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Biomedical subjects

L Wagner

Publications and source records attributed to L Wagner.

At least 469 records · Page 26Linked to original sources
PubMed1992

Decision time for rationing.

As Oregon state officials await a decision from HCFA on whether it will issue a waiver of Medicaid rules needed to implement a healthcare rationing proposal, the debate rages on. The state hopes for a decision by early February so the program can be up and running by July, but there are still many issues to be addressed before the plan's start-up.

Health Care Rationing↗
PubMed1992

1992 healthcare business outlook.

Whether it's with apprehension or expectation, most of us are wondering what the new year will hold. With that question in mind, Modern Healthcare staff writers and healthcare industry leaders offer their short- and long-range forecasts for all sectors and on a variety of all-encompassing issues. Some key questions: Will presidential politics pressure healthcare reform efforts? How will investor-owned companies fare under another year of regulatory scrutiny? What awaits hospitals and physicians under the new fee schedule and other Medicare rule changes?

Attitude of Health Personnel↗
PubMed1992

Hypofibrinogenemia due to fibrin formation in subserosal type eosinophilic gastroenteropathy.

A 33-year-old woman presented with abdominal pain and distention, diarrhoea and marked eosinophilia in blood and ascites. As other causes could be excluded, the subserosal type of eosinophilic gastroenteropathy was diagnosed. The low plasma fibrinogen level (less than 100 mg/100 ml) found in this patient is an as yet undescribed feature. During prednisolone therapy it increased concurrently with the fall of blood eosinophils and the relief of clinical symptoms. Interest was further directed to the ascitic fluid where not only the presence of eosinophils (74%) enveloped in fibrin yarn and of basophils (2%) but also of 24% T lymphocytes (among them 75% CD4+, 24% CD8+, 4% CD25+, less than 1% CD19+, less than 1% natural killer cells) could be demonstrated. These lymphocytes are likely to be the source for lymphokine production chemoattracting eosinophils into the intestine. In addition they seem to be involved in IgE hyperproduction, which after adequate therapy and complete resolution of the clinical symptoms, tended to decrease slowly.

Adult↗
PubMed1992

Incidence and phenotype restriction of lymphoid BLT-serine protease granules in spontaneously diabetes prone BB rats compared with a normal rat strain.

In diabetes prone BB rats a relative increase of serine protease (SP)-positive lymphocytes (39.8 +/- 10%) was observed in peripheral blood at the time of diabetes manifestation (DM) compared with non-diabetic healthy Sprague Dawley control rats (Co: 10.3 +/- 4%), with BB rats at age of premanifestation (PM: 14.7 +/- 4%) and beyond age of expected manifestation (non-diabetic animals, ND: 25.2 +/- 4%). Similar absolute numbers were found in diabetic BB rats in comparison with Sprague Dawley rats. In PM, absolute numbers were lower in comparison with diabetic BB rats. SP granular positivity was found restricted to OX8+ lymphocytes. SP granule-bearing OX8+ lymphocytes were more frequently seen in the BB rat strain (PM: 74.3 +/- 8%; DM: 79.4 +/- 8%; ND: 78 +/- 10%) compared with normal rats (Co: 32.5 +/- 8%). Absolute numbers were lower in PM animals in comparison with DM rats. OX8+ cells were found in a higher relative number in DM animals (49.1 +/- 7%) compared with controls (28.2 +/- 3%), PM (26.3 +/- 5%) and ND (34 +/- 2%) animals. T lymphocytes expressing the W3/25+ marker, invariably negative for SP granules, were present in a higher relative number in ND (49.8 +/- 7%) and the control group (52.3 +/- 10%) compared with PM (31 +/- 8%) and DM (38 +/- 11%) animals. Absolute numbers of the OX39+ lymphocyte subpopulation were decreased in PM and DM-BB rats in comparison with the control group.

Animals↗
PubMed1992

The effect of cholesterol screening on college students.

