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The Future Of Public Health Law, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Developments in medicine and constitutional law dictate modification of public health legislation in the United States. Traditionally overlooked by legislators, present public health laws provide inadequate decision-making criteria and inappropriate procedures for dealing with issues. Revised legislation should provide health care officials and agencies with the tools to balance individual rights against public health necessities. This article makes four recommendations for legislative reform: (1) remove artificial legislative distinction between venereal and other communicable diseases; (2) provide criteria defining "public health necessity" to limit discretionary exercise of police power by health officials; (3) provide strong confidentiality protections in the collection and …

Echocardiographic Features Of Metastatic Pericardial And Myocardial Malignancy, Carey Green, Mohsin Alam, Howard S. Rosman, Jeffrey B. Lakier

Henry Ford Hospital Medical Journal

Clinical and echocardiographic features of a patient with extensive metastasis to the pericardium and myocardium are presented. Echocardiography revealed pericardial effusion, markedly thickened pericardium, and myocardium with increased echogenicity. These findings were subsequently confirmed during surgery and autopsy, which revealed marked tumor encasement of the heart and pericardial myocardial infiltration.

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Changes In Rarotongan Attitudes Toward Health And Disease: Historical Factors In The Development Of A Mid-Twentieth-Century Understanding, Raeburn Lange

Pacific Studies

No abstract provided.

Water-Cover Influences On Diatom Ingestion Rates By Meiobenthic Copepods, Alan W. Decho

Faculty Publications

Laboratory experiments on meiobenthic copepods using ¹⁴C-diatoms were conducted to investigate whether: (1) feeding rates or (2) food sources (planktonically-suspended foods or benthic sediment-associated foods) vary in response to the presence or absence of water-cover (i.e. simulated Higher-water vs Low-water conditions). Three diatom-feeding harpacticoids were examined. Scottolana canadensis feeds at significantly higher rates (2x) during Higher-water (HW) conditions (P<0.001), at which time it consumes planktonic foods; during Low-water (LW), feeding is greatly reduced. These feeding patterns are related to its burrow-dwelling and to its subtidal habitat. Cletocamptus deitersi remains virtually unaffected by changes in ambient water-cover, feeding at nearly equal rates during HW and LW conditions but always tending to consume more benthic diatoms. Microarthridion littorale consumes food at nearly equal rates during HW and LW …

Potassium And Heart Failure, Howard S. Rosman, Mihai Gheorghiade, Sidney Goldstein

Henry Ford Hospital Medical Journal

No abstract provided.

Bilateral Dislocation Of The Crystalline Lens In A Patient With Presumed Syphilitic Uveitis, Jeffrey S. Rapkin, David D. Bogorad

Henry Ford Hospital Medical Journal

Dislocation of the crystalline lens has been described in association with numerous systemic disorders and as a complication of ocular trauma. We present a case of bilateral lens dislocation in a patient with presumed syphilitic uveitis. The mechanism of lens dislocation is related to humoral and cellular effects of inflammation, although the role of trauma cannot be ignored. Persistent uveitis should be considered as a sign of active infection.

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Echocardiographic Evaluation Of Patients With Congestive Heart Failure, Mohsin Alam

Henry Ford Hospital Medical Journal

Echocardiography is a useful noninvasive test for evaluating patients with suspected heart failure and enlarged cardiac silhouette. This test can obtain the dimensions and wall thickness of all four cardiac chambers and can evaluate left ventricular function. The test results are reproducible, and in many instances the etiology of heart failure can be determined.

The Effect Of Aortic Valve Replacement On Left Ventricular Function In Patients With Aortic Valvular Disease, Tennyson Lee, Cathy L. Glick, Jeffrey B. Lakier, Sidney Goldstein

Henry Ford Hospital Medical Journal

Despite improved surgical techniques and survival in patients following aortic valve replacement for aortic stenosis and aortic insufficiency, the proper timing for surgery remains controversial. The incomplete reversibility of left ventricular dysfunction remains a concern, and postoperative improvement of left ventricular function is not consistently demonstrated. We studied 11 patients with aortic stenosis and nine patients with aortic insufficiency using angiographic and radioisotope assessment of left ventricular function preoperatively. Postoperative left ventricular function was assessed over nine to 13 months by radioisotope multiple-gated acquisition (MUGA) scan. All patients with impaired left ventricular function preoperatively showed slow but significant recovery toward …

Early Identification Of Risk For Noncompliance In Tuberculosis Patients, Penny Klein Weismuller

Loma Linda University Electronic Theses, Dissertations & Projects

In this descriptive study of early identification of risk for noncompliance to tuberculosis treatment or prevention regimens, 523 patients, from four ethnic groups, were rated by nurses trained as participant-observers of several predictive factors. The predictive factors included acceptance of diagnosis. attentiveness, eye contact, the treatment's interference with the patient's lifestyle, fear of side effects, fear of needed medical procedures, and the presence and degree of the patient's social support. An observational measure by the nurse of the patient's Health Locus of Control was also included. The patient was asked to provide a self-rating on the degree of difficulty anticipated …

The Aids Project News (August 1986), The Aids Project

AIDS Project News (1986)

No abstract provided.

