Biomedical subjects
Publications and source records attributed to L Uzych.
Managed care has been heralded by enthusiastic advocates as representing a viable way to put a brake on runaway health care costs. Still, there is concern that managed care may compromise quality of medical care because of incentives leading to underservice. The author overviews the concept of managed care and discusses the need to examine the possible cost-effectiveness of using such a system.
Direct-to-the consumer advertising of prescription drug products is increasingly scrutinized by the federal Food and Drug Administration, spurred in part by growing concern about the potential for abuse posed by such advertising in the absence of effective regulation. Drug industry officials claim they are providing the public with valuable information, but many physicians and health care professionals are distressed by the new trend.
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Anabolic-androgenic steroid use may have a wide range of adverse psychiatric and behavioural effects. The available data, however, are often inconsistent and inconclusive concerning possible effects of anabolic-androgenic steroids on libido in men, in women and also the way in which they affect libido differently in males and females. Anabolic-androgenic steroids may both relieve and cause depression. Cessation or diminished use of anabolic-androgenic steroids may also result in depression. More study is required to determine whether or not the disparate data on depression are consistent clinical observations. The level of testosterone appears to be positively associated with "aggression", particularly in response to provocation. Various psychotic symptoms and manic episodes may be associated with anabolic-androgenic steroids. The possibility of hypomania induced by synthetic androgens must also be considered.
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Drug testing policies have been enacted affecting a large number of athletes. Complex, wide-ranging technical questions are raised by drug testing programs designed for athletes. Issues are also raised concerning the structural elements commonly included in a substance abuse policy affecting athletes. The selection of particular athletes for testing, random drug testing, consent forms, constructing a list of banned substances, the handling, collecting and transporting of testing samples, and selected flaws and limitations affecting the drug testing process are among the topics covered in this article.
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America's health care system is characterized by unacceptably high cost, inequity, and insufficient technology assessment. Cost containment has failed in part because of misunderstanding of the nature of the health care system. Inadequate technology assessment and the malpractice crisis have also contributed to the rise in health care costs. Explicit, systematic rationing of health care services is one way to radically alter the existing system; the instituting of some type of national health program is another. Less drastic measures include systematic technology assessment; growing emphasis on group medical practice; more preventive services; and malpractice reform, including exploration of no-fault legislation and an expanded federal role.
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