{"title":"The problem of antibiotic resistance.","authors":"J O Hendley","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77458,"journal":{"name":"Virginia medical quarterly : VMQ","volume":"124 2","pages":"96-8"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20050719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Virginia Health Care Foundation. Meeting the challenge.","authors":"L B Middleditch","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77458,"journal":{"name":"Virginia medical quarterly : VMQ","volume":"124 3","pages":"166"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20171389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Deferred demise.","authors":"J L McClenahan","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77458,"journal":{"name":"Virginia medical quarterly : VMQ","volume":"124 4","pages":"228-9"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20270806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D Byrne, W D Byrne, P D Kiernan, W Harshaw, J Bryne, T Fulcher, L Stanton, S Goodman, M Karnaze
Limb ischemia, both acute and chronic, presents a risk to life and limb with mortality rates from 3% to 37% and amputation rates of the same range. Our experience with urokinase thrombolysis as the initial therapy for acute and non-acute ischemic extremities over 57 consecutive cases of native arterial occlusion by either thrombus or embolus has resulted in no mortality and only 3.5% requiring amputation (2 of 57). In 74% of cases initial thrombolytic therapy was followed by either balloon angioplasty (35 patients) or surgery (7 patients) to relieve the underlying cause of obstruction (i.e., stenosis, occlusion or aneurysm). Thrombolysis alone was sufficient and effective treatment in the remaining 26% (15 patients).
{"title":"Urokinase thrombolysis as initial therapy for acute and non-acute ischemic extremities.","authors":"D Byrne, W D Byrne, P D Kiernan, W Harshaw, J Bryne, T Fulcher, L Stanton, S Goodman, M Karnaze","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Limb ischemia, both acute and chronic, presents a risk to life and limb with mortality rates from 3% to 37% and amputation rates of the same range. Our experience with urokinase thrombolysis as the initial therapy for acute and non-acute ischemic extremities over 57 consecutive cases of native arterial occlusion by either thrombus or embolus has resulted in no mortality and only 3.5% requiring amputation (2 of 57). In 74% of cases initial thrombolytic therapy was followed by either balloon angioplasty (35 patients) or surgery (7 patients) to relieve the underlying cause of obstruction (i.e., stenosis, occlusion or aneurysm). Thrombolysis alone was sufficient and effective treatment in the remaining 26% (15 patients).</p>","PeriodicalId":77458,"journal":{"name":"Virginia medical quarterly : VMQ","volume":"124 1","pages":"41-4"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19971071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The health care provider's duty to report child abuse in Virginia.","authors":"J C Fuhr","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77458,"journal":{"name":"Virginia medical quarterly : VMQ","volume":"124 2","pages":"78-80"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20050717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This adult care program epitomizes the values most recently espoused in debates on health care reform. Public/private partnerships are strengthened by emphasizing unique contributions of all resources of health care: private physicians, private pharmacists, local government, local health departments, community hospitals, business leaders, volunteer free clinics and a private medical school. The success of this program is also contingent on a high degree of patient responsibility. Patients must demonstrate a willingness to share in their care through improved capabilities of self-management. They must share in the cost of their medications, and if there is a propensity to abuse the services (unnecessary ER usage, doctor hopping), they run the risk of termination of services. Expectations are high and patients are being taught how to meet them. The next step is an intensive evaluation of outcome measures. It is felt that this evaluation must extend over a minimum of 5 years in order to be valid and demonstrate trends. We are currently pursuing funding for such an evaluation.
{"title":"Community partnerships work.","authors":"S T Selden, N M Welch","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This adult care program epitomizes the values most recently espoused in debates on health care reform. Public/private partnerships are strengthened by emphasizing unique contributions of all resources of health care: private physicians, private pharmacists, local government, local health departments, community hospitals, business leaders, volunteer free clinics and a private medical school. The success of this program is also contingent on a high degree of patient responsibility. Patients must demonstrate a willingness to share in their care through improved capabilities of self-management. They must share in the cost of their medications, and if there is a propensity to abuse the services (unnecessary ER usage, doctor hopping), they run the risk of termination of services. Expectations are high and patients are being taught how to meet them. The next step is an intensive evaluation of outcome measures. It is felt that this evaluation must extend over a minimum of 5 years in order to be valid and demonstrate trends. We are currently pursuing funding for such an evaluation.</p>","PeriodicalId":77458,"journal":{"name":"Virginia medical quarterly : VMQ","volume":"124 3","pages":"147-8"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20171384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Improving access to health care for all Virginians. Trigon Blue Cross Blue Shield.","authors":"R Grinnan","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77458,"journal":{"name":"Virginia medical quarterly : VMQ","volume":"124 3","pages":"160-1"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20171387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Two chairs and beyond: protecting our patients and our medical profession.","authors":"P Wootton","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77458,"journal":{"name":"Virginia medical quarterly : VMQ","volume":"124 3","pages":"170-3"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20171391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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