Biomedical subjects
J Hadley
Publications and source records attributed to J Hadley.
Can urban hospitals afford care for the poor?
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Correlation between changes in rat sperm membrane lipids, protein, and the membrane physical state during epididymal maturation.
An enriched plasma membrane fraction was isolated from caput, corpus, and cauda rat spermatozoa and analyzed for lipid and protein content, thermal phase transition temperature using electron paramagnetic resonance spectroscopy (EPR), and enzymatic assays of calcium-dependent ATPase activity. Based on sperm concentration, total membrane phospholipid, cholesterol, and protein content declined as sperm passed through the epididymis. A more refined analysis of the bulk plasma membrane phospholipid revealed that approximately 56% of the phospholipid consisted of choline (PC) and ethanolamine (PE) phosphoglycerides; the remainder consisted of sphingomyelin (SM), phosphatidylserine (PS), and diphosphatidylglycerol (DPG). The mole percent of PE increased in sperm proceeding from the caput to the corpus epididymis and then declined from the corpus to the cauda epididymis. The phospholipid-bound fatty acids consisted primarily of palmitate (C16:0) and stearate (C18:0), with a significant increase in the mole percent of the docosapentenoyl acyl group (C22:5) in cauda sperm. Arrhenius' plots of the EPR peak height signals using the lipid soluble spin label, 5-doxyldecane, and the calcium-dependent ATPase activity as a function of temperature demonstrated a change in the apparent fluidity of the membrane and energy of activation of the calcium-dependent ATPase associated with the three sperm membrane preparations. These data suggest that the apparent fluidity and biochemical composition of the sperm membrane change during epididymal maturation.
Hospital responses to Medicare's Prospective Payment System.
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The economically unattractive patient: who cares?
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Facts about childhood. Hyperactivity.
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Future issues in health care reform.
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"Snowboarder's fracture": fracture of the lateral process of the talus.
BACKGROUND: As physicians caring for patients who sustain snowboarding ankle injuries, we have noted that fracture of the lateral process of the talus occurs frequently. The incidence of this fracture, however, is very low in other accounts of ankle injuries. We report a case of fracture of the lateral process of the talus and review the pertinent literature of this injury. METHODS: A literature review was performed using MEDLINE files from 1966 to the present. We found additional references from the bibliographies of available reports. RESULTS AND CONCLUSIONS: Physicians caring for snowboarders should look specifically for fracture of the lateral process of the talus in a snowboarder with a lateral ankle or foot injury. This fracture can mimic a lateral ankle sprain, yet the fracture is easily missed on plain radiographs of the ankle. Because displaced or comminuted fractures can cause long-term disability, primary care physicians and specialists alike need to be aware of the association of this fracture with snowboarding.
The use of the Varney brace for subluxating shoulders in stroke and upper motor neuron injuries.
Applying the Varney shoulder brace for painful subluxating shoulders in stroke and head injury patients with or without spasticity has proved to be an extremely effective means of reducing the subluxed shoulder. Other causes for painful shoulders in these patients must be ruled out. Not every shoulder which subluxes with or without spasticity is painful. Correct diagnosis of the etiology of the pain is essential to help the patient. Rotator cuff tendinitis, reflex sympathetic dystrophy, glenohumeral arthritis, shoulder contracture, pain due to central nervous system origin (thalmic pain) and other intrinsic causes of referred pain must be ruled out. Once the subluxed shoulder is proven to be the cause of pain, the Varney brace is an excellent orthosis for the reduction and maintenance of position. Pain usually subsides completely within 5 to 7 days.
Breast cancer treatment choice and mastectomy length of stay: a comparison of HMO and other privately insured women.
This study uses hospital discharge abstract data from five states (Massachusetts, New York, New Jersey, Maryland, and California) for two years (1988 and 1991) to investigate whether enrollment in an HMO affects nonelderly breast cancer patients' treatment choice (breast-conserving surgery or mastectomy) and hospital length of stay for women who have a mastectomy. Since HMO insurance creates financial incentives that differ from other types of insurance coverage, it is important to assess whether the type of insurance coverage affects the care received by breast cancer patients. Although the results vary from state to state, they suggest that HMO enrollees are less likely to receive breast-conserving surgery (relative odds =.93). However, an unambiguous interpretation of this findings requires better data on patients' opportunity costs and preferences, which also may vary with type of insurance coverage. Among women who had a mastectomy, HMO enrollment was generally associated with a 4.5% shorter average length of stay and a greater likelihood of a short stay (one or two days, relative odds = 1.21-1.29). A much higher proportion of mastectomy patients in California than in other states had a short stay. Follow-up of these women may indicate whether short stays lead to adverse long-term health effects.