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Biomedical subjects

B B Roe

Publications and source records attributed to B B Roe.

At least 19 recordsLinked to original sources
PubMed1987

Air embolism prevention.

Although fortunately rare, the serious and potentially fatal complication of air embolism continues to occur following open-heart surgery. Its reliable prevention is dependent on the avoidance of specific procedural hazards and the exercise of various maneuvers to evacuate residual air from the heart before it is allowed to eject. Specifically, the beating heart should not be opened without ventricular fibrillation, cardioplegia, or aortic cross-clamping unless special precautions are exercised.

Cardiac Surgical Procedures↗
PubMed1985

Rational remuneration.

Physicians face the end of a phase of unrealistic and unprecedented prosperity fostered by unrestrained third-party remuneration policies. The cost of that phase, along with inflation and the use of expensive technology, has created an economic crisis. I urge my colleagues to take the initiative to address this crisis with other affected groups in the private sector by working to develop guidelines to restrain abuses, promote cost effectiveness, simplify administration, and increase fairness in the remuneration system. Remuneration scales should reflect variations among specialties in terms of skill, stress, and time involved, but should avoid unmeasurable and unverifiable differences within each category of service. Slowness and ineptitude should no longer be rewarded under the guise of "complexity." In the long run, standardized fees will be fair and will simplify the payment process greatly. Reasonable remuneration for agency-subsidized services can be derived in several ways, and once the median remuneration for various services has been established in each specialty, existing relative-value scales can be applied for other cases in that specialty. These measures would effect substantial savings in health care costs without incurring bureaucratic interference or impairing the quality of service. Moreover, they would allow distribution deficiencies to be remedied by permitting a response to market forces--i.e., higher payments would be made in underserved areas.

Economic Competition↗
PubMed1978

Cardiac valve replacement in patients over 65 during a 10-year period.

From 1967 through 1976, 754 adult patients were subjected to open heart procedures for acquired valvular disease at the University of California, San Francisco, 104 of whom were 66 years of age or over (mean = 70 years). The operative mortality of 15.0% in the elderly group did not differ significantly from that of 14.3% in the entire adult series for the 10-year period. Mortality was consistently higher in combined procedures (multiple valve replacement and valve replacement with coronary grafting). Since the introduction, in 1973, of hypothermic hyperkalemic coronary washout for intraoperative protection of the ischemic myocardium, the hospital mortality rate has decreased to 8.1% overall, 6.0% for isolated aortic valve replacement and 0% for isolated mitral valve replacement in patients over 65. Moreover, the long-term survival following aortic and mitral valve replacement in this series appears to approximate the survival curve of the normal population of the same age. This experience suggests that cardiac surgery has become safer for all patients during the past 10 years and that operative mortality is related primarily to the type and severity of disease rather than to age.

Age Factors↗