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Biomedical subjects

F D Moore

Publications and source records attributed to F D Moore.

At least 91 records · Page 5Linked to original sources
PubMed1982

A mirror for self-examination by a patient with an aphakic eye.

A mirror with a radius of curvature of 211.5 mm permits a patient who has undergone cataract surgery to examine his own aphakic eye without corrective lenses. A slight adjustment of the eye-to-mirror distance also permits examination of a normal eye, a hyperopic eye, and a presbyopic eye requiring a plus lens correction. The mirror can be used to monitor postoperative status and the course of a disease, and for inserting and removing contact lenses.

Aphakia, Postcataract↗
PubMed1982

Surgical manpower: past and present reality, estimates for 2000.

The growth in the number of board-certified surgeons in the 1970s, projections of the need for surgeons in the year 2000, and possible factors softening the impact of surgical expansion are discussed in detail. The best index for the optimal supply of surgeons in the United States is related to the phenomenon of local community needs.

Adult↗
PubMed1982

Intracellular potassium: 40K as a primordial gene irradiator.

We have been interested in the possibility that the low energy electrons (Auger and Coster-Kronig) emitted after the electron capture decay of 40K may have highly localized radiochemical effects on the genetic material--effects dependent upon the intracellular locus of potassium. We report here that these effects are such that the likelihood of mutagenesis by their impact on DNA is substantial. This suggests that intracellular 40K has played a significant role as a mutagenic agent in evolution.

Animals↗
PubMed1982

Antibody restores human alternative complement pathway activation by mouse erythrocytes rendered functionally deficient by pretreatment with pronase.

Activation of the human alternative pathway of complement (C) by surfaces requires the initial deposition of C3b by fluid-phase C3 convertase and sustained C3 cleavage by C3 convertases fixed to the surface. Nonactivating particles have previously been characterized by an inability to sustain the function of C3 convertases on their surfaces because these sites were susceptible to the regulatory action of the control proteins. Pronase converts the mouse erythrocyte (E) from an activator to a nonactivator by markedly decreasing the ability of the cell to affix C3b generated by a fluid-phase C3 convertase; this conversion is unrelated to the action of the control proteins on bound C3b. The capacity of antibody and its F(ab')2 or Fab' fragments to restore the alternative pathway-activating function of pronase-treated mouse E indicates that the contribution of antibody is mediated by its combining site without a requirement for bridging or for the Fc portion. The fab'-dependent activation of the alternative pathway of C relates to the deposition of C3b on the particle surface, which is a first and continuing step in alternative pathway activation. The antibody effect is not directed to the action of the regulatory proteins. Thus, particle-dependent activation of the alternative C pathway has been shown for the first time to be abolished and restored by cell surface-directed mechanisms that function independently of the regulatory proteins.

Animals↗
PubMed1981

Board-certified physicians in the United States: specialty distribution and policy implications of trends during the past decade.

Board certification is a universal ambition among graduates of American medical schools. It is a measure of postgraduate achievement and clinical ability that leads to staff appointments, promotions, clinical privileges, increased fees, and reduced malpractice premiums. The number of physicians receiving specialty-board diplomas each year has increased remarkably over the past 15 years. The annual mean for the years of 1976-1978 was 17,381--larger than the graduating medical class four years before. The number of board-certified physicians in medicine, surgery, and the clinical services increased from 106,300 in 1971 to 158,900 in 1978. The percentage of board-certified physicians in these fields has increased from 65 to 78 per cent. Board certification in family practice commenced in 1970 and is still increasing sharply (from 1523 [1970-1972] to 3444 [1976-1978]). The growth of internal medicine and its subjacent specialties is the most spectacular and has been more rapid than that of either surgery or the clinical services, in both which the board-certification rate and number of board-certified practitioners have stabilized since 1973. As board certification becomes a virtually universal criterion that carries the implication of de facto licensing, its social role should be reevaluated.

Certification↗
PubMed1981

What's in a review.

Explore the source record for details and available documents.

Book Reviews as Topic↗
PubMed1981

The high cost of low-frequency events: the anatomy and economics of surgical mishaps.

We conducted a one-year prospective survey to identify adverse outcomes due to error during care in the field of general surgery. We identified 36 such cases among 5612 surgical admissions to the Peter Bent Brigham Hospital, but in 23 cases the initiating mishap had occurred in another hospital before transfer. In two thirds of the cases the mishap was due to an error of commission: an unnecessary, defective or inappropriate operative procedure. Twenty of these patients died in the hospital, and in 11 death was directly attributable to the error. Five of the 16 survivors left the hospital with serious physical impairment. A satisfactory outcome was achieved in only 11 cases (31%). The average hospital stay was 42 days, with the duration ranging from one to 325 days; the total cost for the 36 patients was $1,732,432. We suggest that all hospitals develop comprehensive methods to identify and prevent these costly and unnecessary events.

