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Biomedical subjects

M J Feldman

Publications and source records attributed to M J Feldman.

At least 55 records · Page 3Linked to original sources

Decentralized preparation of short-term prescriptions for discharged patients.

The rationale for and implementation of a decentralized system for filling short-term discharge prescriptions are described. To prevent interruption of drug therapy, orders for three-day supplies of medications were filled in the outpatient pharmacy and returned to patients before discharge. Under the old system, more than 20% of medications ordered were not received by patients. Reasons for this problem were identified, and a new system was designed in which these discharge prescriptions were filled in satellite pharmacies. A follow-up study under the new system showed that only 1.5-3% of discharge medications were not received by patients and that patients' use of the discharge medication program was increased. Implementation of a decentralized discharge prescription program using the existing satellite pharmacies allowed increased efficiency in delivery of medications to patients at the time of their discharge from the hospital.

Boston↗

Determining the date of manufacture of drug products from lot numbers.

Information necessary to determine the date of manufacture of many drug products from assigned lot numbers is presented. Eighty-four U.S. drug manufacturers were surveyed by mail. Response was received from 71 (85%) of the companies contacted, but only 34 provided the information necessary to determine the date of manufacture of their drug products from assigned lot numbers. Pharmacists can use this information to remove potentially deteriorated drug products from inventory.

Drug Industry↗

Intraepithelial neoplasia of the uterine cervix in the teenager.

One hundred and seventeen teenagers with abnormal cervical cytology were evaluated using colposcopy and directed biopsies. Eighty-eight cases of cervical intraepithelial neoplasia were discovered including 24 cases of severe dysplasia or carcinoma in situ. Erradication of these lesions is essential as a preventative measure. The importance of routine cytologic screening and early evaluation of abnormal Papanicolaou smears in the teenager is emphasized.

Adolescent↗

False positive cervical cytology: an important reason for colposcopy.

Over an 18 month period, 352 patients with a report of abnormal cervical cytology ranging from mild dysplasia to invasive carcinoma were evaluated with colposcopy and, if indicated, directed biopsies. From the group, there were 26 women in which a lesion consistent with the cytologic diagnosis was not found in each of these cases, an error in the interpretation of the Papanicolaou smear, resulting in a false positive report, was suspected. The cytology was reviewed and the results were compared to the original reports. Twelve cases were reinterpreted as negative for cervical neoplasia. A similar review of the histology failed to reveal a previously missed lesion. Cervical conization in four patients and repeat cytology and colposcopy in 22 patients confirmed the false positive interpretations of the original cervical cytology. The importance of colposcopy as a means of recognizing false positive cytology and avoiding an unnecessary cervical conization is emphasized.

Cervix Uteri↗

Evaluation of a serologic test for gonorrhea in a low-risk female population.

This is a report of an evaluation of a new serologic test for gonorrhea--the Gonosticon Dri-Dot Test--as compared to the standard Thayer-Martin culturing technics in a low-risk female population. The Gonosticon Dri-Dot Test detected only 50% of the gonorrhea cases discovered by the conventional culture method. Furthermore, the serologic technic accounted for 17% false-positives, indicating that a reactive Gonosticon test is not necessarily consistent with active gonococcal infection. The efficacy of the Thayer-Martin culture plate diagnostic procedure for uncomplicated gonorrhea in women was reaffirmed by this study.

Cervix Uteri↗

Abnormal cervical cytology in the teen-ager: a continuing problem.

Abnormal cervical cytology is being discovered in an alarming number of sexually active teen-agers. Over an 18 month period, cytology consistent with mild dysplasia or worse was noted in 188 of 2,655 teen-agers screened. This represents a rate of 70.8 per thousand. Colposcopically directed biopsies in 65 patients revealed 15 cases of severe dysplasia-carcinoma in situ. Cryosurgery was the principle method of treatment and, combined with colposcopy, is a safe and effective means of managing these patients.

Adolescent↗

The making of a colposcopist. A safe and sensible approach.

A program was established to determine the accuracy of colposcopy at our institution. Forty-three patients with cytologic or histologic evidence of severe dysplasia or worse underwent diagnostic conization following satisfactory colposcopy. Thirty patients subsequently had either therapeutic conization or hysterectomy preceded by biopsy only. In all 73 cases, the surgical specimen did not reveal a more advanced lesion. However, when the colposcopy was unsatisfactory, the rate of error was 20.8%. It is our opinion that colposcopy is a safe and valuable technique as long as one recognizes the need for training and understands the indications for further diagnostic studies. The use of the colposcope for the evaluation of abnormal cervical cytology has increased steadily over the last few years, and several excellent courses are now offered throughout the United States. Armed with a certificate from such a course, many gynecologists then become self-proclaimed colposcopists in spite of warnings to the contrary by the instructors. In addition, supervision by experienced personnel is not always available. How, then, does one indeed become an accomplished colposcopist to the point that he or she can safely spare the patient the risk, inconvenience and expense of diagnostic cervical conization? Although several recent publications 2,5,6,9,11 document the diagnostic accuracy of colposcopically directly biopsies, we feel each individual should develop and evaluate his or her own skill before altering or abandoning conventional methods of diagnosis and management. The purpose of this report is to present our experience with colposcopy utilizing a program which can perhaps serve as a model to other clinicians.

Biopsy↗