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S Bondurant

Publications and source records attributed to S Bondurant.

At least 19 recordsLinked to original sources
PubMed2001

Silicone breast implants: lessons from a saga.

In the following eleven lessons learned from the silicone breast implant saga in the United States are listed. Some Lessons From The Saga Of Silicone Breast Implants In The U.S. 1. The intrinsic differences between science and the law mean that there will continue to be tension at the interface between the two. 2. Weak scientific evidence makes for weak scientific, clinical and legal judgments. 3. Health policy can influence the weighing of evidence as did the FDA ban on gel filled silicone breast implants in 1992. 4. As the probative value of scientific evidence decreases (that is, the quality and relevance of the evidence) the courts have increasing difficulty in evaluation. 5. Weak scientific evidence along with poor legal judgments can distort clinical understanding and result in harm to patients. 6. Widely publicized speculation and litigation can obscure less dramatic but frequent and serious complications. 7. Clinicans, toxicologists, industry and regulators should maintain surveillance of medical devices, in representative groups if not in all recipients of the devices. 8. The precise identity and composition of each medical device implanted into a person should be recorded both by the manufacturer and in the health care record. 9. The factual basis for informed consent should be vetted by a disinterested party. 10. Patients, clinicians and industry all have a strong interest in assuring the safety of medical devices through regulation. 11. The criteria and process for evaluating the admissibility of scientific evidence in legal proceedings have been improved but universal adoption of the improvements has not been accomplished and further changes may be necessary.

Breast Implantation↗
PubMed1995

Health care reform continues: themes for academic medicine.

The challenge for U.S. academic medicine in this decade is to redesign itself to serve its classic functions--teaching, research, and special service to patients--while filling the needs of what is evolving into a comprehensive integrated system of health care. First, in the absence of federally legislated comprehensive health care reform, the health care community must develop a consensus on the purposes, scope, and content of health care to bring some reason and order to the short-term, market-driven incrementalism that governs today's health care. Specifically, the author proposes that the issues of health care be defined in a broad social context, that the gap between public health and medicine be lessened, and that perspectives of public health and health promotion and disease prevention be more effectively incorporated into medical education. Second, there is an urgent need for new approaches to funding and financial management of teaching, research, and patient care in academic health centers to counter the erosion of traditional sources of support. Third, to sustain generalist physician practices of high quality, a conceptual basis for generalism must be defined in affirmative functional terms, and the generalist's frame of reference and intellectual tools and processes must be formulated. Last, many forces are now acting to reduce the intellectual content of medical practice and teaching. Academic medicine--in teaching and in research--must nurture and promote the intellectual content and standards of all aspects of medicine to sustain the quality of clinical practice over time.(ABSTRACT TRUNCATED AT 250 WORDS)

Academic Medical Centers↗
PubMed1986

Contributions of aerospace medicine to clinical medicine.

The contributions of aerospace medicine to clinical medicine far exceed the aggregate of the clinical applications of individual technologies which originated in aerospace medicine, important though these be. Contributions of aerospace medicine to clinical medicine will be discussed in seven categories: The raising of issues, questions, and need for systems for protection or support for man before such issues and needs were recognized by clinicians to be important or feasible; Contributing to the manpower pool of able clinical investigators through recruitment and special training in research; Providing fundamental insights into specific biologic processes of clinical significance; The recruitment of disciplines not previously involved extensively in addressing biologic problems and the creation or strengthening of hybrid disciplines such as bionics and bioengineering; Pioneering emphasis on safety, prevention and environmental health now being incorporated into clinical medicine; The development of specific research technologies which have been used to address an array of clinical problems; Specific technologies of clinical significance to which aerospace medicine has contributed, including systems for air transport of patients, many components of modern systems for patient monitoring, components of circulatory and ventillatory support systems, hypoxia warning systems, prevention of toxic exposure and treatment of toxic injury, prevention and treatment of burns, restraint systems, artificial organs, the application of models to clinical practice, and the ordering and automating of information processing.

Aerospace Medicine↗
PubMed1984

Antepartum diagnosis of fetal intracranial hemorrhage by ultrasound.

Presented is a patient with acute onset of preeclampsia and abruptio placenta at approximately 26 weeks' gestation. Ultrasonography demonstrated evidence of in utero fetal intracranial hemorrhage, which was confirmed at autopsy. The implication of this finding is discussed.

Adult↗