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Biomedical subjects

A D Heymann

Publications and source records attributed to A D Heymann.

13 recordsLinked to original sources
PubMed2005

Mandatory computer field for blood pressure measurement improves screening.

METHODS: We evaluated the effectiveness of a compulsory data field in a computerized medical record (CMR) in improving blood pressure (BP) screening. RESULTS: The proportion of study patients who had their BP measured increased from 40.6% to 58.5% (P < 0.001) after the intervention. After adjusting for age, gender and number of visits, patients were 73% more likely to have their BP recorded after the introduction of the compulsory field.

Adult↗
PubMed2005

Gender differences in healthcare utilization and medical indicators among patients with diabetes.

OBJECTIVE: To describe differences in healthcare utilization and health indicators of patients with diabetes, according to gender. STUDY DESIGN: A population-based outcome study conducted on 21,277 diabetic patients between the ages of 45 and 64 years who are members of the second largest health maintenance organization in Israel. METHODS: Data on healthcare utilization (process indicators) and health problems (outcome indicators) were obtained from computerized medical records that are stored routinely by the organization. The study period was the year 2002. RESULTS: Significantly (P < 0.05) lower healthcare utilization was observed in men compared with women for all indicators examined (number of visits to physicians and the performance of urine, lipids and creatinine tests). Nonetheless, men showed better health outcomes (lower low-density lipoprotein cholesterol, triglycerides, HbA1c). CONCLUSIONS: Women who suffer from diabetes use more healthcare services and have a higher morbidity rate compared with men. Future research should seek to identify the factors contributing to this observation, which can potentially make an important contribution to the development of disease management strategies that target diabetic women.

Diabetes Mellitus↗
PubMed2004

The use of organizational data for the evaluation of mass prevention programs.

BACKGROUND: The effectiveness of health promotion campaigns is hard to measure due to complex outcome and external factors. This study presents a method to evaluate a mass women's health promotion campaign held in a large health maintenance organization (HMO) in Israel. METHODS: This population-based study used administrative and medical databases to examine whether postal invitation to 120,231 HMO-female members increased adherence with certain preventive medicine recommendations (LDL-C, bone density test, and mammography breast cancer screening). A comparison was made using three different reference data: pre- and post-campaign periods (1998-2003), HMO-male members who were not targeted by the campaign, and rates of urine tests, which were also not targeted by the campaign. RESULTS: During the 2 months following the campaign, adherence with mammography (3.8%) and LDL-C (12.5%) reached their maximum rates in 5 years. Adherence with bone density test increased from 2.3% in 2000 to 2.8% in the campaign period. No similar trends were observed for urine or LDL-C tests among men. CONCLUSIONS: The use of multiple reference groups through the analysis of administrative and medical databases supports the association between the campaign and improved adherence with screening tests. A similar methodology may be adopted for the analysis of mass health promotion campaigns in large HMOs.

Adult↗
PubMed2001

Carbohydrate antigen 19-9 and carcinoembryonic antigen immunostaining in benign multicystic mesothelioma of the peritoneum.

A 58-year-old Italian man was incidentally discovered to have an elevated carbohydrate antigen 19-9 (CA-19-9) level of 132 U/mL on routine blood testing. Multisystem imaging studies revealed multiple benign-appearing cysts of the liver and single cysts in the pancreas and kidney parenchyma. Throughout 14 months, fluctuations were observed in the elevated serum CA-19-9 levels from 99 to 450 U/mL. Serum carcinoembryonic antigen (CEA) and other tumor markers were normal. Laparoscopy disclosed multiple cystic lesions on the surface of the liver, on the serosal surface of the ileum, and in the mesentery. Electron microscopy characterized the cells as mesothelial. The pathologic diagnosis was benign multicystic mesothelioma of the peritoneum (BMMP). Aspirated fluid from the liver cyst revealed CA-19-9 levels at 28 500 U/mL, strongly linking the elevated serum CA-19-9 levels with mesothelial cyst secretion. Immunostaining was positive for CA-19-9, CEA, and cancer antigen 125 (CA-125). We believe this is the first documented instance of CA-19-9 and CEA secretion in BMMP.

CA-19-9 Antigen↗
PubMed1979

Clinical aspects of grave pyogenic abscesses of the liver.

Solitary hepatic abscess has a favorable prognosis in contrast with multiple abscesses which generally are fatal. As compared with the classical cause of appendicitis, at present, abscesses are frequently related to biliary tract and diverticular disease. Occult or temporally remote processes are responsibile for many solitary abscesses. Lethality of multiple abscesses is related to fulminant hepatic and source sepsis, atypical syndromes, late diagnosis and difficult, complex treatment. Causative organisms are predominantly gram-negative and increasingly anaerobic, requiring special bacteriology for isolation. Various laboratory data are useful in diagnosis and prognosis, but liver scans and celiac angiography are critical procedures. Treatment aimed at lowering the mortality of multiple liver abscesses includes early diagnosis, surgical exploration and abscess drainage, direct bacterial identification emphasizing anaerobic techniques, intense specific antibiotic therapy and identification and definitive therapy of the seeding focus with special attention being given to the biliary tract.

Adult↗
PubMed1978

Dermatopathic lymphadenitis presenting as lateral breast mass.

Two cases of dermatopathic lymphadenitis involved external mammary lymph nodes and presented clinically as breast masses. The variable position and number of external mammary lymph nodes account for the difficulty in differentiating intrinsic breast pathological conditions of the lateral margin of the breast from lymphadenitis. Recent publicity may account for a lower threshold for detection of such lesions by patients as well as physicians. Dermatopathic lymphadenitis should be included in the differential diagnosis of persistent solid masses involving the lateral margin of the breast and should be confirmed by excisional biopsy.

Adult↗
PubMed1978

Recurrent renal carcinoma causing intestinal hemorrhage.

Three cases of gastrointestinal bleeding caused by secondary renal carcinoma are presented. Hemorrhage occurred secondary to invasion of bowel anatomically related to the primary tumor. Bleeding can best be controlled by excision of tumor and involved intestine. Surgery is justified by the unpredictable prognosis for renal carcinoma with secondary disease.

Adenocarcinoma↗
PubMed1977

Successful reimplantation of the penis using microvascular techniques.

The second case of traumatic amputation of the proximal shaft of the penis is reported. Microvascular techniques were used for direct anastomoses of the dorsal arteries of the penis. The apparent advantage of immediate restoration of arterial blood supply to the corpora and skin with a reduced amount of skin slough is evident.

Amputation, Traumatic↗
PubMed1977

The effect of incidental hypothermia on elderly surgical patients.

Elderly surgical patients are especially susceptible to incidental hypothermia. Thermoregulatory mechanisms and cardiopulmonary systems are limited in recovery potential. To prevent postoperative shock secondary to decreased cardiac output an hypoxia, temperature should be carefully monitored with vital signs during and after surgery.

Female↗