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Biomedical subjects

J M Engel

Publications and source records attributed to J M Engel.

At least 37 records · Page 2Linked to original sources
PubMed1997

The Test of Sensory Functions in Infants: test-retest reliability for infants with developmental delays.

OBJECTIVE: The Test of Sensory Functions in Infants (TSFI) is one tool that occupational therapists use to identify sensory processing disorders among infants. However, data on the reliability of TSFI scores with infants with developmental delays are lacking. METHOD: Test-retest reliabilities for TSFI total test and subtest scores were determined with a sample of 26 infants with developmental delays. All infants were between 10 months and 18 months of age. The test-retest interval ranged from 5 days to 10 days. Magnitudes of difference between test and retest scores and percentages of agreement among the TSFI classification categories (i.e., normal, at-risk, deficient) also were determined to examine relationships between test scores. RESULTS: Reliability for the total test score was borderline, with an intraclass correlation coefficient of .78. Reliability coefficients for the five subtests ranged from .54 to .74. Percentage of agreement for the total test classification categories between test and retest was adequate (81%). Percentages of agreement for subtest classification categories were low, ranging from 58% to 68%. CONCLUSION: TSFI scores should be interpreted cautiously and used only in conjunction with findings from additional developmental assessments and clinical observations for infants with developmental delays.

Developmental Disabilities↗
PubMed1993

Necrotizing periorbital cellulitis.

We report traumatic necrotizing periorbital cellulitis attributed to group A beta-hemolytic streptococci in a 4-year-old child. The infection was successfully treated via surgical cleansing, drainage, and grafting. The virulence of this organism requires an aggressive approach to the patient with periorbital cellulitis, which is refractory to intravenous antibiotics. Early treatment may limit extensive eyelid necrosis, the resultant secondary deformity, and the need for multiple reconstructive procedures.

Cellulitis↗
PubMed1992

Long-term follow-up of relaxation training for pediatric headache disorders.

The long-term effects of relaxation training for pediatric headache disorders was determined for 17 of 20 original participants from a prospective control-group experimental design study with random assignment to autogenic relaxation, progressive relaxation, autogenic plus progressive relaxation, or waiting list control groups. Long-term follow-up data were obtained at an average of 51 months post-treatment. All participants reported some increases in headache activity. Participants in the three relaxation treatment groups, however, had significantly more headache-free days and less severe headaches compared to the control group. There were no significant effects of treatment for headache duration, medication intake and rest time due to headache. Twelve of the 13 treated participants indicated relaxation training was effective in relieving headaches, with 7 reporting they practiced relaxation exercises within the past month. The results generally support the long-term benefits of relaxation in reducing headaches originating in childhood.

Adolescent↗
PubMed1992

Relaxation training: a self-help approach for children with headaches.

Children and adolescents frequently complain about recurrent nonmalignant headaches. Relaxation exercises are one possible treatment for these headaches. As the role of occupational therapy in pediatric pain management emerges, relaxation training is becoming one of the treatment activities. The present study investigated the efficacy of progressive relaxation exercises in reducing headache complaints, particularly those headaches of a mixed variety. Ten subjects with a mean age of 11.5 years completed the 6-week self-help program. A multiple-baseline across-subjects design was used. Baseline periods were randomly assigned and ranged from 7 to 25 days with treatment introduced in a time-staggered fashion across subjects. After completing their treatment, 8 of the 10 subjects had a mean increase of 15% in headache-free days. Specific guidelines for relaxation training are provided in the outlined treatment program.

Adolescent↗
PubMed1989

Use of the carbon dioxide laser in the drainage of subretinal fluid.

Hemorrhage and retinal perforation are two sight-threatening complications associated with techniques employed to drain subretinal fluid in rhegmatogenous retinal detachment. We hypothesized that the carbon dioxide (CO2) laser would reduce these complications because of its cauterizing action and high absorption in water. The CO2 laser was compared with a conventional technique of using a penetrating diathermy electrode to drain subretinal fluid in rabbits with experimentally detached retinas. No hemorrhage occurred in 223 drainage trials using the CO2 laser, whereas hemorrhage occurred in 21 (4.8%) of 434 trials using the penetrating diathermy electrode. Furthermore, a depth of saline of only 45 microns protected the retina from perforation at CO2 laser dose adequate for drainage. These results indicate that further evaluation of the CO2 laser in treating human retinal detachment is warranted.

Animals↗
PubMed1986

The reliability of measurements of the lumbar spine using ultrasound B-scan.

