Ryan Appell

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OBJECTIVE To compare the efficacy and safety of controlled-release oxybutynin with conventional, immediate-release oxybutynin and determine rates of dry mouth. METHODS Patients (n = 226) who were known to be responsive to anticholinergic therapy and who had seven or more urge incontinence episodes per week were randomized to receive controlled-release(More)
Falls are a leading contributor to disability in older adults. Increased muscle co-contraction in the lower extremities during static and dynamic balance challenges has been associated with aging, and also with a history of falling. Co-contraction during static balance challenges has not been previously linked with performance on clinical tests designed to(More)
INTRODUCTION Our study examined the wait time from ready-to-treat to radiation therapy for cohorts of breast cancer patients requiring adjuvant radiation therapy in 2001 and in 2005 after the implementation of strategies to reduce wait times for radiation treatment. We also examined the overall time from diagnosis to radiation treatment and whether distance(More)
The radiologic appearance of inflammatory and tumorous lesions in the iliac bone is characterized by destructive alterations and consolidations simultaneously. This pattern is nonspecific. The value of plain films of this area is compromised by the anatomy of the iliac bone and by overlying structures. Therefore tomography, computer tomography and bone(More)
Seven children and adolescents with sclerotic and periosteal alterations of the clavicle are reported, two of them in detail. Malignancies and bacterial inflammatory processes, which were first suspected, could be excluded. Clinical and radiographic features as well as differential diagnosis are discussed, as is the pertinent literature. The etiology of(More)
When doctors seek help from their colleagues, both come up against certain problems. The aid-seeker tends to develop denial mechanisms by "psychologizing" physical suffering, and manifesting mental suffering in the form of physical symptoms. The history often shows evidence of an immoderate fear of disease, lack of self-confidence, a life-negating stance,(More)
A boy with inoperable mediastinal echinococcosis is reported, who developed anaphylactic reactions during chemotherapy with mebendazole. IgE-mediated hypersensitivity was demonstrated by elevated echinococcus-specific serum IgE-antibody concentrations, by allergen-induced histamine release from washed leukocytes, and by passive sensitization of(More)
External irradiation of the head and neck has been shown to increase the incidence of thyroid carcinoma. Fourteen cases have also been reported of thyroid cancer developing in individuals treated with radioiodine for hyperthyroidism. Another patient's case is reported here to emphasize the possible role of I131 on the genesis of thyroid malignancy and the(More)
The arteriomesenteric occlusion of the duodenum is a rare form of intestinal obstruction in children and adolescents. Precipitating factors are disorders of the spine, loss of weight and kachexia. The angle formed by the mesenteric artery and the aorta determines whether or not an obstruction at this point occurs. With the exception of acute forms of(More)