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Feldman L, Goldstein L, Ouyang B, Chen M. O-029 Oral contraceptive and hormone replacement therapy in women with cerebral aneurysms. J Neurointerv Surg 2010. [DOI: 10.1136/jnis.2010.003244.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Beberashvili I, Azar A, Sinuani I, Yasur H, Feldman L, Averbukh Z, Weissgarten J. Reply. Nephrol Dial Transplant 2010. [DOI: 10.1093/ndt/gfq367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Beberashvili I, Azar A, Sinuani I, Yasur H, Feldman L, Averbukh Z, Weissgarten J. Objective Score of Nutrition on Dialysis (OSND) as an alternative for the malnutrition-inflammation score in assessment of nutritional risk of haemodialysis patients. Nephrol Dial Transplant 2010; 25:2662-71. [DOI: 10.1093/ndt/gfq031] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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DiMasi JA, Feldman L, Seckler A, Wilson A. Trends in risks associated with new drug development: success rates for investigational drugs. Clin Pharmacol Ther 2010; 87:272-7. [PMID: 20130567 DOI: 10.1038/clpt.2009.295] [Citation(s) in RCA: 440] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This study utilizes both public and private data sources to estimate clinical phase transition and clinical approval probabilities for drugs in the development pipelines of the 50 largest pharmaceutical firms (by sales). The study examined the development histories of these investigational compounds from the time point at which they first entered clinical testing (1993-2004) through June 2009. The clinical approval success rate in the United States was 16% for self-originated drugs (originating from the pharmaceutical company itself) during both the 1993-1998 and the 1999-2004 subperiods. For all compounds (including licensed-in and licensed-out drugs in addition to self-originated drugs), the clinical approval success rate for the entire study period was 19%. The estimated clinical approval success rates and phase transition probabilities differed significantly by therapeutic class. The estimated clinical approval success rate for self-originated compounds over the entire study period was 32% for large molecules and 13% for small molecules. The estimated transition probabilities were also higher for all clinical phases with respect to large molecules.
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Labovsky V, Hofer E, Feldman L, Fernández Vallone V, García Rivello H, Bayes-Genis A, Hernando Insúa A, Levin M, Chasseing N. Cardiomyogenic differentiation of human bone marrow mesenchymal cells: Role of cardiac extract from neonatal rat cardiomyocytes. Differentiation 2010; 79:93-101. [DOI: 10.1016/j.diff.2009.10.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2009] [Revised: 09/03/2009] [Accepted: 10/09/2009] [Indexed: 11/30/2022]
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Gilbert J, Lee J, Argiris A, Feldman L, Haigentz M, Burtness B, Forastiere A. Phase II randomized trial of bortezomib (B) plus irinotecan (I) or B with addition of I at progression in recurrent (R) or metastatic (M) squamous cell carcinoma of the head and neck (SCCHN) (E1304): A trial of the Eastern Cooperative Oncology Group. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.6020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6020 Background: B, inhibits activation of NF- κβ and inhibits growth of SCCHN cell lines. NF-κβ dysregulation contributes to chemoresistance, including I. Pretreatment with B increases tumor sensitivity to I in vitro. Methods: Eligibility: 0–1 prior chemo regimens, ECOG PS 0–1. Pts randomized to B 1.3 mg/m2 IV d 1, 4, 8, 11 and I 125 mg/m2 IV d 1, 8 every 21 days (Arm 1) or B with addition of I at time of progression (Arm 2). Primary endpoint was response rate (RR) using RECIST and Simon's optimal 2-stage design. Results: 62 pts analyzable (Arm 1, N = 23; Arm 2, N = 39) of 71 enrolled . Pt. characteristics: median age 61 yrs., ECOG PS 1 - 53 %, and 71% had prior chemo. To date, RR (all PRs) 13% Arm 1 and 3% Arm 2 with SD 17% Arm 1 and 23% Arm 2. However, 3 patients remain on active therapy in Arm 2 and PFS and updated RR will be reported. 7 patients (including 3 pts on Arm 2) received 6–10 cycles of therapy. No responses in all 11 analyzable pts in Arm 2 with I added at progression. Median OS 9.1 months - Arm 1 and 7.3 months - Arm 2. Toxicity of B + I (125 mg/m2): grade 3/ 4 neutropenia (31%), vomiting (15%), diarrhea (15%), dehydration (23%). Grade 5 toxicity in 3 pts, 2 possibly related to therapy. Trial amended to decrease I to 90 mg/m2 3 patients (33%) - grade 3 / 4 diarrhea; no grade 3/ 4 neutropenia or grade 5 toxicities. Arm 2: grade 3 / 4 fatigue (15%). Conclusions: B alone is well tolerated. To date, RR low but prolonged stable disease noted in some pts. B in combination with I is a toxic regimen with disappointing activity. [Table: see text]
