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Z Amsel

Publications and source records attributed to Z Amsel.

27 records · Page 2Linked to original sources

The dentist as a referral source of first episode head and neck cancer patients.

This analysis was conducted to shed more light on the role of the dentist in the detection and referral of patients with head and neck cancer. No other study of the referral practices of dentists has examined the characteristics of these patients in contrast to those referred by physicians to understand the selection of pathways to care. The findings reported here indicate that: "anatomical provinces" exist for both types of practitioners that are well recognized by the lay community and perhaps reinforced by the health field; advanced stage referrals on the parts of physicians may occur because patients delayed seeking care until symptoms required medical attention; and dentists as a group may b better prepared to detect oral cavity lesions, but not lesions at other head and neck sites. The findings of this study, as well as those of Adams and others and Pogrel, suggest the need for improved educational programs about head and neck cancer directed to the public as well as physicians and dentists. The public should be aware not only of the etiology of head and neck cancers and the associated signs and symptoms, but also of the availability of the dentist, as well as the physician, as a diagnostic resource. Furthermore, educational programs should be developed in dental and medical schools to teach and reinforce detection and diagnostic skill including soft-tissue examination procedures; the use of the indirect mirror for examination of the base of the tongue, larynx, and the lower posterior pharyngeal wall; and biopsy techniques.

Dentists↗

Reliability and validity of self-reported illegal activities and drug use collected from narcotic addicts.

In follow-up of 1,500 drug-using applicants to the NIMH civil commitment program under Titles I and III of the Narcotic Addict Rehabilitation Act, efforts were made to measure the reliability and validity of self-reported criminal and drug-taking behavior. Various methods to assure reliable and valid responses were developed and implemented. These methods included choice of interviewer, intraquestionnaire safeguards, interview-reinterview procedures, and use of police records and urinalysis reports. Overall, the results indicated that the responses for 829 respondents were reliable. The greatest limitation to the validity study was the incomplete and unreliable police records and urinalysis reports.

Alcohol Drinking↗

Adverse virus-drug interactions.

Over the last 3 decades, epidemiologists and clinicians have identified a few clinical entities that appear to result when a viral infection and a chemical exposure overlap and interact. Ampicillin rash during infectious mononucleosis, Reye's syndrome following salicylate ingestion and certain viral infections, and the association of AIDS-related Kaposi's sarcoma with abuse of nitrite inhalants and infection due to human immunodeficiency virus are examples of such phenomena. Preclinical research provides additional evidence that viruses and chemicals may interact and produce illnesses in animals. We hypothesize that other virus-drug interactions may exist. Identifying such interactions may lead to a better understanding of the pathogenesis of currently baffling illnesses and may provide insights into ways of preventing and/or treating diseases that appear uncontrollable now.

Acquired Immunodeficiency Syndrome↗

Breast cancer screening: effect of physician specialty, practice setting, year of medical school graduation, and sex.

We surveyed physicians of different specialties in a large metropolitan area to determine how their characteristics affected their performance and beliefs about breast cancer screening. Of 664 general internists, obstetrician-gynecologists, and cardiologists surveyed, we received 298 responses (45%). We found significant differences in reported performance of breast cancer screening and physicians' beliefs about mammography screening among practicing obstetrician-gynecologists, internists, and cardiopulmonary specialists. Cardiopulmonary specialists performed the fewest breast examinations and screening mammograms and were most likely to believe annual mammography screening unnecessary even for women in their 50s. We observed no difference between physicians graduating before 1960 and those graduating afterward and no differences according to physician sex. We found similar screening practices and beliefs in the three types of practice settings examined: community-based, private practices, a large health maintenance organization (HMO), and academic medical centers. Obstetrician-gynecologists and internists differed only in the frequency with which they performed breast examinations. Physicians graduating before 1960 in these two groups reported somewhat poorer performance and knowledge of breast cancer screening than those graduating more recently. A majority of all respondents disagreed with American Cancer Society guidelines for mammography screening. Physicians of all specialties reported performing far more breast examinations than screening mammograms on women of all ages, even for those 50-59 years of age. We conclude that all physicians need to improve their screening rates. However, intervention programs should first target those physicians with the greatest deficiencies in breast cancer screening performance and knowledge; these include medical specialists and older physicians in primary care specialties.

Age Factors↗