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Biomedical subjects

B Turner

Publications and source records attributed to B Turner.

At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

Variation in the diagnosis of upper respiratory tract infections and otitis media in an urgent medical care practice.

BACKGROUND: Variation among hospitalized medical conditions have been reported previously, but there is little information on variation among physicians for medical conditions that constitute a substantial part of ambulatory care. OBJECTIVE: To measure variation in the diagnosis of 2 common medical conditions, otitis media (OM) and upper respiratory tract infections (URIs) in an urgent care practice. DESIGN: Estimate the variation in the incidence of new diagnoses of OM and URIs among 19 physicians working at 2 urgent care clinics between January 1, 1995, and March 31, 1995. Patients are seen in order of arrival, and assignment to each physician is random. PARTICIPANTS AND SETTING: Two urgent care clinics staffed by the same 19 physicians. During the 3-month study period, 21,259 patients were seen at the 2 clinics; of these, 1839 (8.65%) received a diagnosis of first time OM; and 8020 (37.73%), of an URI. MAIN OUTCOME MEASURE: Incidence of new diagnoses of OM and URI estimated as a proportion of all diagnoses for each individual physician. RESULTS: There was substantial variation between physicians in the diagnosis of OM, ranging from a low of 4.2% to a high of 21.8%. There was less variation in the diagnosis of URI (31.7%-48.4%). Some physicians with a low incidence of OM or URI diagnoses had increased the proportion of diagnoses in the other diagnostic category. For OM the variation was greatest for children younger than age 5 years, but substantial variation was also found in adults. For URIs the variation was more uniform across all age groups. The variation was not explained by type of specialty training or years in medical practice. CONCLUSIONS: There is substantial variation between physicians in their diagnosis of OM and URI in an urgent care setting. This variation has implications for cost of diagnosing and treating these conditions, the training of physicians, and our understanding of the treatment of OM.

Adolescent↗
PubMedDate not supplied

Oral health care issues in HIV disease: developing a core curriculum for primary care physicians.

BACKGROUND: Given the high occurrence of oral manifestations in patients infected with human immunodeficiency virus (HIV), the relative ease in recognizing these manifestations on physical examination, and their potential impact on the health care and quality of life in these patients, it is critical to provide adequate training for primary care physicians in this area. METHODS: Based on a review of the published literature and the consensus of a national panel of primary care physicians and dentists with clinical and research expertise in this area, a core curriculum was developed for primary care physicians regarding oral health care issues in HIV disease. RESULTS AND CONCLUSIONS: We describe the process of developing the core curriculum of knowledge, skills, and attitudes regarding oral health care issues in HIV disease. The final curriculum is in a format that allows for easy accessibility and is organized in a manner that is clinically relevant for primary care physicians.

Clinical Competence↗
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Combined modality therapy of locally advanced breast cancer. One institution's experience and a review of the literature.

Fourteen patients with locally advanced breast cancer were treated at Stanford University Medical Center with a combined modality approach. Treatment consisted of an initial 5 day course of cyclophosphamide followed by three cycles of combination chemotherapy (CAF or CMF). Patients subsequently received radiation therapy to the involved breast and regional nodal areas, followed by mastectomy if resistant disease was present following irradiation. Additional chemotherapy (CMF) was administered for 6 cycles. With a median follow up of 42 months, all fourteen patients are free of local disease. Five out of the fourteen patients have experienced distant relapses and two patients died. We conclude that an aggressive combined modality approach to treatment of locally advanced breast cancer can result in excellent local control and survival even in poor prognosis patients. A review of pertinent studies on multimodality treatment for locally advanced breast cancer confirms our findings.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Influenza viruses from avian and porcine sources and their possible role in the origin of human pandemic strains.

Studies on influenza viruses from feral ducks trapped in Canada in August 1976, gave a 26% isolation rate from cloacal samples of juvenile birds. Several different influenza A viruses were isolated, some of which possessed novel hemagglutinin and/or neuraminidase antigens. Influenza A viruses isolated from the rectum of feral ducks replicate in the upper respiratory tract and also in the intestinal tract of feral and domestic ducks. Representative human influenza viruses of the H0N1, H3N2 and Hsw1 N1 subtypes replicate in the upper respiratory tract of ducks but not in the intestinal tract. The A/Hong Kong/68 [H3N2] influenza virus that has not been isolated from man for several years was recently isolated from pigs originating from The People's Republic of China. A/Victoria/3/75-like influenza viruses that are currently circulating in man were also isolated from pigs. Both the A/Hong Kong/68 and the A/Victoria/75-like viruses transmitted readily from pig to pig in experimental studies. The susceptibility of ducks and pigs to infection with human influenza viruses suggests that these animals may play an important role in the ecology of influenza A viruses.

Animals↗