who were smoking at 6-month follow-up, 74% began smoking during week 1 or 2. Among all placebo patch patients who were smoking at 6-month follow-up, 86% began smoking during week 1 or 2. CONCLUSIONS: Smoking status (abstinent or smoking) during the first 2 weeks of nicotine patch therapy, particularly week 2, was highly correlated with clinical outcome and can serve as a powerful predictor of smoking cessation. Early smoking behavior also predicted outcome among placebo patch users. Traditional measures of dependence are not consistently predictive of cessation success. Clinicians are advised to emphasize the importance of total abstinence after a quit attempt and to follow-up with patients within the first 2 weeks of quitting; smoking during this critical time should be assessed and treatment may be altered as appropriate.

Administration, Cutaneous↗
PubMed1994

Normal heart: evaluation with echo-planar MR imaging.

PURPOSE: To evaluate the appearance of the heart on spin-echo (SE) and gradient-echo (GRE) echo-planar magnetic resonance (MR) images. MATERIALS AND METHODS: Nine healthy volunteers were examined with an MR imager with transaxial echo-planar imaging (EPI) capabilities. SE EPI and GRE EPI sequences were used. Full k-space signal was obtained with readout time of 40 msec per image, and total image acquisition time was 72 and 52 msec, respectively, for SE EPI and GRE EPI. RESULTS: Delineation of cardiac structures was superior with SE EPI, reflective of significantly higher contrast between myocardial and intraluminal signal intensity (SI) (P < .001). The higher (P < .01) and more homogeneous (P < .001) intraluminal SI with GRE EPI allowed better assessment of intracardiac flow. Septal SI was significantly higher for GRE EPI (P < .01), but signal homogeneity was similar for both sequences (P > .2). CONCLUSION: Diagnostic images of the heart were obtained with both SE EPI and GRE EPI. GRE EPI is more suitable for flow studies because of the higher and more homogeneous intravascular SI.

Adult↗
PubMed1991

Smoking prevention: towards a process approach.

Current studies of smoking prevention treat the adolescent as a target of influence, they emphasize the acquisition of skills for resisting peer pressure and give too little attention to motivation for resistance. Studies consistent with this social learning framework show moderate reductions in the incidence of smoking for the short term; recent, long-term follow-ups show no reduction in experimental over control conditions. We propose a re-examination of the influence framework and suggest that adolescents use smoking and dress, to project an image of self that will increase the likelihood of success in the formation of relationships in which participants share feelings and attitudes toward each other and the adult world. We also suggest that adults focus upon external, perceptible, and remote threats, e.g. smoking is seen as evil, a response to peer pressure, and a long term threat to health, and ignore discourse about proximal, subjective feelings respecting the changing sexual urges and feelings of social anxiety that accompany adolescence. The socialization of these affects is left to the peer group. It is suggested that future programs intensify their focus on motivation for resisting smoking based upon a revised view of the adolescents objectives in self definition, and combine this with the best of the current skills approaches.

Adolescent↗