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Asherson P, Zhou K, Anney RJL, Franke B, Buitelaar J, Ebstein R, Gill M, Altink M, Arnold R, Boer F, Brookes K, Buschgens C, Butler L, Cambell D, Chen W, Christiansen H, Feldman L, Fleischman K, Fliers E, Howe-Forbes R, Goldfarb A, Heise A, Gabriëls I, Johansson L, Lubetzki I, Marco R, Medad S, Minderaa R, Mulas F, Müller U, Mulligan A, Neale B, Rijsdijk F, Rabin K, Rommelse N, Sethna V, Sorohan J, Uebel H, Psychogiou L, Weeks A, Barrett R, Xu X, Banaschewski T, Sonuga-Barke E, Eisenberg J, Manor I, Miranda A, Oades RD, Roeyers H, Rothenberger A, Sergeant J, Steinhausen HC, Taylor E, Thompson M, Faraone SV. A high-density SNP linkage scan with 142 combined subtype ADHD sib pairs identifies linkage regions on chromosomes 9 and 16. Mol Psychiatry 2008; 13:514-21. [PMID: 18180756 DOI: 10.1038/sj.mp.4002140] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
As part of the International Multi-centre ADHD Genetics project we completed an affected sibling pair study of 142 narrowly defined Diagnostic and Statistical Manual of Mental Disorders, fourth edition combined type attention deficit hyperactivity disorder (ADHD) proband-sibling pairs. No linkage was observed on the most established ADHD-linked genomic regions of 5p and 17p. We found suggestive linkage signals on chromosomes 9 and 16, respectively, with the highest multipoint nonparametric linkage signal on chromosome 16q23 at 99 cM (log of the odds, LOD=3.1) overlapping data published from the previous UCLA (University of California, Los Angeles) (LOD>1, approximately 95 cM) and Dutch (LOD>1, approximately 100 cM) studies. The second highest peak in this study was on chromosome 9q22 at 90 cM (LOD=2.13); both the previous UCLA and German studies also found some evidence of linkage at almost the same location (UCLA LOD=1.45 at 93 cM; German LOD=0.68 at 100 cM). The overlap of these two main peaks with previous findings suggests that loci linked to ADHD may lie within these regions. Meta-analysis or reanalysis of the raw data of all the available ADHD linkage scan data may help to clarify whether these represent true linked loci.
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Pasek J, Feldman L, Romer D, Jamieson KH. Schools as Incubators of Democratic Participation: Building Long-Term Political Efficacy with Civic Education. APPLIED DEVELOPMENTAL SCIENCE 2008. [DOI: 10.1080/10888690801910526] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Huisse M, Feldman L, Guillin M, Steg P. MECHANISMS ASSOCIATED WITH FAILURE OF THROMBOLYTIC THERAPY TO RECANALIZE THE INFARCT ARTERY IN ACUTE MYOCARDIAL INFARCTION. J Thromb Haemost 2007. [DOI: 10.1111/j.1538-7836.2007.tb02319.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Feldman L, Efrati S, Eviatar E, Abramsohn R, Yarovoy I, Gersch E, Averbukh Z, Weissgarten J. Gentamicin-induced ototoxicity in hemodialysis patients is ameliorated by N-acetylcysteine. Kidney Int 2007; 72:359-63. [PMID: 17457375 DOI: 10.1038/sj.ki.5002295] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Aminoglycoside (AG) antibiotics are associated with several side effects, including a reversible nephrotoxicity and a permanent ototoxicity. Oxidative stress is thought to contribute to the pathophysiology of both conditions. We studied the possible protective effect of the antioxidant N-acetylcysteine (NAC) in gentamicin-induced hearing loss in hemodialysis patients. This study includes 53 hemodialysis patients scheduled to receive gentamicin for dialysis catheter-related bacteremia that were randomized to receive the antibiotic with or without NAC. Hearing function was assessed by the standard technique of pure-tone audiograms over a range of frequencies. Audiometric evaluations were performed at baseline, 1 week and at 6 weeks after the completion of gentamicin therapy. A total of 40 patients completed the study protocol with a mean duration of therapy of almost 15 days. At both 1 and 6 weeks after the completion of antibiotic therapy, there were significantly more patients exhibiting ototoxicity in the control group compared with the group receiving NAC. Additionally, significantly more patients in the control group had bilateral ototoxicity. The greatest otoprotective effect of NAC was noticed in the high audiometric tone frequencies. Taken together, our study suggests that NAC treatment may ameliorate gentamicin-induced ototoxicity in hemodialysis patients.
