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Biomedical subjects

R Roberts

Publications and source records attributed to R Roberts.

645 records · Page 36Linked to original sources
PubMedDate not supplied

Cyclosporine absorption in two patients with short-bowel syndrome.

We present the cases of two patients with short-bowel syndrome who failed to achieve therapeutic cyclosporine serum concentrations on oral drug but were successful on intravenous administration. One patient received cyclosporine after renal transplantation for renal failure secondary to enteric oxalosis; the second received cyclosporine for active Crohn's disease. The rapid bowel transit time was the critical factor in limiting cyclosporine absorption in both cases. In studying oral and intravenous pharmacokinetic profiles, we support a zero-order kinetic model for oral cyclosporine absorption.

Administration, Oral↗
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The quality of burns coding. Compliance with standards and the effects on clinical data.

Coded burns cases in two NSW public acute care facilities were reviewed to determine 1. the degree of compliance with Australian Coding Standards (ACS) relating to burns separations 2. the relationship between coding errors and poor quality documentation and 3. the impact of coding errors on ANDRG allocation. Despite high compliance with specific aspects of the ACS, coding errors occurred in 89% of cases. The ANDRG changed in 9% of total cases as a result of recoding. While some cases changed to a higher weighted ANDRG, overall the hospitals would have lost $98,445 after recoding. Significant associations were found between coding errors and poor quality documentation. The results indicate that while the ACS are adhered to, a high degree of coding variation still exists. This is largely due to inadequacies in medical record documentation. Clinicians and coders need to work together to ensure that coding variation is kept to a minimum.

Australia↗
PubMedDate not supplied

Certain physician recruitment and retention activities found to be suspect.

A new "Fraud Alert" from the Office of Inspector General of the Department of Health and Human Services will cause hospitals to be especially circumspect in their dealings with actual and potential members of the medical staff. The authors analyze the alert and its potential impact on hospitals and physicians.

Fraud↗
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Physician self-referral on the fast track.

One of the most hotly debated areas of health care fraud and abuse has been the prohibition on physician self-referral. Now, this prohibition is limited to physicians referring patients to clinical laboratories in which they have an ownership interest and for which the services are reimbursed under the Medicare program. However, this law may be expanded to include other health care services to which physicians cannot refer, as well as to other federal programs and private payers. While Congress works toward this end, many state governments have already taken the lead in expanding the prohibition beyond clinical laboratories and the Medicare program. "Health Law" is a regular feature of Physician Executive contributed by Epstein, Becker, and Green. Mark Lutes of the firm's Washington, D.C., offices serves as editor of the column.

Fraud↗
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Sexually transmitted diseases in pregnancy.

Sexually transmitted diseases (STDs), grouped together are one of the most common medical complications of pregnancy. They can have serious adverse effects on the health of both the pregnant mother and her baby. The increasing prevalence of many STDs and the advent of human immunodeficiency virus (HIV)-related problems emphasize the need for STD awareness in the care of pregnant women.

Female↗
PubMedDate not supplied

Cor triatriatum: unusual cause of transient ischaemic attacks in a 67-year-old man.

Cor triatriatum is a rare congenital cardiac malformation, and in its most common form is characterised by a membrane that separates the left atrium into a proximal and distal chamber. First manifestation in adulthood has been reported previously, but at 67 years of age this patient is one of the oldest to present for the first time. It was diagnosed after a probable TIA, episodic vertigo and central retinal artery occlusion. The value of echocardiography in patients with neurological disease of presumed embolic origin is demonstrated here.

Aged↗