Faculty Bibliography

The decision, announced last week, comes after Blue Cross-Blue Shield said it had been sued by more than a dozen people and consumer groups seeking the experimental therapy, which costs up to $125,000 per patient. Blue Cross-Blue Shield lost more than half the suits and had to pay for the treatment. In the past, the costs for experimental procedures have been borne largely by the government, research-oriented hospitals, private foundations and patients. Insurance companies have refused to pay the costs of experimental care, although many have paid indirect costs such as for hospital stays when infections and other serious complications result from experimental procedures and therapies. Paying for experimental treatments ''is a role health insurers have never seen themselves playing before,' said Cheryl van Tilburg, a spokeswoman for Blue Cross-Blue Shield. She said the decision reflected an evolution in Blue Cross-Blue Shield's process of evaluating new technologies

Experts in high blood pressure say that millions of Americans are being overtreated for the mildest form of high blood pressure, and they blame a government health strategy that they call wasteful, expensive and possibly dangerous

The authors of the report, headed by Dr. Robert Berg of Strong Memorial Hospital in Rochester, N.Y., and Dr. Joseph Cassells of the Institute of Medicine, studied 13 risk factors such as misuse of medications, falls and social isolation, which affect large numbers of elderly people and for which remedial interventions are available. o Osteoporosis, loss of bone substance. Research is needed to improve fracture rehabilitation programs and to evaluate estrogen replacement therapy, calcium supplements and exercise. o Falls. A hip fracture is the most devastating hazard of a fall. About 50 percent of elderly people who were able to walk before suffering a hip fracture were unable to walk independently afterward

People 65 years and older make up the fastest-growing segment of the American population. Although benefits of health promotion among the elderly have been documented, the academy urged further research because of the scarcity of data related specifically to avoiding disability in the elderly. 13 Risk Factors 'Physicians are not as proficient as they might be in optimal prescribing for the elderly,' the report said. To improve such care, the academy urged doctors to periodically review all drugs taken by elderly patients. In prescribing such drugs, the academy said doctors should consider lowering the amount according to the age of the patient and the body makeup. Falls. Falls are a major cause of death and disability among the elderly. A hip fracture is the most devastating hazard of a fall. About 50 percent of elderly people who were able to walk before suffering a hip fracture were unable to walk independently afterward. The report called for research to determine ways to prevent fractures and to develop energy-absorbing surfaces and protective clothing for elderly people who are at high risk of suffering fractures

People 65 years and older are now the fastest-growing segment of the American population. Although benefits of health promotion among the elderly have been documented, the academy urged further research because of the scarcity of data related specifically to avoiding disability in the elderly. 13 RISK FACTORS -- Research is needed to determine ways to prevent fractures and to develop energy-absorbing surfaces and protective clothing for elderly people who are at high risk of suffering fractures. Falls are a major cause of death and disability among the elderly. -- Doctors should periodically assess the diet and nutritional status of elderly patients. Research is also needed to assess the minimal daily nutrient and energy requirements of the elderly

Scabies is caused by a mite, Sarcoptes scabiei, that is one-sixtieth of an inch long and is responsible for an epidemic in many countries. The mite is usually transmitted directly from one person to another from contact as intimate as sexual intercourse. The mite can also spread through contaminated clothing and bedding, which is possibly how the woman got it in the hospital in New York City. The scabies mite was first described in Spain in the 12th century, but doctors failed to link it with the disease until 1654. Medical historians say that the 17th century finding gave scabies the distinction of being the first human disease with a known cause. The scabies mite causes epidemics that generally strike throughout the world and last about 15 years. Then a 15-year gap follows before the cycle begins again. The latest scabies epidemic began in the late 1960's. But, for unknown reasons, the current one has not abated as predicted

Dr. Bruce C. Vladeck, president of the United Hospital Fund in New York City, a nonprofit research and philanthropic organization whose goal is to improve health care, said it was ''reassuring'' to find that hospital costs could be lowered without sacrificing quality. The study provided ''a more powerful methodology to pull together the bits and pieces of evidence'' that the cost-containment measures had not harmed the overall quality of care, Dr. Vladeck said in an interview. Patients who were discharged ''quicker and sicker'' in medically unstable conditions were more likely to die within 90 days than were those who went home in medically stable condition. Among the problems contributing to the medical instability of such patients were rapid heart beats, fast breathing rates and urinary and fecal incontinence, problems that were not present at the time of admission. The senior author, Dr. Robert H. Brook, said the nature of the study did not allow his team to determine ''how many deaths could have been prevented if patients were kept in the hospital longer or if there had been better plans for their care at home.''

A comprehensive national study has found that measures to limit federal health care costs have not reduced the quality of hospital care for the elderly, as experts had feared

Measures imposed in 1983 to shorten hospital stays for people aged 65 and older who are insured by Medicare have not disrupted a trend of improved chances for their survival, said the study, which is being reported today in The Journal of the American Medical Association. Medicare now reimburses hospitals at a fixed amount for specific categories of illness called diagnosis-related groups, a system that the medical association has opposed. Previously, the payments were simply based on what the hospital charged. The study of 14,000 Medicare patients found a 1.1 percent drop in death rates for the five most serious diseases covered by Medicare in the critical 30-day period after admission, when most deaths occur. The drop was from 16.5 percent to 15.7 percent

Two more patients of a Florida dentist who apparently transmitted the AIDS virus to a patient have also been found to be infected, Florida health officials said Friday. The new AIDS infections were found two weeks after a newspaper in Palm Beach and nearby Stuart printed a letter from a dentist, Dr. David Acer, who died of AIDS on Sept. 3 at the age of 40. Last month, the Centers for Disease Control in Atlanta reported that it appeared the dentist had infected a patient with the AIDS virus during a dental procedure