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Alling A, Doherty O, Logan H, Feldman L, Dustan P. Catastrophic coral mortality in the remote central Pacific Ocean: Kirabati Phoenix islands. ACTA ACUST UNITED AC 2007. [DOI: 10.5479/si.00775630.551.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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62
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Brookes K, Xu X, Chen W, Zhou K, Neale B, Lowe N, Anney R, Aneey R, Franke B, Gill M, Ebstein R, Buitelaar J, Sham P, Campbell D, Knight J, Andreou P, Altink M, Arnold R, Boer F, Buschgens C, Butler L, Christiansen H, Feldman L, Fleischman K, Fliers E, Howe-Forbes R, Goldfarb A, Heise A, Gabriëls I, Korn-Lubetzki I, Johansson L, Marco R, Medad S, Minderaa R, Mulas F, Müller U, Mulligan A, Rabin K, Rommelse N, Sethna V, Sorohan J, Uebel H, Psychogiou L, Weeks A, Barrett R, Craig I, Banaschewski T, Sonuga-Barke E, Eisenberg J, Kuntsi J, Manor I, McGuffin P, Miranda A, Oades RD, Plomin R, Roeyers H, Rothenberger A, Sergeant J, Steinhausen HC, Taylor E, Thompson M, Faraone SV, Asherson P. The analysis of 51 genes in DSM-IV combined type attention deficit hyperactivity disorder: association signals in DRD4, DAT1 and 16 other genes. Mol Psychiatry 2006; 11:934-53. [PMID: 16894395 DOI: 10.1038/sj.mp.4001869] [Citation(s) in RCA: 431] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, starting in early childhood and persisting into adulthood in the majority of cases. Family and twin studies have demonstrated the importance of genetic factors and candidate gene association studies have identified several loci that exert small but significant effects on ADHD. To provide further clarification of reported associations and identify novel associated genes, we examined 1,038 single-nucleotide polymorphisms (SNPs) spanning 51 candidate genes involved in the regulation of neurotransmitter pathways, particularly dopamine, norepinephrine and serotonin pathways, in addition to circadian rhythm genes. Analysis used within family tests of association in a sample of 776 DSM-IV ADHD combined type cases ascertained for the International Multi-centre ADHD Gene project. We found nominal significance with one or more SNPs in 18 genes, including the two most replicated findings in the literature: DRD4 and DAT1. Gene-wide tests, adjusted for the number of SNPs analysed in each gene, identified associations with TPH2, ARRB2, SYP, DAT1, ADRB2, HES1, MAOA and PNMT. Further studies will be needed to confirm or refute the observed associations and their generalisability to other samples.
