[Charity Hospital in Berlin from the 18th century to the middle of the 19th century].
The communication is a concise narrative of Charity Hospital at Berlin.
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The communication is a concise narrative of Charity Hospital at Berlin.
In 1897 there was in Paris a fire at the charity Bazaar, resulting in 126 casualities. This episode is perfectly described in the famous book by Dr. Oscar Amoedo, "L'Art dentaire en Medecine Legale", where there are related the pathetic scenes undergone at that moment. There are enclosed testimonies of de victims'dentists, who had the necessary elements for their identification.
The author, a midwife, describes how she accomplished a strenuous, organised trek in China to raise funds for the charity The Foundation for the Study of Infant Deaths. The experience was a challenge which taught many of the participants more about themselves as well as about the country they visited.
Revocations of local property tax exemptions, class action lawsuits, and state and Congressional investigations all beset the not-for-profit sector of the hospital industry. These problems originated from issues relating to the pricing of services to the uninsured, the relative availability of "charity care" or lack thereof and the collection tactics that some hospital-contracted collectors use. Is this controversy really just symptomatic of the extent to which health care charging and payment systems are out of whack? Are ambiguous government regulations to blame? Is large-scale payment reform the real answer?
Eighty-nine maternal deaths occurred at Charity Hospital of New Orleans between 1965 and 1984, for an overall rate of 60.8 per 100,000 live births. The mortality rate increased with increasing maternal age, was greater with cesarean than vaginal delivery, and has not continued to decline over the 20-year interval. Of those decedents delivered abdominally, more than half of the deaths were attributable to operative complications, including anesthesia, rather than to an underlying disease. Although the majority of obstetric deaths were attributable to complications of hypertension, hemorrhage, and infection, the single most common cause at autopsy was pulmonary edema. Potentially preventable pulmonary edema was responsible for one-third of the obstetric deaths from hypertension and hemorrhage.
The experience of the Charity Hospital surgeons in dealing with desmoid tumors is examined retrospectively over a 30-year period. Sixteen cases are presented. A 33 per cent rate of recurrence was noted despite excisions with margins free of tumor in each instance. In accordance with chi-square analysis, unequivocal statistical significance is given to the fact that women who have been pregnant are more likely to have abdominal than extraabdominal desmoid tumors. It was also found to be significant that parous women in whom desmoids develop are more likely to have the tumor within 10 years of their last pregnancy.
This paper analyzes the significance of the confrontation between the Jewish Labor Federation and the Hadassah Medical Organization in 1926-1928 over the requirement that unemployed workers produce a "Poverty Certificate" as a condition for an exemption from hospitalization charges. This confrontation lasted 2 years and ended with the revocation of the Poverty Certificate and with the resignation of the director-general of Hadassah. The showdown between Hadassah and the Labor Federation resulted in the endorsement of a doctrine that health services should be provided irrespective of income. Medical care of the poor was considered to be a social right, rather than charity. An additional consequence of this event was the decision of the Labor Federation to institute its own hospitals, rather than to rely solely on Hadassah for the provision of inpatient services.
Despite increased screening and public education efforts, there continues to be a subset of patients with breast carcinoma who do not seek medical attention until their lesions are locally advanced. Recently, there has been increasing interest in administering preoperative chemotherapy to these patients. The purpose of this study was to evaluate the Charity Hospital experience with preoperative chemotherapy for locally advanced breast carcinoma. Thirty-three poor urban women with T3 or T4 breast lesions were treated with preoperative chemotherapy before surgical resection, between 1987 and 1995. Their charts and pathology were reviewed and analyzed. Local treatment was in the form of radical mastectomy (n = 3), modified radical mastectomy (n = 26), or lumpectomy with axillary dissection (n = 4). After preoperative chemotherapy, 4 patients had a complete histologic response (12%), 19 had a partial response (58%), and 10 had no response (30%). After a mean follow-up of 40.6 months, stage IIIA (n = 16) and stage IIIB (n = 12) patients were found to have 5-year survival rates of 50.2 and 26.7 per cent, respectively. Stage IV (n = 5) patients had a median survival of 23.1 months with no survivors at 3 years. Patients who had a complete or partial response to chemotherapy had a median survival of 43.0 months versus 23.1 months for the nonresponders. We conclude that our response rate, for poor urban women with locally advanced breast carcinoma, to preoperative chemotherapy, is comparable with that found in the literature. Furthermore, the initial response to this chemotherapy may be an important indicator of ultimate prognosis.
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