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Full-Text Articles in Medical Specialties

Pace: A Capitated Model Towards Long-Term Care, John Shen, Ann Iverson Mar 1992

Pace: A Capitated Model Towards Long-Term Care, John Shen, Ann Iverson

Henry Ford Hospital Medical Journal

No abstract provided.


The Structure And Function Of Urban Pharmacies: Visits To Community Pharmacies In Inner-City Chicago, Thomas J. Reutzel, Laura A. Wilson Mar 1992

The Structure And Function Of Urban Pharmacies: Visits To Community Pharmacies In Inner-City Chicago, Thomas J. Reutzel, Laura A. Wilson

Henry Ford Hospital Medical Journal

Visits were made to 21 pharmacies in two poor neighborhoods on the west side of Chicago and interviews conducted with pharmacists-in-charge. The objective of the study was to provide a comprehensive description of the function, capabilities, and problems of urban pharmacy. We present results on the structure and function of these inner-city pharmacies. The pharmacies fit one of three structural forms: chain, independent, or medical center. The majority of respondents viewed the function of the inner-city pharmacy as patient-centered but also identified several barriers to effective patient communication. The results suggest that inner-city physicians and pharmacists should communicate with patients …


Health Priorities Of The State Of Michigan, Vernice Davis Anthony Mar 1992

Health Priorities Of The State Of Michigan, Vernice Davis Anthony

Henry Ford Hospital Medical Journal

No abstract provided.


Moving From Health Care Research To Action, Claudia R. Baquet, Katherine Marconi, George Alexander Mar 1992

Moving From Health Care Research To Action, Claudia R. Baquet, Katherine Marconi, George Alexander

Henry Ford Hospital Medical Journal

Although the United States spends more on health care than any country in the world, access to that care is becoming increasingly difficult. The National Cancer Institute and other federal agencies are sponsoring innovative research for delivering effective medical services, particularly to underserved populations. Models of successful collaboration between private and public sectors concerned with health care can be adapted and implemented at the national, state, and local levels. However, other measures are needed to ensure access to adequate health care for all Americans. Minimal but effective regulations are needed to ensure quality control, reduce duplication of services, and minimize …


The Urban Hospital: Rediscovering Abandoned Values, Thomas W. Chapman Mar 1992

The Urban Hospital: Rediscovering Abandoned Values, Thomas W. Chapman

Henry Ford Hospital Medical Journal

No abstract provided.


Urban Hospitals: Their Plight And Mission, Jeffrey C. Merrill, Elliott C. Roberts, Mary Corita Heid Mar 1992

Urban Hospitals: Their Plight And Mission, Jeffrey C. Merrill, Elliott C. Roberts, Mary Corita Heid

Henry Ford Hospital Medical Journal

No abstract provided.


Adenocarcinoma Of The Prostate: Overview Ii, Joseph C. Cerny Mar 1992

Adenocarcinoma Of The Prostate: Overview Ii, Joseph C. Cerny

Henry Ford Hospital Medical Journal

No abstract provided.


The Epidemiology Of Prostate Cancer In Black Men, David A. Burks, Ray H. Littleton Mar 1992

The Epidemiology Of Prostate Cancer In Black Men, David A. Burks, Ray H. Littleton

Henry Ford Hospital Medical Journal

Data on the epidemiology of prostate cancer from the 1930s to the present document a dramatic racial difference in incidence, survival, and mortality rates in American men. American black men have the highest incidence and mortality rates of prostate cancer in the world. Survival data have been related to access to medical care, genetic and environmental factors, and cultural differences, including diet and social habits. Most reports present conflicting data with no clear positive correlations, and conclusions are often speculative. Better controlled, prospective studies of epidemiologic variables and a comprehensive genetic evaluation of black families with prostate cancer are needed …


Therapeutic Options For Localized Carcinoma Of The Prostate: The Role Of External Beam Radiation Therapy, Mark S. Khil, Jae Ho Kim Mar 1992

Therapeutic Options For Localized Carcinoma Of The Prostate: The Role Of External Beam Radiation Therapy, Mark S. Khil, Jae Ho Kim

Henry Ford Hospital Medical Journal

During the last three decades the use of ionizing radiation, both external beam radiotherapy and interstitial radionuclide implant (brachytherapy), has greatly increased for the treatment of cancer of the prostate. The increased use of radiation therapy is in part due to the technological advance of high-energy megavoltage units as well as the steadily improving long-term results of radiotherapy. Because of the comparable tumor control rates, patients with early stage prostate cancer have several therapeutic options for curative treatment including radical prostatectomy, external beam radiation therapy, and interstitial brachytherapy. The role of external beam radiotherapy is discussed in terms of the …


