Making a consultation service work. An organizational commentary.
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Biomedical subjects
Publications and source records attributed to J L Holtz.
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The increasing pervasiveness of "business" concerns in a cost-controlled medical care environment underscores the need to target communications regarding the operations of consultation-liaison (C-L) programs to the fiscal concerns of hospital and health care program administrators. Descriptions of what C-L programs have to offer should anticipate the specific interests of those who manage inpatient and ambulatory care programs and be phrased in terminology understandable by those managers.
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An outbreak of cadmium intoxication in a jewelry factory provided an opportunity for evaluating the usefulness of diagnostic procedures used to evaluate human cadmium toxicity. Blood cadmium levels in workers exposed to cadmium were higher (.93 micrograms/100ml vs .38 micrograms/100 ml) than in unexposed workers. A dose-response relationship was noted between blood cadmium level and symptom prevalence in four symptoms (dyspnea, chest pain, dysuria, and dizziness). Segmental hair analysis revealed highest cadmium levels (up to 19 micrograms/gm) in segments formed prior to cadmium exposure, suggesting that extrinsic contamination was the primary source of cadmium in the hair. beta2-microglobulin levels were within normal limits. No significant renal or pulmonary dysfunction was noted. Symptoms ceased after a cadmium-containing brazing alloy used in jewelry production was replaced, yet urine cadmium levels remained persistently elevated in four workers. Blood cadmium determinations were found to be useful in evaluating symptoms potentially related to cadmium intoxication.