Biomedical subjects

E L Spitznagel

Publications and source records attributed to E L Spitznagel.

76 records · Page 5Linked to original sources

PubMedDate not supplied

Nitrous oxide, nausea, and vomiting after outpatient gynecologic surgery.

Postanesthetic nausea and vomiting can delay discharge of outpatients and can cause occasional admissions to hospital. Nitrous oxide (N2O) has been thought to increase this frequency, but previous studies have been indecisive. One hundred eighty-five unpremedicated outpatients undergoing laparoscopic tubal ligation were studied to determine the effect of N2O on postanesthetic nausea and vomiting. The patients were divided by registration number, intubated, and given mixtures of either N2O-O2 enflurane or air-O2 enflurane. Intravenous (IV) lidocaine, administered initially prior to intubation to control bucking, was later omitted in randomly chosen cases to determine its effect. The overall prevalence of nausea and vomiting was 29.2% with N2O and 9.3% with air (p less than 0.001). While the lidocaine subseries was small, it appeared to prevent nausea and vomiting, particularly when N2O was omitted. Further study is justified. Fentanyl, given postoperatively for pain, did not increase the prevalence of nausea and vomiting. It was concluded that N2O is associated with an increased prevalence of nausea and vomiting.

Adult↗

PubMedDate not supplied

Nonpsychotic thought disorder: objective clinical identification of somatization and antisocial personality in language patterns.

This report describes a new method of using language patterns to identify somatization and antisocial personality (ASPD) disorders in clinical practice. A set of definitions describing characteristic speech patterns was developed to identify "nonpsychotic thought disorder" (NPTD). Speech patterns of subjects with somatization disorder and/or ASPD were compared with those of controls. Blind raters assessed audiotaped samples of speech obtained through open-ended interviews for instances of elements of NPTD. Women with somatization or ASPD had significantly more NPTD speech responses than controls, and women with both disorders showed the greatest amount. Antisocial men did not demonstrate more NPTD than controls, nor was somatization in men associated with NPTD. Clinical attention to speech patterns in patients may help alert clinicians to these disorders in women and serve as indicators for screening for these disorders. More study is needed to develop psychometric properties of the instruments on larger samples, and to identify speech indicators of personality disorder in men. It is likely that other personality disorders, e.g., borderline personality disorder, can be identified through speech patterns, and they deserve study with these methods.

Adult↗

PubMedDate not supplied

ROC analysis of mammography and palpation for breast screening.

Receiver operating characteristic curves (ROCs) for mammography and clinical palpation individually and in combination are generated using screening data from Breast Cancer Detection Demonstration Project (BCDDP) No. 25. Detailed standard records of disease features observed on screening were kept by all examiners. And actual disease states at examination were determined for each case by pathology or follow-up. The ROCs are produced from these objective data without the usual concern for examiners' ultimate diagnostic conclusions. Comparative analysis of the ROCs illustrates the clear superiority of mammography over clinical palpation as an individual screening modality as well as the further superiority of the combined use of both modalities.

Breast Neoplasms↗

PubMedDate not supplied

Planning around start-up.

When new patients join a prepaid group practice, their utilization of services is usually higher than it will be in a year or so. This "start-up effect" must be considered when planning for group growth. Demand projections are commonly based on data from outside sources and often fail to consider the many critical implications of the start-up effect. More accurate planning can be accomplished by using concrete start-up analysis based on internal information. Administrators who use careful predictions of demand levels rather than guess-work in their planning will provide their organizations with the foundation for a sound system of dynamic growth management.

Forecasting↗