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Biomedical subjects

A Glazer

Publications and source records attributed to A Glazer.

3 recordsLinked to original sources
PubMed1999

Increased capacity may exacerbate rationing problems: with applications to medical care.

Denial of service is more costly or difficult when the capacity to serve an individual exists (or when serving him does not reduce the service provided others) than when limited capacity makes it effectively impossible to serve some persons. In the presence of such differential costs of limiting service, a reduction in capacity (even when free) may increase social welfare. A review of data on medical care suggests that reductions in capacity may be necessary to limit the provision of care.

Health Care Rationing↗
PubMed1997

Preoperative transesophageal echocardiography for assessment of vena caval tumor thrombi: a comparative study with venacavography and magnetic resonance imaging.

OBJECTIVES: Renal cell carcinoma extends into the inferior vena cava (IVC) in 4% to 10% of patients. The purpose of this study was to evaluate the diagnostic accuracy of preoperative transesophageal echocardiography (TEE) in determining the presence and level of IVC involvement in such cases. METHODS: From June 1992 to December 1995, 13 patients with suspected IVC tumor thrombi were studied with preoperative TEE. These patients were also evaluated with either magnetic resonance imaging (MRI; n = 10), contrast venacavography (CVC; n = 8), or both of the latter (n = 5). All patients subsequently underwent surgical removal of the primary tumor and IVC thrombus. The presence and level of IVC thrombus at surgery was correlated with that predicted by the various preoperative imaging modalities. RESULTS: Preoperative TEE accurately delineated the presence and extent of IVC tumor thrombus involvement in 11 of 13 patients (85%); the level of IVC involvement was overstaged in 1 patient and understaged in 1 patient. Accurate diagnostic information was provided by MRI in 9 of 10 patients (90%) and by CVC in 6 of 8 patients (75%). CONCLUSIONS: In patients with IVC tumor thrombi, preoperative TEE can provide accurate information regarding the presence and extent of IVC involvement. However, TEE is an invasive and costly procedure with no diagnostic advantage over MRI in the preoperative evaluation of these patients.

Adult↗