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Biomedical subjects

M Marcus

Publications and source records attributed to M Marcus.

At least 109 records · Page 6Linked to original sources
PubMed1988

Determinants of interhospital transfer of low-birth-weight newborns.

In a single year in New York City, we identified 1413 neonates who were transferred for medical care from their hospitals of birth; 83% of transferred infants were sent from Level 1 hospitals (no special facilities for sick infants) to Level 3 hospitals (newborn intensive care units). Level 2 hospitals (those with an intermediate level of care) participated little in the transfer process as either senders or receivers. Infants weighing more than 2250 g were rarely transferred. Among low-birth-weight infants born at Level 1 hospitals, the major determinants of transfer were birth weight, gestational age, and Apgar score. Peak transfer rates were for infants weighing 1000-1750 g (84% transferred), those with gestational ages of 28-31 weeks (79% transferred), and those with Apgar scores of 4-6 (68% transferred). Infants with values either above or below these modes were transferred less frequently. Transfer from Level 2 hospitals was also significantly related to birth weight and Apgar score. Socioeconomic indicators such as race, maternal education, ward/private status, and financial coverage for the delivery had no effect on transfer rates. Transferred low-birth-weight infants were a highly selected sample of low-birth-weight infants. Infants transferred from Level 1 hospitals were those in better condition (higher Apgar scores) when weighing less than 1750 g, and those in worse condition (lower Apgar scores) when weighing more than 1750 g.

Adult↗
PubMed1988

A comparison of potential treatment costs for group capitation versus voluntary individual enrollment plans.

As competition among insurance companies for increased market share intensifies, dental plans designed for new markets have begun to appear. One such plan is marketed to individuals not eligible for group plans. The purpose of this study was to determine if differences in potential treatment costs exist between patients enrolling in individual-targeted plans and those in group-based plans. The cost of treatment plans to eliminate dental disease and replace missing teeth whenever possible and/or practical was calculated for 119 patient pairs from both types of plans. Individually targeted patients had significantly higher levels of potential treatment costs, which were due primarily to significantly greater needs for operative, periodontal surgery, and endodontic services. These findings are important to insurance companies in designing plans that are both equitable and attractive to consumers and potential providers of care, who must weigh their costs of providing care against anticipated revenues.

Adult↗
PubMed1988

Aspirin and secondary bleeding after traumatic hyphema.

A randomized, controlled study was conducted in 51 patients to investigate the effect of aspirin administration on traumatic hyphema. Aspirin tablets 500 mg tid were administered for seven days. Rebleeding was found in three of 23 eyes of patients who had received aspirin and in two of 28 eyes of control patients. This difference was not statistically significant (P = .405), proving that aspirin is not an important factor in rebleeding in patients with hyphema.

Adult↗
PubMed1987

5-aza-C-induced changes in the time of replication of the X chromosomes of Microtus agrestis are followed by non-random reversion to a late pattern of replication.

Treatment with 5-azacytidine (5-aza-C) causes an advance in the time of replication and enhances the DNase-I sensitivity of the inactive X chromosome in Gerbillus gerbilllus fibroblasts. We found that these changes were not stably inherited and upon removal of the drug the cells reverted to the original state of one active and one inactive X chromosome. In order to determine whether this reversion was random, we used a cell line of female Microtus agrestis fibroblasts in which the two X chromosomes are morphologically distinguishable. In this work we show that the reversion to a late pattern of replication is not random, and the originally late replicating X chromosome is preferentially "reinactivated", suggesting an imprinting-like marking of one or both X chromosomes. The changes in the replication pattern of the X chromosome were associated with changes in total DNA methylation. Double treatment of cells with 5-aza-C did not alter this pattern of euchromatin activation and reinactivation. A dramatic advance in the time of replication of the entire X linked constitutive heterochromatin (XCH) region was however, observed in the doubly treated cells. This change in the replication timing of the XCH occurred in both X chromosomes and was independent of the changes observed in the euchromatic region. These observations suggest the existence of at least two independent regulatory sites which control the timing of replication of two large chromosomal regions.

