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Biomedical subjects

J L Marion

Publications and source records attributed to J L Marion.

9 recordsLinked to original sources

Cost modeling as a technology assessment tool for radiology department capital equipment acquisitions.

Changes reshaping the healthcare delivery system impact capital equipment acquisition decisions within radiology departments. During an era of rapid technological advancement, acquisition decisions often favor new imaging technology with an emphasis on volume and revenue increases. With a slowdown or plateau in new imaging technology and significant changes in the healthcare delivery structure, greater emphasis is now being given to productivity and quality improvement investments. Such investments are aimed at reducing labor and material operating costs through capital investment in electronic alternatives, such as the digital viewing and storage of diagnostic images in lieu of film. This shift in emphasis presents a dilemma for radiology departments because it is often more difficult to show a quality and productivity improvement justification. One approach is to use a formal ¿technology assessment¿ (TA) process wherein a manager considers changes in processes, labor, equipment, space, and consumables, and then assesses that impact on cost, utilization, quality of care, and other factors. A cost model is a useful tool in this process. A review of a number of real world experiences demonstrates the benefits of more timely and informed capital equipment investment decisions. While the direct savings may not entirely offset such investments, TA analysis also evaluates in tangible benefits that may not be quantifiable in economic terms. Both tangible cost savings and intangible benefits need to be weighed against the net investment in a new technology.

Capital Expenditures↗

Electrophysiological study of a case of diffuse loss of sweating with segmental hyperhidrosis associated with areflexia.

Electrophysiological investigations were carried out on a 43 year-old man with segmental hyperhidrosis in three radicular territories, generalized anhidrosis elsewhere and areflexia. A recurrent labial herpetic rash and a history of sweating disorders in his grandfather were the only associated clinical data. Sympathetic skin response was found to be absent in anhidrotic territories, including the hands and feet, although it was present in hyperhidrotic territories. Peripheral adrenergic sympathetic fibers evaluated by photoplethysmography were normally responsive, as were visceral vegetative regulations involved in cardiovascular control during postural changes or exercise. The present case is compared to the previously described Ross Syndrome, associating segmental hypohidrosis, areflexia and tonic pupils. Our results and observations in the literature are consistent with the occurrence of lesions affecting postganglionic cholinergic fibres of the sympathetic system.

Adult↗

[Alcoholic epilepsy. Decrease of tryptophan levels in the blood and cerebrospinal fluid].

The initial, functional stage of alcoholic epilepsy has been attributed to disturbances in neuromediators, including serotonin. Tryptophan, a precursor of serotonin, was assayed in 10 alcoholic patients with epilepsy and in a group of subjects with normal tryptophan metabolism and undisrupted blood-brain barrier. Tryptophan levels were measured in the cerebrospinal fluid and free and total tryptophan levels in plasma, using an automatized continuous flow method. Compared with controls, the alcoholic patients showed a highly significant decrease of all tryptophan fractions.

Adult↗

[Lambert-Eaton syndrome and myasthenia. Nosologic discussion].

The Eaton-Lambert syndrome is a presynaptic neuromuscular blockade with well-defined electrical characteristics. It contrasts with the postsynaptic neuromuscular blockade which typifies myasthenia gravis. A review of the literature shows that cases do not always perfectly fit the description by Eaton and Lambert and that both kinds of blockade may be associated as in the observation reported here. Since its first description in 1956, there have been many publications on the Eaton-Lambert syndrome. However, there are cases in which both types of blockade; i.e. myasthenic and pseudo-myasthenic, are associated and the following case-report has seemed to us worthy of interest.

Carcinoma, Small Cell↗