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Biomedical subjects

W Grossman

Publications and source records attributed to W Grossman.

240 records · Page 14Linked to original sources
PubMedDate not supplied

Noninvasive vascular studies in clubfoot.

A two-phase study investigated vascularity in idiopathic clubfeet (talipes equinovarus, TEV) undergoing a comprehensive soft tissue release. Great toe O2 saturation was measured by pulse oximetry in a consecutive series of 50 TEV (34 patients) in three foot positions: in feet at rest, in feet in maximal passive correction, and in feet immediately postoperatively. Oxygen saturation was between 94 and 100% in 100% of feet at rest, 95-100% in 90% of feet at maximal passive correction, 95-100% in 98% of feet immediately postoperatively, and 97-100% in 100% of feet 3 weeks' postoperatively. Doppler ultrasound studies were performed on 38 TEV. Dorsalis pedis (DP), posterior tibial (PT), and peroneal (P) pulses were recorded at preoperative resting posture, preoperative maximal passive correction, and 3 weeks postoperatively. At rest, DP pulse was present in 37 of 38 feet, PT pulse was present in all feet, and P pulse was present in 20 of 30 tested (67%), whereas 72% PT, 61% DP, and 50% P pulses were unchanged. Pulse oximetry and Doppler assessment are readily available, noninvasive, and reproducible means of monitoring vascular integrity in TEV.

Clubfoot↗
PubMedDate not supplied

Reporting charity care. Hospitals must prepare to comply with new AICPA accounting rules.

To comply with new accounting rules issued by the American Institute of Certified Public Accountants (AICPA), hospitals will have to change the way they report charity care in the financial statements they prepare for fiscal years ending mid-July 1991 and later. In the past, those hospitals which did report charity care information usually lumped it with bad debts under a caption such as "uncompensated services" or disclosed a specific amount of charity care to comply with Hill-Burton or other governmental programs. From now on, however, providers' financial statements must distinguish bad debt from charity care, not report gross patient revenues in the income statement, not imply that charity services generate revenue or receivables, make specific disclosures about the level of charity care provided, and report bad debts as an expense, rather than as a deduction from revenue. Distinguishing bad debts from charity care will be difficult. The AICPA defines bad debts as actual or expected uncollectibles resulting from an extension of credit, and charity care as services for which the provider does not expect payment. The AICPA believes that facilities which establish a definitive management policy on charity care should be able to distinguish between the two. To collect the data necessary to meet the AICPA requirements, hospitals need to establish a method to catalog the charity services they provide. Facilities should also ensure that patients and staff are familiar with their charity care policies.

Accounting↗
PubMedDate not supplied

A multicenter comparison of adhesion, preference, tolerability, and safety characteristics of two transdermal nitroglycerin delivery systems: Transderm-Nitro and Deponit.

One hundred forty-two patients with stable angina were enrolled in a four-week, multicenter, office-based study to compare the adhesion properties, patient preference, and tolerability of two commercially available transdermal nitroglycerin patches. Data from 139 patients were analyzed. Each patient simultaneously wore one 5-mg Transderm-Nitro (TDN) patch and one 5-mg Deponit (DPT) patch. Patients daily recorded the following information in a diary format: number of angina attacks, frequency of sublingual nitroglycerin use, patch adhesion, and problems at the adhesion site or other medical problems. At the end of the study, patients rated their patch preferences based on ease of application and removal, ease of removing backing, overall adhesion, and adhesion under specific conditions, such as showering, swimming, exercise, hot weather, high humidity, and perspiration. They also specified which patch they would choose for their next prescription. Differences in adhesion properties (P less than 0.0001) and tolerability at the site of application favored TDN over DPT. In addition, significantly more patients (P less than 0.0001) specified TDN as their next prescription choice (83% vs 11%).

Adhesiveness↗