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Biomedical subjects

R Michael

Publications and source records attributed to R Michael.

At least 55 records · Page 3Linked to original sources
PubMed1991

Non-inpatient costing study.

Flinders Medical Centre, a University teaching hospital located in the south of Adelaide, spends approximately 27% of its annual budget in the treatment of ambulatory patients. In an attempt to gain a better appreciation of the profile of resource use by this group of patients, the hospital undertook a detailed cost survey. This study has made it possible to identify the cost impact of ambulatory attendances on each of the service areas of the hospital and compare variation in cost within and between specialist clinics.

Ambulatory Care↗
PubMed1991

Case based funding--how or when.

Casemix is on the move, and as with all new crazes, there are instances of the sensible running in parallel with the outrageous. There is certainly a danger that a desire to satisfy everyone's interests will lead to complex and convoluted systems with as little credibility as the current arrangements. The essential elements of case based funding systems are available and can be used to introduce more equity and common sense into health funding. The only thing missing is a clear commitment to use the available tools and limit opportunities to manipulate the system through political means.

Australia↗
PubMed1988

An unusual presentation of gluteal hematoma during anticoagulation therapy for deep venous thrombosis in spinal cord injury.

Soft tissue bleeding can be manifested clinically by swelling, skin discoloration, pain and tenderness. Early recognition can be difficult in the spinal cord-injured population in whom sensation is impaired. We are presenting a case of occult bleeding into the gluteal region during anticoagulation therapy in a paraplegic patient that presented as migrating pain and tenderness in the hip and pelvic area.

Adolescent↗
PubMed1987

[Significance of parathyroid hormone (PTH) within the scope of central nervous system disorders in hemodialysis patients].

The role of PTH as possible uraemic toxin within the scope of disturbances of the central nervous system (progressive dialysis encephalopathy, PDE) was investigated in 88 patients undergoing haemodialysis. A radioimmunoassay covering the C-terminal PTH fragment was used. Patients undergoing haemodialysis with a PDE showed the highest values with 2,015.4 +/- 457.9 pg/ml, and also in the preclinical stage of a PDE the PTH values with 1,845.7 +/- 663.1 pg/ml lay significantly above those ones of the patients undergoing haemodialysis without PDE (794.8 +/- 364.7 pg/ml). The findings speak for the importance of PTH in the development of complications of the central nervous system within the scope of the uraemia syndrome.

Adult↗
PubMed1986

[Morphometric and histochemical studies of the skeletal muscles of patients with chronic renal failure and dialysis patients].

In 19 patients with chronic renal insufficiency in the stage of compensated retention, 20 patients undergoing dialysis and 24 patients with normal renal function muscle tissue was taken by an open biopsy and investigated histologically, histochemically as well as morphometrically. A neurogenic atrophy stood in the foreground of the histologic changes of the striated musculature in uraemia, a pure type II atrophy was found more infrequently. In the patients undergoing dialysis frequency and size of these disturbances were more distinct. Except for a possible influence of a disturbed calcium metabolism other pathogenetic factors supposed in literature could not be found.

Adult↗
PubMed1986

[Histochemical localization of aluminum deposits in bones and their relation to the clinical and histomorphometric findings in patients with chronic renal failure].

In 60 patients with chronic renal insufficiency and 36 dialysis patients an iliac crest biopsy was performed, on the undecalcified bone morphometric determinations were carried out as well as the aluminium deposition was investigated histochemically. Histologically were found in 3 patients normal findings, in 11 patients a fibroosteoclasia, in 23 patients an osteoidosis and in 59 patients a combination fibroosteoclasia and osteoidosis. 3 oft the 60 patients with a chronic renal insufficiency had aluminium depositions in the polyblasts. Of the 36 dialysis patients 19 (55.4%) had a positive aluminium histology: 30.7% of the patients with osteoidosis and 23.7% with a mixed form. There was a positive correlation to the bone and osteoid volume, to the osteoid surface and a negative relation to the activity of osteoblasts, the absorption surface and the activity of osteoclasts. Aluminium depositions on the mineralisation border might be of importance for the changes.

Adolescent↗
PubMed1985

Clonidine and guanfacine in hypertension.

Guanfacine, 1 to 3 mg/day, and clonidine, 0.1 to 0.3 mg twice a day, were compared in a 24-week double-blind, randomized, parallel study of 42 patients with hypertension that was inadequately treated by chlorthalidone, 25 mg/day. Mean reduction of blood pressure was 18/9 mm Hg after guanfacine and 14/8 mm Hg after clonidine. To determine the incidence of rebound hypertension, subjects were hospitalized for 7 days during chlorthalidone therapy for collection of baseline data and once again immediately after abrupt withdrawal of the alpha-agonist after 24 weeks of dosing. Although blood pressure and heart rate rose significantly in both groups, the changes after clonidine withdrawal were greater and occurred earlier (day 2) than those after guanfacine withdrawal (day 4). Forty percent of the subjects receiving guanfacine and 64% of subjects receiving clonidine had diastolic blood pressure elevations greater than or equal to 10 mm Hg from baseline. There were increases in urinary norepinephrine levels in both groups after drug withdrawal, but these correlated poorly with blood pressure rise. Side effects after guanfacine were much the same as those after clonidine. Guanfacine taken once a day provides an effective and safe alternative to clonidine in the management of essential hypertension.

Adult↗
PubMed1979

A further assessment of predictors of the child's behavior in dental treatment.

The child's disruptiveness during dental treatment was related modestly to his age as well as his state, trait, and dental anxiety. In three samples comprising 132 experienced and 49 inexperienced pedodontic patients, the child's behavior during treatment could not be predicted from any aspect of maternal anxiety -- trait, state, or dental. Previous conceptions of maternal influence on the child's dental anxiety should be re-evaluated.

Anxiety↗
PubMed1977

Nonsterile self-intermittent catheterization for male quadriplegic patients.

Individuals with cervical lesions at C6-7 level are capable of performing self-intermittent catheterization if they are deemed appropriate candidates for this type of bladder management by a urologist, and if they are provided with adaptations to help them compensate for limitations in hand function. The purpose of this paper is to present methods used at one university medical center for evaluating a quadriplegic patient's ability to manage self-intermittent catheterization, and to describe the adaptive devices needed for this form of independent bladder management.

Clothing↗