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Biomedical subjects

H Sherman

Publications and source records attributed to H Sherman.

At least 37 records · Page 2Linked to original sources
PubMed1981

Impact of a cardiology data bank on physicians' prognostic estimates. Evidence that cardiology fellows change their estimates to become as accurate as the faculty.

To determine whether physicians would be influenced by the prognostic information in a large coronary artery disease data bank, cardiology faculty and fellows made initial estimates of the prognoses of their patients and then made revised final estimates after seeing the outcome of matched patients (OMP) from the data bank. The faculty cardiologists' original estimates proved to be as accurate as those of the data bank's OMP, and the faculty revised their estimates minimally in response to the data bank's OMP. Conversely, the cardiology fellows' original estimates were less accurate than the data bank's OMP, and under all observed circumstances the fellows responded more to the data bank's OMP than did the faculty. As a result, the accuracy of the fellows' final estimates was similar to the accuracies of both the faculty cardiologists and the data bank's OMP. Computerized data banks seem more likely to have impact when their information is provided to physicians who are relatively inexperienced with the disease in question.

Cardiology↗
PubMed1980

Dissecting the hospital stay: a method for studying patient staging in hospitals.

A methodology is proposed and tested for the staging of patients thorugh a hospital stay. Measurements in a university-affiliated hospital and a community hospital in the Boston area showed similar staging patterns with about half of the sample having abnormal signs and symptoms while under treatment. The second-largest sample group in both hospitals, consisting of 11% of the sample, occupied beds although ready for discharge. The methodology indicated those patient-time units in the hospital which might be amenable to further reduction and gave upper bounds on that compression. Contrary to prior expectations, 90% of the patients sampled followed a well-defined sequence from admission to discharge with only 10% having complications of the admitting diagnosis, new diagnosis or iatrogenic illness.

Bed Occupancy↗
PubMed1977

Toxicological evaluations of some brominated biphenyls.

Extensive toxicological studies were carried out to define the probable hazard of octabromobiphenyl (OBB) to workers, users, and the environment. OBB had low acute toxicity in mammals and birds by various routes of administration. It was essentially non-irritating to rabbit eyes, non-irritating to human skin and caused only mild skin irritation and no sensitization in the guinea pig. OBB caused equivocal effects in the rat fetus. OBB was stored in the body fat of rats and caused liver enlargement at high single doses or low repeated doses. The studies indicate probable low safety factors in application and use and probable bioaccumulation. Hexabromobiphenyl (HBB) was more acutely toxic than OBB by skin absorption in the rabbit and caused liver enlargement at lower single doses.

Abnormalities, Drug-Induced↗
PubMed1976

Quality, efficiency, and cost of a physician-assistant-protocol system for managment of diabetes and hypertension.

Briefly trained physicians assistants using protocols (clinical algorithms) for diabetes, hypertension, and related chronic arteriosclerotic and hypertensive heart disease abstrated information from the medical record and obtained history and physical examination data on every patient-visit to a city hospital chronic disease clinic over a 18-month period. The care rendered by the protocol system was compared with care rendered by a "traditional" system in the same clinic in which physicians delegated few clinical tasks. Increased thoroughness in collecting clinical data in the protocol system led to an increase in the recognition of new pathology. Outcome criteria reflected equivalent quality of care in both groups. Efficiency time-motion studies demonstrated a 20 per cent saving in physician time with the protocol system. Coct estimates, based on the time spent with patients by various providers and on the laboratory-test-ordering patterns, demonstrated equivalent costs of the two systems, given optimal staffing patterns. Laboratory tests were a major element of the cost of patient care,and the clinical yield per unit cost of different tests varied widely.

Costs and Cost Analysis↗
PubMed1976

Conservation in hospital resource use: treatment of pneumonias. An investigation of care in four hospitals over the past decade.

An investigation of patient care in four hospitals compared levels of resource use between 1964 and 1974 for patients with a primary diagnosis of pneumonia. Results showed a decreased length of stay in all hospitals. Unique patterns of increases and decreases existed in each hospital for the changing use of diagnostic and therapeutic resources. Reduction in dollar value of length of stay was larger in all cases than increases in dollar value of diagnostic and therapeutic resource use. This resulted in an overall reduction in hospital resource charges over the decade, when 1974 dollar values were used. Large increases in diagnostic or therapeutic resources (up to 217%) were reflected as only minor increases in the partial hospital bill over the decade ( less than 11%). Increased intensity of resource use has contributed to increasing per-day charges of up to 27%, in the face of recent average cost rises of more than 10 times that size for daily hospital expenses.

Costs and Cost Analysis↗
PubMed1976

Ambulatory care protocols as management tools.

While a protocol is generally used by a physician, it is important for the manager to understand its use in monitoring costs and in assuring conformance with defined optimal standards of care.

Ambulatory Care↗
PubMed1975

Octabromobiphemyl-induced ultrastructural changes in rat liver.

Single oral administration of octabromobiphenyls at 1,000 mg/kg, or two consecutive doses of 3,000 mg/kg, to rats produced liver enlargement. Light microscopic examination revealed hepatocellular hyperplasia, margination of basophillic cytoplasm, and foamy cytoplasmic alteration on the third day posttreatment. Laminated cytoplasmic inclusions developed seven days after treatment and subsequently disappeared about one week later. Under electron microscopy, the cytoplasmic margination corresponded to peripherally displaced granular reticulum and the foamy cytoplasm was recognizable as proliferating agranular reticulum with depletion of particualte glycogen. The cytoplasmic inclusions were identified as myelin configurations enclosing lipid bodies, membrane-bound vacuoles with whorled figures, and vesicular agranular reticulum. In the early developmental stages, the myelin figures were studded with ribosomes and associated with the granular reticulum.

Administration, Oral↗