Biomedical subjects
Publications and source records attributed to J R Moore.
A case of an infant with a large (7 x 5 x 2 cm) solitary cutaneous nevus lipomatosus is reported. As far as we can ascertain, similar large solitary lesions of this type have not been previously reported.
Leiomyoma is a rare tumor in this location. It probably arises from the tunica media of blood vessels. Electron microscopy is necessary to confirm the diagnosis. Local excision of the lesion is adequate treatment.
A case of heparin-induced thrombosis of the brachial artery with thrombocytopenia is described. With discontinuation of the heparin, the circulating platelet volumes returned to normal. The role of pre-existing arterial disease and sepsis in patients exhibiting this phenomenon is unresolved.
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We present a simple method for measuring intramammary pressure. We believe this technique could be helpful in evaluating the firmness of breasts following the implantation of prostheses, and capsulotomies done for this reason.
A case of hearing deficit following nitrous oxide anaesthesia is reported. The mechanism and time course of nitrous oxide-induced intratympanic pressure changes are described and contrasted with the effects of non-nitrous oxide anaesthesia. The rate of increase is about 10 mm H20/min. The possibility that nitrous oxide may cause displacement of tympanic membrane grafts both outwards and inwards, or disrupt the reconstructed middle ear conducting mechanism, is raised again.
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Multiple dislocations of a single finger are rare. We report a patient with complete dislocation of the thumb metacarpal, a condition not reported previously. A 9 year follow-up shows the patient to have a normal-appearing, strong, and painless hand.
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An unusual cause of ankylosis of the temporomandibular joint is presented. The treatment plan took into account the potential hazards of major vessel hemorrhage and airway obstruction.
The challenge of delivering health care on a more cost-effective and equitable basis has led to the formation of new kinds of organizations, which in turn require new kinds of management information systems. The system described in this article is used for planning resource allocation and monitoring the overall performance of Livingston Community Health Services, Inc., a rural community-owned health service designed to provide comprehensive care to a geographically defined target population. The Health Services Data System processes information on performance and productivity, effectiveness with respect to the target population, and billing and financial activities. Input consists of the results of a community census and two household surveys, patient registrations and patient services operating data, and financial data. Besides billing patients automatically, the system integrates financial, demographic, and health services utilization data to generate monthly summaries for the administrators, medical director, and community board. The article discusses several examples of these summaries, stratifying utilization by geographic location of residence, age, income, and race.
An experiment is reported which utilized a professional medical care organization as the base for intern and resident education. The major reason for its failure was the undue rigidity of Title XVIII (Medicare) of the Social Security Act and associated regulations. The data assembled suggest that the mechanism is feasible and could potentially obviate (or at least minimize) many of the existing problems associated with the operation and financing of graduate medical education using a hospital as the organizational base.
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The accuracy of a household health interview survey in measuring the prevalence of chronic illness was tested by comparing survey responses with the same respondents' medical records. Results indicate that the survey is far from a perfect discriminator of recorded medical status. The false-positive rate was 25 percent, and the rate of false negatives was nearly 40 percent. False positives were greater for Mexican-Americans and other nonwhites than for white respondents. The household health interview survey is nonetheless an important planning tool since it reflects respondents' perceived health levels, which may be used to predict utilization of primary medical services.
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