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Biomedical subjects

D A Rubenstein

Publications and source records attributed to D A Rubenstein.

9 recordsLinked to original sources
PubMed1999

Academic medical centers: a prescription for success in an era of managed care and capitation.

Academic medical centers (AMCs) have traditionally symbolized technological advancements and specialization in patient care. AMCs are defined as institutions that include at a minimum a hospital and associated clinics and a medical education role. Today, these institutions face a transition to managed care and radical changes in the financing of health care. These issues are not unique to the private sector health care industry. Military AMCs also must respond to many of the same changes. Their survival may rest on the ability to recognize that they can no longer ignore trends favoring lower costs, less specialization, and more primary care. This paper describes actions being taken at AMCs throughout the country to pursue innovative ways of providing accessible, high-quality, and affordable health care while maintaining quality training programs. Besides examining changes currently taking place within the academic medical industry, recommendations are offered for new initiatives.

Academic Medical Centers↗
PubMed1993

Structure determination of antiviral compound SCH 38057 complexed with human rhinovirus 14.

SCH 38057 (1-[6-(2-chloro-4-methoxyphenoxy)-hexyl]imidazole hydrochloride) is a new, water-soluble antiviral compound that has inhibitory activities against a number of picornavirus infections. The structure of the human rhinovirus 14 (HRV14) complex with SCH 38057 was determined at 3.0 A resolution by single-crystal diffraction techniques using synchrotron X-radiation. SCH 38057 was found to bind at the innermost end of the hydrophobic pocket within the capsid protein VP1, a locus of binding of other antipicornaviral agents; however, the complex differs from previously reported complexes in two important aspects. It leaves a considerable volume near the entrance to the binding pocket unoccupied. In addition, the alterations in the conformation of the VP1 polypeptide are similar to, but more extensive than those observed in HRV14 complexes with other antiviral agents. Although only 9 amino acids of VP1 have close contacts with the SCH 38057 molecule (within 3.6 A), at least 36 amino acids from both VP1 and VP3 have significantly altered conformations (C alpha movement > 0.5 A versus native). The structures of complexes of HRV14 with SCH 38057 and WIN 51711 are compared. Aromatic ring interactions between picornavirus capsid residues and antiviral inhibitors are proposed to be among the major determinants for positioning of these compounds.

Antiviral Agents↗
PubMed1990

The physician's role in an aging America: taking the team approach to eldercare.

With the advent of an aging patient population, the healthcare community is sharpening its focus on geriatric medicine and on how current resources will fare under the demands of an aging America. One approach to effective eldercare is that of a "team" of physician and nonphysician providers, cooperating to meet the multifaceted needs of the elderly patient. As the traditional primary care provider, the physician is a natural choice for the role of team leader.

Aged↗
PubMed1990

A model for marketing in the military health care setting.

Current literature demonstrates a lack of discussion relative to the marketing of military health care. This is unfortunate, as marketing should be approached as a valuable tool for showing the quality of work provided by a medical facility and for improving consumer relations. The benefit is a public better educated about the military health services system and more attuned to the rationale behind various types of access and availability decisions. This article provides a marketing process usable by military hospitals and health care organizations.

Hospitals, Military↗
PubMed1983

Canine biliary carcinoma: epidemiological comparisons with man.

A retrospective study of abstracted data representing 1.1 million hospital examinations of dogs at veterinary university teaching facilities identified 77 with bile duct carcinoma. Using the hospital population, based on patient years at risk, as the expected frequency of particular zoographic characteristics, there was a suggestion of a familial (breed) predisposition in Labrador retrievers and limited evidence of a sex differential. Because mongrel dogs displayed about the same frequency of bile duct cancer as all breeds combined, other causal factors, besides genetics, are implied. A possible association was detected between canine cholangiocarcinoma and host infection by canine hookworms and/or whipworms. Human infection from hookworms (Necator americanus) and whipworms (Trichuris trichiura) is common in the southern rural areas of the U.S.A. (e.g. Appalachia), and tropical and sub-tropical countries of Africa, Central and South America, where there have been unexplained high rates reported for human biliary cancer. It is possible that the presence of these blood-letting nematodes, like a number of other parasites (ascarids, flukes and protozoa), may be related to the occurrence of human cholangiocarcinoma.

Animals↗