Radical Surgery In The Treatment Of Localized Carcinoma Of The Prostate, Dinesh J. Telang, Brian J. Miles, Riad N. Farah, Ray H. Littleton, Aaron K. Kirkemo, James O. Peabody, David A. Burks, Caleb Fleming, Joseph C. Cerny Mar 1992

Radical Surgery In The Treatment Of Localized Carcinoma Of The Prostate, Dinesh J. Telang, Brian J. Miles, Riad N. Farah, Ray H. Littleton, Aaron K. Kirkemo, James O. Peabody, David A. Burks, Caleb Fleming, Joseph C. Cerny

Henry Ford Hospital Medical Journal

New methods of early detection combined with recent advances in surgical techniques have resulted in more patients undergoing radical surgery for treatment of localized carcinoma of the prostate. Over 350 radical prostatectomies have been performed by our group since January 1987. We review the role of radical prostatectomy in the treatment of prostate cancer and our experience with 100 patients undergoing radical retropubic prostatectomy since the advent of nerve-sparing techniques to preserve potency.


Maximal Androgen Ablation: A Review, Brian J. Miles, Joseph Babiarz Mar 1992

Maximal Androgen Ablation: A Review, Brian J. Miles, Joseph Babiarz

Henry Ford Hospital Medical Journal

Primary management of advanced (stage D) adenocarcinoma of the prostate is androgen ablation. Since this principle was discovered in the early 1940s, therapeutic alternatives and "progress" have centered around different ways to obtain castrate levels of androgens. The role of adrenal androgens in supporting prostate or prostatic cancer growth has been debated for decades and until recently was believed to be minimal. In the 1980s the concept of maximum androgen suppression, involving both the testes and adrenal glands, was reintroduced with some investigators claiming exceptional results. We review studies that have examined this concept, with emphasis on the largest trial …


Advances In Therapy Of Female Stress Incontinence, Carl G. Klutke Mar 1992

Advances In Therapy Of Female Stress Incontinence, Carl G. Klutke

Henry Ford Hospital Medical Journal

No abstract provided.


Megakaryoblastic Termination Of Myeloproliferative Disorders, Mahul B. Amin, Koichi Maeda, John L. Carey, Ramesh V. Babu, B. K. S. Raman Mar 1992

Megakaryoblastic Termination Of Myeloproliferative Disorders, Mahul B. Amin, Koichi Maeda, John L. Carey, Ramesh V. Babu, B. K. S. Raman

Henry Ford Hospital Medical Journal

Megakaryoblastic termination of myeloproliferative disorders is rare. The morphology of megakaryoblastic transformation can be subtle and is often mistaken for myeloid or lymphoid proliferations. Previously reported observations suggest a relatively poor prognosis for this category of patients, making precise diagnosis imperative. A multifaceted approach using morphology, ultrastructure, cytochemistry, and immunological membrane analysis may be helpful. We present two cases of myeloproliferative disorder with aggressive megakaryoblastic phases (myelofibrosis with agnogenic myeloid metaplasia and chronic myeloid leukemia with blast crisis). The clinical course is described and the results of the morphological, cytochemical, ultrastructural, and cytogenetic studies of both cases are presented. In …


Cerebral Oxygen Extraction During Severe Viral Encephalitis, Mark G. Goetting, Marwan L. Haddad Mar 1992

Cerebral Oxygen Extraction During Severe Viral Encephalitis, Mark G. Goetting, Marwan L. Haddad

Henry Ford Hospital Medical Journal

Viral encephalitis can cause devastating neurologic injury. Little is known about cerebral hemodynamics and metabolism in this condition. We report two patients with severe encephalitis, one proven and the other suspected to be due to herpes simplex, in whom the global cerebral oxygen extraction ratio (OER) and carbon dioxide (CO2) responsiveness was assessed. OER was low in both patients throughout the acute period. CO2 responsiveness was present initially in both and disappeared later in the more severely affected child. These cases demonstrate that cerebral hyperemia occurs in severe viral encephalitis and that hyperventilation can effectively reduce the intracranial pressure.


The Emerging Role Of Htlv-I/Ii And Hiv-1 Among Intravenous Drug Users In Detroit, Anthony F. Ognjan, Chris A. Lewandowski, Bradley T. Belian, John Burczak, Norman Markowitz, Helen Lee, Louis D. Saravolatz Mar 1992

The Emerging Role Of Htlv-I/Ii And Hiv-1 Among Intravenous Drug Users In Detroit, Anthony F. Ognjan, Chris A. Lewandowski, Bradley T. Belian, John Burczak, Norman Markowitz, Helen Lee, Louis D. Saravolatz

