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  • Book
    Matt Richtel.
    Summary: The immune system is a guardian vigilantly fighting illness, healing wounds, maintaining order and balance, and keeping us alive. Richtel interweaves the stories of four people: a terminal cancer patient who rises from the grave; a medical marvel who defies HIV; two women with autoimmunity who discover their own bodies have turned against them. As he leads us from the Black Plague to twentieth-century breakthroughs in vaccination and antibiotics, to the cutting-edge laboratories that are revolutionizing immunology, his four patients each illuminates an essential facet of our "elegant defense."--Adapted from jacket

    Contents:
    Part I. Lives in the balance. The ties that bind
    Jason
    Bob
    Linda and Merredith
    Part II. The immune system and the festival of life. The bird, dog, starfish, and magic bullet
    The festival
    Festival crashers
    The mystery organ
    The B-word
    T cells and B cells
    Vaccines
    The infinity machine
    Transplant
    The immune system's fingerprint
    Inflammation
    Fever
    Flash Gordon
    The harmonious way
    Three wise men and a monoclonal antibody
    A second immune system
    Part III. Bob. Sex machine
    GRID
    The phone call
    CD4 and CD8
    Magic
    The prime
    Part IV. Linda and Merredith. Linda
    The wolf
    Invisible evidence
    Best of both worlds (sort of)
    Merredith
    Should you pick your nose?
    Microbiome
    Stress
    Sleep
    Part V. Jason. A word about cancer
    Laughter and tears
    The Lazarus mouse
    Wound healing
    Programmed death
    The breakthrough
    Jason races time
    Shepherd of death
    Trials, personal and clinical
    The other shoe
    Part VI. Homecoming. Bob
    Linda
    Jan and Ron
    Jason down the white tunnel
    Jason rises
    Apollo 11
    Home
    Jason's way
    The meanings of life
    The meaning of Jason.
    Digital Access 2019
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  • Article
    Gertman PM, Egdahl RE.
    Ann Surg. 1978 Oct;188(4):544-51.
    Utilization review programs have existed on a national basis for over a decade, but relatively little is known about the patients who are scrutinized and what actions are taken to correct unnecessary use. In the fall of 1976, 44 of the 122 Massachusetts hospitals participated in a two-week in depth study of their utilization review activities. Over 22,000 admission and extended stay reviews were performed during this time period, and of these, 2,120 patients' continued stays in the hospital were questioned. In five admission review cases and 79 extended stay review cases, the UR committee formally terminated continued health insurance benefits, and in 12 admission reviews and 74 extended stay reviews, questioning by the UR committee led the attending physician to discharge the patient earlier than would have otherwise occurred. Ninety-four percent of the terminations occurred in Medicare patients and the median age of these patients exceeded 80 years. For medical patients, a disproportionate share of all those cases questioned and of those terminated occurred in chronic illness categories, such as cancer, heart failure, and organic brain syndromes. A higher than expected percentage of surgical cases questioned by the UR committee were in neurosurgical, cardiovascular and orthopedic procedure groups. The frequency with which UR committees identified and acted upon cases suggests that effective self-policing is occurring. A large portion of the utilization problem, however, may be related to the unavailability of appropriate sub-acute care for patients with chronic medical illness or surgical procedures which require long postoperative rehabilitation and recuperation.
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