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S Bartels

Publications and source records attributed to S Bartels.

14 recordsLinked to original sources
PubMed2004

[Report on the patient forum on medical ethics. "Curse and blessing of knowledge of disease"].

From July 15th to July 16th the Protestant Academy of Tutzing opened its doors for the fourth time to the public for a discussion between medical doctors, patients, relatives, nurses and pastors on the new developments of medical diagnosis. The central idea of this type of forum, first initiated in 1993 by Prof. Reiter-Theil, bioethicist at the university of Basel, is to let patients and their relatives actively participate in the bioethical discussion. The dialogue between medical doctor and patient is part of a complex set of interactions between medical progress, ethical aspects and legal regulations. It should be governed by the respect for the autonomy of the patient and by his or her will and capacity to deal with a difficult diagnosis. The communication should be non directive in its nature, but nevertheless take place in an ethically sensitised and responsible manner. As a result counts not what type of message was intended, but what type of message the patient received. The diverse results of the conference can be summarized under the phrase "the patient should determine the rhythm", i. e. the timing and the type of diagnostic knowledge she or he wants to receive.

Communication↗
PubMed2001

Noise-induced hearing loss: the effect of melanin in the stria vascularis.

Conflicting investigations regarding the potential protective effect of melanin against noise-induced sensorineural hearing loss have suggested that eumelanin and pheomelanin may have differing effects within the stria vascularis. Three strains of C57BL/6J mice, (+/+, a/a) wild-types (dark coats/black eyes), (c2j/c2j, a/a), albinos (white coats/pink eyes), and (+/+, Ay/Ay) yellow mice (yellow coats/black eyes), were subjected to five consecutive days of broad band noise exposure at 112 dB(A) SPL for 3 h/day. Cochlear function was evaluated with auditory brainstem response audiometry to pure tones immediately pre-exposure, 5-6 h postexposure, and 14 days post-exposure. No significant difference in the degree of sensorineural hearing loss induced in the three strains of mice was identified. The eumelanin and pheomelanin content of each stria vascularis and amount of protein per stria for both mouse and guinea pig (2/NCR) were determined via high performance liquid chromatography. No pheomelanin was found in the stria of yellow mice, suggesting that coat color is not an accurate predictor of strial melanin content. The melanin content per mg of strial protein was higher in mice than in guinea pigs. A species-specific difference in melanin content does not explain the absence of a protective effect in mice.

Animals↗
PubMed2000

The relative value of fine-needle aspiration and imaging in the preoperative evaluation of parotid masses.

BACKGROUND: To establish the sensitivity, specificity, and accuracy of imaging and fine-needle aspiration (FNA), alone or in combination, in distinguishing benign from malignant histologic findings for parotid lesions. METHODS: Retrospective blinded review of preoperative imaging and FNA studies of parotid masses and comparison with histologic findings after excision. RESULTS: Forty-eight patients were identified (13 with CT, 35 with MRI); 23 (48%) of the lesions were malignant, 25 (52%) were benign. MRI, CT, and FNA misclassified 17%, 46%, and 21% of the lesions, respectively. The sensitivity/specificity/accuracy of these tests for detecting malignant lesions were as follows: MRI (88%,77%,83%), CT (100%,42%, 69%), and FNA (83%,86%,85%) and were not significantly different. Combinations of imaging and FNA were not significantly better in detecting malignancy. CONCLUSIONS: Imaging and FNA are comparable in their ability to correctly identify malignant parotid lesions preoperatively. Combining these two modalities yields no advantage in terms of specificity, sensitivity, or accuracy of a malignant diagnosis.

Biopsy, Needle↗
PubMed2000

Improving the precision of primary care physician self-report of antidepressant prescribing.