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Feifer AH, Fong BC, Feldman L, Fried G, Stein LA, Metrakos P, Bergman S, Anidjar M. Preoperative evaluation of laparoscopic living renal donors with computerized tomography and its effect on donor morbidity and graft function. THE CANADIAN JOURNAL OF UROLOGY 2005; 12:2713-21. [PMID: 16011820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To assess the efficacy of CT angiography (CTA) in evaluating the renovascular anatomy in 50 patients who underwent laparoscopic donor nephrectomy, and to correlate results with donor morbidity and recipient outcome. METHODS Forty-eight patients were evaluated by CTA prior to laparoscopy. Donors with aberrant renovasculature and their respective recipients were divided into: 1) accurate preoperative CTA ("predictive group", PG), 2) inaccurate CTA ("non-predictive group", NPG). Warm ischemia times (WIT), estimated blood loss (EBL), operative time (OT), and the open conversion rate were compared. Recipient creatinine values on post-operative day 1 and 3 months were recorded with the rate of delayed graft function (DGF) and ureteral complication. Statistical significance was calculated using the student's T-test. RESULTS Among patients with aberrant vasculature (48%, 23/48) at laparoscopy, 14 were accurately predicted by CT angiography (11 arterial, 3 venous). NPG consisted of 5 duplicated arteries, 1 early arterial branching, and 3 anomalous veins. CT accuracy was 85%. The sensitivity and specificity of the arterial imaging were 65% and 100% respectively, while those of venous imaging were 50% and 100%. EBL, WIT, OT, number of open conversions, and ureteral complications were statistically insignificant between groups (p= 0.05, 95% C.I.). The mean decreases in creatinine between NPG and PG on post-operative day 1 and at 3 months were 45.4% and 54.8%, and 71.5% and 79.1% respectively, both statistically insignificant. Two of 8 in the NPG experienced DGF as compared to 1/8 in the PG. CONCLUSIONS Despite the lower sensitivity of this study, the discordance between imaging and laparoscopy did not augment donor morbidity or increase adverse recipient outcomes. This may indicate that regardless of the shortcomings of 2-D CTA for living donors, it represents a safe and effective imaging modality when coupled with meticulous laparoscopic dissection and central intraoperative involvement of the transplant surgeon.
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Sytkowski AJ, Gao C, Feldman L, Chen C. Human selenium binding protein-1 (hSP56) inhibits anchorage-independent growth of PC-3 human prostate cancer cells and is down-regulated in primary human prostate tumor cells. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.9564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
This study was designed to determine the extent to which optometry has been integrated within the hospital delivery system in New York State and to determine the types of services rendered by optometrists in governmental and non-governmental hospitals. A survey was developed and sent to all hospitals in the State to assess which hospitals provided eye care and whether optometrists were on staff. The number of optometrists affiliated with a hospital has increased from 27% in 1978 to 43% in 2003. Virtually all (90%) of city, county, and federal government hospitals used optometrists as compared to 32% of voluntary hospitals. Optometrists were found to provide a full range of medical ocular services including treatment. Given the cost savings of using optometrists, hospitals should consider integrating this profession into their primary eye care services.
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Soroka M, Feldman L, Crump T. Quality-of-care review of optometric records: inter-rater reliability. J Healthc Qual 2004; 26:29-33. [PMID: 15468653 DOI: 10.1111/j.1945-1474.2004.tb00518.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
As managed care organizations (MCOs) move into the realm of vision care, the issue of quality measurement has grown in relevance. This article assesses the inter-rater reliability of a medical record review instrument of a managed vision care plan. This study attempts to duplicate the continuous quality improvement initiative set forth by these MCOs. Twenty examiners, using the review instrument developed by the respective MCO, independently rated the records of 29 patients. Although the reviewers rated more than 86% of all records similarly, statistical analysis and further investigation deemed the instrument inconsistent and thus unreliable in its measurement.
