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Biomedical subjects

A R Rodriguez

Publications and source records attributed to A R Rodriguez.

At least 37 records · Page 2Linked to original sources
PubMed1990

Directions in contracting for psychiatric services managed care firms.

An "irresistible force" has surely emerged in American healthcare; its name is Managed Care. It's a force embarked on an economic holy war, fired by the passions and anxieties of a competitive market economy that now seems uncommitted to spending more on health services. Its army is made up of an ununited confederation of utilization review organizations, health maintenance organizations (HMOs), preferred provider organizations (PPOs), exclusive provider organizations (EPOs), and a number of other entities that have been enlisted to restrain++ the medical-industrial complex. In their march across America, they have frequently assailed the shibboleths and established structures of treatment systems, especially psychiatry and often fought with one another. While some are mercenary forces, others appear as peoples' armies, committed to preserving and strengthening the healthcare system they are transforming. As it encounters the inhabitants of this domain, Managed Care becomes both their master and their slave. As with any occupying force, it must win their hearts and minds over to the new way of doing things. The winning-over process is not going well now. Many patients and providers are angry at the inefficiencies, unproven effectiveness, administrative burdens, affronts to traditions, and threats to quality sometimes posed by Managed Care. This collective unrest has resulted in both a mounting resistance to the problems emanating from managed care changes in the healthcare system and a call to check its unrestrained incursions into professional practice through regulation. The growing tension between what seems an irresistible force and an immovable object can be viewed as part of the natural evolution of all change, particularly in a free market or in a society with requisite checks and balances.(ABSTRACT TRUNCATED AT 250 WORDS)

Contract Services↗
PubMed1989

Evolutions in utilization and quality management. A crisis for psychiatric services?

Psychiatric services have evolved into another time of crisis. Following a 30-year period of growth in psychiatric science, services, and benefits, payors are now retracting and restructuring funding for services they believe are no longer affordable. A number of utilization and quality management initiatives have been instituted to reduce avoidable outlays--some promising and many with deleterious consequences. The precise directions that future competitive and regulatory influences will take in affecting availability and quality of psychiatric services remain unclear. Managed mental health services now appear to be gaining favor with payors because of their use of professional case management resources. Other cost control initiatives do not appear so favorable to psychiatric services.

Cost Control↗
PubMed1989

Psychiatric care in the military community: family and military stressors.

Unique challenges confront members of the military community. Military families must deal with prolonged absences by active-duty spouses and parents, frequent moves, isolation from the civilian community, and the potential loss of a family member in war or preparation for war. The active-duty service member faces the dangers of combat, including the threat presented by chemical and biological warfare, and the increasingly sophisticated technical demands of modern military equipment. The authors review psychiatric stressors that affect service members and their families and highlight aspects of military psychiatry that have implications for the practice of community psychiatry.

Adult↗
PubMed1988

Dot immunobinding assay compared with enzyme-linked immunosorbent assay for rapid and specific detection of retrovirus antibody induced by human or simian acquired immunodeficiency syndrome.

A rapid, specific, and sensitive modification of the dot immunobinding assay was compared with the standard enzyme immunoassay as a screening procedure for the detection of antibody in human or simian acquired immunodeficiency syndrome. Comparative testing with the available enzyme immunoassay procedures, either in commercial kit form or as provided by diagnostic laboratories, indicated excellent correlation. Ease of operation and cost are key features of the dot immunobinding assay procedure.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Current and future directions in reimbursement for psychiatric services.

Psychiatric services are currently facing one of the true crises in a historical development that began in the attics, asylums, and streets. The cause for this crisis in reimbursement is commonly attributed to what many believe is a temporary dip in the economy that has led third-party payers to overreact unnecessarily and unreasonably by limiting benefits and payouts. Such persons believe unwarranted anxieties about the economy and reimbursement for services will lessen with consumer demands, reassurances by health-care providers that the care is quality and cost-effective, and the expected stabilization in a destabilized economy. Others see a much more uncertain and lengthy course of events.

Community Mental Health Services↗
PubMed1983

Infection of baboons ("Papio cynocephalus") with rotavirus (SA11).

A recent survey of nonhuman primate sera indicated that antibody to a rotavirus (SA11) was prevalent among a wide spectrum of animals. Both New and Old World species were found with antibody, many with surprisingly high titers (1:320). Whether or not infection per se was due to SA11 or an antigenically closely related agent could not be determined by that study; however, it is apparent from this study as well as from a survey of the literature that natural as well as experimental infection of nonhuman primates occurs. Recognizing that there is a need for an animal model for the study of viruses associated with human diarrhea, a preliminary investigation attempting to ascertain the susceptibility of the baboon (Papio cynocephalus) to a rotavirus was undertaken. Inoculation of four newborn baboons with SA11 resulted in diarrhea within 24 to 48 hours in all animals. One animal died 10 days postinoculation following severe diarrhea and dehydration. Virus was isolated as well as seen by electron microscopy in the stools of all four animals.

Animals↗
PubMed1981

Erythroleukemia with high fetal hemoglobin after therapy for ovarian carcinoma.

The authors report the association of erythroleukemia (FAB M6) and fetal hemoglobin (HbF) level of at least 65% after therapy for ovarian carcinoma. The patient's erythrocytes had many signs of reversion to fetal-like erythropoiesis including: elevated HbF with a fetal G gamma/A gamma (gly/ala) of 3/1, low hemoglobin A2 (HbA2), macrocytosis, and increased i antigen. These data and data from other case reports suggest that elevation of HbF to greater than 25% with reversion to fetal-like erythropoiesis is useful in differentiating erythroleukemia from other preleukemic disorders.

Adenocarcinoma↗
PubMed1980

Compensated thrombocytolytic state.

A patient with idiopathic thrombocytopenic purpura (ITP), who was in a compensated thrombocytolytic state, remained asymptomatic, with normal platelet counts most of the time, but at various intervals had thrombocytopenia and bleeding disorder. Only when the platelet life-span normalized did the thrombocytopenia and bleeding tendency disappear. Patients with ITP who subsequently go into remission may still be at risk for bleeding diathesis if they are in a compensated thrombocytolytic state rather than in true remission.

Adolescent↗