Trauma In Pregnancy, Victor J. Sorensen, Brack A. Bivins, Farouck N. Obeid, H. Mathilda Horst

Henry Ford Hospital Medical Journal

Management of 12 pregnant trauma patients is reviewed. These patients had injuries to the neck, chest, abdomen, and extremities. Six patients had penetrating wounds, and six others had blunt injuries. Eight of the 12 women required surgical intervention during their hospitalization. Liberal use of diagnostic procedures such as roentgenograms, diagnostic peritoneal lavage, and angiography aided in the evaluation of these patients. None of the 12 patients died, and only two developed major complications. One fetus died as a result of shock in the mother and only one major neonatal complication occurred. Rapid resuscitation combined with thorough diagnostic evaluation and early …

Hemodynamic Response To Fluid Challenge: A Means Of Assessing Volume Status In The Critically Ill, H. Mathilda Horst, Farouck N. Obeid

Henry Ford Hospital Medical Journal

Cardiovascular and oxygen transport variables were studied during fluid challenges in 50 critically ill patients. The results show three distinct patterns of response: hypovolemic, normovolemic, and hypervolemic. Colloid fluid challenge is a rapid, effective diagnostic modality for determination of cardiovascular function in the surgical critical care patient.

Evaluation Of The Economic Impact Of Pharmacist Involvement In Hyperalimentation Therapy, Larry Crots, Larry Shoup

Henry Ford Hospital Medical Journal

A prospective parallel study of patients receiving total parenteral nutrition (TPN) was undertaken to identify characteristics of TPN solution use and waste. Thirty consecutive patients receiving TPN by order of the primary clinical service (control group) were compared with 25 consecutive patients receiving TPN under the supervision and monitoring of the Nutritional Support Service (study group). The patients were evenly divided between medical and surgical problems, with 53% of the control group being surgical patients compared to 56% of the study group. There were 136 L of TPN or 4.5 L/patient discarded in the control group compared to 65 L …

Medical Challenges In Space, Boy Frame

Henry Ford Hospital Medical Journal

No abstract provided.

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Factors That Influence Prepared Childbirth Couples' Use Of Epidural Anesthesia For Labor And Delivery, Terri S. Chambers

Community & Environmental Health Theses & Dissertations

The purpose of this study was to identify factors that influence a Prepared Childbirth couple's decision to utilize epidural anesthesia for labor and delivery. Review of the literature indicated a high correlation between epidural use for uncomplicated labors and deliveries and a high incidence of maternal complications and low neonatal neurological and behavioral scores.

A sample of twenty-nine couples was used in this prospective, non-experimental field study for the research. Data were collected utilizing two developed demographic and factual event tools, Rotter's Internal-External Locus of Control Tool and Spanier's Dyadic Marital Adjustment Tool.

Three hypotheses were developed and data were …

Nutritional Support Of The Brain Injured Patient: Five Years Of Clinical Study In Perspective, Diana L. Twyman, Brack A. Bivins

Henry Ford Hospital Medical Journal

No abstract provided.

Intussusception Of The Appendix And Endometriosis, Roberta E. Sonnino, Mohammed R. Ansari

Henry Ford Hospital Medical Journal

Intussusception of the appendix, though uncommon, is usually diagnosed during surgery. Endometriosis in an intussuscepted appendix is rarely described. A case of appendiceal intussusception of a rare morphologic type associated with endometriosis is presented, and the literature is briefly reviewed. Etiology, classification, and diagnosis are discussed.

Postinfarction Papillary Muscle Rupture: A New M-Mode Echocardiographic Sign, Dipankar S. Dasgupta, I. A. D'Cruz

Henry Ford Hospital Medical Journal

A 58-year-old man with acute inferior wall infarction developed a loud systolic murmur hypotension, and pulmonary edema four days after onset of infarction. M-mode echocardiography demonstrated an unusual diastolic echo that appeared between the mitral valve leaflets. Complete rupture of the posterior papillary muscle was confirmed at surgery for mitral valve replacement.

