An experiment in risk sharing. HMO, manufacturer and distributor devise a plan to capitate materials.
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Capitation Fee↗
Biomedical subjects
B Gould
Publications and source records attributed to B Gould.
Pharmacokinetics of gentamicin in patients with various levels of diabetic proteinuria.
Diabetic nephropathy is a relatively common medical problem. The effects of early-stage nephropathy on the kinetic disposition of renally cleared drugs have received little attention. This study evaluated single-dose pharmacokinetics of gentamicin in 15 patients with various levels of diabetic proteinuria who had relatively normal serum creatinine concentrations. These pharmacokinetic parameters were compared with predicted parameters based on the method used clinically in our institution. The correlation between the amount of proteinuria and each of the pharmacokinetic parameters was also evaluated. The patients evaluated in this series had a gentamicin volume of distribution (P < 0.05) and half-life (P < 0.05) significantly higher than predicted and a gentamicin clearance (P < 0.01) significantly lower than predicted. A significant correlation between the amount of proteinuria and the measured pharmacokinetic parameters was not observed. These findings suggest that patients with diabetic proteinuria should be monitored closely when treated with aminoglycosides.
Adult↗
Educating primary care providers about HIV disease: multidisciplinary interactive mechanisms.
As HIV-related prophylactic and therapeutic research findings continue to evolve, the Health Resources and Services Administration (HRSA) of the Public Health Service has created multidisciplinary mechanisms to disseminate new treatment options and educate primary care providers at rural and urban sites throughout our nation's health care system. HRSA has implemented (a) the International State-of-the-Art HIV Clinical Conference Call Series, (b) the national network of AIDS Education and Training Centers, (c) the nationwide HIV Telephone Consultation Service, and (d) the Clinical Issues Subcommittee of the HRSA AIDS Advisory Committee. These collaborative and comprehensive efforts at HIV information dissemination target physicians, nurses, physician assistants, dentists, clinical pharmacists, mental health care providers, case managers, and allied health professionals. The sites where they provide care include public health clinics; county, State and Federal correctional facilities; private practice offices; community and academic hospitals; military and Veterans Administration facilities; hemophilia centers; schools of medicine, nursing, and dentistry; departments of health; chronic care facilities; visiting nurse and home care agencies; health maintenance organizations; and Indian Health Service clinics and hospitals.
Diffusion of Innovation↗