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Dishy V, Cohen Pour M, Feldman L, Naftali T, Baumer M, Efrati S, Golik A, Horne T, Weissgarten J. The effect of sildenafil on gastric emptying in patients with end-stage renal failure and symptoms of gastroparesis. Clin Pharmacol Ther 2004; 76:281-6. [PMID: 15371988 DOI: 10.1016/j.clpt.2004.04.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Delayed gastric emptying is a common disorder among patients with end-stage renal failure (ESRF). Pyloric relaxation, a major determinant of gastric emptying, is a nitric oxide (NO)-mediated process. NO-induced smooth muscle relaxation is mediated through its second messenger cyclic guanosine monophosphate, which is broken by tissue phosphodiesterases (PDEs). Thus the inhibition of cyclic guanosine monophosphate breakdown by PDE inhibitors can potentiate NO-mediated responses and facilitate pyloric relaxation. In an animal model of diabetes mellitus, treatment with sildenafil (a PDE-5 inhibitor) restored NO-mediated pyloric relaxation and improved gastric emptying. The aim of our study was to examine the hypothesis that sildenafil may improve gastric emptying in patients with ESRF and symptoms of gastric paresis. METHODS We studied 12 patients with ESRF (6 men; age range, 54-80 years; 5 with diabetic nephropathy; 4 +/- 1 years receiving long-term renal replacement therapy) after either placebo or a 25-mg tablet of sildenafil (Viagra; Pfizer Inc). Gastric emptying of a solid meal (one medium-sized fried egg mixed with 37 MBq [1 mCi] technetium Tc 99m phytate plus 1 slice of bread and 150 mL of water at the end of the meal) was assessed 1 hour after dosing by use of a single-headed camera. Images were acquired every 30 seconds for 90 minutes immediately after patients ate. RESULTS The gastric emptying rate was decreased at baseline (after placebo), to 33% +/- 6% (normal, > or =50%). Treatment with sildenafil had no effect on gastric emptying rates after 90 minutes (from 33% +/- 6% after placebo to 30% +/- 6% after sildenafil, P =.9). CONCLUSIONS Sildenafil did not improve gastric emptying in patients with ESRF and gastric paresis. Sildenafil may have opposing effects on gastric peristalsis (causing gastric relaxation) compared with its effects on pyloric relaxation. Studies combining sildenafil with prokinetic drugs are of interest.
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Ferrer JF, Galligan D, Esteban E, Rey V, Murua A, Gutierrez S, Gonzalez L, Thakuri M, Feldman L, Poiesz B, Jonsson C. Hantavirus infection in people inhabiting a highly endemic region of the Gran Chaco territory, Paraguay: association with Trypanosoma cruzi infection, epidemiological features and haematological characteristics. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2003; 97:269-80. [PMID: 12803858 DOI: 10.1179/000349803235001903] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The seroprevalences of anti-hantavirus antibodies were determined in 712 individuals (551 Indians, 140 Mennonites of German ancestry, and 21 Paraguayans of Spanish ancestry) inhabiting a region of western Paraguay in the Gran Chaco territory of South America. The overall seroprevalence of hantavirus infection among the 712 subjects, who were aged 2-80 years, was 42.7% (45.2% in the Indians and 34.2% in the non-Indians). Of the 672 subjects also checked for antibodies against Trypanosoma cruzi, 226 (33.6%) were seropositive for this protozoan parasite. The results of a multivariate regression analysis indicated that, after adjusting for age, sex, setting of residence (rural/urban) and infection with the human T-cell leukaemia/lymphoma virus type II (HTLV-II), a T. cruzi-seropositive individual was 1.73 times more likely to be hantavirus seropositive than a T. cruzi-seronegative individual. Living in a rural setting increased the risk of being hantavirus seropositive 2.17-fold. In both the Indians and non-Indian subpopulations, hantavirus seroprevalence increased with age in both sexes, but only in the non-Indian supopulation was this increase significantly greater in males than in females. Hantavirus seropositivity was significantly associated with thrombocytosis, even after adjusting for the relevant confounders.
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Holstein J, Taright N, Lepage E, Razafimamonjy J, Duboc D, Feldman L, Hittinger L, Lavergne T, Chatellier G. [Quality of medical database to valorize the DRG model by ISA cost indicators]. Rev Epidemiol Sante Publique 2002; 50:593-603. [PMID: 12515929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023] Open
Abstract
BACKGROUND The use of the French version of the DRG model is focused on cost allocation, based on the case-mix system and the use a weight called ISA (Synthetic Index of Activity) for each DRG. However, this administrative database is becoming more and more used by both researchers and health policy makers for health planning and benchmarking. In France, data abstraction and coding of medical records is done by physicians. The objective of this study was to determine the accuracy of a database of the discharge summaries used for DRGs and to compare consequences of inappropriate coding on budget estimation and risk adjustment. METHODS Samples of discharge summaries from six cardiology units were recoded by trained physicians in data abstracting and coding. Comparison between initial and recoded diagnoses (errors on main diagnosis or on comorbidities) used by the DRG system algorithm, and the original and final case-mix were performed. The before and after abstracted data were stratified and compared by principal diagnosis (myocardial infarction or congestive heart failure) and discharge status (dead or alive). MAIN RESULTS Comorbidities were underreported by physicians of cardiology units compared to reabstracted data (mean number of secondary diagnoses per summary: 2.1 vs. 3.6, p<0.001), especially those which had a minimal impact on the DRG classification. In spite of a 15% rate of wrong DRGs, there was no significant difference in the total amount of ISA after data reviewing. Underreporting of comorbidities is more important for medical records of dead patients at discharge but, without significant effect on rate of change in DRG and amount of ISA. CONCLUSION Discharge summaries used in the French DRGs system consistently underestimate the presence of comorbid conditions, which has direct implications for policy-makers comparing performance between hospital units. Both clinical practitioners and policy makers should be aware of this bias when assessing patient's quality of care or performing health planning through discharge summaries.
