Seventy-five patients with pulmonary infection caused by Mycobacterium avium-intracellulare were studied to determine whether results of therapy correlated with in vitro susceptibility testing of mycobacterial isolates. Fifty patients responded to therapy and 25 were nonresponders. The total number of drugs received by responders did not differ significantly from the total number of drugs received by nonresponders. However, responders received significantly more drugs to which their isolate was susceptible in vitro than did nonresponders (2.4 +/- 1.2 versus 1.4 +/- 1.0, p less than 0.001). We conclude that patients with pulmonary M. avium-intracellulare infection should receive chemotherapeutic agents to which their isolate is susceptible in vitro.

Antitubercular Agents↗

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Testing umbilical cords for funisitis due to Treponema pallidum infection, Bolivia.

To establish the frequency of necrotizing funisitis in congenital syphilis, we conducted a prospective descriptive study of maternal syphilis in Bolivia by testing 1,559 women at delivery with rapid plasma reagin (RPR). We examined umbilical cords of 66 infants whose mothers had positive RPR and fluorescent treponemal antibody absorption tests. Histologic abnormalities were detected in 28 (42%) umbilical cords (seven [11%] had necrotizing funisitis with spirochetes; three [4%] had marked funisitis without necrosis; and 18 [27%] had mild funisitis), and 38 [58%] were normal. Of 22 umbilical cords of infants from mothers without syphilis (controls), only two (9%) showed mild funisitis; the others were normal. Testing umbilical cords by using immunohistochemistry is a research tool that can establish the frequency of funisitis due to Treponema pallidum infection.

Antibodies, Bacterial↗

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The elusive cure: health care reform.

Everyone seems to believe Americans are entitled to the best health care, regardless of cost. But how to curb soaring health expenses and provide care to the 37 million uninsured in our country is a perplexing problem, one that policy makers and providers are trying to solve with a wide variety of health reform proposals.

Attitude to Health↗

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1995 Emerging Leaders in Healthcare. The new leaders: Gita Budd, Colene Daniel, Elizabeth Gallup, Scott Wordelman.

Fierce pressures for cost containment. Demands for quality improvements. The drive toward patient-centered care. The push for community involvement. Insistent voices of payers, patients, consumers, physicians. Accumulated tensions amid the chaos of change. Balancing all of these demands while inspiring and encouraging the professionals and other workers within the healthcare organization requires a high level of leadership ability. One that insists on the best from everyone involved in a healthcare system--from physicians to staff, nurses to social workers. And then strives for more. The four young executives who are this year's Emerging Leaders in Healthcare have all pushed their systems beyond traditional boundaries into new territory, helping their patients, their employees, their physicians, and their communities rise to new levels of achievement. At the same time, these leaders emphasize teamwork and consensus-style management, so that their co-workers feel like they're participating in the changes, not being victimized by them. Gita Budd, Colene Daniel, Elizabeth Gallup, and Scott Wordelman are winners of the 1995 award from The Healthcare Forum and Korn/Ferry International that honors ¿dynamic, decisive young leaders (under 40) with the proven ability to nurture the growth of the industry.¿ Korn/Ferry International and The Healthcare Forum are proud to present 1995's Emerging Leaders.

Adult↗

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Disease management. To partner or not to partner?

Explore the source record for details and available documents.

Case Management↗