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Biomedical subjects

M L Finkel

Publications and source records attributed to M L Finkel.

6 recordsLinked to original sources
PubMed1978

The Elective Surgery Second Opinion Program.

The results of the Cornell Elective Surgery Second Opinion Program are presented. From February 1972 to January 1978, 7053 patients were evaluated for proposed elective surgery, and in 27.6% of these, the operations were not approved. The subspecialties of orthopedics and gynecology demonstrated the highest rates of non-confirmation, while that for general surgery was 18%. A group of 318 patients with general surgical diagnosis are reviewed. The percentage of nonconfirmed surgery for this group was 15 percent. The most common reasons for not approving the operations were absence of pathology and failure to utilize medical therapy when indicated.

Female↗
PubMed1978

Second opinion elective surgery programs: outcome status over time.

Given the increasing rate of surgery and the escalating costs of hospitalization, it seems appropriate to review the necessity of recommended elective surgery before the surgery is performed. The second opinion elective surgery program is designed to screen patients before they undergo surgery. Findings are based on all not confirmed for surgery cases and an equal number of confirmed for surgery cases who were evaluated one year after their second opinion consultation. Roughly 77.9% of those not confirmed had not had the surgery and, of this, 64.4% reported no medical treatment (potential surplus surgery). Of the 710 not confirmed cases, one third (34.9%) never reported receiving medical treatment. The majority of those individuals confirmed for surgery did have the operation; however, 25.4% had not had surgery one year from their consultation. Thirty-two per cent of the confirmed cases reported never receiving medical treatment. There were 77 individuals (11.1%) who were confirmed for surgery who neither reported having surgery nor any medical treatment (population at risk). Subsequent follow up studies will present a clearer assessment of the ability of the program to screen potential surplus surgery and to realize cost savings.

Female↗
PubMedDate not supplied

Changes in reflex excitability of spinal motor neurons during day sleep in newborn infants.

A study was made of monosynaptic reflexes elicited by electrical stimulation of the ulnar and fibular nerves (H-reflexes) in newborn children, age five to seven days, during the sleeping--waking cycle. The amplitude of the H-responses was maximal and the coefficient of variation was minimal during the orthodox sleep state (OS) characterized by slow EEG waves and synchronous movement of the chest and stomach. During paradoxial sleep (PS), characterized by desynchronous EEG activity, rapid eye movements, and asynchronous breathing movements of the chest and stomach, the amplitude of the H-responses fell to 25 to 40% of the level during OS, and the coefficient of variation was in excess of 100%. The amplitude of H responses during the waking state was 60% that of the OS stage. The results of the study are considered from the point of view of existing theories about the reorganization of the system of controlling movements during the sleeping--waking cycle.

Humans↗