Boston↗
PubMed1981

Transmissible spongiform encephalopathy (Creutzfeldt-Jakob disease). Atypical clinical and pathological findings.

A middle-aged neurosurgeon had an 18-month illness characterized by abnormal sleep patterns, paresthesias, and necrotizing cutaneous lesions with vasculitis and signs of cerebral, brainstem, vestibulocerebellar, and progressive spinal cord involvement. Biopsy specimens of nerve and skin showed an acute vasculitis with endovascular cellular proliferation in the pattern of a Köhlmeier-Degos lesion and focal epidermal necrosis. Mental changes and cranial-nerve signs developed. Myoclonus occurred occasionally during sleep. Akinetic mutism ensued. At autopsy, major abnormalities were limited to the nervous system and skin. Spongiform encephalopathy typical of Creutzfeldt-Jakob disease was found with amyloid kuru plaques. A cribriform change distinct from the spongiform change was seen focally in the white matter. Scarred skin lesions and a healed, partially obliterative arteritis were noted. Inoculation of brain and lung into nonhuman primates resulted in a spongiform encephalopathy.

Brain Stem↗
PubMed1981

Anticoagulants, venous thromboembolism, and the cancer patient.

The records of 32 cancer patients who were treated with heparin sodium and warfarin sodium for thromboembolic disease were reviewed. Standard techniques for anticoagulation were neither safe nor effective. Sixteen patients experienced 21 different hemorrhagic complications. Eight patients had major hemorrhages that led to cessation of therapy or death. Six of 32 patients had pulmonary embolisms while receiving anticoagulants. It is suggested that venous interruption may be a safer and more effective method of prophylaxis against pulmonary embolism in cancer patients.

Adolescent↗
PubMed1981

Tonsillectomy in Maine: regulation versus education as modulators of medical care.

The reduction in the rate of tonsillectomy, using the state of Maine as an example, and the causes thereof are addressed. Are federal and state regulations required to change the behavior of physicians and the public, or is education of greater importance? A study of tonsillectomy in the state of Maine was based on data covering a period of approximately 30 years. The data were based on direct contact with hospitals, in which we achieved the cooperation of virtually all of the hospitals of Maine, encompassing 98% of the hospital beds. These data were placed in context by information provided by the Maine Health Data Service, and by information for the northeastern United States, for the eastern United States, and for the entire United States, from the Department of Health, Education and Welfare. The operation of tonsillectomy and its variants, including adenoidectomy, has declined remarkably in the past 30 years, most drastically in the past eight years. It now occupies only 4.5% of the total operative admissions for the State, where it formerly was 17%. It now has a populational incidence for the State of 3.3 operations per thousand population per year, whereas it formerly was at a level of about 10.0. From this study, as well as from physicians in Maine, to whom an informal questionnaire was sent, it is clear that this reduction has come about largely because of education of physicians and the public. Increased awareness by the public, pediatricians and general practitioners of the limitations of this operation has been significant. In addition, there is a general sense of improved general health of young people in Maine, with fewer chronic respiratory infections. Some negative opinions were expressed, including the possibility that peritonsillar abcesses may be more frequent in the future and that some pediatricians and general practitioners overuse antibiotics. Federal regulations, state regulations, Medicare, Medicaid, Blue Cross or Blue Shield regulations concerning tonsillectomy were not instituted at any point in the State of Maine, during the period under study. There were no alterations in payment, second opinion programs or other restrictions or constraints placed on the operation at any level of official or hospital regulation. Formerly performed in large numbers by general practitioners, family practitioners, and general surgeons, the operation(s) is now predominantly carried out by trained otolaryngologists, largely board certified. Evidence is presented to support the view that concentration of this operation in the hands of fewer, more highly trained surgical specialists has been positively associated with its sharper indications and declining frequency. The conclusion is offered that increased education of physicians, both specialists and general practitioners as well as family doctors, and of the public as a whole, is the most important single factor in producing this significant alteration in the behavior of the health care system in the State of Maine. Effective limitation of the operation to specialists has been an important feature both of this educational process and of the more rational use of the operation(s).

Adenoidectomy↗