Biomedical subjects

M Penner

Publications and source records attributed to M Penner.

24 records · Page 2Linked to original sources

PubMed1986

[Partial remission of fulminant thrombotic-thrombopenic purpura (Moschcowitz syndrome) by infusion of fresh plasma].

In addition to the typical manifestations of thrombotic-thrombocytopenic purpura like thrombocytopenia, haemolysis, fever, coma and renal failure, signs of a beginning DIC could be seen in a patient after abdominal surgery. Haemostatic, cardiovascular and respiratory data are presented. Pulmonary angiography by using a Swan-Ganz-catheter revealed multiple filling defects reversible with therapy. Treatment with fresh whole blood aggravated thrombocytopenia. Daily infusions of fresh frozen plasma combined with heparinisation and antithrombin III because of DIC, induced haematologic remission. Renal failure and cerebral symptoms could not be influenced. Diagnosis, monitoring and therapy are discussed.

Appendectomy↗

PubMed1984

Elastin accumulation in the chick aorta: effect of 6-hydroxydopamine and deoxycorticosterone acetate.

The net accumulation of aorta elastin in the chick was estimated from day 1 to 14, post-hatching. Increased elastin accumulation was coincident with the elevation in blood pressure observed for this period. Further deoxycorticosterone acetate plus dietary NaCl also caused stimulation of protein synthesis in aorta. In contrast, aorta protein synthesis and net elastin accumulation appeared to be decreased in chicks given 6-hydroxydopamine.

Animals↗

PubMed1980

Asparagine metabolism in chicks and rats.

Asparaginase and asparagine synthetase specific activity (enzyme units/mg protein) was determined in chicks and rats fed various protein diets. The specific activity of asparaginase was twofold higher in the kidney compared to the liver of chicks fed a 25% protein control diet, whereas the specific activity of asparaginase was eightfold greater in the liver compared to kidney tissue of rats fed the 25% protein control diet. The asparaginase specific activity in the chick liver, chick kidney, and rat liver were all significantly increased when animals were fed the 75% protein diet. Asparaginase specific activity increased significantly in rat and chick kidneys when the animals were fasted. Dietary supplementation of asparagine did not significantly increase asparaginase specific activity in either animal. The combined kidney and liver asparagine synthetase specific activity for chicks fed the control diets is over seven hundred times less than the corresponding combined asparaginase specific activity. Rats fed the control diet had a combined kidney and liver asparagine synthetase specific activity about 75 times less than the corresponding asparaginase specific activity. The asparagine synthetase specific activity was significantly increased in the rat and chick kidney when a 2% protein diet was fed.

Animals↗

PubMedDate not supplied

[Homologous blood use and possibilities for autologous hemotherapy as exemplified in hip and knee endoprostheses].

In a retrospective study we documented the need for blood transfusion in total knee (TKR) and hip replacement (THR). The problems with homologous blood transfusion in orthopedic surgery and alternative techniques of autologous-blood transfusions are discussed. In this series patients with primary THR needed 1.69 (+/- 2.25) blood units, with primary TKR 1.58 (+/- 1.54) blood units, and secondary TKR 1.19 (+/- 1.47) blood units, Secondary THR required significantly more units (3.85 +/- 3.07). These procedures also asked for significantly more plasma (3.27 +/- 3.95) than all other procedures. For secondary THR 2.63 (+/- 2.45) blood units were intraoperatively used and only 1.23 (+/- 1.09) blood units postoperatively. All other procedures needed postoperatively significant more units than intraoperatively. In secondary THR the use of blood transfusions increased with age. 45% of the patients with primary THR and 15% with secondary THR were operated without additional blood transfusion. In secondary THR 36% of all patients needed more than 4 blood units and 27% more than 4 plasma units. In TKR 39% of the primary cases and 50% of the secondary cases were operated on without additional homologous blood. Based on these results we established a transfusion concept for our department. Economic, practical, as well as legal aspects were taken into account.

Adult↗

PubMedDate not supplied

Getting ready for professional-risk capitation.

California has long stood as the harbinger for things to come to the rest of the health care nation. Based on research in the state, Maurice Penner warns physician group managers to begin developing a geographically-diverse and credentialed network of physicians to attract the coming hoards of managed care plans. Compensation under capitation, he adds, is worth some advance planning.

California↗

PubMedDate not supplied

Administrative competencies for physician organizations with capitation.

In California, it is common for HMOs to capitate physician organizations (e.g., independent practice organizations and multispecialty medical groups) for all professional and outpatient ancillary services (and to share risk for inpatient care) under professional risk capitation contracts. This arrangement exports most of the financial risk from the HMO to the physician organization. When HMOs and physician organizations contract under these arrangements, HMOs delegate many of their administrative functions to physician organizations--giving the physician organization authority to make the decisions needed to manage capitated risk. As a result, administrators of physician organizations must be competent in such areas as provider network development, financial forecasting, utilization and quality management, contract negotiation, and establishing systems for claims, reporting, authorizations, and the like. In this study four HMO and 22 physician organization administrators were interviewed concerning key administrative competencies for managing capitation contracts. The competencies were assessed as key administrative work activities that required specific knowledge, skill, or ability to perform. Identifying these competencies is important for physician organizations preparing for capitated risk and will be essential for organizations preparing for HMO or Medicare capitation.

Administrative Personnel↗