Biomedical subjects
Publications and source records attributed to J Greene.
At a time when D & O insurance is becoming increasingly difficult to obtain, hospital governing boards are making decisions on issues of growing complexity--decisions that could make trustees the target of lawsuits. This article looks at several alternatives to commercial D & O liability coverage.
The disposition of theophylline was examined in seven children with asthma on two occasions before and on one occasion after chronic phenobarbital dosing (2 mg/kg/day). There was little intrapatient variability in apparent theophylline clearance between the two baseline assessments (0.081 versus 0.073 L/hr/kg). After 19 days of phenobarbital therapy, there was a significant increase in apparent theophylline clearance (0.104 versus 0.077 L/hr/kg), accompanied by a 30% decrease in the mean steady-state serum theophylline concentration (12.0 versus 8.4 micrograms/ml). The inducing effect of phenobarbital on theophylline metabolism may require theophylline dosage adjustment in patients with asthma who receive both drugs concurrently to maintain a given average steady-state theophylline concentration.
Examination of approximately 700 soil samples yielded about 100 actinophages. Restriction analysis of phage DNA indicated that 57 are unique, and of these, 20 produce turbid plaques on one or more of the streptomycetes tested. Five phages are shown to insert into the genome of Streptomyces avermitilis. None of the phages was able to perform generalized transduction of S. avermitilis.
Few studies have examined the reasons women do not obtain medical care during their pregnancies. A retrospective case review of 70 patients in a large metropolitan hospital who received minimal prenatal care examined demographic variables and reasons women gave for not seeking care. Data suggested there are both internal and external barriers to care. More women cited reasons including depression, denial, and fear than cited financial or transportation problems. Implications for social work intervention in the hospital and in the community are drawn from the data and discussed.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
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The clinical value of nonstress testing (NST) in assessing fetal well-being is controversial. This study reviews the monitored tracings and subsequent perinatal outcome of 561 high-risk clinic patients who had undergone NST within one week prior to delivery. Two or more adequate accelerations of the fetal heart rate baseline with sufficient fetal activity over a 20-minute period were associated with a low risk of fetal jeopardy and were classified as a reactive test result. The corrected perinatal mortality of patients with reactive NSTs (1/509) was comparable to that of patients with no apparent antepartum complications (6/1,408) and was significantly lower (p less than 0.05) than those of high-risk patients with either nonreactive NSTs (2/22) or no testing (20/1,000). The incidence of subsequent perinatal jeopardy was significantly lower (p less than 0.001) among those high-risk pregnancies with recent reactive NST results (4%) than in those with recent nonreactive NST results (36%) and those without recent testing (13%). Perinatal morbidity among those pregnancies with recent reactive NSTs usually arose in the intrapartum period, and no reason to explain this jeopardy predominated. A reactive NST can be safely repeated in seven days, regardless of the adequately treated maternal risk factor. The only stillbirth following a reactive NST (1/509) probably arose from a cord accident.
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The medical use of heat produced by microwave radiation is called microwave diathermy, which has been the subject of considerable study by FDA over the last few years. The lack of reliable safety controls on many of these machines to prevent possible overexposure of harmful radiation to patients is one of several reasons why the Agency will soon propose a performance standard that will assure the safety and effectiveness of these medical services.
The chromosomal complement of 28 children with the diagnosis of acute nonlymphocytic leukemia (ANLL) were examined. An abnormal cytogenetic pattern was found in 50% of these patients, which is similar to the results in adults with ANLL. Unlike the reports in adult patients, however, no specific chromosomal changes were found. This observation may imply that the etiology and mechanisms by which abnormal clones develop in ANLL could differ significantly between children and adults. Those patients with chromosomal abnormalities in their initial bone marrow sample had a median survival of 7.1 mo, whereas those with a normal diploid pattern in their bone marrow had a median survival of 20.5 mo (1-sided, p = 0.04). If all metaphases were abnormal, the median survival was only 3 mo.
The US Census Bureau's 1977 projection of the nation's population aged 65 and older by the year 2000 was 31.8 million. This paper addresses the projection that in the future a higher proportion of the population in the United States will be older persons. It is obvious that older Americans are living longer with an increased incidence of diseases such as diabetes, hypertension, cardiac problems, and obesity, requiring medical and nutritional care. This paper discusses commitment to provide quality services in terms of prescribing appropriate and functional therapeutic diets to meet the needs of older Americans. Two mechanisms are discussed that are effective tools for calculating diabetic diet prescriptions and weight reduction diets based on energy level and energy needs. Also discussed are the provision of assistance to meet the social support needs of old people such as food stamps, Meals-on-Wheels, and homemaker's service.
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