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Biomedical subjects

K Steiner

Publications and source records attributed to K Steiner.

46 records · Page 3Linked to original sources

[Organ distribution of 14C-pramiverine in the rat].

Distribution of 4,4-diphenyl-N-isopropyl-cyclohexylamine-hydrochloride (pramiverine, Sistalgin) following single and repeated i.v. and p.o. administration, resp., has been studied in rats. After i.v. administration, pramiverine is rapidly taken up by tissue. Most organs attain higher concentrations than does the blood plasma, especially the lungs and also kidneys, liver, heart and endocrine organs. After p.o. administration, a marked first-pass effect of the liver is observed. The metabolites thus formed show a somewhat less pronounced affinity for organs and tissues. Higher concentrations are found only in the excretory organs, i.e. liver and kidneys. 14C-Pramiverine is rapidly eliminated, 24 h after application the level of radioactivity has fallen below detection limit. After repeated applications of 14C-pramiverine higher concentrations, as compared to one single administration, were observed only in liver and kidneys, especially after i.v. injection. An organ-specific accumulation of the drug can be excluded. No placental transfer of pramiverine and/or its metabolites could be observed.

Animals↗

[Visceral leishmaniasis (kala-azar), an important disease not only in the tropics (author's transl)].

A 39-year-old woman contracted visceral leishmaniasis on a 14-day visit to southern Italy and died of staphylococcal septicaemia before specific treatment could be effective, diagnostic efforts over four months having failed to make the diagnosis until four weeks before death. Eight further cases reported in German-speaking medical journals illustrate similar diagnostic difficulties. The disease is accompanied by septic temperatures, frequently with two daily spikes, hepato- and splenomegaly, normochromic anaemia and leucocytopenia. But diagnosis can only be made by specific tests. The organisms can be discovered in sternal puncture and organ biopsies only if the Giemsa stain is used. Complement-fixation reaction for leishmania should be tried repeatedly, in case the disease is suspected.

Adult↗

A model to manage capitated risk.

The impact of increasing enrollment in Medicare HMOs will require health care providers to develop new strategies in care delivery systems. Key strategies in managing risk include health risk appraisals, proactive case management, disease management, provider education, and the use of inpatient physician managers. Implementing an integrated care management system requires a team approach. The physician inpatient manager, nurse case manager, geriatric clinical nurse specialist, and social worker composed the health care team charged with implementing a care management system responsive to enrollees' needs. A quality management plan is essential for tracking patient outcomes and quality indicators across the continuum. The focus of promoting wellness and preventing illness represents a paradigm shift from the traditional model of episodic care that can yield positive financial results.

Capitation Fee↗