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Biomedical subjects

F J Crosson

Publications and source records attributed to F J Crosson.

18 recordsLinked to original sources
PubMed1997

Aligning organizational strategic planning and research priorities: the Kaiser experience.

Kaiser Permanente, the largest nonprofit HMO in the country, is a prepaid group practice program which provides comprehensive health benefits coverage to more than 8 million Americans in 17 states and the District of Columbia. The Northern California region of Kaiser Permanente is the largest region with more than 2.6 million members. This article describes the creation of a research effort in the Northern California region to develop a long-range strategic research plan. This effort was initiated in order to align research priorities with organizational strategic planning. The plan's aim was to better guide the process of using research to help the region meet its mission, goals and objectives. Twenty-seven strategic research areas were identified organized into four major categories. The top six strategic research areas are discussed.

California↗
PubMed1995

Why outcomes measurement must be the basis for the development of clinical guidelines.

Three approaches to clinical quality improvement, health care standards, clinical guidelines, and quality improvement research, are differentiated by the quality of the available medical evidence linking health care processes to health care outcomes. The key determinant of Permanente Medical Group physician acceptance and use of a clinical guideline is the belief that solid data links the guideline's advice to improved patient outcomes. Purchasers, government agencies, regulatory organizations, and health plans must understand the difference between health care standards and clinical guidelines. Strict adherence to clinical guidelines should never be the basis for accountability for physicians, medical groups, or organized systems of care.

Attitude of Health Personnel↗
PubMed1983

Need for measles revaccination in adolescents: correlation with birth date prior to 1972.

Measles hemagglutination inhibition (HI) antibody titers of less than 1:4 were significantly (P less than 0.05) more prevalent among subjects born from 1962 through 1971 and vaccinated with a single dose of live measles virus vaccine at 12 months of age (14.5%) than among subjects born during the same years but vaccinated at 13 months or older (2.3%). For subjects born in 1972 through 1976, however, this difference was not statistically significant; titers of less than 1:4 occurred in 6.2% of those vaccinated at 12 months, compared to 0% in those vaccinated at 13 months or older. A decline in maternally derived measles HI antibody may be related to the increased rate of HI antibody titers of 1:4 or greater following vaccination of more recently born subjects. Following revaccination of subjects whose measles HI antibody titers were less than 1:4, measles HI titers were lower than would be expected after successful primary vaccination. Nevertheless, measles HI antibody persisted at a level of 1:4 or more until the latest titer measurement of this study (one to two years after revaccination) in 87.5% of those whose initial vaccination had been at 11 or 12 months of age. No adverse reactions to revaccination occurred. Revaccination programs should be considered for adolescents and young adults born before 1972 who received live measles virus vaccine at or before 12 months. Children born from 1972 through 1976 who were vaccinated at 12 months or later are not in need of revaccination.

Adolescent↗
PubMed1981

Atypical mycobacterial cervical lymphadenitis--treatment with surgery and antibiotics.

Five patients, ages 2 to 5 years, were successfully treated for cervical lymphadenitis caused by the avium intercellulari complex of atypical bacteria. Preoperative treatment with standard antituberculosis therapy had been unsuccessful. Extensive surgery requiring a conservative radical neck dissection was sometimes required. Three patients had such extensive and progressive disease that immediate excision was impossible. These patients received a course of Amikacin with considerable improvement, permitting adequate excision and reconstruction. A fourth patient who received Amikacin did not respond, although sufficient excision was possible. This preliminary data indicates that a combined treatment of Amikacin and surgery in extensive cases may be useful in the treatment of cervical lymphadenitis due to atypical mycobacteria.

Amikacin↗
PubMed1977

Acute copper intoxication. Pathophysiology and therapy with a case report.

We report a case of cupric sulfate intoxication in a child who had a serum copper level of 1,650 mug/100 ml. His course was accompanied by hemolytic anemia and renal tubular damage. We review the pathophysiology of copper metabolism and intoxication. We also review modes of therapy, with specific reference to the initial approach, using dimercaprol (BAL) and edetic acid rather than penicillamine.

Acute Disease↗
PubMed1977

Neonatal sepsis at The Johns Hopkins Hospital, 1969-1975: bacterial isolates and clinical correlates.

The experience with neonatal sepsis at The Johns Hopkins Hospital during 1969-1975 was reviewed. Major pathogens included Escherichia coli, group B streptococcus, other streptococci, and Klebsiella. Nineteen percent of coliform isolates were kanamycin-resistant. The frequency of recovery of E. coli was increased in early-onset sepsis, and the frequency of recovery of Klebsiella was increased in late-onset sepsis. The mortality rate was 23%. The frequency of recovery of E. coli was increased in fatal cases, and mortality was highly correlated with the presence of gastrointestinal catastrophe. Ampicillin and gentamicin are the initial antibiotics of choice for neonatal sepsis at this institution; a penicillinase-resistant penicillin should be added when Staphylococcus aureus involvement is likely, and addition of chloramphenicol or clindamycin should be considered for infants at increased risk for Bacteroides fragilis sepsis.

Escherichia coli Infections↗
PubMed1976

Participation of complement in the nonimmune host defense against experimental Haemophilus influenzae type b septicemia and meningitis.

This study was undertaken to determine whether the terminal complement components (C3-9) are involved in the nonimmune host defense against Haemophilus influenzae type b septicemia and meningitis. Using cobra venom factor, infant rats were depleted of C3 and C5. After intranasal challenge with H. influenzae type b, the complement-depleted rats developed a greater incidence and magnitude of bacteremia and a higher mortality rate. In contrast to the effects on bacteremia, complement depletion did not directly influence either the occurrence of meningitis or bacterial multiplication within the cerebrospinal fluid. These experiments provide evidence that the complement system may be an important mechanism of natural immunity to H. influenzae type b.

Aging↗