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Biomedical subjects

K Swartz

Publications and source records attributed to K Swartz.

At least 55 records · Page 3Linked to original sources
PubMed1994

Transvaginal embryo transfer during the zygote intrafallopian tube transfer procedure.

OBJECTIVE: Our purpose was to evaluate a tactile non-ultrasonographically directed approach to transvaginal tubal cannulation and embryo transfer during the zygote intrafallopian tube transfer procedure. STUDY DESIGN: We studied the application of the tactile approach to transvaginal tubal cannulation and embryo transfer in 68 consecutive zygote intrafallopian tube transfer cycles. RESULTS: The tactile approach to transvaginal tubal cannulation and subsequent embryo transfer was successful in 93% of couples. Pregnancy occurred in 16 of the 63 (25%) women undergoing a successful transvaginal embryo transfer. CONCLUSION: The tactile approach to transvaginal tubal cannulation was found to be easily learned and provided a safe and convenient method of tubal embryo transfer. This low-cost approach, which has application to transfer of both embryos and gametes, deserves further study.

Catheterization↗
PubMed1994

Whither employment?

Explore the source record for details and available documents.

Employee Incentive Plans↗
PubMed1993

Personal characteristics and spells without health insurance.

People without health insurance differ not only in their personal characteristics and reasons for being without health insurance but also in the length of time they spend in uninsured spells. A hazard model of spell durations is used to estimate the relative effects of a person's characteristics in the month just before an uninsured spell begins on the duration of the spell. Using the Survey of Income and Program Participation, our analyses indicate that monthly family income, educational attainment, and industry of employment in the month prior to losing health insurance are the characteristics that have the greatest impact on the exit rate from being without health insurance. Because low-income people could end an uninsured spell with either private health insurance or Medicaid, findings from an exploratory competing risks model are also reported.

Adolescent↗
PubMed1993

Spells without health insurance: the distribution of durations when left-censored spells are included.

In a previous paper (1990), we estimated the distribution of durations of uninsured spells for which the beginning could be observed. We raised the concern that uninsured spells that were in progress when the Survey of Income and Program Participation began might not be proportionally represented in a sample of uninsured spells restricted to spells with observed beginnings. This paper includes spells in progress when SIPP began. Including left-censored spells, and correcting for length bias inherent in such spells, does not fundamentally change our previous estimate of the distribution.

Humans↗
PubMed1991

Open versus laparoscopic cholecystectomy: an initial analysis.

Laparoscopic cholecystectomy is a new procedure in the armamentarium of the general surgeon. Its utility was investigated by comparison to open cholecystectomy in terms of procedure time, complications, hospital stay, and total hospital cost. Procedure time was approximately 200% longer with a higher incidence of intraoperative stone and bile spillage (17%) in the laparoscopic group. Hospital stay was reduced by 60% using the laparoscopic technique. No difference in total hospital cost existed between the two groups. The learning curve had an affect on hospital costs, which will decrease as more experience is gained with this procedure. Although laparoscopic cholecystectomy, at least initially, has no cost advantage over open cholecystectomy, laparoscopic cholecystectomy may be preferred by patients seeking shorter hospital stays and presumably shorter total recovery time.

Adult↗
PubMed1990

Why requiring employers to provide health insurance is a bad idea.

There is mounting pressure at the federal (and state) level to require employers to provide health insurance to their employees. However, two quite different groups of workers could be affected by such a mandate. In addition, there are at least five major problems with requiring employers to provide health insurance. Chief among these is the further fracturing of the insurance market, so that the spreading of risk will be reduced, and only the young and healthy will be offered insurance at relatively low premiums. We should be designing a health insurance system that has both universal coverage and a cost-containment structure. Toward this end, we need to tackle issues that transcend alternative methods of financing health care in the U.S.

Evaluation Studies as Topic↗
PubMed1990

Spells without health insurance: distributions of durations and their link to point-in-time estimates of the uninsured.

To be able to design effective policies that will provide financial access to medical care to the uninsured, we need to know how many people experience long versus short spells without health insurance. Previous studies of the characteristics of the uninsured have relied almost exclusively on data from a point in time. Using the Survey of Income and Program Participation (SIPP), this paper provides a link between the distributions of four characteristics of the uninsured at a point in time and the expected uninsured spell lengths of people in specific subgroups of each characteristic. Our findings indicate that half of all uninsured spells end within 4 months while only 15% last longer than 24 months. Also, people who are employed (either full-time or part-time) in the first month of an uninsured spell are highly likely to have short uninsured spells, while people who are unemployed or out of the labor force are more likely to have long uninsured spells. This implies that efforts to increase health insurance coverage via employer mandates should proceed cautiously until we know how many people with long uninsured spells are employed.

Adult↗
PubMed1989

Uses and abuses of a biosynthetic dressing for partial skin thickness burns.