Animals↗
PubMed1987

Cloning of a human S-phase cell cycle gene: use of transient expression for screening.

We report here the cloning of a human cell cycle gene capable of complementing a temperature-sensitive (ts) S-phase cell cycle mutation in a Chinese hamster cell line. Cloning was performed as follows. A human genomic library in phage lambda containing 600,000 phages was screened with labeled cDNA synthesized from an mRNA fraction enriched for the specific cell cycle gene message. Plaques containing DNA inserts which hybridized to the cDNA were picked, and their DNAs were assayed for transient complementation in DNA transformation experiments. The transient complementation assay we developed is suitable for most cell cycle genes and indeed for many genes whose products are required for cell proliferation. Of 845 phages screened, 1 contained an insert active in transient complementation of the ts cell cycle mutation. Introduction of this phage into the ts cell cycle mutant also gave rise to stable transformants which grew normally at the restrictive temperature for the ts mutant cells.

Adult↗
PubMed1987

Ordinal discrimination of ECG orthogonal features.

A rigorous mathematical analysis of Electrocardiogram (ECG) data is presented in this paper, as a decision support system for ECG interpretation. The mathematical analysis: provides a new insight to the ECG data, provides flexibility for future understanding of the heart system or the ECG, and avoids the need of measurements of parameters and the disagreement concerning the standard criteria of those parameters. The system enables compressed storage of the ECG data and an easy and accurate retrieval ability. An "ordinal straight line" method is presented for simple description of the ECG features as a combination of straight lines. A new developed discrimination method--the bisector method--is used for discrimination and classification between the normal and pathological groups. The physician's decision is based on both the physician's heuristic approach and the system's classification.

Data Collection↗
PubMed1987

A content analysis of dental capitation plan grievances.

As the health care system becomes more impersonal, competitive, and cost conscious, there is a potential for increased dissatisfaction with health care providers. This paper describes the use of content analysis to examine aspects of patient dissatisfaction with delivery of health services in a capitated dental plan. All written complaints from three regions of California from June 1984 to June 1986 were collected, and a content analysis was performed on these letters. The rates of grievances differ substantially across regions; however, three regions were similar in their grievance patterns. Access to care was the single largest category of concern, and these grievances were registered because patients had to wait for an appointment (35 percent) or had to wait in the office (32 percent) to receive care. Provider technical competence was the second largest category. Significant variables from a logistic regression that predicts complaint status of an eligible member are (1) years covered, (2) age, and (3) income. The grievance rate and grievance categories described in this study can help define new strategies and policies in the overall mission of a dental capitation organization.

Adult↗
PubMed1987

Coronary bypass without angiography: an unusual circumstance.

This paper presents an unusual case of an individual with myocardial ischemia, angina pectoris, and myocardial infarction who also had an anaphylactic reaction to angiographic dye. The coronary bypass operation was guided by the use of intraoperative coronary reactive hyperemia assessed by Doppler ultrasound. The patient has had a good response to the operation without additional angina or difficulties.

Angina Pectoris↗
PubMed1987

Myopia and congenital esotropia.

Patients with congenital esotropia and high myopia were surgically treated by recession of both medial rectus muscles. The results are presented and discussed.

Child, Preschool↗
PubMed1987

An evaluation of the Robert Wood Johnson Foundation's Hospital-Sponsored Ambulatory Dental Services Program.

This article summarizes the results of an evaluation of the Hospital-Sponsored Ambulatory Dental Services Program funded by the Robert Wood Johnson Foundation. Goals of the program were to increase service to the underserved both in the volume of persons treated and in continuity of care, while supporting expanded dental general-practice residency training and aiding financial viability of the dental departments. The principal findings were that, while the volume of new patients increased, the number of disadvantaged persons did not. Continuity of care may have worsened. Policy implications are that hospital dental departments should improve their efficiency and narrow their goals to the special populations best treated in their environment. Innovative financial mechanisms should be explored, including combining with medical care hospital-based HMOs. However, the goals cannot be reached without expanded and continuing governmental subsidy.

