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Biomedical subjects

A Brodsky

Publications and source records attributed to A Brodsky.

At least 19 recordsLinked to original sources
PubMed1996

A new resource for managing malpractice risks in managed care.

The risk of malpractice liability faced by physicians is exacerbated by third-party intrusions such as those encountered in today's managed care environment. The likelihood that a malpractice action will be brought is increased by the interaction among patients, families, or physicians who are at high risk for litigation and situations (eg, denial of treatment benefits by the managed care organization) that create adversity. To prevent the ready translation of resource adversity into an adversarial physician-patient-family relationship, a forensic psychiatric consultation is recommended.

Family↗
PubMed1995

History of the medical uses of radiation: regulatory and voluntary standards of protection.

The main focus of this paper is on the historical development of safety standards in the use of radiation or radioactive materials in medicine. However, to provide better understanding and perspective on this history, it must be interwoven with major events and advancements in the development and use of radiation, particularly in the field of medicine. Since this history, as well as that of major events that stimulated the development of radiation protection standards, is extensive, only a very brief overview can be given here. Thus, a sufficient list of references is also provided to allow further examination of detailed historical documentation, and to provide an easier entry into further research. Also, some identification of individuals who have made important contributions to the development of standards, but who are not widely identified in either the relevant standards or the historical literature, is included. This will aid the serious historian in examining files of organizations to uncover facts or rationale that could better explain historical events or developments.

Education↗
PubMed1995

[Afebrile infections in adult patients with acute leukemia].

Characteristics of afebrile infection episodes among adult patients with acute leukemia are here described. Afebrile episodes represented 14.3% of all infections. They significantly differed from the febrile episodes because: 1) they prevailed among patients with granulocyte count greater than 500/mm3 (p < 0.001); 2) they often involved patients in complete remission (p < 0.0002); 3) they affected more frequently the kidney and urinary tract than febrile infections (p = 0.0005) and 4) they lacked lung involvement (p < 0.01). The rate of documented infections by cultures, cytology or serological tests was not different between both infection types. Observed mortality during afebrile episodes was threefold less than febrile infections; this difference, however, did not reach statistical significance. In conclusion, afebrile infection in acute leukemia is a distinct clinical entity, unlike febrile infection.

Adolescent↗
PubMed1994

The rebirth of forensic psychiatry in light of recent historical trends in criminal responsibility.

The forensic specialist's expertise lies in mapping the interaction of cognitive, affective, and physiologic processes as they affect and are affected by the choices people make, and in connecting this analysis with laws, legal criteria, and other standards. More simply and broadly, it lies in describing both the unique and the universal characteristics of any human being and distinguishing clearly between the two. This is a psychiatrist who conducts in a different arena, and from a more critical perspective, but for the same larger humane purpose, the in-depth journey into the self and its response to stress that is the essence of clinical practice.

Forecasting↗
PubMed1992

Exact calculation of probabilities of false positives and false negatives for low background counting.

The purpose of this paper is to demonstrate the derivation and use of exact formulas, and their algorithms, for calculating the probabilities alpha of Type I errors, and beta of Type II errors, for low blank total counts (Poisson-distributed). The calculations are carried out to examine the alpha and beta probabilities at low blank levels of the decision level (DL) and minimum detectable amount (MDA) formulations as adopted in the Health Physics Society Standard, "Performance Criteria for Radiobioassay." These formulations are consistent with those published by L.A. Currie, which have received wide acceptance in defining lower limits of detection (LLD). Although Currie's formulation was derived assuming a normal distribution in net counts, the behavior of the distribution of net counts at low count levels, which is a distribution of the difference between two Poisson variates, is such that the MDA formulation in the standard could be considered acceptable for the purpose of providing one simple formulation of MDA. The derivations in this note can also be useful in other problems involving differences in Poisson variates, such as those in certain population studies.

Background Radiation↗
PubMed1991

Beyond cognition: the role of disordered affective states in impairing competence to consent to treatment.

Most of the criteria for competence in current use emphasize cognitive rather than affective dimensions. Our clinical experience indicates that affective disorders may impair competence in a detectable and identifiable way. In particular, patients with major affective disorders can retain the cognitive capacity to understand the risks and benefits of a medication, yet fail to appreciate its benefits. A case study of a pathologic grief reaction is introduced to illustrate how cognitive and affective impairments may coexist and require separate remedial strategies for restoration. Further empirical work on the role of affective disorder in impairing competence is warranted and planned.

Aged↗
PubMed1989

Stevens-Johnson syndrome, respiratory distress and acute renal failure due to synergic bleomycin-cisplatin toxicity.

A patient presenting with a cervix uteri epidermoid carcinoma had acute renal failure after treatment with cisplatin and bleomycin. She later developed fatal bleomycin-induced pneumonitis and Stevens-Johnson syndrome. This is a very rare association of adverse effects. The risk of causing a drug interaction thus increasing the severity of bleomycin undesired effects must be taken into account when a nephrotoxic drug is added to the former. The authors stress the importance of monitoring renal function under these conditions.

Acute Kidney Injury↗