Search PubMed⌕ Search

Biomedical subjects

M Paris

Publications and source records attributed to M Paris.

At least 91 records · Page 5Linked to original sources
PubMed1982

Psychiatric records: variations based on discipline and patient characteristics, with implications for quality of care.

In this study of the delivery of outpatient psychiatric care to Medicaid patients at all 29 free-standing psychiatric clinics and at six hospital clinics in New York City, the authors found that nonphysician mental health workers provided much direct patient care: diagnosis and identifying data, necessary for reimbursement, were always included in records whereas mental status and medical history were poorly documented; and nonphysicians in hospitals generally surpassed physicians in the latter two areas. An additional observation was that attitudes of mental health workers toward certain diagnostic and ethnic groups may be inferred from the selective completeness of their psychiatric record keeping.

Attitude of Health Personnel↗
PubMed1981

Investigation of the mechanism of action of prostaglandin synthesis inhibitors on renin and aldosterone secretion and sodium excretion.

Mean blood pressure (MBP) was found to be lower, while renal plasma flow (RPF), glomerular filtration rats (GFR), sodium excretion rate (U(Na)V), potassium excretion rate (U(k)V) and urinary prostaglandin E (PGE) concentration were higher in 15 normotensive subjects (15NS) compared with the values obtained in 15 essential hypertensive patients (15EHP) of the same mean age. After volume expansion of the 15HP with isotonic saline infusion, RPF, U(Na)V, U(k)V, urine volume (UV) and urinary PGE increased significantly while plasma renin activity (PRA) decreased significantly. Urinary aldosterone concentration and MBP decreased also but not significantly. After oral administration of 75 mg of indomethacin, in the same loaded group of 15 EHP, urinary PGE, urinary aldosterone and PRA decreased significantly while RPF, GRF, U(Na)V remained unaltered and MBP increased. When these values obtained in saline loaded and indomethacin treated 15EHP were compared to those obtained in the same group before volume expansion, it was found that RPF, U(NaV, U(k)V and UV were higher after indomethacin-saline administration while MBP, GRF and urinary PGE did not differ significantly and PRA and urinary aldosterone were significantly lower. These findings argue against the suggestion that PGE increases sodium reabsorption at the distal tubule and indicate that the unaltered sodium excretion rate in saline loaded and indomethacin treated unanaesthetized subjects, results from the simultaneous decrease of renomedullary PGE, Renin and aldosterone secretion.

Adult↗
PubMed1980

Medicaid records and the psychiatric private sector.

The authors report a study or records maintained by private practitioners for their Medicaid patients. The quality of record keeping in general fell far short of Medicaid requirements. Board-certified or hospital-affiliated psychiatrists kept better charts than those who did not have these credentials. Educational background did not correlate with extent of record keeping.

Certification↗
PubMed1980

Providers and receivers in the private psychiatric Medicaid system.

The authors investigated the credentials of foreign medical graduate (FMG) and U.S. medical graduate (USMG) psychiatrists providing a substantial amount of Medicaid care and compared them with those of a group of other psychiatric practitioners in New York City. USMGs were more likely to be Board certified, but FMGs were as likely to have APA membership, psychoanalytic training, medical school and hopsital affiliation, and fellowships. The credentials of the Medicaid psychiatrists and the group of New York psychiatrists were similar. Hispanic FMG psychiatrists provided a major service for the Spanish-speaking community, but the poor black population underused Medicaid services. Diagnosis did not appear to be influenced by racial bias.

Black or African American↗
PubMed1980

Psychiatric diagnoses as reported to Medicaid and as recorded in patient charts.

This study was undertaken to address the issue of data reporting in the psychiatric sector of New York City Medicaid, the largest publicly financed psychiatric health care delivery system in the nation. Six outpatient psychiatric clinics in general hospitals, four with residency programs, and all 29 free standing psychiatric clinics in New York City were audited as were charts from 120 psychiatrists billing for 10 or more Medicaid patients. Overall agreement of chart and Medicaid diagnoses was 91% for psychiatrists, 79% for free-standing clinics, and 77% for hospital clinics. Agreement varied by diagnosis. Bias in the Medicaid diagnosis of Neurosis was found at the four hospitals having residency programs. Patients most likely to be misreported as having minimizing diagnoses were male, or between the ages of 18 and 29 years, or to have a prior history of psychiatric treatment. The errors in reporting in each provider sector would pose a methodological obstacle if Medicaid data were used in epidemiological research.

Adolescent↗
PubMed1980

Monitoring ambulatory care: impact of a surveillance program on clinical practice patterns in New York City.

Administrative records of the Title XIX (Medicaid) Program of New York City were reviewed to determine the impact of a surveillance system introduced to monitor physician billing. Billing patterns of the physicians subject to program sanctions, as well as the larger universe of all participating New York City physicians, showed changes coincident with the introduction of the surveillance program: utilization of x-rays, lab tests, injections, and first visit billing decreased.

Ambulatory Care↗
PubMed1979

An analysis of nonconfirmation rates. Experiences of a surgical second opinion program.

A review was conducted of the first 12 months' experience with a voluntary second opinion surgery consultation program. The program covers approximately 950,000 persons: employees of the city of New York, retirees, and their dependents. On a simple yes or no basis, the program's surgical nonconfirmation rate was 25%. More detailed analysis of consultants' narrative suggestions for patient care showed that a firm rejection of surgical intervention occurred in only 8% of the cases reviewed. Nonconfirmation rates were found to be unsatisfactory measures of program success in preventing potentially unnecessary surgery. Data from second surgical opinion programs should not be used to estimate the prevalence of unnecessary surgery in a community. The key benefit of such programs may be to facilitate and to encourage patient-physician communication.

