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Biomedical subjects

A M Zuckerman

Publications and source records attributed to A M Zuckerman.

At least 37 records · Page 2Linked to original sources
PubMed1992

Peripheral transcatheter embolization with platinum microcoils.

Embolotherapy with platinum microcoils delivered through the Tracker-18 microcatheter (Target Therapeutics, San Jose, Calif) was performed in 16 patients when peripheral superselective catheterization with standard angiographic catheters was not possible. The Tracker-18 catheter could be directed distally into small peripheral vessels for delivery of the microcoils. These microcoils, with attached fiber strands, resulted in vascular occlusion within a few minutes in all cases. Embolotherapy was technically successful in all patients. The procedures were clinically successful in 15 of 16 patients (94%), and no complications were encountered. Embolization with platinum microcoils through the Tracker-18 catheter is useful when standard methods of embolization are not possible.

Adolescent↗
PubMed1992

Making the most of the shift to outpatient services.

As hospitals watch an increasing percentage of their business shift to the outpatient setting, they will have to adapt their facilities and services to the new requirements of ambulatory care. Convenience and accessibility head the list of patient expectations. The following case studies show how two hospitals captured more ambulatory business in their markets--one by expanding its home health care program, the other by introducing management control systems and streamlining operations.

Ambulatory Care↗
PubMed1990

Mental healthcare: expand with caution. There is more involved than financial incentives.

Increased needs, insurance coverage, and physical expansion are evidence of mental healthcare's growth. Greater societal acceptance, the demand for more local care with deinstitutionalization, and liberal reimbursement have expanded mental health services. However, reduced federal funding and competition demand specialization in such areas as geriatric services. Ambulatory services make mental healthcare more affordable and accessible. Providers must target populations who use such outpatient care and study local trends before planning these programs. Inpatient mental health services continue to expand, although at a slower rate. Thus organizations and professionals have begun selective contracting, and capitation reimbursement based on case management is developing. Providers considering expansion or initiation of mental health services confront competitive marketing and must recognize trends in outpatient, chronically ill patient, and after-care services. Strategic planning is essential to uncover opportunities and potential risks. Other issues to consider include the psychiatrist shortage, uncertain payment systems, and a possible reversal of growing mental health services and declining acute care needs.

Attitude to Health↗
PubMed1989

Osteoarthropathy of patients undergoing long-term hemodialysis.

Maintenance hemodialysis, while capable of prolonging life, is an incomplete substitute for the patient's native functioning kidneys. Recently, it has become clear with time that long-term survivors of hemodialysis develop an osteoarthropathy differing from classic secondary hyperparathyroidism. The radiographic appearance includes erosive or destructive changes of articular surfaces, bone cysts, osteopenia, and periarticular calcific deposits. The most important clinical factor related to the development of the disease is increasing duration of hemodialysis. Although amyloid appears to be a causative factor, the exact etiology and treatment remain uncertain. It is important that the radiologist be aware of this entity and not mistake it for secondary hyperparathroidism, a variant of rheumatoid arthritis or infection.

Bone Diseases, Metabolic↗
PubMed1986

Strategic planning: a balanced view of a balanced portfolio.

The application of portfolio analysis to strategic planning in health care organizations is presented. The practical use of this approach is demonstrated through a case example. Advantages and disadvantages of the approach are delineated.

Hospital Planning↗
PubMed1983

Planning for rehabilitation: a new approach.

The development of inpatient physical medicine and rehabilitation services has been hindered by a lack of proven methods for predicting future demand for services. Existing planning approaches are assessed and a new method for identifying and projecting rehabilitation needs from the acute care patient population is presented. The method incorporates an individual chart review mechanism and allows for quantification of potential demand under varying assumptions.

Health Services Needs and Demand↗
PubMedDate not supplied

Percutaneous varicocele occlusion: long-term follow-up.

PURPOSE: The authors summarize their 11-year experience with percutaneous varicocele occlusion at the Johns Hopkins Hospital. PATIENTS AND METHODS: Data were obtained from the patients' medical records and from a mailed questionnaire. Most of the data analysis is based on the 182 patients who responded to the questionnaire. RESULTS: Most of the occlusions were performed for infertility. The mean length of time couples had been attempting to conceive was approximately 44 months. Occlusion was technically successful in 95.7% of cases. Patients were followed up for a mean period of 59 months. Success is difficult to define because many patients and/or their wives received additional infertility treatment. Fifty-seven percent of all couples and 60% of a subgroup of couples who received no other treatment eventually conceived. CONCLUSION: Percutaneous occlusion is a well-established treatment for varicoceles. Pregnancy rates and recurrence rates are comparable to those following surgical varicocelectomy. It is unlikely that resultant pregnancies occur from random chance alone.

Adult↗
PubMedDate not supplied

Sterilization with methyl cyanoacrylate-induced fallopian tube occlusion from a nonsurgical transvaginal approach in rabbits.

PURPOSE: To evaluate a nonsurgical, nonhormonal sterilization procedure performed with use of transvaginal microcatheterization techniques and methyl cyanoacrylate (MCA) as a sclerosing agent MATERIALS AND METHODS: Seventeen adult virgin female rabbits underwent bilateral fallopian tube cannulation through a nonsurgical transvaginal approach with use of a coaxial catheter system with fluoroscopic guidance. Fourteen of the rabbits underwent bilateral fallopian tube occlusion with direct MCA injection; the remaining three rabbits were separated as controls. Three of the rabbits with occlusions were killed as temporal histologic controls. The remaining 11 rabbits with occlusions and the initial three controls underwent 6 months of mating trials. All 17 rabbits were killed. Gross inspection was performed and histologic specimens of their fallopian tubes were obtained. RESULTS: None of the 11 rabbits with occlusions that underwent mating became pregnant. All three control rabbits became pregnant. Histologic examination of the occluded fallopian tubes demonstrated long-segment tubal wall fibrosis with varying degrees of occlusion. No peritoneal abnormalities were identified. Histologic findings for the three control animals were normal. CONCLUSION: With use of a nonsurgical transcervical coaxial catheter system, MCA can be placed directly into fallopian tubes without difficulty. MCA administration leads to fallopian tube fibrosis and occlusion. A 100% nonpregnancy rate was demonstrated. Further investigation may lead to a safer, more convenient, and less expensive form of permanent sterilization.

Animals↗
PubMedDate not supplied

Competitive strategies for faculty practice plans in the 1990s.

The upsurge in clinical revenue of faculty practice in academic centers over the last decade may be succumbing to RBRVS growth in managed care plans. Author Alan M. Zuckerman, FAAHC, investigates this possibility in his article.

Academic Medical Centers↗
PubMedDate not supplied

Strategic responses of academic medical centers to the growth in ambulatory care.

Alan M. Zuckerman, M.A., FAAHC, executive vice president of Chi Systems Inc., examines how academic medical centers are faring as ambulatory care becomes an increasing reality in this country. He presents geographic and integration strategies for these centers to maintain an economic edge as their markets shrink.

Academic Medical Centers↗