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Biomedical subjects

O L Peterson

Publications and source records attributed to O L Peterson.

At least 19 recordsLinked to original sources
PubMed1988

A randomized clinical trial of total parenteral nutrition in malnourished surgical patients: the rationale and impact of previous clinical trials and pilot study on protocol design.

The rationale for a large-scale clinical trial of preoperative total parenteral nutrition (TPN) is described in the context of previous clinical trials that have attempted to demonstrate reduction of operative morbidity with preoperative TPN. Defects in study design or execution potentially compromising the validity of these studies are analyzed. Results of a single-institution pilot study performed during the planning phase of the multiinstitutional preoperative TPN trial are presented. This literature review and pilot study provided the data necessary to permit appropriate design of many critical elements in the protocol for the clinical trial including sample size, eligibility criteria, duration and intensity of treatment regimens, and end-point criteria. The rationale underlying critical decisions in protocol design are presented in detail to allow more meaningful interpretation of the results of the clinical trial.

Clinical Trials as Topic↗
PubMed1988

Study protocol: a randomized clinical trial of total parenteral nutrition in malnourished surgical patients.

CSP #221 is a randomized multiinstitutional clinical trial to assess the efficacy of 10 d of perioperative total parenteral nutrition (TPN) in reducing morbidity and mortality in malnourished patients undergoing intraperitoneal and/or intrathoracic operations. In this paper a detailed protocol for the clinical efficacy trial is presented primarily as a reference document for use in interpretation of the results of the clinical trial. It is also anticipated, however, that review of this protocol may be useful to other investigators planning future clinical nutrition intervention trials.

Clinical Trials as Topic↗
PubMed1984

Landmark article June 14, 1941: Sulfadiazine. Therapeutic evaluation and toxic effects on four hundred and forty-six patients. By Maxwell Finland, Elias Strauss, and Osler L. Peterson.

sulfadiazine appeared to be as effective as sulfapyridine or sulfathiazole in every condition in which it was used. Toxic effects from sulfadiazine were relatively mild and infrequent. Nausea and vomiting occurred in 9.2 per cent of the cases. Nitrogen retention of moderate degree was noted in 5 cases. Leukopenia occurred early and was transient in some cases. In 3 cases the leukocyte counts dropped between the eleventh and the sixteenth day and returned to normal on cessation of therapy. Morbilliform eruptions were observed in 9 cases

Adolescent↗
PubMed1984

Comparison of internist and oncologist evaluations of cancer patients' need for hospitalization.

This study attempts to compare the clinical judgment of oncologists and primary care internists in terms of the needs of identical cancer patients for acute hospitalization and to estimate the suitability of patients for alternative care settings. Oncologists and internists had broad agreement as to the reasons for hospitalization, e.g., diagnosis, treatment to cure, treatment to prolong life, and treatment to control symptoms. More than 40% of the patients were classified by both physician groups as requiring hospitalization for symptom control or to prolong life. Oncologists and internists agreed that one quarter of the sample of patients could be cared for at home or in alternative facility. Lower cost alternatives to inpatient care are now an attractive strategy. This study suggests that these approaches are clinically viable as well as economically sound.

Home Care Services↗
PubMed1983

Surgeons and operating rooms: underutilized resources.

A classification of surgical procedures, based on degree of complexity and the need for facilities and personnel, was applied to all 50,782 surgical interventions performed in the Valle del Cauca, Colombia during 1974. Three-fourths of all operations were of low levels of complexity, and most could be performed on an ambulatory basis with immediate discharge after recovery from anesthesia. Mean numbers of operations per year for surgical specialists and other physicians were 119.7 and 18.1, respectively. The 76 existing operating rooms were utilized only 41.6 per cent of the time. The implications of underutilization of personnel and facilities and low productivity of surgeons are discussed.

Colombia↗
PubMed1983

Regionalization of surgical services.

