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Biomedical subjects

L Deutsch

Publications and source records attributed to L Deutsch.

12 recordsLinked to original sources
PubMed1994

Building a children's health network: city-wide computer linkages among heterogeneous sites for pediatric primary care.

For many infants and children in our cities, quality of care and health status outcomes suffer due to poor continuity and coordination among ambulatory care sites. Despite proximity to technologically-advanced secondary and tertiary institutions, primary care services for children are fragmented, multiple-site use is common, and data flow among providers serving the same patients is primitive. Preventive and acute health care is often incomplete or redundant, and aggregate information for public health purposes is insufficient. This paper focuses on the development of a city-wide computer-based pediatric health care network to improve provider decision-making and follow-through, parent role in their children's care, and community-wide data. A process of building consensus for a regional system is presented, addressing issues of establishing a uniform data base, coordination among heterogeneous institutions, system development, confidentiality, and integration with public health reporting and planning functions.

Child↗
PubMed1985

Twice-daily penicillin in the treatment of streptococcal pharyngitis.

An investigation was performed to compare the effectiveness of oral penicillin V given twice daily with penicillin V given three times daily in the treatment of group A beta-hemolytic streptococcal (GABHS) pharyngitis. Patients were randomly assigned to receive 250 mg of penicillin V either two or three times daily for ten days. Overall, 23 (23%) of 99 patients had the same strain of GABHS isolated from their follow-up as from their initial throat culture and were considered to have bacteriologic-treatment failures. Of the 50 patients in the three-times-daily group, nine (18%) had bacteriologic-treatment failures, while 14 (28.5%) of 49 patients in the twice-daily group had bacteriologic-treatment failures. The results of this and earlier investigations suggest that penicillin V given twice daily is as effective as penicillin V given three times daily for the treatment of GABHS pharyngitis.

Administration, Oral↗
PubMed1984

Latex agglutination tests for rapid identification of group A streptococci directly from throat swabs.

A comparison of the accuracy and practicality of two new latex agglutination tests for the rapid identification of group A beta-hemolytic streptococci directly from throat swabs was performed in a busy pediatric office. The Directigen Group A Strep Test kit had a sensitivity of 84%, specificity 99%, positive predictive value 99%, and negative predictive value 93% when compared with blood agar cultures. The Culturette Brand 10-Minute Group A Strep ID Kit had a sensitivity of 83%, a specificity 99%, positive predictive value 97%, and negative predictive value 93% when compared with blood agar cultures. When cultures with less than 10 colonies of group A beta-hemolytic streptococci per plate were not considered positive, both rapid tests had a sensitivity of 95%. The Culturette Brand test required considerably less time, equipment, supplies, and skill than the Directigen test. Only the Culturette Brand test appeared to be practical for routine use in a pediatrician's office. Further investigations of the accuracy of both of these rapid tests need to be performed before either is accepted as a substitute for the throat culture.

Adolescent↗
PubMed1982

Factors that predict relapse of calcium nephrolithiasis during treatment: a prospective study.

We evaluated 522 patients with idiopathic, recurrent calcium nephrolithiasis using a comprehensive clinical and laboratory protocol, and obtained additional laboratory measurements during their subsequent years of treatment in our program. In 57 patients, a new calcium stone ultimately formed during treatment (relapse), whereas 189 others have been free of recurrence during at least two years (average 4.3 +/- 2.2 [SD] years) of follow-up. Compared with the patients who remained stone-free, the patients with relapse (1) had a shorter interval between the time they entered our program and the time their last recurrent, pretreatment stone formed; (2) excreted more calcium *in mg/kg of body weight pr 24 hours) in their urine during treatment (2.79 +/- 1.08 versus 2.39 +/- 0.98 [SD] for relapse and stone-free); and (3) increased their urine volume less during treatment compared with pretreatment values (delta in liters per 24 hours was -0.02 +/- 0.48 versus 0.23 +/- 0.54 for relapse and stone-free). The two groups were otherwise the same. All comparisons used only data obtained prior to relapse. A discriminant function using only these three characteristics correctly identified 72 percent of patients with relapse and 67 percent of those who remained stone-free.

Allopurinol↗
PubMedDate not supplied

A quick strep test.

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Humans↗