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Biomedical subjects

J Herman

Publications and source records attributed to J Herman.

245 records · Page 14Linked to original sources
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Issues in computerized spirometry.

Computerization of pulmonary function testing is forcing rewrites of time-honored protocols and shifting responsibilities from technician to machine. Spirometry, in particular, has become a diagnostic test virtually free of manual measurements and calculations; computerization even provides interpretation of the results. Along with these improvements, computerized spirometry also raises questions regarding reference values, interpretive criteria, and standardization.

Diagnosis, Computer-Assisted↗
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Open versus laparoscopic appendectomy.

BACKGROUND/AIMS: To asses the role of laparoscopic appendectomy in the treatment of acute as well as chronic appendicitis on the basis of our own experiences. METHODOLOGY: From the set of 849 patients treated with appendectomy (from January 1993 to December 2000) 331 were singled out, i.e.; those unable to work for some time and thus being on sickness benefit who asked for a medical certificate. They were operated on for either acute or chronic appendicitis. RESULTS: In our set of 331 patients (158 males, 173 females, the average age 29.4) open appendectomy was performed on 179 patients and laparoscopic appendectomy on 152. Laparoscopic appendectomy was performed in 43 males (28%) and 109 females (72%); open appendectomy in 115 males (64%) and 64 females (36%). Laparoscopic appendectomy took 53.7 +/- 18.1 minutes, open appendectomy took 43.6 +/- 8.99 minutes. The time of work disablement is longer in open appendectomy (open appendectomy: 41.2 +/- 9.91 days; laparoscopic appendectomy; 29.1 +/- 15.11 days). A significant difference (p < 0.00001) can be seen in the length of hospitalization (laparoscopic appendectomy: 5.0 +/- 2.75 days, open appendectomy: 8.3 +/- 2.83 days). CONCLUSIONS: Patients who undergo laparoscopic appendectomy spent less time in hospital, and they can return to work rather earlier. On the other hand the time of surgery is longer. Higher cost is compensated for with shorter hospitalization and early return to work.

Acute Disease↗
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Therapeutic nihilism?

The view that the era of modern medicine began with the introduction of the sulfonamides is supported by a standard textbook of pharmacology that refers to the years 1908-35 as being characterized by "therapeutic nihilism". However, a survey of several sources listing some of the treatments then available yields 15 infectious, 7 deficiency and 3 endocrine disorders amenable to cure. In addition, palliation that even today would be considered rational could be given for congestive heart failure, angina pectoris, asthma, epilepsy, migraine, and Parkinson's disease, to mention only a few. A total of 38 surgical, pharmacological, nutritional and physical remedies were identified, many of them still in use. These findings represent a minimum estimate as the review was not exhaustive, being aimed chiefly at recapturing the therapeutic atmosphere prevailing 75 years ago. Nothing in the textbooks of medicine, pharmacology and treatment suggests that physicians of the 1920's lacked either the means or the enthusiasm for treating their patients.

Attitude of Health Personnel↗
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Forecasting the nursing workforce in a dynamic health care market.

The ability to discern the interacting factors that affect supply and demand for nurses could help nurse educators and nurse leaders allocate resources to meet these needs. Forecasting models must take into account the interactions of three crucial groups of health care providers--physicians, nurse practitioners, and physician's assistants. Buerhaus has noted that market size, wages, preferences for nursing services, and availability of substitutes influence the demand for nursing services. Changes in nurse supply resulting from Medicare reimbursement for nursing services have not been studied, though it could safely be projected that such reimbursement will increase nurse supply. Nurses with baccalaureate degrees and advanced practice preparation will be in the greatest demand in ambulatory care, managed care, public health, and home care settings, raising concerns again that the educational mix is in need of adjustment upwards.

Delivery of Health Care↗