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Biomedical subjects

C Cassel

Publications and source records attributed to C Cassel.

32 records · Page 2Linked to original sources

Mucinous colon carcinoma in a black family.

Carcinoma of the large bowel developed in an autosomal dominant pattern in 13 members of a black-American family. Seven members were affected prior to initial ascertainment of the family in 1976. Thereafter, the remaining six were affected while 0.2 cases were expected (p less than 0.001). Median age at diagnosis of colon cancer was 39 years (range, 22-62 years) in this family, compared with 65 years among black-Americans, in general. Histologic review of surgical specimens from six patients and medical record data for a seventh patient showed mucinous adenocarcinoma of the colon, an uncommon histologic variant. Studies of several family members a decade ago had revealed no biologic markers of cancer susceptibility.

Adenocarcinoma, Mucinous↗

Medical responsibility and thermonuclear war.

The attention of physicians is being drawn to the issue of nuclear weapons and nuclear war, creating controversy about whether a political concern is appropriate for health care professionals. The use of nuclear weapons would incur human death and injury on a scale both unprecedented and unimaginable, and possibly damage the ecosphere far beyond the weapons' immediate effects. Medical supplies and facilities would be nonexistent; no meaningful medical response would be possible. A physician's responsibility to prevent nuclear war is based on the imperative to prevent a devastating incurable disease that cannot be treated. Such an imperative is consistent with the historic tradition of the social responsibility of health professionals, and can be justified by philosophical argument.

Humans↗

A diagnostic index of clinical practice.

In this method of accural of medical data by clinicians, entry and retrieval of information is facilitated by directly recording patient data in diagnostic categories according to the familiar anatomical organ system classification instead of a numerical code. The diagnostic index is kept in looseleaf form, with tabulation of the patient's name, chart number, diagnosis, and other conditions present. Certain diagnoses are frequent enough to warrant insertion in a separate column of the page or on a separate page under the appropriate organ system. Special pages are used for diagnostic procedures, deaths, perplexing problems, and complaints, making it possible to assemble all pertinent data derived from ambulatory or hospital practice. This system allows any physician access to his own clinical experiences with minimal effort.

Diagnosis↗

Quantification of interventions and outcomes in an outpatient telemanagement and care management congestive heart failure program.

The congestive heart failure continuum was developed in collaboration with the medical management committee of our hospital in response to a need to decrease readmissions for this chronic and progressive disease. This is accomplished via a multidisciplinary team that provides education and long-term telemanagement, as well as care management to assist these patients in maintaining an optimum level of functioning and the ability to remain in their homes for as long as possible. Since October 1996 there have been 375 patients referred with a decrease in the 31-day readmission rate from 21% to an average of 5%. Costs are presently $55.00 per month per patient. Evaluation of the congestive heart failure phone management tool revealed a strong 77% positive correlation between the patient's score and the number of interventions needed to stabilize the patient. Care management visits, when necessary, help reduce the need for hospitalization. (c)2000 by CHF, Inc.

Journal Article↗

Hospital utilization patterns and costs for adult sickle cell patients in Illinois.

OBJECTIVES: To determine population size, demographic characteristics, hospital utilization patterns, the specialties of physicians providing care, and costs for hospitalized adult sickle cell patients in Illinois. METHODS: A statewide, administrative dataset for the two-year period from january 1992 through December 1993 was analyzed retrospectively. RESULTS: There were 8403 admissions among 1189 individual sickle cell patients for the two-year period. Eighty-five percent of patients resided in the Chicago metropolitan area. The median age of the 1189 patients was 29; two-thirds had Medicaid or Medicare coverage. Emergency departments were the primary source of admissions (85.7%). The most common admitting diagnosis was painful crisis (97.4%), and average length of stay was four days. The median number of admissions per patient was three; most patients (85%) used only one or two hospitals. A small group used more than four hospitals and accounted for 23% of statewide admissions. Primary care physicians cared for most patients, and total hospitalization charges were more than $59 million. CONCLUSIONS: In Illinois the adult sickle cell population is concentrated in major urban centers, primarily the Chicago metropolitan area. These patients accounted for approximately 8400 admissions and more than $59 million in hospital charges during the two-year study period. A small group of patients used multiple hospitals and accounted for more than 23% of total hospitalization charges. This study shows the necessity of and provides a useful framework for developing targeted programs for adult sickle cell patients as well as for training physicians to efficiently provide comprehensive health care services for this population.

Adolescent↗