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Biomedical subjects

H R Spiro

Publications and source records attributed to H R Spiro.

At least 19 recordsLinked to original sources
PubMed1982

Reforming the state hospital in a unified care system.

Without reform and linkage to unified care system, state hospitals may become overcrowded and underfunded during the coming decades. The author delineates ten epidemiologic, demographic, and systemic factors that point to increases in episodes of chronic illness which are most likely to end in state hospitalization. General hospitals, nursing homes, and community-based programs are compared as possible substitutes for state hospitals. Finally the author recommends twelve internal reforms to strengthen the state hospital system as an integral part of the chronic care network.

Community Mental Health Services↗
PubMed1977

Correlation between antiinflammatory and antiproteolytic properties of substituted benzylidenes.

Twelve substituted benzylidenes were evaluated for antiinflammatory activity against carrageenin-induced edema in rats. The protection afforded by these compounds at a dose of 100 mg/kg, i.p., ranged from 30 to 60%. Sodium salicylate (100 mg/kg, i.p.), used as a reference drug, exhibited a 30% antiinflammatory activity under similar experimental conditions. The in vitro effects of substituted benzylidenes were also investigated on the activity of trypsin during hydrolysis of bovine serum albumin, serum glutamate oxaloacetate transaminase, serum glutamate pyruvate transaminase, and endogenous lipid peroxide formation by liver homogenates. These results have provided some correlation between antiinflammatory and antiproteolytic properties of substituted benzylidenes.

Animals↗
PubMed1977

Anticonvulsant activity and selective inhibition of NAD-dependent oxidations by 1,4-disubstituted piperazines.

Several 1-(1-aryl-3-ethylthiocarbamido)-4-(arylaminothiocarbonyl)piperazines were synthesized, characterized by their sharp melting points and elemental analyses and evaluated for anticonvulsant activity. All disubstituted piperazines at a dose of 100 mg/kg i.p. provided 10-90% protection against pentylenetetrazol-induced convulsions in mice. These disubstituted piperazines selectively inhibited the in vitro oxidation of nicotinamide adenine dinucleotide (NAD)-dependent oxidation of pyruvate, alpha-ketoglutarate, beta-hydroxybutyrate and NADH by rat brain homogenates. The NAD-independent oxidation of succinate remained unaltered. The anticonvulsant activity possessed by disubstituted piperazines was unrelated with their ability to selectively inhibit respiratory activity of rat brain homogenates. Amongst 1-(substituted benzyl)-4-(substituted benzoyl)piperazines exhibiting central nervous system (1, 2) depressant activity it was found that 1-(2-chlorobenzyl)-4-(2-chlorobenzoyl)piperazine possessed maximum activity (2). The ability of piperazine carbamides (3) and piperazinothiocarbamides to possess anticonvulsant activity (4) prompted synthesis of 1-(1-aryl-3-ethylthiocarbamido)-4-(arylaminothiocarbonyl)piperazines and evaluation of their anticonvulsant activity. The effects of these disubstituted piperazines were also investigated on the in vitro respiratory activity of rat brain homogenates in an attempt to elucidate the biochemical mechanism of action for their anticonvulsant activity.

Animals↗
PubMed1975

Cost-financed mental health facility. I. Clinical care pattern in a labor union program.

Cost-financed mental health facilities create opportunities for new patterns of mental health service analogous to community mental health centers in some ways and to HMOs in others. This paper describes the first facility based on such financing. The concept of cost-financed mental health practice is introduced and defined as including a multidisciplinary team serving a defined population of enrollees through prepaid or prebudgeted financing. The financing may be capitation based or generated through an agreed-upon budget for predefined services. Ordinary fee-for-service insurance creates purchasing power but not care system. Cost financing can create service mechanisms. The paper describes the clinical system made possible through such financing. The direct patient service systems for the United Auto Workers at the Johns Hopkins Hospital funded through cost financing included an early case-finding program, intake and evaluations specially designed for blue-collar workers, a full range of continuous treatment modalities, and programs in chronic care and rehabilitation. Programs in prevention, consultation, and education were also included. Conern is described. The authors conclude that this clinical form has the potential to offer both the advantages of the community mental health center and of the private practice system.

Attitude to Health↗
PubMed1975

Cost-financed mental health facility. II. Utilization profile of a labor union program.

Specific data are presened concerning the utilization profile of a cost-financed mental health facility. The utilization is enhanced by a mental health education campaign, but total utilization remains within manageable limits (13 per 1000). The visit rate is 8.5 units per patient and remains well within the plan's dollar limits. Comparison between utilizers and the population from which they are drawn shows disproportionate numbers of males in contrast to other outpatient insurance studies. This may be a unique feature of work-related programs. "Acting out" disorders are more common among these workers than in other psychiatric programs in the same geographic area.

Acting Out↗
PubMed1975

Cost-financed mental health facility. III. Economic issues and implications for future patterns of health care.

Data are presened concerning the economics of a cost-financed mental health facility and a lobor union insurance program. The total cost per insured enrolle for all mental health services did not exceed $5.41 per year. The cost per treated patient per year remained under $490. These data strongly support the feasibility of including mental health benefits in national health insurance. Costs are then compared between fee-for-service insurance and cost financing. Average costs per treated patient in the cost-financed facility were $302 over a 4-year period. Similar computations under fee-for services financing showed costs of $824. The difference reflects much greater use of hospitalizations in the fee-for-service system. These data and the data from the preceding two papers on the clinical and utilization partterns of cost-financed facilites suggest that these facilities are practical clinical forms. Implications for national health insurance, HMO legislation, and community mental health centers are explored.

Community Mental Health Services↗