Henry Ford Hospital Medical Journal

During 1987-1988, a seroprevalence study of the human immunodeficiency virus (HIV-1) and the human T-cell lymphoma/leukemia virus (HTLV-l/II) was performed among Detroit intravenous drug users unaffiliated with substance abuse programs. Seroprevalence data along with patient demographic information were compared to a similar study performed in 1985-1986. In the earlier study, 12 (12.5%) of 96 individuals tested positive for HIV-1. Of the 74 available negative samples retested in 1987-1988 for retroviruses, 7 (9.5%) tested positive for HTLV-I/II. Thus, the overall retroviral (HIV-1, HTLV-I/II) seropositive rate for 1985-1986 was 22%. In 1987-1988, 11 (15.7%) of 70 individuals tested positive for HIV-1 and …


Interpretation Of The Pattern In Rate Ratios Across Strata, Paul F. Visintainer, Suzanne Havstad Mar 1992

Interpretation Of The Pattern In Rate Ratios Across Strata, Paul F. Visintainer, Suzanne Havstad

Henry Ford Hospital Medical Journal

The pattern in the ratio of disease rates over strata is a summary statistic used to describe the changing risk of disease in one group relative to another. While patterns of the ratios of disease rates over strata appear to correspond to specific changes in disease rates, plots of the disease rates over strata seem to contradict the information yielded by the ratios. For example, if disease rates from populations A and B have identical rates of decline (parallel lines), the difference in the rates (A - B) at each strata remains constant, while the ratio of the rates (AIB) …


Presentation And Evaluation Of Patients With Epidermoid Head And Neck Cancers, Michael S. Benninger Mar 1992

Presentation And Evaluation Of Patients With Epidermoid Head And Neck Cancers, Michael S. Benninger

Henry Ford Hospital Medical Journal

Epidermoid cancer of the head and neck occurs most frequently in individuals with predisposing factors for neoplastic development. Primarily these include exposure to smoking and alcohol, although other predisposing factors may he present. Site-speciflc symptoms along with a history of predisposing environmental exposure can direct physicians to suspect head and neck cancer. Endoscopy and ancillary testing are performed for tumor staging and subsequent treatment planning.


The Why And Wherefore Of Fructosamine, Daniel B. Mendlovic, Fred W. Whitehouse, Craig C. Foreback Mar 1992

The Why And Wherefore Of Fructosamine, Daniel B. Mendlovic, Fred W. Whitehouse, Craig C. Foreback

Henry Ford Hospital Medical Journal

No abstract provided.


Non-Q Wave Myocardial Infarction, Steven Borzak, Howard S. Rosman Sep 1991

Non-Q Wave Myocardial Infarction, Steven Borzak, Howard S. Rosman

Henry Ford Hospital Medical Journal

Non-Q wave myocardial infarction is a distinct and changing clinical entity characterized by lower initial mortality and a higher rate of reinfarction compared to Q wave infarction. Clinical and pathologic data suggest that the syndrome results from transient or incomplete coronary occlusion resulting in an infarct which is smaller than when Q waves are present. High-risk patients can be identified during hospitalization, allowing for aggressive therapy aimed at revascularization. Relatively few clinical trials have examined initial therapy or secondary prevention in this group of patients. These studies are reviewed and management guidelines suggested.


Intravenous Nitroglycerin For Acute Myocardial Infarction, Steven Borzak Sep 1991

Intravenous Nitroglycerin For Acute Myocardial Infarction, Steven Borzak

Henry Ford Hospital Medical Journal

Intravenous nitroglycerin (IV TNG) has been increasingly used in the setting of acute myocardial infarction. The seven randomized trials comparing IV TNG with placebo, and one trial comparing IV isosorbide dinitrate with furosemide, were reviewed for evidence of beneficial clinical effects. IV TNG in low dosage is safe in the setting of acute myocardial infarction and modestly effective in relieving chest pain. Favorable hemodynamic effects are most pronounced in patients with congestive heart failure. Limited evidence suggests that IV TNG, particularly when administered early, reduces both infarct size and mortality when given prophylactically.


Psychological Factors Relevant To The Prehospital And In-Hospital Phases Of Acute Myocardial Infarction, Lori W. Kenyon, Mark W. Ketterer, Richard C. Preisman Sep 1991

Psychological Factors Relevant To The Prehospital And In-Hospital Phases Of Acute Myocardial Infarction, Lori W. Kenyon, Mark W. Ketterer, Richard C. Preisman

Henry Ford Hospital Medical Journal

Recognition and treatment of psychological factors relevant to the acute prehospital and in-hospital phases of myocardial infarction (Ml) are reviewed. Various emotions and personality characteristics can be both risk factors for and consequences of acute Ml. Components of the Type A behavior pattern and levels of somatic and emotional awareness have been linked with excessive treatment-seeking delay for Ml patients. Psychiatric conditions such as panic disorder may mimic symptomatic presentation of Ml and therefore have implications for differential diagnosis in the emergency room. Additionally. anxiety, depression, and neurobehavioral disorders such as delirium are relatively common during the hospitalization period and …


