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Biomedical subjects

R A Berman

Publications and source records attributed to R A Berman.

9 recordsLinked to original sources
PubMed1986

Severity of illness and the teaching hospital.

In the current environment of cost containment pressures on health care providers, teaching hospitals are facing increased financial risks that could jeopardize their special role in the health care delivery system. One of these risks is that the Medicare prospective payment system does not adequately account for severity of illness. Whether teaching hospitals treat a case mix of patients with more severe illness than do nonteaching hospitals was tested in the study reported here using two severity measures, Horn's severity of illness index and Gonnella's "disease staging." Teaching hospitals were found to treat a significantly greater proportion of severely ill patients than community hospitals, especially when measured by the severity of illness index. Differences in case mix of severity of illness among hospitals can have a significant impact on patient care costs, which may not be adequately met by a reimbursement system based on diagnosis related groups. Hospital managers can use severity of illness measures to assess the resource needs of patients and the practice patterns of physicians. If severity of illness measures help describe the special burden of treatment that teaching hospitals bear, they should be used to establish the case for adequate financial support.

Costs and Cost Analysis↗
PubMed1979

Systemic thermotherapy (whole body hyperthermia).

This is an article reviewing the literature and our experience to date (six months) in the treatment of cancer using whole body hyperthermia in the first 60 patients. WBHT is an effective method of treating cancer. Patients were treated for a total of eight hours, 180 degrees F for two hours. WBHT was induced by means of two high-flow water filled blankets. Toxicity included fatigue, nausea, diarrhea and first degree burns. There was no evidence of visceral damage. There were no mortalities during the procedure. Objective responses were 50%, subjective responses were 65%. The literature demonstrates and our study confirms that under closely monitored conditions, WBHT is a feasible, safe and active anti-cancer therapy. WBHT may be safely used as an adjunct to other active cancer therapies including X-ray therapy and chemotherapy.

Animals↗
PubMed1975

Fungal infection following renal transplantation.

Twenty-seven deep fungal infections developed in 22 of 171 patients following renal transplantation. These infections included cryptococcosis (ten), nocardiosis (seven), candidiasis (four), aspergillosis (two), phycomycosis (two), chromomycosis (one), and subcutaneous infection with Phialophora gougeroti (one). Twelve infections occurred in living-related and ten in cadaveric recipients. Nineteen of the 22 patients were male. Infections occurred from 0 to 61 months after transplantation. Complicating non-fungal infections were present concomitantly in 15 patients. Thirteen patients died, eight probably as a result of fungal infection. Appropriate diagnostic procedures yielded a diagnosis in 20 of 27 infections, and therapy was begun in 18 patients. Serologic, culture, and biopsy procedures useful in making rapid diagnoses are advocated in the hope of increasing survival.

Adolescent↗