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H L Lipton

Publications and source records attributed to H L Lipton.

116 records · Page 7Linked to original sources
PubMed1971

Dominant olivopontocerebellar atrophy with dementia and extrapyramidal signs: report of a family through three generations.

The olivopontocerebellar atrophies (OPCA) can be divided into five disease entities. One of these, dominant OPCA with dementia and extrapyramidal signs, is better defined by the family we studied. Five persons in three generations were affected by progressive ataxia, tremor, rigidity and mental deterioration, beginning in their twenties and thirties. Neurologic examination showed mental deterioration, high-pitched dysarthric voice, gaze paresis, rigidity and coarse tremor. This disease differs from other dominant and recessive OPCAs clinically because of the prominent mental deterioration and extrapyramidal signs, and pathologically because of cortical, lentiform and substantia nigra neuronal loss.

Adolescent↗
PubMedDate not supplied

Social, behavioral, and practical factors affecting antibiotic use worldwide: report of Task Force 4.

In addressing its charge from the General Chairperson of this study, Task Force 4 decided to direct special attention to antibiotic use in developing nations because of the critical importance of the disease burden of bacterial infections in these regions of the world. The task force recognized the impact of respiratory and diarrheal diseases on morbidity and mortality among young children in developing nations. Another major concern was the potential for global spread of resistant strains. Emergence and spread of antibiotic-resistant bacteria is augmented in settings in which treatment may be inadequate because of socioeconomic constraints and where there is crowding and poor sanitation. Much of the information concerning the factors that govern antibiotic use in these countries is anecdotal. No two countries are identical in their use of antimicrobial agents, and patterns of use may differ greatly in regions within the same country. Efforts to improve the usage of antibiotics in developing countries must take into consideration the perception of health and disease of the populations, the availability of antibiotics, and the characteristics of the established systems of medical care.

Acute Disease↗
PubMedDate not supplied

Managing the pharmacy benefit in Medicare HMOs: what do we really know?

An estimated five million Medicare beneficiaries received outpatient prescription drug benefits through Medicare + Choice in 1999. However, little is known about how these benefits are managed or about their effects on costs and quality of care. This exploratory study applies a case-study methodology to four large Medicare health maintenance organizations (HMOs) to identify and assess drug-use management strategies. It also poses a number of important issues for consideration by both policymakers and health services researchers, as the debate rages on over the creation and administration of a Medicare outpatient drug benefit, especially in light of the predilection for the use of private pharmacy benefit managers (PBMs) in many of these proposals.

Ambulatory Care↗
PubMedDate not supplied

Assessing the appropriateness of physician prescribing for geriatric outpatients. Development and testing of an instrument.

OBJECTIVE: In a randomized, controlled trial evaluating the impact of clinical pharmacists' consultations on physicians' prescribing decisions, a seven-member physician/pharmacist panel developed an instrument to characterize and quantify the full range of drug-prescribing problems. The instrument was tested for validity and reliability. SAMPLE: The instrument was applied in reviewing prescribing for 236 geriatric outpatients. METHODS: To ensure internal validity of the instrument, five panel meetings were devoted to reaching a consensus on procedures, categories, criteria, and scoring. Each case was evaluated independently by two reviewers and each drug in the regimen was evaluated for drug-drug interactions, dosage, schedule, allergic reactions, therapeutic duplication, use of drugs without established diagnoses, and inappropriate drugs for the patient's clinical conditions; discrepancies were adjudicated by the panel chairperson. Self-reported adverse effects of 60 study patients who were interviewed, and hospital readmissions of all study patients were used to test the external validity of the instrument. RESULTS: Inter-rater reliability improved over time, reaching a high of 97.1 percent after six months. A positive association was determined between the prescribing scores and the number of reported adverse effects (rho = 0.28, p = 0.02). Although the number of patients with drug-related hospital readmissions was too few to establish a significant association between the prescribing scores and readmissions, the findings were expected. CONCLUSIONS: Given current requirements for drug utilization reviews in hospitals, health maintenance organizations, and Medicaid programs, this instrument may prove to be very useful.

Aged↗