BACKGROUND: Methods to select physicians most likely to benefit from educational interventions to improve the outcome of depression have not been adequately developed. OBJECTIVE: The purpose of this study was to identify a combination of primary care provider (PCP) self-report questions to improve the precision of PCP estimates of actual antidepressant prescribing as a potential tool for PCP selection. METHODS: The total number of new and refill antidepressant prescriptions written by 124 PCPs and actually filled at pharmacies over a 2-year period were matched with telephone survey results of these PCPs completed before the 2-year period. Multiple regression techniques were used to identify a set of variables that improved upon PCPs' self-report of prescriptions. RESULTS: The mean for PCP-reported antidepressant prescriptions written in the last week was 7.8 (+/-11.2). The average weekly prescriptions actually filled was 6.72 (+/-5.65). Most survey variables were significantly correlated with antidepressant prescriptions. The final model included 6 variables that explained 52% of the variance in prescriptions. In addition to PCP-reported number of antidepressants prescribed, average number of primary care patients seen per week and number of patients covered by managed care were directly related to the volume of prescriptions. PCP age, percentage of patients referred immediately without treatment, and mental health services being too far away were inversely related. CONCLUSIONS: PCP self-reports on antidepressant prescribing are reasonably accurate proxies of actual prescribing. The precision of estimates of actual prescribing can be improved by considering practice structural and financial characteristics.

Antidepressive Agents↗
PubMed2000

Job hazards for musculoskeletal disorders for youth working on farms.

A series of eight focus groups were convened to: (1) identify tasks and activities performed by youth on farms with the potential for causing non-traumatic work-related Musculoskeletal Disorders (MSDs); (2) determine the participants perceptions about risks of MSDs for youths performing those tasks; and (3) determine other factors that might relate to MSDs for youth working on farms, such as possible interventions for prevention. Seventy-two farm family members, 40 adults and 32 farm youth aged 8-18, participated in focus groups. Ten questions were posed to each of the eight groups about what tasks youth perform on the farm, how the work is assigned, and what risk factors are associated with the work. There was general agreement among the adults that maturity rather than age is the dominant factor for determining what tasks are performed by youth workers on the farm. Youth, on the other hand, believed that task urgency dictated what jobs were assigned to youth workers. Most adults indicated that lifting objects, forking, or shoveling was responsible for most of the serious non-traumatic injuries. Bending over while working, sitting in an awkward position looking back at equipment from a tractor, sitting in a cramped position, looking down at a combine header, and long hours of work were also identified as potential problems. Youth described muscle aches and strains of the legs, arms, shoulder, back or neck as everyday occurrences. According to the youth, "If it's not broken, you're fine". Only basic training is provided and most respondents believed that youth learned best through observation. There was general agreement that physician recommended guidelines for assigning youth to tasks would be ignored unless they carried the force of the law.

Accidents, Occupational↗
PubMed1999

The need for a system in the care of depression.

BACKGROUND: Many problems have been identified in the usual care of patients with depression, including lack of identification, overreliance on medications, and inadequate treatment and follow-up. Most of these problems can be attributed to an absence of depression care systems in primary care practice. We collected information from a group of practices to assess the need for and acceptability of such systems. METHODS: We conducted 4 focus groups with primary care physicians and their staffs to identify attitudes and perceived behaviors for depression problems and to determine the participants' level of acceptance of alternative systematic approaches. We also surveyed clinicians and a sample of patients who recently visited their practices. RESULTS: Systematic screening was viewed unfavorably, and many barriers were identified with collaborative care with mental health clinicians. Participants did support involvement of other office staff and more systematic follow-up for patients with depression. The patient survey suggested that some patients with depressive symptoms were unrecognized and undertreated, but the key finding was considerable variation in care among practices. CONCLUSIONS: These findings suggest that a more systematic approach could improve the problems associated with treatment of patients with depression in primary care and would be acceptable to physicians if introduced appropriately. There are at least 2 promising approaches to introducing such changes. One involves external feedback of data about their care to the practices, followed by offering a variety of systems concepts and tools. The other involves an internal change process in which a multiclinic improvement team collects its own data and develops its own systematic solutions using rapid-cycle testing.

Attitude of Health Personnel↗
PubMed1993

Atherosclerosis-associated changes in the carbohydrate-binding capacities of smooth muscle cells of various human arteries.

