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Biomedical subjects

B D Weiss

Publications and source records attributed to B D Weiss.

At least 73 records · Page 4Linked to original sources
PubMed1986

Bicycle helmet use by children.

Children are the most frequent victims of bicycling accidents. Among fatal accidents, head injury is the most common cause of death. Because bicycling helmets may reduce the risk of serious head injury, this study was undertaken to determine the frequency with which children and adolescents in various age groups use bicycle helmets. Students were observed arriving at four elementary schools, three junior high schools, three senior high schools, and one university campus. The number of students riding bicycles and the percentage wearing helmets were noted. Of 108 elementary schools bicyclists, only two (1.85%) wore helmets. None of 103 junior high bicyclists and only two of 107 (1.86%) senior high bicyclists wore helmets. Ten percent (15/150) of university bicyclists wore helmets; this is a significantly higher rate than in the other age groups (chi 2 = 10.27, P less than .01). The failure of school-aged children to wear bicycling helmets represents a potentially serious health hazard. Pediatricians and family physicians have a unique opportunity to provide education to families and communities about the importance of using helmets.

Adolescent↗
PubMed1986

The effect of malpractice insurance costs on family physicians' hospital practices.

One hundred fifty-two family physicians responded to a questionnaire about malpractice insurance from the Arizona Academy of Family Physicians. Physicians were asked whether they had limited their hospital privileges, by choice, because of the cost of malpractice insurance. One hundred thirty-eight (90.8 percent) of the physicians had a hospital practice. Of these, 36 (26.1 percent) reported that they had restricted their hospital practice because of the cost of insurance. Most commonly, restricted activities involved the discontinuation (38.7 percent of the 36 physicians) or limitation (22.2 percent) of obstetrical activities. Other physicians had eliminated general abdominal surgery (24.9 percent) and other surgical and radiologic procedures. The tendency of family physicians to limit their practices because of the cost of insurance premiums has important implications for health care in rural areas. It also may affect the scope and practice patterns of family physicians and other primary care physicians.

Arizona↗
PubMed1985

Full clinical departments of family practice: their relationship to hospital privileges in university hospitals.

All 52 family practice residency programs that hospitalize patients at a university hospital were surveyed to determine how many have full clinical departments of family practice and what effect having a full clinical department has on hospital privileges. A full clinical department is defined as one in which all hospital privileges for family physicians are reviewed and recommended by the family practice department without need for review by other specialties, even when the requested privileges overlap with another specialty. Responses were received from 100 percent of the surveyed hospitals. At 16 hospitals (30.8 percent) there is a full clinical department of family practice. When these hospitals were compared with the 36 (69.2 percent) at which there is no full clinical department, it was found that in every area of patient care, hospital privileges for family physicians are more extensive at hospitals with full clinical departments. The American Academy of Family Physicians is currently promoting the formation of full clinical departments of family practice as a method for improving hospital privileges for its members. The results of this study suggest that promoting the formation of full clinical departments will be an effective intervention.

Family Practice↗
PubMed1985

Bowel preparation for flexible sigmoidoscopy.

One hundred ten consecutive patients undergoing 35-cm flexible sigmoidoscopy were enrolled in a study to compare the efficacy of one vs two enemas (Fleet's) in achieving adequate bowel preparation. Fifty-five patients received two enemas administered one and three hours before sigmoidoscopy. The other 55 subjects received one enema given one hour before the procedure. Bowel preparation was considered inadequate if sigmoidoscopy was terminated prematurely because fecal material obscured visualization through the sigmoidoscope. Inadequate bowel preparation occurred in 12.9 percent of subjects who received one enema and in 20.0 percent of those who received two enemas (chi 2 = 0.97, P = .36). There was no difference between the groups in depth of penetration of the sigmoidoscope or duration (in minutes) of the examination. It is concluded that either one or two enemas are equally effective in preparing patients for sigmoidoscopy. Patient acceptance of sigmoidoscopy could be enhanced by using one enema instead of two with no decrease in adequacy of bowel preparation.

Enema↗
PubMed1985

Hematospermia.

Hematospermia is not uncommon. Patients who note blood in their semen experience anxiety because of a concern that their symptoms are due to malignancy. Since most cases resolve spontaneously, reassurance can usually be given. In most patients under age 30, hematospermia is idiopathic or associated with inflammatory or infectious conditions. When it occurs in association with other urologic symptoms, or when it persists in patients over age 40, more serious disorders must be considered.

Adult↗
PubMed1984

Chronic indwelling bladder catheterization.

