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E J Spiegler

Publications and source records attributed to E J Spiegler.

9 recordsLinked to original sources
PubMed1997

Implementation of an acute myocardial perfusion imaging program for patients with chest pain and nondiagnostic electrocardiogram: the St. Agnes experience.

One of the current focuses of the chest pain emergency department (CPED) movement is to improve community awareness of chest pain signs and symptoms and thereby encourage patients to be evaluated early. However, such a strategy may overwhelm the mechanisms currently in place to evaluate these patients in a timely and cost-effective manner. In this article, the author reviews the experience of St. Agnes HealthCare using acute myocardial perfusion imaging (MPI) to help stratify patients who present with chest pain and nondiagnostic or normal ECG into low- and high-risk groups for the development of acute cardiac events. Currently, St. Agnes is participating in a randomized, multicenter trial to assess clinical and cost efficacy of employing a strategy of acute MPI in the CPED.

Chest Pain↗
PubMed1992

A noninvasive test of sphincter of Oddi dysfunction in postcholecystectomy patients: the scintigraphic score.

The ideal noninvasive test of sphincter of Oddi dysfunction (SOD) does not exist and the diagnosis of patients with postcholecystectomy pain often relies on invasive procedures. In this paper we describe a scintigraphic test for SOD: the scintigraphic score. This score combines quantitative and visual criteria for interpretation of hepatobiliary scans. Twenty-six consecutive postcholecystectomy patients underwent hepatobiliary imaging, ERCP, and sphincter manometry. Twelve patients had SOD and 14 had normal sphincters determined by clinical findings, ERCP, and manometric studies. All patients with normal sphincter had scores of 0-4, while patients with SOD had values of 5-12 for a perfect sensitivity and specificity of 100%. Hepatobiliary scans scored in this fashion may become the noninvasive test of choice to screen postcholecystectomy patients with suspected SOD.

Adult↗
PubMed1991

Detection of tricuspid regurgitation by Tc-99m DTPA renal scintigraphy.

Tc-99m DTPA renal scintigraphy is an established technique for evaluating renal perfusion and function. A patient is described with clinically unsuspected tricuspid regurgitation detected during the perfusion phase of renal scintigraphy and confirmed by Doppler echocardiography. A review of extrarenal anomalies detected during renal blood flow imaging is presented.

Aged↗
PubMedDate not supplied

Minimally invasive parathyroidectomy utilizing a gamma detecting probe intraoperatively.

The most common pathologic finding in primary hyperparathyroidism is a single adenoma. Traditionally, all four glands have been explored during surgery for primary hyperparathyroidism. With the advent of accurate localizing diagnostic studies, such as the sestamibi scan, some surgeons are now recommending single-gland exploration. In addition, when a sestamibi scan is performed the day of surgery, a gamma detecting probe can be used intraoperatively to direct the dissection. Although an experienced surgeon will successfully locate the abnormal gland 95% of the time with the traditional approach, this new technique results in a smaller incision with better cosmetic results as well as decreased operative time. Our initial experience with eight cases utilizing this technique is presented.

Humans↗