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Feldman L, Holowaty P, Harvey B, Rannie K, Shortt L, Jamal A. A comparison of the demographic, lifestyle, and sexual behaviour characteristics of virgin and non-virgin adolescents. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2002; 6:197-209. [PMID: 12348566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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71
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Bertinetti C, Milone G, Kohan A, Saporito G, Robinson A, García JJ, Milone J, Cerutti I, Feldman L, Jarchum G, Bordone J, Koziner B. Cell processing practices in Argentina: report of a multicenter survey. Cytotherapy 2002; 3:127-33. [PMID: 12028835 DOI: 10.1080/14653240152584695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Lami N, Laissy JP, Gibeault M, Feldman L, Schouman-Claeys E. [Aortic dissection and aberrant right subclavian artery: CT and MR findings]. JOURNAL DE RADIOLOGIE 2002; 83:653-5. [PMID: 12063430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
A case of aortic dissection extending to an aberrant right subclavian artery seen at CT and MRI is reported. The clinical and imaging patterns of this rare disease are described and compared with those of the literature. Multiplanar views are, in this particular case, very useful for a precise assessment of the involved aberrant artery.
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Horvilleur J, Benamer H, Aubry P, Himbert D, Gaultier C, Feldman L, Steg PG, Juliard JM. [Myocardial revascularization at the acute phase of myocardial infarction in the octogenarian]. ARCHIVES DES MALADIES DU COEUR ET DES VAISSEAUX 2002; 95:143-9. [PMID: 11998327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Elderly patients are at high risk of complications in acute myocardial infarction (AMI). In this population, myocardial reperfusion at the acute phase improves the prognostic. The mortality rate is above 50% in the absence of reperfusion strategy, and decreases at less than 20% in case of such treatment. The thrombolytic use is limited in those patients, coronary angioplasty is taking an important place in this reperfusion therapy, but is not well evaluated in patients older than 80 years. Prospective registry of patients older than 80 years admitted in Hôpital Bichat for acute myocardial infarction within the first 6 hours (n = 92), between 1990 january to 1999 december. Eight patients (10%) received a thrombolytic therapy. Coronary angiogram was achieved in eighty patients (87%). In 58 (63%) patients a coronary angioplasty was performed. The success rate of the coronary angioplasty was 86%. In-hospital mortality rate was 26% (death in 24 patients), 20% in the absence of cardiogenic shock and 62% when this complication was noted. Two patients (2%) were treated by emergent coronary artery bypass surgery. The results comparison between the periods of 1990 to 95 and 1955 to 99 showed, a real trend of decrease mortality rate (28 to 13% in the absence of cardiogenic shock, p = 0.10), an increase of the proportion of patients treated by angioplasty. These results are more and more encouraging. Coronary reperfusion by primary angioplasty in possible in patients older than 80 years with a low rate of complications. Technical progress such as stents and GpIIb/IIIa inhibitors must be evaluated in this population.
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Altclas J, Requejo A, Jaimovich G, Milovic V, Feldman L. Clostridium difficile infection in patients with neutropenia. Clin Infect Dis 2002; 34:723. [PMID: 11823965 DOI: 10.1086/338721] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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75
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Feldman L, Kleiner-Baumgarten A, Maislos M. Large pericardial and pleural effusions associated with familial lymphedema. THE ISRAEL MEDICAL ASSOCIATION JOURNAL : IMAJ 2001; 3:769-70. [PMID: 11692554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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