Chronic bladder catheterization is the treatment of last resort for incontinence. Urinary infection is a normal state in these patients. It should be treated only when there are signs of systemic illness. Accumulations of encrusted debris cause urinary leakage. This problem can be lessened by using silicone catheters and acidifying the urine. Urethritis is common, but catheters made of certain materials can reduce its severity. Bladder spasm can be treated pharmacologically.

Bacterial Infections↗
PubMed1984

Hospital privileges for family physicians at university hospitals.

Of the more than 350 family practice residency programs in the United States, 72 are affiliated with a medical school. Seventy-eight percent of these university programs hospitalize all or some of their patients at a university hospital. These hospitals grant various privileges to family physicians with the following frequencies: general medicine (94 percent), adult intensive care (50 percent), coronary care (65 percent), general pediatrics (81 percent), pediatric intensive care (29 percent), normal newborn nursery (79 percent), intensive care nursery (12 percent), routine obstetrics (77 percent), and high-risk obstetrics (31 percent). Sixteen (22 percent) of the university-based programs do not use a university hospital at all, either because the university hospital is too far away or because there is no university hospital. Only one program does not use the university hospital because of difficulty in obtaining privileges. Family physicians are unable to obtain various hospital privileges because of political reasons at the following percentages of university hospitals: general medicine (2 percent), adult intensive care (33 percent), coronary care (40 percent), general pediatrics (8 percent), pediatric intensive care (31 percent), newborn nursery (8 percent), intensive care nursery (29 percent), routine obstetrics (13 percent), and high-risk obstetrics (17 percent).

Coronary Care Units↗
PubMed1983

Intractable urinary incontinence in geriatric patients. A management approach.

Care of the permanently incontinent patient is aimed at collection or controlled release of urine and maintenance of personal hygiene. Before the patient is submitted to long-term catheterization and its attendant risks of infection, incrustation, and urethritis, alternatives should be explored. These include condom catheters, penile clamps, incontinence underpants, and various surgical procedures. Management is much the same for men and women, except that incontinence underpants are employed more often for women. In all patients, long-term catheterization should always be considered a last resort.

Aged↗
PubMed1983

Traveler's diarrhea: update 1983.

Each year, more than one million American travelers develop diarrhea, usually due to toxin-producing Escherichia coli. Traveler's diarrhea can be prevented with bismuth subsalicylate or doxycycline, but neither is suitable for pediatric patients. Trimethoprim-sulfamethoxazole is effective for prophylaxis and treatment in adults. It is also safe for children and may prove to be efficacious. It may be possible to avoid widespread prophylaxis and to give medication only if diarrhea develops.

Bismuth↗
PubMed1983

Family physicians in university hospital intensive care units.

Although physicians in most family practice residency programs hospitalize their patients at community hospitals, those in 21 programs in the United States hospitalize patients exclusively at university hospitals. Through a questionnaire mailed to directors of each of these programs, it was learned that family practice residency faculty have medical intensive care (ICU) privileges at 38 percent of these university hospitals. No family physicians had ever been denied ICU privileges at any of these hospitals. Mandatory consultations were reported by only a minority of programs. At 62 percent of these university hospitals, family physicians do not have ICU privileges. However, no family physician had every made a formal application for them. Intensive care patients at these hospitals were generally cared for by specialists and house staff in internal medicine or critical care.

Data Collection↗
PubMed1983

Unstable bladder in elderly patients.

In more than half of geriatric patients with urinary incontinence, bladder instability is the underlying cause. Unstable bladder is due to decreased bladder capacity and reduced ability to inhibit voiding, which often occur as a part of aging. Behavior modification has been used to treat this problem. Medications, including those with anticholinergic properties and smooth muscle relaxants, are also helpful. Bladder distention therapy and intravesical anesthetics are rarely used.

Aged↗
PubMed1982

Confidentiality expectations of patients, physicians, and medical students.

One hundred seventy-seven patients, 53 medical students, and 109 house staff were surveyed by questionnaire regarding the confidentiality of information that patients give to physicians. Physicians and students reported discussing cases in situations in which most patients did not expect this to occur. These included discussions at parties (36% v 9%) and with spouses (51% v 17%), and identification of patients by name (60% v 23%). Both patients and medical personnel thought it was common to discuss cases with other physicians, even at large meetings, for additional opinions or because of interest. However, patients were less likely than physicians to think that this occurred (90% v 51%). Medical students in their first 60 days of training responded more like physicians than like the lay public. Physicians responded similarly at various levels of training. Primary v non-primary care physicians showed no differences in response.

Arizona↗