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Biomedical subjects

H Katz

Publications and source records attributed to H Katz.

At least 55 records · Page 3Linked to original sources
PubMed1982

Subcutaneous facial emphysema complicating dental anaesthesia.

A 20 year-old female developed swelling and protrusions of the tongue and marked facial swelling while under general anaesthesia for dental restoration and gigivectomy. The initial diagnosis was angioedema; however x-rays showed marked subcutaneous emphysema more extensive in the perimandibular area with a minimal amount in the neck. There was no evidence of pneumomediastinum or pneumothorax. The iatrogenic subcutaneous emphysema was felt to be due to air-driven dental equipment. Tracheal intubation was maintained for 21 hours to prevent airway obstruction. The patient was treated with oxygen and antibiotics. Subcutaneous emphysema may occur following root canal therapy, tooth extraction, periodontal surgery and operative dentistry, due to the use of air-driven dental equipment. It has the potential to cause obstruction.

Adult↗
PubMed1982

Episode-based efficiency comparisons for physicians and nurse practitioners.

Most previous studies comparing the efficiency of new health practitioners with that of physicians have used the visit as the basic unit of output. Several researchers have noted, though, that the episode is a conceptually superior output unit in several respects, although it is more complex to deal with methodologically. This study demonstrates the application of episode-based methods for comparing the efficiency of physicians with that of nurse practitioners. Data are drawn from the information system of the Columbia Medical Plan and from observations of provider time inputs. The analysis is confined to care episodes for otitis media and sore throat in the Department of Pediatrics. Results indicate that per episode costs with nurse practitioners as the initial provider are approximately 20 per cent below the costs of episodes in which physicians are the initial provider. Examination of a limited amount of data on patient-reported measures of effectiveness indicates that while nurse practitioners' care is less costly, it is not less effective. These findings are particularly interesting in light of recent doubts expressed about cost-savings from using new health practitioners, and particularly nurse practitioners, in group practice settings.

Ambulatory Care↗
PubMed1982

Douglas revisited. A stethographic method for visualizing thoracoabdominal motion.

The stethograph is an air-filled tube strapped to the chest. It was popular in the early part of the century as a means of detecting rib cage motion. When a second stethograph is strapped to the abdomen and coupled to an x-y recorded, a 'loop' is generated which characterizes the thoracoabdominal motion during inspiration. Inspiratory muscle weakness or dysynchrony can be reliably and economically evaluated with this technique. Visualizing thoracoabdominal motion on an x-y recorded provides a useful means of instructing patients during breathing retraining.

Abdomen↗
PubMed1980

Psychosocial and psychosomatic diagnoses in primary care of children.

In this study in seven primary care facilities the proportion of children recognized as having behavioral, educational, or social problems was much higher than generally assumed. Although there was great variability among the facilities, at least 5% and as many as 15% of children seen in one year were diagnosed as having these problems in all but the hospital teaching facilities. The prevalence was even higher among children from poor families. The variability among facilities was much less for psychosomatic problems, which were diagnosed in 8% to 10% of the children. For both psychosocial and psychosomatic types of problems, but especially for psychosocial ones, the proportion of visits with the diagnoses was much lower than the proportion of children with them, so that these problems engendered fewer visits for their management than might have been expected from their frequency in the population. However, available evidence suggests that individuals with unresolved psychosocial problems make more than their share of visits for other diagnoses. The findings of this study have implications for the content of educational programs for primary care practitioners, for the organization of primary care practice, and for the current debate over policy concerning reimbursement and benefit packages.

Adolescent↗