Using data from the Studies on Surgical Services for the United States (SOSSUS), the extent of existing surgical care regionalization was examined in a defined area. Specialist surgeons comprised 55 per cent of all physicians who did operations, but performed nearly three-fourths of all operative work. About one-third of the most complex operations (CRV greater than or equal to 30), more than one-fifth of medium complexity (CRV = 20-29), and 14 per cent of low complexity (CRV less than 20) were obtained out of county of residence. Nearly one-half of all surgical patients at the university hospital were from other counties; but for those obtaining the most complex operations (CRV greater than or equal to 30), three-fourths of them were from other counties. Thus there was a substantial amount of regionalization of surgical care already existing in this area.

Catchment Area, Health↗
PubMed1982

Practice characteristics of surgeons in the United States.

The results are discussed of two SOSSUS studies, one a questionnaire to obtain information from a representative sample of surgeons about their practice organizations, work loads, work time, and other relevant data, and the other a comprehensive examination of surgeons' work loads in four diverse areas of the United States.

General Surgery↗
PubMed1979

Physician manpower expansionism: a policy review.

A lack of national health goals has allowed physician manpower policy to be dominated by an expansionist philosophy. Scarce resources have been channeled into the production of specialist physicians trained to provide complex and expensive care for uncommon diseases, using other scare and expensive resources and adding to the steep rise in medical care costs. Society seems to want access to primary care--a lack it views with dismay--and simultaneously fears increasing costs of care. Lack of access plus high cost might lead to rash implementation of other inappropriate policies. Success of policy decisions is pure serendipity if made without reliable and relevant information or based on inappropriate data, such as opinions alone. If information is unavailable, then physician manpower decisions should be delayed or, if made, implemented cautiously.

Health Planning↗
PubMed1979

General surgeons and their surgical practices.

The work characteristics of general surgeons were studied as part of a national study of surgeon manpower. General surgeons were found to work long hours relative to other surgical specialists. Although general surgeons' operative workloads ranked fourth among the 10 surgical specialties, they were only modest in comparison with the surgeons with the highest operative loads (thoracic surgeons). The major conclusion is that the supply of general surgeons is more than adequate to meet the need for general surgeon consultants.

Certification↗
PubMed1979

Thoracic surgeons and their surgical practice.

The work characteristics of thoracic surgeons were studied as part of a national study of surgeon manpower. Thoracic surgeons were found to have the greatest operative work loads, longest workweeks, and equivalent median incomes compared with all other surgical specialties. The major conclusion that the number of thoracic surgeons was adequate concurs with the findings of the National Thoracic Surgery Manpower Study on number of practitioners.

Certification↗
PubMed1978

Otolaryngologists and their surgical practice.

Practice characteristics of otolaryngologists, studied as part of a national survey of surgeon manpower, are compared with those of other surgical specialists. Otolaryngologists had relatively short workweeks and spent more professional time in their offices than in hospitals compared with other surgeons. Their California relative value (CRV)-weighted surgical work load ranked eighth among all surgeons. Although otolaryngologists performed, on the average, more operations annually than did other surgical specialists, their procedures were generally less complex (low CRV weights). The per capita rate for tonsillectomy, the procedure that comprised more than one third of the weighted work load of otolaryngologists, has declined precipitously. The conclusion drawn from this study is that a reduction in the number of trainees in otolaryngology would be in the best interest of the young and other otolaryngologists whose capabilities are now seriously underutilized.

Age Factors↗
PubMed1978

Surgeons in the United States. Practice characteristics.

Data on practice characteristics were obtained as part of a national questionnaire study of surgeons in the United States. These included location and organization of surgeons' practices, use of nonphysician personnel, provision of ambulatory care, other professional activities, and variables associated with work load volume. A multivariate analysis was done to examine the relation between operative work loads and various practice characteristics. The variables associated with larger operative work loads were group or partnership practice, principal office not in a hospital, more nonphysician assistants in direct contact with patients, more hospitals in which operations were regularly done, and smaller proportions of nonsurgical patients. Group or partnership practice and nonsurgical practice were found to be most strongly related to operative work load.

Ambulatory Care↗
PubMed1978

Urologists and their surgical practice.

The work characteristics of urologists were studied as part of a national study of surgeon manpower. Urologists were found to work short hours relative to other surgical specialties, and their operative work load ranked sixth among the ten surgical specialties. The major conclusion was that the supply of urologists was greater than necessary to meet the need for urologic consultants.

Age Factors↗