Intimations Of Life: Extracorporeality And The Law, George P. Smith Ii

Scholarly Articles

This article will study and evaluate the efforts of the state and the federal government to approach the problem of procreational autonomy and to resolve the perimeters of its recognition and application. In order to posit a framework for principled decision making, an analysis of the Australian and British efforts to deal with this problem, respectively, through their Waller and Warnock Commissions, will be undertaken together with a consideration of the famous case of Melbourne's "orphan" Rios embryos where, for the very first time, the issue of excess fertilized embryos was presented.

The thesis to be postulated here is simple: …

The Women's Construction Collective: Building For The Future, Ruth Mcleod

Poverty, Gender, and Youth

This edition of SEEDS focuses on a project developed to integrate low-income women into Jamaica's construction industry. In two years, 34 women passed through the project's basic training and skills upgrading courses. More than 90 percent of these women became employed, the majority as masons and carpenters. The story of how this field was identified as a potential source of income for women, and how the project developed and evolved in response to changing circumstances, presents many useful lessons. These should be of particular interest to those seeking to identify employment areas where women's participation is feasible and in helping …

Caring Choices: Decision-Making About Treatment For Catastrophically Ill Newborns, Betty Wolder Levin

Publications and Research

Decision making for catastrophically ill newborns has recently emerged as a social issue. Advances in biomedical technology and practice, and changes in other economic, social and political factors have led to controversy about norms to guide treatment choice. While much has been written on how such decisions should be made, there has been little social science research on how such decisions are actually made.

The purpose of this dissertation is to elucidate the way that clinicians think about treatment decisions for catastrophically ill newborns. The focus is on decision making with respect to the limitation of treatment in those situations …

Intraocular Lens Implant Image Quality: The Optico-Retinal Interface, David D. Bogorad

Henry Ford Hospital Medical Journal

Improvements in intraocular lens implants during the past ten years have revolutionized cataract surgery. Both anterior and posterior chamber lenses are currently in wide use, but the optical superiority of the posterior chamber location has yet to be demonstrated. To do so, a more detailed analysis is required of visual function than is clinically routine. Also required is appreciation that the retina is an integral part of the eye's optical system because of its directional characteristics, which are known as the Stiles-Crawford effect. The optical quality of the pseudophakic eye is affected by the optics of the implant, its centration, …

Some Unusual Foreign Bodies In The Anterior Segment Of The Eye And The Orbit, Saul Sugar

Henry Ford Hospital Medical Journal

No abstract provided.

Malnutrition And Length Of Stay - A Relationship?, Marvin D. Anderson, Gladys Collins, Gloria Davis, Brack A. Bivins

Henry Ford Hospital Medical Journal

The admission nutrition status of 135 consecutive general medical patients admitted to a single nursing unit was evaluated using a simple questionnaire and available laboratory studies. A statistical analysis of the data obtained indicates that prolonged length of stay may be related to admission nutritional status.

Hereditary Sclerocornea, David Barsky, Steven P. Dunn

Henry Ford Hospital Medical Journal

A rare case of total hereditary sclerocornea is presented along with clinical history, histopathology, and a review of the possible pathogenesis and current literature on the subject. It is quite possible that imperfect cleavage of the anterior chamber angle may be the predisposing factor in scleralization of the cornea due to a failure of neural crest cell differentiation. If surgical intervention to correct for the corneal opacification is indicated, corneal transplantation should be performed as soon as possible after birth, similar to the indications for removal of dense congenital cataracts to avoid deprivation amblyopia.

Primary Hyperparathyroidism: Changing Patterns In Presentation And Treatment Decisions In The Eighties, D. Sudhaker Rao

Henry Ford Hospital Medical Journal

No abstract provided.

Dermatomyositis Complicated By Thrombotic Thrombocytopenic Purpura, Maria A. Sawdyk, Jeffrey Jundt

Henry Ford Hospital Medical Journal

A 65-year-old woman who had a documented history of dermatomyositis was hospitalized for evaluation of a syncopal attack. During the course of her stay, she experienced progressive neurologic dysfunction, hemolytic anemia, and thrombocytopenia. A clinical diagnosis of thrombotic thrombocytopenia purpura (TTP) was made, and therapy was initiated with glucocorticoids, plasmapheresis, plasma infusion, and antiplatelet medication. The pathogenesis of TTP has not been cleady elucidated. However, reports in the literature have postulated immune damage of the endothelium with demonstration of IgM and complement deposits as the origin of the condition. Further, there are reported cases of TTP associated with collagen disorders …