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Biomedical subjects

I Jacoby

Publications and source records attributed to I Jacoby.

At least 37 records · Page 2Linked to original sources
PubMed1986

Direct mailing as a means of disseminating NIH consensus statements. A comparison with current techniques.

The Office of Medical Applications of Research of the National Institutes of Health conducted a survey to evaluate the effectiveness of mass mailing of consensus statements as compared with traditional dissemination methods. The consensus statement on osteoporosis, published earlier in JAMA, was selected for study. Physicians (N = 695) within each of five relevant specialties in two comparable metropolitan areas were surveyed. Findings suggest that while a small but significant increase of awareness resulted from direct mailing, this increase should be weighed against costs and effectiveness of other methods.

Information Services↗
PubMed1984

Single-dose amoxicillin therapy of acute uncomplicated urinary tract infections in women.

Of 210 women who were experiencing dysuria, frequent urination, pyuria, and significant bacteriuria and who were treated with a single 3-g dose of amoxicillin, 165 (79%) were cured of their original infections. Patients with infections that were negative by antibody-coated-bacteria assay were cured at a significantly higher rate than those with infections that were positive by antibody-coated-bacteria assay (90 versus 59%; P less than 0.001). Similarly, those with infections caused by amoxicillin-susceptible organisms were cured at a significantly higher rate than those with infections caused by resistant organisms (85 versus 50%; P less than 0.001). Of 27 patients who had infections caused by amoxicillin-susceptible organisms and who had relapses after single-dose therapy, 14 (52%) had relapses again after a conventional 10-day course of therapy, although all responded to a 6-week course. An additional 27 patients experiencing dysuria, frequent urination, and pyuria but who had a lower number of uropathogens in the urine (10(2) to 10(4.5)/ml of urine) were treated with single-dose therapy, with a 100% eradication of organisms and an 89% rate of symptomatic relief.

Acute Disease↗
PubMed1981

Graduate medical education. Its impact on specialty distribution.

A model was developed that describes the flow of residents through the graduate medical education (GME) system (derived from anonymous GME histories of the 160,000 US medical school graduates [1960 to 1977] on the American Medical Association's physician's master file in 1979). The model showed ultimate specialty distribution among practitioners as a function of specialty distribution among residents at entry to GME indicating that an increase in family practice residents will probably yield an increase in primary care practitioners, owing to the lower level of attrition from family practice residencies as opposed to specialists in internal medicine and pediatrics. Increases in first-year family medicine residencies led to decreases in primary care residencies as a whole led to increases in internal medicine subspecialists but to decreases in surgical subspecialists.

Career Choice↗
PubMed1981

Demographic factors associated with physician staffing in rural areas: the experience of the National Health Service Corps.

To determine which demographic factors favor rural communities obtaining physicians, county characteristics of National Health Service Corps sites are analyzed. Through the use of a difference of means test, sites which were staffed at least once are compared with sites which were never able to obtain physicians. Since a major portion of the sites never staffed were located in the Southeast, the effect of "southeast location" as a separate, binary variable is considered. Five factors related to income, employment and education significantly (p less than 0.01) distinguish the staffed from the "never-staffed" sites. A function derived from discriminant analysis correctly classifies more than 70 per cent of the sites as staffed or never-staffed; inclusion of the southeast variable increases the number of correctly classified sites by 6 per cent. Given the presence of both socioeconomic and nondemographic constraints on rural communities, significant improvements in physician distribution may require that programmatic interventions be intensified.

Demography↗
PubMed1980

Successful treatment of cerebral cryptococcoma and meningitis with miconazole.

Cryptococcal meningitis and a cerebral cryptococcoma developed in a patient with pulmonary cryptococcosis ("coin lesion") shortly after infected area of lung was removed. Treatment with amphotericin B and flucytosine failed to clear the organisms and antigen from the spinal fluid or alter the neurologic manifestations related to the cerebral lesion. Therapy with miconazole cured the meningitis and led to disappearance of the lesion in the brain (serial computed tomographic scan). Study of the patient over the next 5 years disclosed no evidence of relapse of infection and completely normal findings on neurologic examination.

Brain Diseases↗
PubMed1977

Tetracycline-induced pleural symphysis for recurrent hydrothorax complicating cirrhosis. A new approach to treatment.

Two patients with cirrhosis and ascites complicated by extensive unilateral pleural transudates refractory to therapy with dietary sodium restriction, diuretics, and repeated thoracentesis were successfully managed by tetracycline-induced pleural symphysis. The intrapleural instillation of this antibiotic prevented the recurrence of the effusion and substantially relieved the patients' symptoms with minimal undesirable side effects.

Female↗
PubMed1975

Task analysis in National Health Service Corps field stations: a methodological evaluation.

An occupational survey using a task inventory as survey instrument was conducted at four National Health Service Corps clinics providing primary ambulatory care. The prime objective of the study was to determine whether the methodology of task analysis could validly be applied to obtain data of potential value in improving personnel management in clinics. It is concluded that the taskinventory could generate such data. A first level analysis provides some interpretations of task interrelationships and role definition among clinic staff. In the clinics studied, no staff member's role was sufficiently well defined for efficient utilization of his capabilities. In particular, many tasks performed by the physicians and nurses could also be performed by less well-trained personnel. A number of steps are suggested for examining the task profiles of clinic staff and identifying areas of potential task redistribution. Also discussed are ways of improving the presentation of data obtained through task analysis to enhance the data's usefulness to local clinic management.

Community Health Services↗
PubMedDate not supplied

The roentgenographic findings associated with air embolism in sport scuba divers.

Records on all patients with arterial gas embolism (AGE) presenting to UCSD from 1982-1989 and for whom chest radiographs were available were reviewed. Of the 31 patients, 13 roentgenograms (42%) showed evidence of pulmonary barotrauma demonstrated by pneumomediastinum (N = 8), subcutaneous emphysema (N = 3), pneumocardium (N = 2), pneumoperitoneum (N = 1), or pneumothorax (N = 1). Pneumopericardium was not seen. Sixteen (52%) of the 31 patients had pulmonary infiltrates. Radiographic evidence of barotrauma was on occasion subtle, and in four cases was overlooked. Evidence of barotrauma (i.e., extra-alveolar air) was often identified along the left cardiac border, aortic arch, descending aorta, and hilar vessels. Subtle findings of ectopic air can confirm the clinical diagnosis of AGE; however, radiographic evidence of concomitant near drowning occurs more frequently.

Adolescent↗
PubMedDate not supplied

Disaster preparedness of home health care agencies in San Diego County.

A questionnaire was sent to 53 home health care agencies in San Diego to assess their state of disaster readiness. Thirty agencies returned completed questionnaires. Of these, 90% have written disaster plans, but only 33% conduct regular drills to practice their written plans. A 24-h telephone number is available to patients at 96% of the agencies. One-fourth of the agencies serving ventilator-dependent patients do not make utility companies aware of their special needs. Of 11 hospital-sponsored agencies, 18% include backup agreements with other agencies, while 79% of non-hospital-sponsored agencies have planned such backup. The majority (92%) of "private-for-profit" agencies have backup arrangements, but only 38% of the public or nonprofit agencies have such arrangements. Additionally, 31% of the home health care agencies do not feel they would be able to meet the needs of their clients in the event of a disaster. Specific recommendations for such agencies in developing disaster plans, and exercising them, are made.

California↗