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Biomedical subjects

P R Summers

Publications and source records attributed to P R Summers.

14 recordsLinked to original sources
PubMed2000

State Medicaid home health licensing and certification.

This study collected and analyzed data on the number of licensed and certified home health care agencies and licensed home care/personal care agencies in the US. The study also examined the state laws and regulations pertaining to Medicaid home health agency requirements. There were 14,045 licensed home health agencies and 801 other licensed home care or personal care agencies in the US, but only 59 percent of these agencies were certified in 1998. The percent of certified agencies ranged from 22 percent in Maryland to 100 percent in ten states that only allowed certified agencies to provide home care. There was a wide range in the number of agencies in states with the average being 6.1 agencies per 100,000 population. The 41 states with state licensing of home health agencies had a wide range of policies but most were more lenient than the federal Medicare certification requirements.

Certification↗
PubMed1998

Vulvovaginal candidiasis: epidemiologic, diagnostic, and therapeutic considerations.

Although it is the second most common vaginal infection in North America, vulvovaginal candidiasis is a non-notifiable disease and has been excluded from the ranks of sexually transmitted diseases. Not surprisingly, vulvovaginal candidiasis has received scant attention by public health authorities, funding agencies, and researchers. Epidemiologic data on risk factors and pathogenic mechanisms remain inadequately studied. Most important, standards of care, including diagnosis and therapy, remain undefined. A conference was held in April 1996 to define and summarize what is known and supported by scientific data in the areas of epidemiology, diagnosis, and treatment of vulvovaginal candidiasis; but, more important, the conference aimed at defining what is not known, poorly studied, and controversial. Guidelines for the treatment and diagnosis of the different forms of vulvovaginal candidiasis are suggested.

Antifungal Agents↗
PubMed1994

Microbiology relevant to recurrent miscarriage.

The best evidence suggests that infection is an occasional cause of sporadic spontaneous abortion, and, consistent with statistical probability, recurrent miscarriage due to infection occurs with a frequency that is much lower. In the medical literature, the limited evidence linking infection and recurrent pregnancy loss in humans remains largely anecdotal and generally cannot be reproduced in prospective studies. This observation reflects the low frequency with which the necessary microbial and maternal factors combine to cause recurrent miscarriage. The patient's susceptibility to chronic infection must play a determining role in some of the reported cases. Susceptibility factors that allow severe chronic infection, such as immunocompromise, are rare in the general infertility population and may remain unrecognized in broad cumulative studies. Probable factors that play a role in the risk of abortion due to infection are the following: 1. Primary exposure during early gestation 2. The capability of the organism to cause placental infection 3. The development of an infectious carrier state 4. Immunocompromise caused by immunosuppressants, chemotherapy, corticosteroids, or acquired immune deficiency syndrome. Exposure to a microbe that can establish chronic infection that can spread to the placenta in an immunocompromised patient is probably the most obvious risk situation for habitual abortion. In routine medical practice, it is not necessary or efficient to screen universally for the unexpected, but it is necessary to be aware of the rare possibilities. Most patients with a history of recurrent miscarriage will not benefit from an extensive infection workup. All patients should first be categorized according to their own personal risk infection, as outlined in Table 2.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Habitual↗
PubMed1991

A case report of giant cell arteritis of the uterus and adnexa.

Giant cell arteritis of the uterus and adnexa is a rare disorder, which is generally asymptomatic and occasionally associated with temporal arteritis. The true clinical significance of this dramatic microscopic finding remains obscure, but arteritis of the uterus and adnexa may be associated with later development of giant cell arteritis elsewhere in the body.

Adnexal Diseases↗
PubMed1991

Pregnancy outcome in patients with repeat visits to the labor observation area near term.

Patients whose pregnancies are near term and who repeatedly visit the labor observation area but are found not to be in labor and have no clear diagnosis for their complaints remain a source of concern for the obstetrician. In order to determine whether this is a population with special perinatal risks, such cases were reviewed over a 4-month period at Charity Hospital in New Orleans. Seventy-one patients were identified who had repeatedly visited the labor observation area near term. Compared with those in the general obstetrics population, these patients had a significantly increased risk of cesarean section for "failure to progress." Repeat visitors to the labor observation area should be viewed as having a high risk for later abnormalities of active labor. Careful management of labor abnormalities in such patients could theoretically lower their need for cesarean section.

Cesarean Section↗
PubMed1990

Relative strength of a new suture technique for fascial closure.

In an attempt to decrease the risk of fascial dehiscence, a new suture technique for fascial closure is proposed, referred to as the "secured" stitch. The secured interrupted stitch is performed by taking a double bite of fascia at each traditional site of fascial puncture. Relative strength of the secured interrupted stitch in comparison with the simple interrupted stitch is determined in samples of fresh bovine fascia. A significantly greater force is required to disrupt fascia repaired with the secured stitch compared with a simple interrupted repair. The secured stitch may afford a greater degree of protection from fascial dehiscence.

Animals↗
PubMed1989

High hepatitis B carrier rate among non-Oriental patients with acute salpingitis.

Hepatitis B surface antigen screening was performed on non-Oriental patients with the diagnosis of acute salpingitis. Six of 59 (10.17%) had hepatitis B surface antigenemia. We therefore recommend hepatitis B screening for all patients with salpingitis. The detection of covert hepatitis B helps to protect hospital staff and provides important information for the patient. Further, the administration of hepatitis B vaccine may be appropriate for those patients with acute salpingitis who are found to be hepatitis B surface antigen-negative.

Acute Disease↗
PubMed1988

The effect of hepatitis B antigenemia on pregnancy outcome.

Sixty patients documented to have hepatitis B antigenemia during pregnancy were identified retrospectively and compared with an equal number of matched control patients. Maternal and newborn infant parameters were examined. No statistically significant differences were noted between the two groups, except for an increase in infant birth weight in the group showing antigen-positive test results, specifically in infants born to Oriental mothers. It is concluded that infants born to women testing positive for hepatitis B surface antigen represent normal infants eminently suitable for peripartal preventive immunotherapy.

Adult↗
PubMed1987

The pregnant hepatitis B carrier: evidence favoring comprehensive antepartum screening.

The prevalence of hepatitis B surface antigen among 15,399 gravidas screened in the prenatal clinic at Charity Hospital of Louisiana in New Orleans was 0.88%. The race-specific prevalence was 0.56% for whites, 0.62% for blacks, and 8.8% for Orientals. Identifiable risk factors could not be found for approximately half of the hepatitis B surface antigen-positive women. Comprehensive antepartum hepatitis B screening is recommended, based upon the significant risk of perinatal transmission to the neonate and upon the failure of selective screening to identify the majority of maternal hepatitis B surface antigen carriers in our population. The cost-effectiveness of general antepartum screening compares favorably with current blood bank hepatitis screening costs.

Carrier State↗