PubMed Health⌕ Search

Biomedical subjects

G D Spoelhof

Publications and source records attributed to G D Spoelhof.

7 recordsLinked to original sources
PubMed1996

Renal emboli and atrial septal aneurysm.

A 53-year-old woman presented with flank pain and hematuria. She was suspected of having a renal stone but instead was found to have segmental renal infarction. Further evaluation revealed an atrial septal aneurysm, which was presumed to be the source of an embolism. Renal emboli should be considered when more common cause of flank pain are excluded. Atrial septal aneurysm should be considered when embolic events occur without an evident source. Transesophageal echocardiography is the best test to diagnose atrial septal aneurysms.

Echocardiography, Transesophageal↗
PubMed1995

When to suspect an acoustic neuroma.

Acoustic neuroma is a rare but important cause of sensorineural hearing loss. Patients with asymmetric hearing loss or unilateral tinnitus should be evaluated expeditiously to prevent further neurologic damage. Gadolinium-enhanced magnetic resonance imaging is the best tool for making the diagnosis of acoustic neuroma. Surgical removal using a translabyrinthine approach, is the favored treatment, although radiation therapy and expectant management may be chosen for patients at high surgical risk.

Cerebellar Neoplasms↗
PubMed1994

Colposcopy in a private family practice: a one year experience.

OBJECTIVE: To describe results achieved by family physicians performing colposcopy in our private practice. METHODS: A chart review was performed one year after initiating colposcopy services. RESULTS: Forty-five patients underwent 47 colposcopic exams, most often for mild dysplasia or persistent atypia on Papanicolaou smears. Of the 21 patients with persisting atypia on smear, 16 (76.2%) showed dysplasia on biopsy. Twenty-five patients (55.6%) underwent cryotherapy, which successfully eradicated the abnormality in 16 of the 20 (80%) for whom follow-up is complete. Ten patients (22.2%) were referred to gynecologists for further evaluation and/or treatment. Six patients (13.3%) had not received the recommended follow-up after either colposcopy or cryotherapy. CONCLUSIONS: Family physicians in private practice performing colposcopy and cryotherapy can provide complete care for 75% of patients with abnormal Papanicolaou smears. Patients with squamous atypia on smear may have dysplasia on biopsy more often than previously reported. A recall system and regular chart audits are recommended to improve follow-up.

Adolescent↗
PubMed1993

Pressure ulcers in nursing home patients.

Pressure, moisture, shear forces and friction lead to skin ulcer formation. Nursing home and home-bound patients with restricted mobility, poor nutrition, incontinence and chronic conditions such as anemia, diabetes and dementia are at risk for ulcer formation. Bedridden patients should be turned from side to side at 30-degree angles at least every two hours. Mattress and chair cushions, splints and cradle boots may reduce pressure. Good hygiene and barrier ointments, condom catheters, absorptive products and scheduled toileting for incontinence may control moisture. Calorie and protein supplements, feeding assistance and serial weight measurements are essential in the management of malnourished patients. Treatment should be based on the stage of the ulcer and the presence of conditions such as necrotic debris, infection and drainage. Saline wet-to-dry dressings and enzymatic and surgical debridement are necessary to remove necrotic tissue. Saline-soaked gauze, hydrogel preparations and occlusive dressings provide the physiologic environment for fibroblasts to grow and form granulation tissue. Patients with sepsis may require hospital admission for both further evaluation and systemic antibiotic therapy.

Aged↗
PubMed1989

Back pain pitfalls.

Pain along the vertebral column is such a frequent complaint that it is easy to overlook unusual etiologies or serious complications. In addition to the common traumatic and degenerative causes of back pain, infectious, rheumatic and neoplastic conditions must also be considered. Nonmusculoskeletal disorders may sometimes be mistaken for lumbosacral strain. A systematic and sympathetic approach to the diagnosis may uncover uncommon pathologies.

Abscess↗