John P. Connelly

Premature Death in the United States: Years of Life Lost and Health Priorities

This study is concerned with premature mortality in the United States. The authors introduce the concept of potentially productive years of life lost (PPYLL) examine the leading causes of premature death and show how this measure can be used to target prevention programs and health care planning. Particular consideration is given to mortality due to accidents homicide suicide perinatal conditions and firearms as well as to differences in mortality from these causes by race and sex. (ANNOTATION)

Physician Productivity in the Delivery of Ambulatory Care: Some Findings from a Survey of Pediatricians

The delegation of ambulatory patient care tasks by pediatricians is directly related to the types and numbers of health workers per doctor employed in solo and two-man practice settings. Physician productivity rate is directly related to patient care task delegation in settings of all sizes. Larger size settings, especially multispecialty groups, compare unfavorably with those solo and small specialty group settings which employ two or more health workers per physician both in patient care task delegation frequencies and in physician productivity. Physician productivity in smaller practice settings may be a reflection of the community demand for care in areas where medical manpower is in short supply and where the physician, motivated to respond to their demand, employs more ancillary help as a method of discharging his responsibilities. Whether similar factors influence the productivity of physicians in multispecialty groups cannot be answered from the data at hand.

Chronic Serous Otitis Media in Childhood A New Treatment

HAROLD F. SCHUKNECHT, M.D. Professor of Laryngology and Otology, Harvard Medical School; Chief, Department of Otolaryngology, Marssachusetts Eye and Ear Infirmary HERBERT SILVERSTEIN, M.D. Resident in Otolaryngology, Massachusetts Eye and Ear Infirmary R:GER C. LINDEMAN, M.D. Senior Resident in Otolaryngology, Massachusetts Eye and Ear Infirmary; Teaching Fellow in Otolaryngology, Harvard Medical School GEORGE MILLER, M.D. ,

Viral and Drug Hazards in Pregnancy

Should pregnant mothers be immunized against smallpox? Poliomyelitis? What is the incidence of fetal loss or major congenital anomalies if a pregnant woman contracts rubella? Poliomyelitis? Rubeola? Mumps? Or varicella? Is there a relationship to the time of the infection during pregnancy and congenital anomalies? Is there a higher fetal mortality associated with the use of the sulfonylurea drugs for pregnant diabetic mothers? Are progesteroids harmless to the fetus when given to a pregnant woman? Anti-thyroid drugs? Thiazides?

Boric Acid Poisoning in an Infant

THIS report is made to re-emphasize the hazards of using boric acid as an antiseptic and leaving drugs in dangerous areas. It also provides an opportunity for comparison of quantitative observation...

Choanal Atresia Part II: Surgical Management

Unilateral choanal atresia is repaired by simply removing a portion of the posterior nasal septum. The trans- palatal correction of bilateral choanal atresia is explained and illustrated.

Use of Ancillary Personnel in Children's Out-Patient Departments New Trends in Extending Medical Services

The increasing demand and the increasing ability to pay for medical care in the United States is straining available medical facilities in every field.1, 2 Concomitantly, a medical man power shortage has already developed and is clearly going to become worse—all this at a time when the ideal of promoting good health has expanded to the point where new ways are needed for providing more services to a greater number of children.

Lead Poisoning in Children

How does lead usually enter the body and what systems are usually involved? What one symptom above all others should arouse the suspicion of lead poison ing? In follow up of children with lead en cephalopathy, frequently they have a lower I.Q. than their peers. What is the evidence for this? Should the gastro-intestinal tract of chil dren with lead poisoning be cleared of re sidual lead before treatment is instituted? What public health measures are recom mended if a case of lead poisoning is dis covered ?

Case 23-1963

Presentation of Case A nine-year-old boy was referred to the hospital because of pain in the abdomen. The child was the product of a normal pregnancy and delivery and exhibited normal growth and de...

Congenital Valvular Aortic Stenosis

on routine examination in September 1965. His past history is remarkable in that’ the patient’s growth and development has been entirely normal. He was entirely asymptomatic except for the fact his mother noted a propensity for afternoon naps and ability to fall asleep anywhere. On presentation to the hospital in February, his physical examination revealed a pulse of 70, a blood pressure of 100/70 and an entirely healthy looking male whose height and weight was in the 50th percentile. He had the auscultatory findings compatible with valvular aortic stenosis. His chest x-ray showed a prominent left ventricle and his cardiogram showed questionable left ventricular hypertrophy. He underwent right and left t heart cardiac catheterization with left t