Long-run forecasts of prices and expenditures for physician and hospital services.
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Biomedical subjects
Publications and source records attributed to J Rodgers.
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A series of 102 patients with presumptive acute appendicitis entered a prospective, randomized, clinical trial of intrarectal metronidazole given over a 48-h period commencing before surgery. Adequate levels of circulating metronidazole were achieved. A significant reduction in the incidence of anaerobic wound infection was observed in the treated group (P less than 0.02). The convenience and short duration of the prophylactic regimen allowed early discharge from hospital. No untoward effects were observed.
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The depth- and field-size dependence of the in-phantom wedge factor have been determined for a Cobalt-60 (Co-60) teletherapy unit and four medical linear accelerators with 4-, 6-, 10-, and 18-MV x-ray beams containing 15 degrees-60 degrees (nominal) lead, brass, and steel wedge filters. Measurements were made with ionization chambers in solid water or water with a source-skin distance of 80 or 100 cm. Field sizes varied from 4 x 4 cm up to a maximum allowable size for each wedge filter. Measurements were performed for symmetric and half-collimated asymmetric fields at depth of maximum dose, 5- and 10-cm depths. For half-collimated fields, wedge factor reference points were located at a fixed off-axis distance from the collimator's rotational axis. These systematic measurements on wedges indicate that the wedge factor dependence on depth and field size is a function of beam energy as well as the design of the treatment head and wedge filters. Significance of the results reported herein are discussed for the most commonly used treatment depths and field sizes with various beam energies and wedge filters.
Type 2 diabetes is complex and difficult to treat, and patients often present with hyperlipidaemia and hypertension. We now have compelling evidence that adequate treatment of hyperglycaemia, together with tight blood pressure control, can reduce the risk of developing long-term complications of diabetes. This article explores the syndrome of type 2 diabetes, including some of the causal mechanisms. The various forms of treatment are explored: diet, exercise, different oral hypoglycaemic agents and insulin therapy. Finally, the importance of the nurse in assessing the most suitable therapeutic intervention for people with type 2 diabetes is outlined.
The benefits to patients of health professionals working harmoniously together are almost too obvious to state, so why is there so much contention between nurses, doctors and other staff? The author explores some of the reasons behind this tension, and suggests some means of overcoming them.
In March 1990, nearly 14 percent of the U.S. population was without health insurance. This article examines five approaches to increase coverage: tax credits for the purchase of private insurance; changes in the regulation of the private insurance market; additional requirements on employers to provide employment-based insurance; expansion of Medicaid to selected groups; and a universal public health insurance program. Coverage would be most improved under a universal public insurance plan, and least improved by regulatory changes in the private insurance market. Significant but incomplete increases in coverage could be achieved through either new employer mandates or expansion of Medicaid. A tax credit could increase coverage appreciably only if it was substantial relative to the cost of insurance, and even then most of the credits would go to those who would have purchased insurance anyway.
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This blinded study describes the effect of ibuprofen (IBU) on experimental pressure ulcers (PU) induced in the fuzzy rat model. Ibuprofen's fibrinolytic activity has been found effective in preserving dermal vasculature in rats following burn injury. Experimental pressure ulcers were generated on the hips of fuzzy rats with the aid of computer control, using five daily, 6-hour pressure sessions. In the first study, 17 rats received intraperitoneal (I.P.) injection of IBU or saline control after each pressure session. In the second study, 44 rats received IBU or control, before, during, and after application of pressure by I.P. or intramuscular (I.M.) injections. Quantitation of histology is based on five prominent lesions, including: ulceration, infarction, panniculus carnosus necrosis, fat atrophy, and deep muscle necrosis. The following hypothesis was tested: Reperfusion injury and vascular occlusion in pressure ulcers may be similar to that which occurs in burns and, therefore, is responsive to IBU intervention. The results indicate that IBU does not have significant effects on the development of pressure ulcers. The mechanisms of IBU action in other organ and tissue systems are discussed in relation to the effect of IBU on the pressure ulcer model.