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Biomedical subjects

H I Feldman

Publications and source records attributed to H I Feldman.

43 records · Page 3Linked to original sources
PubMed1991

Changes in causes of death after renal transplantation, 1966 to 1987.

This descriptive study was undertaken to examine survival and changes in cause of death after renal transplantation. One fourth (259) of the 1,022 patients who received a renal transplant between 1966 and 1987 at the University of Pennsylvania had died by January 1, 1988. Causes of death for 246 (96%) of the deceased patients were analyzed. Despite an increase in age and number of comorbid diseases before transplantation, posttransplant survival increased significantly over the study period. All-cause mortality rates at 1, 2, and 5 years decreased significantly. Infectious disease cumulative mortality rates at 1, 2, and 5 years also decreased between 1966 and 1985. No trend in the 1-, 2-, or 5-year cardiovascular disease cumulative mortality rates was detected. The decline in the rate of deaths due to infection led to a decrease in the proportion of infection-related deaths and an associated increase in the proportion of cardiovascular disease-related deaths. The reduction in mortality over the past 2 decades is associated with the simultaneous improvement in immunosuppression and treatment of infectious diseases.

Cause of Death↗
PubMed1989

Reprocessing of hemodialyzers: a critical appraisal.

The reprocessing of hemodialysis equipment was originally developed to conserve scarce resources and to reduce the time necessary to construct early dialyzers. Although most dialyzers in current use are marketed as disposable items, the majority of dialysis facilities in the United States reprocess these devices and use them multiple times on the same patient. Recent studies have shown that certain reprocessing techniques confer improved biological properties on dialyzers compared with new membranes as prepared by manufacturers. Several studies have suggested that these biological properties may lead to improved clinical outcomes. However, critics of dialyzer reprocessing argue that it may expose patients to risks that produce increased morbidity and mortality. This article critically reviews the available scientific information regarding reprocessing hemodialyzers.

Cellulose↗
PubMedDate not supplied

Epidemiological pitfalls using Medicaid data in reproductive health research.

The purpose of this report is to discuss methodologic issues in using Medicaid claims data to conduct epidemiologic analyses in reproductive health. We conducted case-control studies that used Medicaid claims data to evaluate two specific reproductive health questions. Case and control pregnancies were selected from among 106,000 women identified in a Medicaid claims file. Medical record review was conducted for randomly selected cases and controls. Several methodological issues were identified. Women could contribute multiple pregnancies that qualified as either case pregnancies, control pregnancies, or both. The results of the medical record review indicated that 25% of one case group (low-birthweight infants) could not be confirmed, and 70% of the second case group (CNS birth defects) were misclassified. Thirty-five percent of women classified as not having undergone diagnostic ultrasonography based on Medicaid claims data had evidence of having received diagnostic ultrasound during pregnancy on the basis of medical record review. Several problems were encountered with the use of Medicaid billing data to address epidemiologic questions in reproductive health. Although solutions to some of these problems could be identified, others could not be addressed without careful review of the medical records. These limitations may not apply to all state Medicaid databases or other claims data, but they should be carefully considered when planning claims-based analyses of reproductive health issues.

Adolescent↗
PubMedDate not supplied

Utilisation of drugs for diabetes mellitus.

This article reviews the data from drug utilisation research on antidiabetic agents, oral hypoglycaemics and insulin. Study methods specific to this type of pharmacoepidemiological research are discussed and critiqued. A brief overview of the sources of drug utilisation data is presented, followed by a review of specific pharmacoepidemiological investigations. We evaluate the usefulness of these studies in assessing true drug consumption, in evaluating comorbidity in diabetic patients and in measuring the prevalence of diabetes. International comparisons of antidiabetic drug utilisation, also reviewed and analysed, demonstrate wide variations in the use of hypoglycaemic agents, which have arisen for reasons which are unclear. Drug utilisation research thus far has been limited by the paucity of studies relating these variations in antidiabetic drug use to specific clinical outcomes. There is a need to expand the applications of research on the use of antidiabetic agents, including assessment of patterns of morbidity across geographic boundaries and over time.

Diabetes Mellitus↗