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Biomedical subjects

H Meyers

Publications and source records attributed to H Meyers.

10 recordsLinked to original sources
PubMed1992

Ethics rounds at the nursing home: an alternative to an ethics committee.

The increased attention in US medicine to medical ethics reflects in large part the "new" demography of a growing elderly population and the conflict of whether decisions regarding medical care should be based on cost-effectiveness or "human-effectiveness." Currently, about 40 percent of the nation's elderly end up in nursing homes where they confront ethical and legal dilemmas that would not arise in their own homes. In the nursing home, difficult medical-ethical decisions generally rely on two approaches: the often used but frequently invalid concept of informed consent and little used ethics committees. At The Jewish Home and Hospital for Aged in New York City we have developed a program of "ethics rounds" as an alternative to ethics committees. We conduct the rounds in the open style of a forum or clinical conference rather than with the aura of a decision-making group. We encourage the participation of patients and family and seek to educate the staff, any one of whom may choose to attend. The rounds consist of a multidisciplinary case presentation, an interview of patient and/or family, a discussion by the staff, and an overview by an ethicist. Staff response to the educational and interdisciplinary aspects of the rounds has been remarkably positive.

Ethical Review↗
PubMed1986

Preoperative radiation therapy for rectal cancer. An effective therapy in need of a clinical trial.

Sixty patients with locally advanced adenocarcinoma of the rectum have been treated with preoperative high-dose pelvic irradiation in an attempt to improve operability and increase local control. Fifty-six patients showed no evidence of distant metastases at surgery and their records have been analyzed with respect to recurrence patterns, survival, and complications. The results have been compared with those of a similar analysis of 106 patients treated with curative surgery alone. There was a statistically significant improvement in local control between groups, with 16% of patients in the radiotherapy group having a component of local failure compared with 40% in the surgery group. A dose response was observed, with 67% local control at 4000 rad (4000 cGy) and 91% local control at 5000 rad (5000 cGy). Despite the more advanced clinical stage of the irradiated patients, no significant difference in survival was seen between groups, with a five-year survival rate of 52% in the irradiated patients and 48% in patients treated by surgery alone. Preoperative high-dose radiotherapy was well tolerated, with a 5% incidence of major complications in both groups.

Adenocarcinoma↗
PubMed1977

Preliminary studies using electron radiography for mammography.

An electron radiography mammography system was used for phantom studies and to obtain 230 craniocaudal view patient studies, of which 140 were compared to xeroradiographs for their ability to visualize 7 features of diagnostic importance. The average exposure of the electron radiographs was 89 mR. The technique was considered equal or superior to xeroradiography in 58% of the compared diagnostic features, while patient dose was reduced.

Breast Neoplasms↗
PubMed1977

Does this patient have primary open angle glaucoma?

An overview on the literature on primary open angle glaucoma that has appeared in the optometric and ophthalmological journals during the past ten years indicates a continuing reevaluation, and perhaps at times a seeming disagreement, regarding the parameters of this disease. Opinions have varied, and still do, on such matters as to whether or not the diagnosis of glaucoma is contingent upon a field defect, the existence of low tension glaucoma, the ramifications of ocular hypertension, what constitutes a glaucomatous appearance of the disc, field defects versus the appearance of the disc, field defects versus the appearance of the disc, and what constitutes an early glaucomatous field defect. Voices have been raised in some quarters that claim that waiting for a field defect to develop may not be in the best interest of the patient, and that the glaucoma suspect should be identified as early as possible. Treatment before the development of a field defect is enjoying support from some glaucoma authorities. Good clinical practice will permit the conscientious optometrist to identify those patients who have very early signs of this disease.

Diabetes Complications↗
PubMed1976

Anatomical site and size of 222 early asymptomatic oral squamous cell carcinomas: a continuing prospective study of oral cancer. II.

The site and size of 222 asymptomatic, primarily erythroplastic, cancers of the oral mucosa in 161 patients have been prospectively documented. Of 207 intraoral lesions (excluding 15 of the lip), 201 (97.1%) were found in three locations; floor of the mouth (101), ventral or lateral tongue (36), and soft palate complex (64). Of the 101 in the floor of the mouth, 73 occurred in the anterior portion with 33 involving the papilla at exit of Wharton's Duct (submaxillary gland). Of the cancers 84.2% were 2 cm or less and 41.9% were 1 cm or less. Of the lesions 2 cm or less 70.6% were invasive carcinoma. Minimal size does not preclude invasiveness. In view of the apparent predilection of oral carcinoma for particular sites (where there is no obvious agent), rather than random occurrence, the three aforementioned sites are designated as high risk areas which deserve particular scrutiny in an examination of the oral cavity. It is incumbent upon the clinician to biopsy all asymptomatic, persisten (14 days or more) mucosal aberrations in the high risk areas, especially those with erythroplastic components, regardless of size.

Carcinoma, Squamous Cell↗
PubMed1976

Clinical and theoretical considerations of a patient with narrow angles and shallow anterior chambers.

Clinicians must always be on the alert to identify those individuals who appear to be anatomically disposed to narrow angle glaucoma. However, it is not axiomatic that these individuals can be provoked into an attack even if a history of subacute attacks exists. In this paper, and in one other to follow, the case histories of several interesting patients that were seen by the author for routine eye examinations will be discussed. The intent of the papers is to demonstrate that the diagnosis of glaucoma, existent or potential, can be quite time consuming and is dependent on far more than just tonometry.

Female↗
PubMed1975

Individual variation in inosine triphosphate accumulation in human erythrocytes.

Erythrocytes from 5% of a normal population accumulated relatively high amounts of radioactive inosine triphosphate (i.e., greater than 70 nmoles/10(10) cells in 2 hr) when they were incubated with [14C]hypoxanthine. The incidence of this characteristic in a mentally retarded population was 16%. Inosine triphosphate was synthesized from [14C]hypoxanthine, but not from [14C]adenine or [14C]guanine. The metabolism of [14C]adenine and [14C]guanine was the same in erythrocytes that accumulated "normal" and "high" amounts of inosine triphosphate. Inosine triphosphate did not accumulate in leukocytes.

Adenine↗