Patterns of eye care use and expenditures among children with diagnosed eye conditions.

PURPOSE: Little is known about use and expenditure patterns of children's eye-care services and about possible disparities in care among children. This report describes the use and expenditure patterns of eye care and non-eye care services for children under 18 years old in the United States. METHODS: Levels of use and expenditure were estimated using self-reported information from the nationally representative Medical Expenditure Panel Surveys (1996-2001) for 48,304 subjects under 18 years old from randomly selected households in the United States. Means presented for children with and without diagnosed eye conditions were adjusted for child and family characteristics using generalized linear models. RESULTS: Children with diagnosed eye conditions had higher levels of use and expenditure than children without diagnosed conditions. Families of children with diagnosed eye conditions incurred higher out-of-pocket expenditures. Black children and children living below 400% of the federal poverty level had lower levels of use and expenditure, indicating that they received fewer and less intensive services. CONCLUSIONS: Children with diagnosed eye conditions experienced higher overall use of health care. Some groups of children appear to be underserved. Estimates of use and expenditure patterns, stratified by socioeconomic factors, will be needed to plan for future delivery of children's eye and vision care services and to assess progress toward Healthy People 2010 goals.     

Upper and midureteral calculi: percutaneous extraction with an occlusion balloon catheter

In 44 patients with one or more calculi in the upper two-thirds of the ureter, single-stage percutaneous nephrolithotomy was performed through a middle or upper calyceal nephrostomy after cystoscopic placement of an occlusion balloon catheter distal to the calculus; in 42, the procedure was successful. The occlusion balloon catheter permitted retrograde opacification of all systems for enhanced renal puncture. In the last 30 patients an attempt was made either to push the calculus upward mechanically or to flush it upward into the renal pelvis with carbon dioxide or dilute contrast material. This was successful in 24 of these patients. Prior overnight occlusion of the ureter by means of ureteral dilatation further facilitates dislodgment of the calculus, which was successful in 12 of 13 patients.     

Detection of Platelet Antibody Using Rosette Technique with Anti-IgG Antibody-Coated Polyacrylamide Gel

Abstract. Paraformaldehyde-fixed platelets from normal donors were used for detection of antibody to platelet by in vitro sensitization (indirect method) utilizing rabbit anti-human IgG heavy chain specific antibody-coated polyacrylamide gels (Immunobeads). The sensitized platelets formed rosettes with Immunobeads and the positive rosette count was over 30%, while control showed less than 8% when normal sera were used. This method was also applicable for detecting antibody-sensitized platelets in vivo (direct method) in patients with autoimmune thrombocytopenia. This method is simple, rapid and reproducible for clinical use. Direct and indirect immunofluorescent antibody tests and a blocking test with anti-human serum also supported the results of Immunobead rosetting technique.