Diagnostic ultrasound is used in research and clinical settings to determine the size of the lumbar spinal canal. When the technique was first introduced, measurements were obtained directly from an A-scan while concurrently viewing a B-scan. However, measurements obtained directly from a B-scan are now commonly used despite the undetermined reliability of the technique. To determine the reliability, 50 randomly selected ultrasound B-scan examinations were read on two separate occasions by three investigators. For each spinal level, the mean intraobserver error (same investigator), from the first to the second reading was determined, as was the interobserver error (between investigators) and the error due to variability in obtaining the ultrasound images. The resultant errors were approximately double those reported previously for the technique using A-scan. Interobserver variations were the major source of measurement error.

Adult↗
PubMed1985

Ultrasound of the spine in focal stenosis and disc disease.

In the course of reviewing ultrasound scans of the lumbar spine in 67 symptomatic patients, focal stenosis, either as an isolated finding or in conjunction with diffuse stenosis, was noted in 44 patients. The results of ultrasonograms are compared with findings at myelography and surgery. In addition, using gray-scale technique, we found it possible to examine areas of focal stenosis and to visualize herniated discs with a high degree of accuracy. The finding of focal stenosis alone was associated with disc herniation in 53% of patients who came to surgery. Where ultrasound identified a "triple density" representing soft-tissue protrusion between two bony landmarks within the extradural space resulting in focal stenosis, the sensitivity for indicating disc disease was 89%.

Humans↗
PubMed1984

Thermologic methods in clinical pharmacology-skin temperature measurement in drug trials.

With the increasing availability of thermographic equipment the definition of "thermography" and "thermologic methods" is important, since differing techniques and standards may be applied. Recommendations are given for optimum use of skin-surface temperature measurements in the assessment of clinical drug trials. Sites for thermographic measurement, different methods for quantitation, and sources of further information are included. A brief checklist of minimal technical requirements and an example of information for patients are also included.

Drug Evaluation↗
PubMed1981

Acute acalculous cholecystitis. Ultrasonic diagnosis.

Ultrasonography is an effective and accurate diagnostic test for acalculous cholecystitis. Until recently, however, little attention was focused on the gallbladder wall as an indicator of disease. By accurately visualizing and measuring the gallbladder wall, ultrasonography can be used to screen patients in whom acute acalculous cholecystitis is suspected. If the gallbladder wall measures 3.5 mm or greater, in the absence of ascites, a diagnosis of acalculous cholecystitis can be made safely with a specificity greater than 98 percent. Four of our five patients with acute acalculous cholecystitis had ultrasonically measured gallbladder walls 3.5 mm or greater in width. We have found ultrasonography useful in any clinical situation, even in the face of ileus, jaundice or pancreatitis. In addition, with the use of the portable real-time ultrasound machine, postoperative, traumatized and other critically ill patients can be examined at the bedside.

Adult↗
PubMed1981

Sonography of the anterior abdominal wall.

The improved penetrating power of high frequency, high resolution transducers has made possible routine examination of the anterior abdominal wall. Over 2 years, 79 abdominal wall examinations were performed and the results compared with anatomic findings at surgery. The abdominal wall may be divided into three sonographically distinct regions: the midline, the paramedian, and the inguinal regions. Normal structures can be seen in relation to constant landmarks, and disruption of normal architecture identified.

Abdominal Muscles↗
PubMed1981

Ultrasonic detection of acute cholecystitis with pericholecystic abscesses.

Perforation of the gallbladder is a life-threatening complication of acute cholecystitis that is often difficult to diagnose at an early stage. Standard radiographic and laboratory tests have not been reliable in identifying patients with this complication. In contrast, biliary sonography correctly diagnosed pericholecystic abscesses preoperatively in three patients with acute cholecystitis. The ultrasonic appearance of acute cholecystitis with a pericholecystic abscess was similar in all three patients. There was an extraluminal fluid collection located contiguous to a thick-walled gallbladder in the fundic region. The fluid collection was constant in location and could be seen in at least two different views. Two of these three patients had acalculous cholecystitis; the initial clinical diagnosis in one was pancreatitis, and in the other alcoholic hepatitis. Biliary sonography, by demonstrating a thickened gallbladder wall in the absence of ascites, strongly suggested that these two patients had acute acalculous cholecystitis, and not hepatitis or pancreatitis. The ultrasonic examination was a critical factor in the decision for prompt surgery instead of continued nonoperative management in these patients. These data suggest that not only can biliary sonography aid in the diagnosis of acute cholecystitis, calculous as well as acalculous, but can also visualize a pericholecystic abscess when it is present.

Abscess↗