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Biomedical subjects

L Kahn

Publications and source records attributed to L Kahn.

At least 37 records · Page 2Linked to original sources
PubMed1983

High-dose methotrexate in small cell lung cancer. Lack of efficacy in preventing CNS relapse.

Few studies have incorporated high-dose methotrexate (MTX) with leucovorin rescue in the treatment of small cell lung cancer (SCLC). Potentially therapeutic levels of MTX can be achieved in the central nervous system (CNS) by systemic administration of high doses of this drug. Utilizing a combination chemotherapy program of Adriamycin, vincristine, cyclophosphamide, and methotrexate, 31 patients were sequentially assigned to receive either low-dose MTX (40 mg/m2), or high-dose MTX (500 mg/m2) with leucovorin rescue. Radiation therapy to the primary site was also administered. At these dosage levels there were no statistically significant differences in response rate or survival between the two groups. High-dose MTX did not prevent the appearance of CNS disease; there being 2/15 and 3/15 CNS relapses in the HD MTX and LD MTX treated groups, respectively. The occurrence of CNS disease did not significantly affect overall survival as compared to patients not similarly affected.

Aged↗
PubMed1979

The influence of funding on the future of pediatric nurse practitioner programs.

Current funding sources threaten the future position of PNPs as providers of primary care. Most nurse practitioner programs of all disciplines including pediatrics rely for funds on the Division of Nursing, Bureau of Health Manpower, Department of Health, Education and Welfare. These funds are sufficient only for about half of currently operational programs and other sources of financing are not adequate to support the remainder. Another factor affecting the future of such programs is the trend to modify the preparation of the nurse practitioner from the clinically centered continuing education format to that based in schools of nursing and directed toward the MS degree. This is against the fundamental philosophy of the training of the PNP and will lead to diminishing participation of pediatricians in training programs. Unless there is evidence to show that the shift to graduate type education is fundamental to the competence of the nurse practitioner, the enthusiastic nurse who chooses to extend her professional skills should be allowed to do so without limiting this activity only to those who seek advanced academic degrees.

Education, Nursing↗
PubMed1978

The cost of a primary care teaching program in a prepaid group practice.

Costs were determined for a teaching program in general pediatrics and general internal medicine for advanced residents in a prepaid group practice, the Medical Care Group of Washington University. A time and motion study was conducted to measure the productivity of faculty physicians before and after the establishment of the teaching program. There was a statistically significant loss in productivity for internists and an apparent loss, though not significant, for pediatricians as a result of their teaching effort, but the productivity of the residents more than compensated for the loss. The residual positive value of a full time equivalent (FTE) pediatric resident after reimbursement of all possible lost productivity by faculty pediatricians represented 43.9 per cent of a FTE pediatrician. For a FTE resident in internal medicine the residual positive value was 49.7 per cent of a FTE internist.

Costs and Cost Analysis↗