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Biomedical subjects

R E Melcher

Publications and source records attributed to R E Melcher.

4 recordsLinked to original sources
PubMed1988

Pressure sores in the elderly. A systematic approach to management.

Pressure sores are a serious but often avoidable problem. The best management plan focuses on early identification of high-risk patients, appropriate allocation of resources, and adequate techniques of pressure relief. A standardized treatment plan that is familiar to care givers should be followed. The clinician must correct all conditions that retard the healing process, including nutritional deficits and underlying medical problems. Multiple-drug therapy must be eliminated, and only established skin care protocols should be followed. Use of systemic antibiotics is reserved for complications, such as osteomyelitis, cellulitis, and sepsis.

Aged↗
PubMed1979

Methotrexate for psoriasis-revisited.

If maximum medical management-hospitalization, tar and sunlight therapy, topical steroids with plastic-wrap occlusion--is not effective, and PUVA is not available, methotrexate therapy should be considered, especially in a patient with severe psoriatic arthritis. It should be used if systemic steroids are inadvisable and if the patient has a normal liver biopsy and no history of alcohol excess. The least toxic and most effective method of administration is three divided doses every 12 hours, once a week.

Adult↗
PubMedDate not supplied

Small colon polyps: the primary physician's dilemma.

This case report and literature review is presented to alert primary care physicians performing flexible sigmoidoscopy and limited colonoscopy to the malignant potential of even diminutive polyps. The term "polyp" refers to any circumscribed mass of tissue that arises from mucosa and protrudes into the lumen of the gastrointestinal tract. The significance of this lesion in the rectum and colon is its propensity for malignant change. Although small polyps in the region of the rectum tend to be hyperplastic and those more proximal tend to be adenomas with a significant malignant potential, there is no way to distinguish them visually; hence, all need to be biopsied. The following case report shows the necessity of identifying neoplastic lesions within diminutive polyps (less than 1 cm). Standard biopsy technique usually removes these lesions; nevertheless, when histology confirms the presence of adenoma or carcinoma, the patient requires additional evaluation of the entire large intestine and more frequent follow-up examinations.

Adenocarcinoma↗