Search PubMed⌕ Search

Biomedical subjects

H E Golembesky

Publications and source records attributed to H E Golembesky.

7 recordsLinked to original sources
PubMed1995

New market forces are special challenge to academic health centers.

New market forces--insurer integration into the provider business, "mega-mergers, price and premium reductions, a scramble to create specialty carve-out networks, and the like--have emerged that are placing significant pressure on academic medical centers. All of these forces are accelerating the pace of managed care market maturation. In order to effectively compete in this new marketplace, academic health centers have substantial barriers to overcome. To do so will require the creation of a system to manage the health care of populations while minimizing system costs and maximizing quality. This will require the establishment of a unified medical center approach to markets and value management. Academic health centers will by necessity develop strategies to include strong primary care-based network affiliations in order to accomplish these tasks.

Academic Medical Centers↗
PubMed1995

How to integrate your practice into the new health care system.

In the evolving health care delivery paradigm, physicians manage overall health status rather than illness, and providers rather than insurance companies bear the risk. Consequently, interest in prevention--long of prime interest to pediatricians--is increasing among all providers. The ethical practice of medicine in a managed care environment involves providing care at a level that avoids high cost with poor outcomes. High cost with poor outcomes can be the result of either undertreatment or overtreatment. Purchasers of health care today are clear about what they want--low cost, convenient access for their employees, medically appropriate, documented treatment, and patient satisfaction--and they are clear about how they intend to get what they want. Different areas of the country are at different stages in the evolution of managed care. Physicians who practice in markets that are still in early stages must plan ahead, taking the lead in shaping the changes that are occurring and preparing their practices for managed care. Otherwise, someone less concerned about quality of care will shape them. Solo or small group practices will survive, but those that survive will not be independent. The necessary affiliation with larger entities does not mean that clinical autonomy and freedom must be sacrificed.

Health Care Costs↗
PubMed1985

Normal nasal cytology in infancy.

Nasal cytology in the first year of life has rarely been utilized diagnostically because of an early report that nasal eosinophilia is a common finding in normal young infants. Using an improved sampling technique with a flexible nasal probe, we obtained nasal mucosal specimens for histologic examination from 22 healthy infants and five infants with upper respiratory tract infections. None of the healthy infants had nasal eosinophilia and no adverse effects were noted during the sampling procedure. We concluded that the present sampling technique is as safe and effective in infants as in children and adults and that the majority of healthy young infants do not have nasal eosinophilia.

Basophils↗
PubMed1984

Lymphocyte ecto-5'-nucleotidase activity in infancy: increasing activity in peripheral blood B cells precedes their ability to synthesize IgG in vitro.

Ecto-5'-nucleotidase activity was measured in peripheral blood lymphocytes isolated from serial specimens from nine healthy full-term infants and two premature infants at 0, 2, 4, and 6 mo of age. The postnatal nadir in activity was 7.1 +/- 2.0 nmol/hr/10(6) cells, which is the same as the activity in cord blood lymphocytes (7.0 +/- 2 nmol/hr/10(6) cells). The activity rose twofold to 13.2 +/- 3.8 nmol/hr/10(6) cells at 6 mo of age (p less than 0.001, paired t-test), which is similar to the activity in adult peripheral blood lymphocytes (14.1 +/- 6.3 nmol/hr/10(6) cells). This increased activity in total lymphocytes reflects increased activity in the B cell population. B cell ecto-5'-nucleotidase activity in two infants at 12 to 13 mo of age was 19.3 and 25.2 nmol/hr/10(6) cells, values that are four-to fivefold higher than for cord blood B cells (5.6 +/- 2.8 nmol/hr/10(6) cells) and within the normal range for adult B cells (27.9 +/- 12 nmol/hr/10(6) cells). In spite of a greatly expanded peripheral blood B cell population, studies of immunoglobulin biosynthesis in vitro demonstrated that infant peripheral blood B cells are functionally immature with no synthesis of IgG in response to Epstein Barr virus. Thus, the increase in peripheral blood B lymphocyte ecto-5'-nucleotidase activity in infants precedes their acquisition of a capacity for IgG synthesis in vitro. Data from a hypogammaglobulinemic infant revealed a persistently low ecto-5'-nucleotidase activity over a 10-mo period until at 14 mo of age the activity was 8.8 nmol/hr/10(6) cells in total lymphocytes and 13.0 nmol/hr/10(6) cells in B cells, which correlated with in vivo and in vitro evidence of delayed B cell maturation. Thus, ecto-5'-nucleotidase activity may be a useful cell surface marker in studies of human postnatal B cell maturation.

5'-Nucleotidase↗
PubMedDate not supplied

Rees-Stealy merges with the future.

Last year's merger of the 60-year-old Sharp Rees-Stealy Medical Group and the San Diego Hospital Association was watched closely by groups around the Country who are considering similar arrangements. A look one year later shows that the merger has met the group's expectations.

California↗