Cost Control↗
PubMed1979

Urinary prostaglandins in kidney disease.

Substances having the chromatographic behaviour and the bioassay properties of prostaglandins (PGE and PGF) were detected in the urine of 30 patients with kidney disease and 15 healthy subjects. The mean urinary PGE and PGF values in 15 patients with chronic glomerular disease or nephrosclerosis were significantly lower than those of 15 patients with chronic pyelonephritis and other forms of chronic interstitial nephritis, polycystic kidney disease, obstructive nephropathy or diuretic phase of acute renal failure, and of the mean PGE and PGF values found in the healthy subjects. It was suggested that in contrast to disease affecting primarily the renal medulla, chronic glomerular disease and nephrosclerosis are accompanied by a decrease of renal prostaglandin synthesis and/or release.

Glomerulonephritis↗
PubMed1979

Is low urinary prostaglandin concentration a stage in the development of essential hypertension?

Urinary prostaglandin E and F (PGE and PGF) concentrations, renal plasma flow (RPF), glomerular filtration rate (GFR), sodium excretion rate (UNaV), potassium excretion rate (UKV), urinary osmolarity (Uosm) and osmolar clearance (Cosm) were found to be higher, while mean blood pressure (MBP) was lower in a group of 15 normotensive subjects (15NS), compared to those values obtained in a group of 25 essential patients (25EHP) of the same mean age. After volume expansion, of the 25EHP, urinary PGE concentration, RPF, noncortical plasma flow (NCPF), UNaV, UKV, UNaV/UKV, Cosm and urine volume (UV) increased significantly, MBP, GFR, Uosm, free water reabsorption (Tc water) and urinary aldosterone concentration did not change, while plasma renin activity (PRA) decreased significantly. It was concluded that the deficiency in renomedullary PG synthesis in the EHP is accompanied by a decrease in RPF, NCPF and UNaV. This decrease in UNaV and renal hemodynamics could increase, in the long term, the BP in these patients. Nevertheless, these findings do not exclude the interpretation that the decrease in renomedullary PGE release in the EHP indicates an attempt to increase sodium excretion at the distal tubule by diminishing sodium reabsorption by this agent in order to prevent further increase in BP. In any case, it seems that renomedullary PGs play an important role in intra-renal control systems.

Adult↗
PubMed1979

In vivo regulation of secretion of bronchiolar Clara cells in rats.

We used ultrastructural morphometric methods to study the in vivo regulation of secretion in bronchiolar Clara cells of rats. The Clara cells studied were located in airways with an internal diameter of 0.21 +/- 0.06 mm (mean +/- SD) at a transpulmonary pressure of 20 cm H2O. We found that pilocarpine caused a 50% decrease in the volume density of secretory granules of Clara cells in 60 min and that atropine blocked this effect. Isoproterenol produced a similar fall in volume density and this was blocked by propranolol. Propranolol also blocked the effect of pilocarpine. The fall in volume density of the secretory granules produced by pilocarpine and by isoproterenol occurred without any change in the surface-to-volume ratio of the granules. This indicates the change in volume density reflected a decrease in number rather than in size of the secretory granules. The observation that propranolol blocks the secretory response to pilocarpine as well as the response to isoproterenol suggests a dual in series cholinergic adrenergic regulation of secretion in bronchiolar Clara cells in rats.

Animals↗
PubMed1979

Isolation and toxicological study of tetrahydrocannabivarol, an homolog of tetrahydrocannabinol (delta 1--THC).

Selection and culture in a Phytotron of plants of Cannabis sativa L. with high content of propyl-THC are obtained. Then it was possible to isolate a large quantity of propyl-THC by column chromatography. Spectroscopic analysis is done. Pharmacological tests are being run; first results revealed the allergenicity of this substance by comparison with the properties of tetrahydrocannabinol, the active principle of Cannabis.

Animals↗
PubMed1978

Medicaid-funded private psychiatric care in New York City. The role of foreign-trained physicians.

Data were obtained from the tax records and the Professional Registry maintained by the New York City Department of Health as well as from the Biographical Directory of the American Psychiatric Association to determine which psychiatrists were providing care under the Medicaid Program and how they compare with the pool of psychiatric practitioners in New York City. The data reveal that psychiatrists educated in foreign medical schools provide disproportionately more care to Medicaid recipients than would be anticipated from their numbers, and are a majority of those who received more than +30,000 in payments in 1976. Furthermore, these psychiatrists account for 80 per cent of those delivering care at the two largest "shared health facilities," commonly referred to as "Medicaid mills." These findings indicate that although the Title XIX Program has facilitated the access of the poor to the private psychiatric sector, in New York City their access is biased toward treatment by foreign-educated psychiatrists.

Foreign Medical Graduates↗
PubMed1978

Optic tract syndrome. A review of 21 patients.

Twenty-one patients with lesions compromising the optic tract were reviewed. The involvement of the optic tract may be diagnosed in the presence of highly incongruous hemianopia, an afferent pupillary defect, and characteristic atrophy of the optic discs. Behr's pupil, hemianopic pupillary reaction (Wernicke's sign), and associated major neurologic deficits were encountered rarely.

Adolescent↗