A set of labelled neoglycoproteins and sulfated polysaccharides, recognizing carbohydrate receptors specific for glucose (glu), mannose (man), lactose (lac), fucose (fuc), fucoidan (fud), dextran sulfate (dex), and heparin (hep), as well as polyclonal antibodies specific for an endogenous beta-galactoside-specific lectin of molecular weight 14kD (A14kD) and a heparin-binding lectin (AHL) have been applied to the main arteries of 10 autopsy cases. Slides of the following types of vessels were incubated with solutions of the biotinylated probes or antibodies at room temperature for 60 min: right and left coronary artery, carotid artery, abdominal and thoracic aorta, pulmonal artery, and the left femoral artery. Atherosclerotic lesions and non-atherosclerotic areas were analyzed for each individual type of vessel. The percentage of the determined expression of the presence of specific binding sites for the various probes was the lowest in the carotid and cardiac arteries, and the highest in the pulmonal artery. Pronounced quantitative differences between the normal and atherosclerotic arterial walls were noted for binding of fuc-, man-, and lac-exposing neoglyco-proteins of the right coronary artery and the carotid artery. Pulmonal and femoral arteries differed with respect to fucoidan or dextran sulfate binding. The heparin-specific lectin and the 14kD-lectin were found to be present in nearly all arterial walls, independent from the localization and the presence of an atherosclerotic lesion. The findings suggest that the expression of sugar receptors, as assessed by labelled neoglycoproteins or sulfated polysaccharides, may be of importance in the development of atherosclerotic lesions in the coronary and carotid arteries.

Aged↗
PubMed1987

Pineal region tumours of childhood.

In Germany, the relative frequency of pineal region tumours seems to be much higher than hitherto assumed. At the University Hospital Hamburg, from 1980-1985 17 children with pineal region tumours were encountered amongst 102 children with CNS tumours. Two-cell-type germinoma is the most frequent pineal region tumour. Cerebrospinal fluid cytology is highly successful in identifying this germ cell tumour. Surgical removal has become a reasonably safe procedure in the treatment of pineal region tumours and was successful in all 10 cases so treated. In addition, our patients with two-cell-type germinomas received craniospinal axis radiation. All children, treated by both surgical removal and craniospinal axis radiation are so far relapse-free and are functioning on a pretreatment level.

Brain Neoplasms↗
PubMed1984

[Nitrogen and mineral metabolism of growing lambs fed straw treated in different ways].

Lambs were fed diets containing 500 g straw, 50 g sucrose and 30 g minerals per day. The straw was untreated (A), wafered after addition of NaOH (B) or gassed with ammonia. Diets A and B, in addition contained urea, so that equal amounts of dietary N were offered. Digestibility of OM was increased by 12 units after addition of NaOH and by 8 units after gassing with NH3. As significantly more faecal N was excreted in animals fed diet C, it is concluded that N of NH3-treated straw is less available than of added urea. When NaOH-treated straw was fed, renal excretion of phosphorus was increased.

Ammonia↗
PubMedDate not supplied

Bipolar scissors in facial plastic surgery.

BACKGROUND: Many methods are available to the facial plastic surgeon for elevating and separating tissue, from cold steel to monopolar cautery to various laser-cutting technologies. Bipolar cautery has replaced monopolar cautery as the optimal hemostatic technique because of its decreased tissue damage and improved capabilities. Bipolar scissors concurrently offer a dissecting technique with hemostatic capability. Little exists in the otolaryngology literature on the use of bipolar scissors for soft tissue dissection. OBJECTIVE: To describe our experience using bipolar scissors in a variety of facial plastic and reconstructive procedures. SETTING: Tertiary care referral academic center. DESIGN: We retrospectively reviewed 78 procedures performed using bipolar scissors between June 1997 and August 1999. In facial plastic cosmetic surgery, bipolar scissors were used 31 times for deep plane face-lifts and 16 times for endoscopic browlifts. In facial plastic reconstructive surgery, bipolar scissors were used in 15 radial forearm free flaps, 10 fibula osteocutaneous flaps, 3 rectus abdominis free flaps, and 3 latissimus dorsi myocutaneous free flaps. RESULTS: In all procedures, bipolar scissors facilitated the dissection. By allowing for a drier field, less time was required to elevate the flap and obtain hemostasis. Complications were not increased compared with historical controls. In the harvesting of fibula osteocutaneous free flaps, use of bipolar scissors allowed harvesting without use of a tourniquet. CONCLUSION: Bipolar scissors, a new technology in facial plastic surgery, allow the same control as sharp dissection and provide simultaneous hemostasis.

Dissection↗