Continuity of Patient Care↗
PubMed1986

Estimating treatment and treatment times for special and nonspecial patients in hospital ambulatory dental clinics.

Increased time to treat the special patient is often cited as a barrier to dental care. The purpose of this study was to analyze the separate and combined effects of differences in dental services planned, services actually performed, and differences in treatment time requirements between special and nonspecial patients in a hospital ambulatory clinical setting. Data for this study were obtained from the UCLA evaluators of the RWJ-funded Hospital-Sponsored Ambulatory Dental Services Program (HSADSP). The results show that special patients require more dental treatment than nonspecial patients for advanced dental disease (i.e., periodontics, surgery, and removable prosthetics) and that they receive more of such services. The study also found that special patients should not be viewed as a homogeneous group when evaluating dental needs and required time resources for treatment. Three subgroups of special patients were identified: developmentally disabled, severely compromised, and moderately compromised. The developmentally disabled as compared to the nonspecial patients required significantly more (20 percent) provider time in completing a "representative" treatment plan.

Adult↗
PubMed1985

DNA hypomethylation causes an increase in DNase-I sensitivity and an advance in the time of replication of the entire inactive X chromosome.

We have examined the effect of 5-azacytidine (5-aza-C) induced hypomethylation of DNA on the time of replication and DNase I sensitivity of the X chromosomes of female Gerbillus gerbillus (rodent) lung fibroblast cells. Using in situ nick translation to visualise the potential state of activity of large regions of metaphase chromosomes we show that 5-aza-C causes a dramatic increase in the DNase-I sensitivity of the entire inactive X chromosome of female G. gerbillus cells and this increase in nuclease sensitivity correlates with a large shift in the time of replication of the inactive X chromosome from late S phase to early S phase. These effects of 5-aza-C on the inactive X chromosome are associated with a 15% decrease in DNA methylation. Our results indicate that DNA methylation concomitantly affects both the time of replication and the chromatin conformation of the inactive X chromosome.

Animals↗
PubMed1985

DNase I sensitivity in facultative and constitutive heterochromatin.

In situ nick translation allows the detection of DNase I sensitive and insensitive regions in fixed mammalian mitotic chromosomes. We have determined the difference in DNase I sensitivity between the active and inactive X chromosomes in Microtus agrestis (rodent) cells, along both their euchromatic and constitutive heterochromatic regions. In addition, we analysed the DNase I sensitivity of the constitutive heterochromatic regions in mouse chromosomes. In Microtus agrestis female cells the active X chromosome is sensitive to DNase I along its euchromatic region while the inactive X chromosome is insensitive except for an early replicating region at its distal end. The late replicating constitutive heterochromatic regions, however, in both the active and inactive X chromosome are sensitive to DNase I. In mouse cells on the other hand, the constitutive heterochromatin is insensitive to DNase I both in mitotic chromosomes and interphase nuclei.

Animals↗
PubMed1985

Responses of opsonic substances to major trauma and sepsis.

Adequate opsonic capability is vital for normal host defense against infection. The presence of complement fraction 3 (C3) indicates both classical and alternative pathways of complement activation, while complement fraction 4 (C4) indicates only classical pathway activation. C-reactive protein (CRP) functions as an opsonic substance. We measured serum levels of C3, C4, and CRP in 32 trauma patients. Six suffered minor injuries and 26 suffered major injuries. Nineteen of the major-injury patients developed post-trauma sepsis. Complement levels fell immediately after injury and remained low for approximately 8 days in all patients. CRP levels rose by 12 h, peaked at 48 h, and correlated with the severity of injury and the presence of sepsis. Elevated CRP levels after 4 days postinjury indicated the presence of sepsis in all cases. CRP elevations preceded clinical diagnosis by an average of 2.4 days. Serial measurements of CRP are valuable in monitoring the course of trauma patients and may indicate the presence of septic complications before clinical detection.

C-Reactive Protein↗