Managed care. Beam me up, Scotty.
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Biomedical subjects
Publications and source records attributed to S McFarland.
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This study compared the relative efficiency of forward and concurrent chaining strategies in teaching the use of a commercial washing machine and laundry soap dispenser to four high school students with severe handicaps. Acquisition and maintenance of the laundromat skills were assessed through a multielement, alternating treatment within subject design. Results indicated that the concurrent chaining strategy was more efficient than forward chaining in facilitating acquisition of the activities. Four week and eight week follow-up probes indicated that concurrent chaining resulted in better maintenance of the activities. The implications of these results for teaching community activities and future research in building complex chains are discussed.
Results of intravesical CDDP or CDDP combined with external beam radiation are compared in a group of 13 patients with low-stage bladder cancer. Six patients with low-stage bladder cancer received 4 or 12 treatments of CDDP intravesically with an initial complete response in 3 patients. Within six months, recurrent disease developed in 2 of 3 patients. Seven patients received the combination therapy of 400 rad (weekly for six weeks) followed two hours later with 50 mg of intravesical CDDP. A positive response was observed initially in all 7 patients as determined by pathology, PAP cytology, fluorescence cytology, and quantitative nuclear fluorescence determinations. Therapy was discontinued in 1 patient in each group because of irritative symptoms. The results indicate combination therapy is of tolerable toxicity, and quantitative fluorescence cytology is a useful adjuvant for guiding future treatments in patients with low- and high-grade bladder tumors.
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Peritonitis during peritoneal dialysis is the most frequent complication associated with this dialysis technique. We studied patients undergoing peritoneal dialysis when they were without peritonitis and during episodes of clinical infection. Peritonitis was associated with a significantly decreased dialysate effluent volume, increased absorption of glucose, clearance of urea and creatinine, and protein loss in the dialysate effluent. We suggest that the changes occurring to the peritoneal dialyzing surface with peritonitis might be explained by alterations in peritoneal blood flow, effective membrane surface area, or permeability.
Continuous ambulatory peritoneal dialysis is a new dialysis technique. It is unknown at this time which patient would be served best by this therapy. Two cases of dialysis-related ascites were successfully treated by this technique. We suggest that the continuous control of salt and water balance possible with this technique, as well as frequent drainage of the peritoneal cavity to prevent fluid reaccumulations, contributed to successful treatment. Continuous ambulatory peritoneal dialysis may be used to treat dialysis-related ascites.
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The incidence rate of mammary neoplasia in a large colony of beagles and the relationship to internal skeletal and/or liver radiation, age, relatively late ovariectomy (4 years and older), endometritis, parity status, and adrenal weight were examined. Of these various factors, age was the only condition that was clearly correlated with changes in the mammary tumor incidence. The rate became significant at approximately eight years of age and increased progressively throughout the older age classes. Among the female dogs, the incidence of mammary cancer was higher than that of any other form of spontaneous malignancy.
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