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Biomedical subjects

J Tierney

Publications and source records attributed to J Tierney.

52 records · Page 3Linked to original sources
PubMedDate not supplied

Laparoscopic surgery and its potential for medical complications.

Laparoscopic surgery is very popular among physicians and patients because this technique is associated with safety, shorter hospital stay, early return to normal activity, and cosmetic acceptance of the operative scar. Although the procedure involves minimal invasion and tissue damage, it has potentially serious complications, including cardiopulmonary effects that result mainly from hypercarbia and raised intraabdominal pressure caused by pneumoperitoneum. Absorbed carbon dioxide from the peritoneal cavity tends to cause acidosis. Leakage of the gas into tissue spaces may induce subcutaneous emphysema, pneumothorax, pneumomediastinum and pneumopericardium. Cardiac effects include arrhythmias, hypotension, cardiac arrest, gas embolism, pulmonary edema, and myocardial ischemia or infarction. Some of these effects, though rare, are serious and potentially fatal. Physicians should anticipate these problems in their patients undergoing laparoscopic procedures. This review discusses the technique of and physiologic considerations in laparoscopic surgery as well as its potential complications.

Cardiovascular Diseases↗
PubMedDate not supplied

The effect of the Medicare regulations on hospice practice: enhancing staff performance.

The purpose of this paper is to examine the federal hospice regulations (42 CFR 418.50-.100) and identify from these standards key characteristics that help define important aspects of palliative hospice care. The other purpose will be to examine these requirements to determine what these standards say or imply about the functioning of the hospice staff within the certified program. We assert that in order for a certified program to function in the capacity outlined in the federal hospice requirements, both the administration and staff need to understand, and then practice, the complex role delineated within the Congressional Law and ensuing regulations. The Medicare hospice regulations are a recognized program standard throughout the nation. These requirements, finalized in 1983, were developed by the Health Care Financing Administration (HCFA) as a result of the Congressional Tax Equity and Fiscal Responsibility Act (TEFRA, 1982). Since the promulgation of these regulations, hospices wishing to gain certification have had to adapt and mold their program focus and clinical procedures to meet this legislative mandate. Although some hospice administrators may perceive the Medicare requirements simply as hoops to be jumped through in order to gain funding, in truth, these regulations stand as a benchmark in the history of American hospice care. In their totality, the rules set forth a system of health care that is singular in program design.

Certification↗
PubMedDate not supplied

Hospice care versus home health care: regulatory distinctions and program intent.

A significant percentage of community health care agencies have both a certified hospice and home health program component. These agencies commonly utilize many of the same "cross-trained" staff in both programs. However, these programs are not identical in focus, scope and regulatory practice. This paper examines both certified hospice and certified home health care practice from the standpoint of the Code of Federal Regulations (CFR). The distinctions made in these two sets of regulations (hospice, 42 CFR 418.50-.100 and home health, 42 CFR 484.10-.52) point to important differences in program and management practice.

Certification↗
PubMedDate not supplied

Small cell neuroendocrine carcinoma of the urinary bladder: case report of a rare primary tumor.

Primary small cell neuroendocrine carcinoma of the bladder is a rare condition, with fewer than 140 cases having been reported. It is an aggressive tumor with an average five-year survival rate of less than 10 percent as cited by multiple case reports. We report a 73-year-old white woman with primary small cell neuroendocrine carcinoma of the bladder who was treated with radical cystectomy and adjuvant cisplatin/etoposide-based chemotherapy.

Aged↗