Beta-Adrenergic Blocking Agents In The Treatment Of Patients After A Myocardial Infarction, Sidney Goldstein Sep 1991

Beta-Adrenergic Blocking Agents In The Treatment Of Patients After A Myocardial Infarction, Sidney Goldstein

Henry Ford Hospital Medical Journal

Beta-adrenergic blocking agents have been widely used in ischemic heart disease. They have achieved their greatest benefit in the secondary prevention of recurrent events in patients following acute myocardial infarction (Ml). This is a review of the major clinical investigations exploring the effects of beta-adrenergic blocking agents in patients following acute Ml and in a variety of patient subsets. These data indicate that the routine use of beta-adrenergic blocking agents in postinfarction patients results in a 25% to 35% decrease in mortality and has increased relative and absolute benefit in patients with ventricular ectopy and left ventricular dysfunction. The adverse …


Special Feature: Management Of Acute Myocardial Infarction: Introduction, Mihai Gheorghiade Sep 1991

Special Feature: Management Of Acute Myocardial Infarction: Introduction, Mihai Gheorghiade

Henry Ford Hospital Medical Journal

No abstract provided.


Prehospital Care Of Acute Myocardial Infarction: A Review, Asit R. Gokli, Jay L. Kovar, Terry Kowalenko, Richard M. Nowak Sep 1991

Prehospital Care Of Acute Myocardial Infarction: A Review, Asit R. Gokli, Jay L. Kovar, Terry Kowalenko, Richard M. Nowak

Henry Ford Hospital Medical Journal

Each year more than 1 million people in the United States suffer from acute myocardial infarction (Ml) with most of the deaths occurring within hours of symptom onset. Over the last 25 years, different prehospital systems have evolved throughout the world which allow early cardiac monitoring and treatment of acute Ml patients. Thrombolytic therapy in acute Ml has been shown to decrease mortality and preserve left ventricular function when administered early after onset of symptoms. The potential role of Emergency Medical Services or Mobile Coronary Care Units in achieving early thrombolysis is under investigation. Several studies of prehospital interventions to …


Calcium Channel Blockers In The Management Of Myocardial Infarction Patients, Mihai Gheorghiade Sep 1991

Calcium Channel Blockers In The Management Of Myocardial Infarction Patients, Mihai Gheorghiade

Henry Ford Hospital Medical Journal

No abstract provided.


Front Matter Sep 1991

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.


Neuroendocrine Responses To Acute Myocardial Infarction, Arlene B. Levine, T. Barry Levine Sep 1991

Neuroendocrine Responses To Acute Myocardial Infarction, Arlene B. Levine, T. Barry Levine

Henry Ford Hospital Medical Journal

No abstract provided.


Recovery Of Left Ventricular Function Following Acute Myocardial Infarction, Hani N. Sabbah, Paul D. Stein, Mihai Gheorghiade Sep 1991

Recovery Of Left Ventricular Function Following Acute Myocardial Infarction, Hani N. Sabbah, Paul D. Stein, Mihai Gheorghiade

Henry Ford Hospital Medical Journal

No abstract provided.


Biochemical Diagnosis Of Myocardial Infarction, Craig C. Foreback Sep 1991

Biochemical Diagnosis Of Myocardial Infarction, Craig C. Foreback

Henry Ford Hospital Medical Journal

A rapid, sensitive, and specific marker for the diagnosis of acute myocardial infarction (MI) and the assessment of reperfusion following thrombolytic therapy has been sought by research workers for years. Creatine kinase-MB (CK-MB) is the best biochemical marker currently available to the cardiologist and the emergency room physician for the assessment of patients presenting with symptoms of acute Ml. CK-MB is best measured using immunoassay techniques at 3- to 4-hour time intervals during the first 12 hours after onset of.symptoms. Other currently available markers include lactate dehydrogenase and its isoenzymes and myoglobin. Future developments include assays for troponin, reported to …


The Role Of Echocardiography In Acute Myocardial Infarction, Mohsin Alam Sep 1991

The Role Of Echocardiography In Acute Myocardial Infarction, Mohsin Alam

Henry Ford Hospital Medical Journal

Our institutional experience with two-dimensional echocardiography and color flow Doppler tests, as welt as a review of the literature, reveals that echocardiography is useful in diagnosing myocardial infarction. Furthermore, complications of myocardial infarction such as mitral regurgitation with or without papillary muscle rupture, acquired ventricular septal defect, true and false left ventricular aneurysms, left ventricular thrombi, right ventricular infarction, and pericardial effusion in the setting of acute infarction can he detected by cardiac ultrasound. Echocardiography is also useful in assessing prognosis of postinfarction patients based on degree of left ventricular dysfunction. This test, however, is not 100% sensitive and specific …