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J Feinglass

Publications and source records attributed to J Feinglass.

59 records · Page 4Linked to original sources
PubMedDate not supplied

Patterns of care for HIV-related Pneumocystis carinii pneumonia in a university medical program: a case study.

BACKGROUND/OBJECTIVE: Previous studies have identified large variations in patterns of in-hospital acquired immunodeficiency syndrome (AIDS) care among groups of hospitals and physicians. We evaluated the patterns of care for patients with AIDS-related Pneumocystis carinii pneumonia (PCP) care at a single university program with patients treated at an adjacent county and Veterans' Administration (VA) hospital. All medical care was provided by physicians in a single residency program, but attending physician staffs were separate. SETTING AND PATIENTS: A randomized sample of patients with human immunodeficiency virus (HIV)-related PCP from the two hospitals who received care between 1987 and 1990. RESULTS: During the study years, the VA hospital provided care for approximately one fourth as many AIDS patients as the county hospital. Patients at the VA hospital had a higher bronchoscopy rate (39.7% versus 27.7%, P = .05), higher intensive-care unit (ICU) rate (11.8% versus 2.9%, P = .008), longer hospitalizations (mean length of stay of 18.9 versus 13.9 days, P = .004), but delayed initiation of anti-PCP therapy (median of day 2 versus day 1, P < .05). The odds of death were significantly different between the VA and county hospitals, even after adjusting for differences in important patient characteristics. CONCLUSION: Patterns of in-hospital PCP care differed between the two hospitals of this medical school. Possible explanations include organizational differences related to level of attending physician HIV experience, hospital case loads of AIDS patients, or specific hospital considerations such as concerns over tuberculosis exposure.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Radiographic screening for tuberculosis in a large urban county jail.

OBJECTIVE: This study was designed to evaluate an innovative program of high speed radiographic screening for pulmonary tuberculosis (TB) at a large urban correctional institution, Cook County Jail in Chicago. METHODS: From March 1992 to February 1994, 126,608 inmates were screened on intake with a 100-mm mini-chest radiograph. RESULTS: Sixty-seven cases of active TB were identified by radiograph and 19 others from diagnostic work-up. The case finding rate for active disease with radiographic screening was approximately double the rate previously achieved with Mantoux skin testing. Mean time from jail entry to isolation was reduced from 17.6 days with Mantoux skin testing to 2.3 days with radiographic screening. CONCLUSIONS: In large jail facilities, high speed X-ray screening for TB can minimize disruption of the intake process and lead to dramatic improvements in the efficiency of medical follow-up and isolation.

Chicago↗