Biomedical subjects
Publications and source records attributed to G E Howe.
Physician issues are at the heart of today's debate on how to reconfigure the delivery and financing system. Leaders agree that you can't live without doctors, but it can be difficult to live with them. In this fourth and final CEO Summit series planned by McMannis Associates and cosponsored by Hospitals & Health Networks, CEO leaders dissect some of the trickier physician issues.
There's a flood of change coming, and health care executives are quickly building and loading big boats to sail to the future. But what do you take--and what do you leave behind? What will be needed in the new world--and what won't? In the third of an exclusive four-part series planned by McManis Associates and co-sponsored by Hospitals & Health Networks, some top CEOs talk about their travel plans.
A new breed is evolving in health care. A provider sponsored network i s part insurance function and part provider function. But no one knows exactly how it will behave. In the second entry of the exclusive four-part CEO Summit series planned by McManis Associates and cosponsored by H&HN, some top leaders in health care discuss some of the conflict in this changing delivery system.
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The serum of 45 men with sperm in the ejaculate post-vasovasostomy was tested for antisperm antibodies. Agglutinating antibodies were found in 48 per cent of the men whose partners became pregnant and in 94 per cent of those whose partners did not become pregnant (p less than 0.01). No such correlation was found for sperm immobilizing antibodies. Spontaneous in vivo autoagglutination was not demonstrated in any of the patients. Although functional failure seems likely to be associated with an immunologic event neither sperm agglutination nor sperm immobilization seems to be the mechanism of that event.
Three cases are presented of spontaneous regression of peripelvic renal cysts. The lesions were manifested by lateral extrinsic pressure defects in the renal pelvis and major calices (all 3 cases), and selective renal angiography showing stretching of vessels plus sharply defined defects in the nephrographic phase (2 patients). In 1 case the mass disappeared following trauma to the flank, while in the remaining 2 cases it disappeared spontaneously.
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Catheterization should not be used without true indication. Careful control of hydration, sedation, anesthesia and use of anticholinergic agents before, during and after operation can do a great deal to prevent the need for catheterization. When the procedure is necessary, simple, inexpensive measures of care usually are sufficient. Prophylactic antisepsis before and after, with reexamination of the urine after discontinuance of antiseptic drugs to make sure there is no recrudescence, prevents acute and chronic infections. The catheter recommended for routine male and female catheterization is the 14-16 (French) olive tip coude (Tieman) catheter or the Tieman-Foley. Closed drainage systems are the best. Continuous irrigation is without value. Water is an excellent irrigant. Calcium deposits are prevented by Renacidin(R) instillation and acetic acid irrigation.
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In 34 selected patients with prostatic carcinoma treated with total perineal prostatovesiculectomy, the morbidity was low and mortality nil. Fourteen patients were alive and well for over five years and 12 patients are alive and well for less than five years at the time of report. Six patients were dead, two with prostatic carcinoma. Two of the survivors had recurrent carcinoma.
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