This study was designed to determine the effect of cholesterol screening on college students' knowledge retention and self-reported behavior change. Students (N = 180, age M = 21.4 +/- 4.1 years) enrolled in a self-paced personal fitness course participated in a screening accompanied by two educational handouts and oral information from the technician. Six weeks later, subjects completed a questionnaire that revealed that 76% remembered their exact cholesterol level. Only 36%, however, remembered specifically why their cholesterol level was important, 22% remembered the three National Cholesterol Education Program (NCEP) categories and values, and only 36% could fully identify their correct NCEP follow-up. Chi-square analyses revealed no significant differences between expected and observed frequencies for gender or cholesterol category by cognitive information retention. Analyses did reveal more self-reported dietary and exercise changes for those testing above 200 mg/dL than for those below 200. Although college students may remember their cholesterol level after 6 weeks and may take some action if they are above the desirable level, the knowledge base established in a typical screening situation appears inadequate. Educational efforts accompanying most screenings should be improved, and some attention should be given to young adults who test at the high end of the desirable category.

Adolescent↗
PubMed1992

T-cell selection and T-cell receptor variable beta-chain usage in chronic hemodialysis patients.

Thymic and extrathymic selection processes are responsible for the shape of the T-cell repertoire. T-cell receptor (TCR) variable (V) chain usage, holding a place in tolerance, autoimmunity and response to external agents, was analyzed in 41 patients maintained on chronic hemodialysis treatment. Leukocyte (mean: 6444 +/- 2277 cells/microliters), lymphocyte (mean: 1457 +/- 707 cells/microliters) and T-cell (mean: 67 +/- 16%) counts were within expected limits, but hemodialysis patients showed an impressive increase of TCR V beta 6.7 positive peripheral blood lymphocytes (PBL) and a massive deletion of TCR V beta 8 positive PBL. V beta 6.7 positive PBL were detectable in all hemodialysis patients (n = 41, mean: 2.47 +/- 1.61% PBL) in contrast to a healthy population, where only 45% of subjects expressed V beta 6.7 on PBL (n = 9, mean: 3.50 +/- 1.83% PBL). Only 27% of our hemodialysis patients expressed V beta 8 on PBL (n = 11, mean: 1.00 +/- 1.94% PBL) in contrast to healthy subjects, who presented V beta 8 positive PBL (n = 20, mean: 2.89 +/- 1.23% PBL) in every case. Neither primary kidney disease, nor response to vaccination for hepatitis-B, nor dialyzer membranes used, were associated with these alterations of the TCR V beta-pool. It is likely, that the well-known impairment of the cytokine network in chronic renal failure, uremic toxins or response to infectious agents, may contribute to these different and possibly independent T-cell selection mechanisms in uremia.

Cell Separation↗
PubMed1992

Non-institutional care for the elderly. A Danish model.

A 4 year long Action Research Project including the reorganization and co-ordination of services and facilities for the elderly had been conducted in a Danish municipality. The project was started in June 1984 when a conceptual framework was developed to establish the foundation for the design of the project. The concept of self-care and WHO's strategy "Health for all by the year 2000" were central aspects of the framework. Self-care is the process of choosing and deciding over our own bodies and lives. In a more institutionalized health care system, citizens are often not able to take part in the decision-making process, or only with difficulty. A survey study was conducted to assess the social and health service needs and wishes of persons over 67 years of age. Comprehensive interdisciplinary training of staff was carried out. During the latter part of this period, a 24 hour service was planned, and the former nursing home was converted into a health care centre, with sheltered flats, guests flats and a day centre, open to all citizens, irrespectively of age. Out of consideration for both the inhabitants of the former nursing home and the staff, who were to test both the new ways of working together and the new working methods the changes were initiated slowly with careful preparation and coordination among the respective parties.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMed1991

Hospitals to carry on fight over Medicaid restrictions.

While the compromise over Medicaid tax and donation programs was an improvement over the original rules proposed in September, hospital executives are voicing their displeasure with some of its provisions. The battle now moves from Capitol Hill to state legislatures, where questionable tax/donation schemes will have to be reworked to conform to the new law. Hospital officials in some states have vowed to carry on the crusade.

Economics, Hospital↗