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Biomedical subjects

J Sands

Publications and source records attributed to J Sands.

60 records · Page 4Linked to original sources
PubMedDate not supplied

Case management: a formula for resource conservation.

Case management as a concept of efficiency and effectiveness has demonstrated its applicability in acute care. This article addresses one model of case management that integrates the traditional structure of independently functioning, nonrevenue-producing activities of quality, risk, and utilization management under the comprehensive umbrella of quality resource management. The model transformed existing full-time equivalent services at an acute care hospital in Florida into value-added services on behalf of patients, physicians, the hospital, and payers and presented a practical approach to organizing a case management program. Issues in the transformation process also are addressed.

Case Management↗
PubMedDate not supplied

Corneal rupture from blunt trauma 22 months after radial keratotomy.

This report describes a case of traumatic corneal rupture 22 months after radial keratotomy in a 39-year-old woman. The patient struck her face on the side of her car resulting in a limbus rupture in her cornea through the horizontal incisions of a four-incision radial keratotomy. An orbital blowout fracture was also present. A sclerotomy was performed to drain persistent choroidal detachment. After the hemorrhage in the anterior chamber resolved, the iris and lens were found to be absent. Visual acuity of 20/40 was achieved with aphakic correction.

Adult↗
PubMedDate not supplied

Hemodialysis access flow measurement. Comparison of ultrasound dilution and duplex ultrasonography.

Decreased hemodialysis access flow is associated with an increased risk of access thrombosis. Duplex ultrasonography can measure access flow and select a subset of patients at increased risk for access failure. With in-line techniques (ultrasound dilution), access flow can be measured during hemodialysis. This study attempted to determine if access flow measured by ultrasound dilution (QA-T) was comparable to that measured by duplex ultrasonography (QA-S). The authors performed 66 simultaneous measurements of hemodialysis access flow in 19 patients by ultrasound dilution and duplex ultrasound with time-domain correlation during 19 hemodialysis treatments. The mean access flow was 1,086 +/- 505 ml/min by ultrasound dilution and 1,026 +/- 513 ml/min with duplex ultrasonography (NS). Regression analysis revealed a linear relationship between the two techniques described by the equation QAT = 246.14 + 0.8104(QAS) (correlation coefficient of 0.83; p < 0.0001). Measurement of hemodialysis access flow by ultrasound dilution was essentially equivalent to that obtained by duplex ultrasound. Additional studies are needed to determine if regular in-line flow measurements can predict and prevent future access thrombosis and decreased the cost of access management.

Arteriovenous Shunt, Surgical↗