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Biomedical subjects

L Goldman

Publications and source records attributed to L Goldman.

At least 397 records · Page 22Linked to original sources
PubMed1981

Anemic inpatients. Correlates of house officer performance.

To determine the correlates of the adequacy of the diagnostic evaluation of anemia, we conducted a prospective study on the medical services of a university-affiliated hospital. With the use of explicit criteria mapping techniques, the conditions of 204 (79%) anemic inpatients were adequately evaluated. By multiple regression analysis, the adequacy of evaluation showed significant correlations with the identity of the responsible house officer, the severity of the anemia, the patient's sex, and the service in which the patient received care. The performances of individual house officers were not significantly correlated with their subjective rankings by either their supervising residents or their attending faculty; however, a composite subjective ranking derived from the average of these two subjective rankings did correlate with objective performance in the anemia audit. We conclude that both patient and physician characteristics influence the adequacy of anemia evaluations and that objective audits may be a useful adjunct to the usual subjective methods for evaluating house officers' performances.

Anemia↗
PubMed1981

Laser medicine in America: an overview.

Laser medicine, as differentiated from laser surgery, has made tremendous progress in recent years. Laser diagnosis includes various laser techniques such as spectroscopy, Doppler velocimetry, and cytofluorometry, including cell sorter systems for current hybridoma technology. In addition, there is laser-induced fluorescence for cancer detection and treatment. Laser immunobiology includes laser nephelometry. Laser acoustical microscopy and laser transillumination for cancer diagnosis are also a part of current laser medicine, which offers much for cancer research, diagnosis, and treatment.

Blood Flow Velocity↗
PubMed1981

Comparative reproducibility and validity of systems for assessing cardiovascular functional class: advantages of a new specific activity scale.

Reproducibility and validity are prerequisites for a useful clinical scale. We therefore prospectively tested the reproducibility and validity of the New York Heart Association criteria and the Canadian Cardiovascular Society criteria for the assessment of cardiac functional class and compared these criteria with a new Specific Activity Scale based on the metabolic costs of specific activities. The New York Heart Association estimates made by two physicians had a reproducibility of only 56%, and only 51% of the estimates agreed with treadmill exercise performance. Functional estimates based on the Canadian Cardiovascular Society criteria were significantly more reproducible (73%), but not significantly more valid. The Specific Activity Scale was as reproducible as the Canadian Cardiovascular Society criteria, and its 68% validity was significantly higher than the validities of the other systems. The easily administered Specific Activity Scale was equally reproducible and valid when used by a nonphysician. It was especially better than the other systems for the evaluation of true class II patients and was significantly less likely to underestimate treadmill performance. Although no set of questions can perfectly predict exercise tolerance, the Specific Activity Scale deserves wider prospective testing.

Canada↗
PubMed1981

Thrombotic angiokeratoma circumscriptum simulating melanoma.

Three patients with solitary angiokeratomas, two of the circumscribed type (Fabry) and one of the Mibelli type, are described to show that when extensive thromboses develop in an angiokeratoma, this nodular bluish-black lesion may clinically simulate a nodular melanoma.

Adult↗
PubMed1981

Impact of a cardiology data bank on physicians' prognostic estimates. Evidence that cardiology fellows change their estimates to become as accurate as the faculty.

To determine whether physicians would be influenced by the prognostic information in a large coronary artery disease data bank, cardiology faculty and fellows made initial estimates of the prognoses of their patients and then made revised final estimates after seeing the outcome of matched patients (OMP) from the data bank. The faculty cardiologists' original estimates proved to be as accurate as those of the data bank's OMP, and the faculty revised their estimates minimally in response to the data bank's OMP. Conversely, the cardiology fellows' original estimates were less accurate than the data bank's OMP, and under all observed circumstances the fellows responded more to the data bank's OMP than did the faculty. As a result, the accuracy of the fellows' final estimates was similar to the accuracies of both the faculty cardiologists and the data bank's OMP. Computerized data banks seem more likely to have impact when their information is provided to physicians who are relatively inexperienced with the disease in question.

Cardiology↗
PubMed1981

Granuloma gluteale infantum.

An infant had a persistent ulcerative nodular diaper dermatitis with negative laboratory findings for pathogens. With bland therapy and avoidance of powdering, the lesions cleared. This reaction was considered, without proof, to be granuloma gluteale infantum. This condition should be considered in the differential diagnosis of the various types of diaper dermatitis. This reaction may also occur in the incontinent elderly.

Buttocks↗
PubMed1981

Noncardiac surgery in patients receiving propranolol. Case reports and recommended approach.

Signs consistent with the propranolol withdrawal rebound syndrome may occur when propranolol hydrochloride administration is temporarily discontinued because of major noncardiac surgical procedures. The time course of the appearance of these signs indicates that the risk of the propranolol withdrawal rebound syndrome peaks about four to seven days after drug discontinuation. Continuation of propranolol up to the time of surgery appears safe from an anesthetic standpoint and may also help to postpone the risk of the withdrawal rebound syndrome until after oral propranolol therapy can be reinstituted.

Anesthesia, General↗
PubMed1980

Fate of cardiology research originally published in abstract form.

A computerized search of 276 randomly selected cardiology abstracts published in conjunction with three national meetings revealed that 137 abstracts (49.6 per cent) led to full-length articles in peer-reviewed journals within a period of 37 to 43 months. The median interval between publication of the abstract and of the article was 14 months. Full-length articles were derived from 5. per cent of the abstracts presented at the meetings of the American Federation for Clinical Research, the American Society for Clinical Investigation, and the Association of American Physicians ("clinical societies"); 55 per cent of the abstracts presented at the American Heart Association Scientific Sessions; 49 per cent of the abstracts presented at the American College of Cardiology Scientific Sessions; and 35 per cent of the abstracts submitted to the clinical societies but not presented. During the observation period, each abstract was cited a mean of 1.6 times in a journal reference list; the number of citations was not significantly higher for abstracts that led to articles than for abstracts that did not. These findings emphasize the preliminary nature of abstracts and suggest restraint in their citation as references.

Abstracting and Indexing↗
PubMed1980

Direct skin microscopy as an aid in the early diagnosis of precancer and cancer of the skin in the elderly.

As part of the routine physical examination of the elderly, the skin, especially on the commonly exposed areas of the face, neck, hands and forearms, should be examined for early signs of precancer and cancer. Various lesions are describaed. The early signs of precancerous actinic keratoses usually are missed without a special examination which includes the use of magnifiers or the new skin microscope. This microscope is a long focal-lens stereobinocular instrument that can scan large areas of skin for the early detection of precancer and cancer. As part of the routine examination of elderly patients, it is a valuable aid in the practice of preventive geriatric medicine.

Aged↗
PubMed1980

Ordering patterns and clinical impact of cardiovascular nuclear medicine procedures.

We analyzed the ordering and impact of the first 171 fee-for-service cardiovascular nuclear medicine procedures at one hospital. The ordering physicians said 72% of the study results were useful and 28% contributed to changes in patient management. Experienced cardiology reviewers, however, felt that only 65% of studies were appropriately ordered, that 97% of appropriately ordered studies provided potentially useful information, and that 12% of all studies made important contributions to appropriate changes in patient management. The revieweres were most likely to rate exercise thallium procedures and procedures ordered by physicians from distant hospitals as being appropriately ordered and having important clinical impact. We conclude that (1) ordering physicians and revieweres may disagree substantially in their estimates of the impact of a diagnostic test; and (2) although a test may yield important information in appropriate patients, its total clinical impact will depend on how often it is suitably ordered and used.

Cardiovascular Diseases↗