The following report reviews 851 applications of Biobrane on partial skin thickness burn wounds awaiting epithelialization. After the patients had been evaluated and resuscitated as needed, the burn wounds were cleansed and debrided. Those evaluated as shallow were treated with Biobrane application. Joint surfaces were splinted for immobilization. The wound was inspected at 24 and 48 h and if any fluid had accumulated it was aspirated and the wound was redressed. When the Biobrane was adherent, the wound was covered with a light dressing and joint immobilization was discontinued. Treatment with Biobrane dressing provided certain advantages over other topical wound care. As the dressing changes were performed less frequently outpatient care was possible, with a resultant decrease in both the length of hospital stay and the ultimate cost of burn care. Wound desiccation is prevented and pain is decreased. Accurate diagnosis of wound depth is crucial if Biobrane is to be used. Very deep wounds will not allow Biobrane adherence, neither will it occur if the wound has a high bacterial count. If joint surfaces are not splinted, the Biobrane will shear and not adhere to the wound. Convex and concave surfaces can be treated with Biobrane, which may need to be meshed.

Adolescent↗
PubMed1989

The impacts on hospital costs between 1980 and 1984 of hospital rate regulation, competition, and changes in health insurance coverage.

In this paper, we report the results of an analysis of hospital expenses in 43 large SMSAs between 1980 and 1984. We found that hospital rate regulation--specifically Medicare's TEFRA and PPS and state multi-payer systems--was the single most important factor leading to the slowdown in the rate of increase in hospital costs between 1980 and 1984. In 1984, hospital costs covered by Medicare's PPS were 12.5% lower than they would have been in the absence of rate regulation, and in the four states covered by all-payer rate regulation, hospital costs were between 11% and 15% lower. In contrast, changes in the proportion of people either covered by employer-group health insurance or enrolled in HMOs, reduced hospital costs by less than 1%. Measures of competition suggest that hospital costs are higher where there is more competition. We also found that almost all of the effect of regulation on costs came from gains in the efficiency of producing hospital care and/or from reductions in the quality of care. It appears that controlling hospital payment rates gave hospitals a strong incentive to provide care at lower cost.

Catchment Area, Health↗
PubMed1987

Technetium-thallium scintiscanning for localization of parathyroid adenomas and hyperplasia. A reappraisal.

The dual tracer nuclear scintiscan using technetium and thallium to localize enlarged or ectopic parathyroid tissue has been reported to be highly accurate and efficacious. Fourteen previous series reporting results of the technique have been compiled from the literature and analyzed. This analysis has revealed a total of 317 surgically confirmed scan results with a low false-positive rate (17 of 317 scans), a sensitivity rate of 82 percent, and an overall accuracy rate of 78 percent. Forty-five patients from five Portland area hospitals have been retrospectively studied. They had a total of 49 preoperative scans. In our experience with the scan, a higher false-positive rate (4 of 45 scans), a sensitivity rate of 78 percent, and an overall accuracy rate of 73 percent were noted. The scan's effectiveness in acknowledged areas of difficulty in parathyroid surgery, such as patients with ectopic adenomas, hyperplastic glands, and those with previous neck explorations, has been analyzed. We conclude that the scan is a useful preoperative localization tool, especially in patients with ectopic adenomas or with persistent hypercalcemia after neck exploration. However, it is less accurate than initially reported in complex patients, and additional localization techniques are frequently required.

Adenoma↗
PubMed1986

Characterization of monoclonal antibodies against rat glandular kallikrein.

Monoclonal antibodies can be produced in large amounts, are homogenous and can be highly purified. A specific monoclonal antibody against glandular kallikrein could be very useful in studies of the kallikrein-kinin system, both in vivo and in vitro. Two monoclonal antibodies against rat glandular kallikrein (rgKK) were produced by immunized mouse spleen and lymph node fusion with myeloma Ag8.653. Both antibodies, named 2E9.8 and 2E9.9, bound active 125I-kallikrein and phenylmethylsulfonyl fluoride (PMSF)-inactivated 125I-kallikrein. A radioimmunoassay (RIA) was developed with each of the antibodies using rabbit anti-mouse gamma globulin to separate bound from free 125I-rgKK. The standard curve (range 10-1000 ng/tube) was curved even when subjected to logit-log transformation. Using 3% polyethylene glycol (PEG) to assist separation of bound from free, the standard curve became straight for 2E9.8 and the RIA was more sensitive, with a binding range of 0.35-2.4 ng/tube. Both antibodies were specific for rgKK since they had negligible cross-reaction with purified proteases from the submandibular gland of the rat (tonin, esterases B and E). They did not cross-react with mouse nerve growth factor, epidermal growth factor, nor with pig pancreatic kallikrein. Antibody 2E9.9 did appear to bind some human kallikrein when tested with high concentrations of this enzyme, while 2E9.8 did not. When preincubated with purified rgKK, both antibodies prevented the enzyme from releasing kinins from semi-purified dog kininogen and from cleaving [3H]-L-arginine methyl ester (3H-TAME). These results suggested that both antibodies bind an epitope near to, and maybe including, the active site of the enzyme. Monoclonal antibody 2E9.8 appears to be specific for rgKK, can be used in a sensitive RIA, and is capable of inhibiting the enzymatic activity of kallikrein. It should prove to be useful in vivo for examining the role of kallikrein in physiological processes.

Animals↗