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Biomedical subjects

P L Wong

Publications and source records attributed to P L Wong.

13 recordsLinked to original sources
PubMed1997

Medicaid managed care in Texas. What have we learned from the pilots?

Texas has a plan for statewide implmentation of Medicaid managed care by 2001. This article presents evidence from initial demonstration projects, which were implemented in 1993. The 1st-year experience is described and preliminary effects are examined in terms of reactions of clients and providers and changes in utilization patterns and costs of care. Results of the evaluation indicate implementation difficulties with several operational aspects of managed care, variable effects in terms of client and provider reaction to the reform, and little or no change in utilization patterns, but significant cost-savings to the state. Because of the implementation difficulties identified by the evaluation and the mixed results regarding effects, further research is recommended to determine the potential benefit of this reform.

Child↗
PubMed1995

A prospective randomized comparison of single versus multidose gentamicin in the treatment of CAPD peritonitis.

There is an increasing trend towards the use of aminoglycosides in a once-daily dose administration for the treatment of severe infections in nonrenal failure patients. The use of once-daily dose aminoglycoside therapy may be associated with a reduction in toxicity. We performed a prospective randomized study comparing once-daily versus multiple-dose gentamicin in the treatment of continuous ambulatory peritoneal dialysis (CAPD) peritonitis. Seventy-three patients with 100 new episodes of peritonitis were enrolled in the study. At presentation of peritonitis, the patients were alternately assigned to receive either intraperitoneal gentamicin at a dose of 40 mg/2 L dialysate administered as a once-daily dose or gentamicin at a dose of 10mg/2 L dialysate administered 4 times per day. All patients also received intraperitoneal vancomycin at a dose of 1 g per week. There were no significant differences in the treatment success (88% vs 82%, p = NS) and relapse (18% vs 20%, p = NS) rates between the once-daily dose and multiple-dose groups. The mean trough serum gentamicin level was higher in the once-daily dose group compared to the multiple-dose group (0.75 +/- 0.72 vs 1.50 +/- 1.40 mg/L). In conclusion, gentamicin administered in a once-daily dose is as effective as multiple-dose administration in the treatment of CAPD peritonitis. The lower gentamicin level with once-daily dose administration may be associated with a reduction in aminoglycoside toxicity.

Anti-Bacterial Agents↗
PubMed1994

Effects of beta 2-adrenergic agonists on isolated guinea pig lung mast cells.

The mast cell protective effects of the newly developed long-acting beta 2-agonists salmeterol and formoterol were compared with those of conventionally used beta 2-agonists, non-specific beta-agonists, disodium cromoglycate (DSCG) and theophylline. With the exception of DSCG, all the test agents inhibited ovalbumin-induced histamine release from enzymically dispersed guinea pig lung mast cells in a dose-dependent fashion. At the maximum concentration tested, theophylline produced the highest level of protection, inhibiting up to 90% of ovalbumin-induced histamine release whereas DSCG produced only 10% inhibition. The maximum inhibition produced by all the beta 2-agonists tested was around 45%. While salmeterol was equipotent with salbutamol, formoterol was at least a 100-fold more potent. Hence the present study confirmed the previously reported mast cell stabilizing actions of conventional beta 2-agonists and extended the observation to the newly developed long-acting analogues.

Adrenergic beta-2 Receptor Agonists↗
PubMed1994

Effects of long-acting beta 2-adrenoceptor agonists on mast cells of rat, guinea pig, and human.

The effects of two recently developed long-acting beta 2-adrenoceptor agonists, formoterol and salmeterol, on mast cells from different sources were compared with those of the prototype short-acting analogue, salbutamol. With the exception of high concentrations of salmeterol (> 10(-5) M), none of the tested beta 2-adrenoceptor agonists inhibited the anti-IgE-induced histamine release from rat peritoneal mast cells. In contrast, all three compounds dose dependently inhibited the immunologically induced histamine release from isolated lung mast cells of guinea pig and human at concentrations < or = 10(-5) M.

Adrenergic beta-Agonists↗
PubMed1994

Isolation of organisms in CAPD peritonitis: a comparison of two techniques.

The identification of organisms is important in the treatment of continuous ambulatory peritoneal dialysis (CAPD) peritonitis. We compared two techniques for isolating organisms in CAPD peritonitis. Clinical and microbiologic data on all episodes of peritonitis from 1991-1993 were prospectively recorded. The isolation of organisms from 77 episodes of peritonitis was done using the conventional centrifugation culture method from 1991-1992; the isolation of organisms from 121 episodes of peritonitis was done using the BACTEC method from 1992-1993. The total culture-positive rates were 75% for the BACTEC technique and 58% for the conventional technique (p = 0.05), with a higher isolation rate for gram-negative organisms (36% vs 18%, p < 0.05). In the isolation of organisms from new episodes of peritonitis, the culture-positive rates were significantly higher for the BACTEC than for the conventional technique (82% vs 55%, p < 0.01). The recovery rates of organisms for both techniques were similar for relapse peritonitis. The treatment outcomes of CAPD peritonitis for the two technique groups, and for the culture-positive and culture-negative groups were not significantly different. In conclusion, the BACTEC method yielded a higher rate of positive cultures for CAPD peritonitis, but did not affect treatment outcome of the infections.

Bacteriological Techniques↗
PubMed1986

Clinical survey of antibodies against red blood cells in horses after homologous blood transfusion.

Serum samples of 20 horses were evaluated for antibodies against RBC after homologous blood transfusion. Transfusion-associated antibodies against RBC were detected in 10 horses. Antibodies recognizing horse blood group antigens Aa, Ae, Db, and Dc were identified. Antibodies against Aa were found in all samples from Aa-negative horses that were transfused with Aa-positive RBC. Antibodies against Aa persisted for at least 1 year after transfusion. Antibodies against Ae were detected in 7 of 8 horses transfused with Ae-positive RBC. Initial appearance and persistence of antibodies against Ae differed among the horses; antibodies were initially detected 1 week to 154 weeks after transfusion and disappeared as early as 4 weeks after transfusion. Antibodies against Db or Dc were detected in less than or equal to 33% of the horses that lacked Db or Dc antigens and were transfused with Db- or Dc-positive RBC. Antibodies against Db and Dc were initially detected in sera later than were the A-system antibodies. Three mares with transfusion-associated antibodies subsequently produced healthy offspring. Two foals had RBC antigens corresponding to their dam's alloantibodies; maternal colostrum with antibodies against Aa was withheld from the Aa-positive foal. The Db-positive foal remained healthy after nursing the mare with serum antibodies against Db.

Animals↗
PubMed1985

Synovial membrane changes after experimental transection of the cranial cruciate ligament in dogs.

Degenerative joint disease and inflammation of the synovial membrane were produced in the left stifle of 16 dogs by severing the cranial cruciate ligament. Arthrotomy only was performed on the right stifle. Synovial membrane from these joints was histologically examined at 1, 2, 8, and 13 weeks after surgical operation. Similar tissue was obtained from 4 healthy dogs for comparison. Inflammatory changes in the synovium of the left stifle progressed with time and were prominent at 8 weeks postoperatively; subsynovial fibrosis was greatest at 13 weeks. Inflammation of the synovial membrane and subsynovial tissue was characterized by synovial cell hypertrophy and hyperplasia, plasma cell and lymphocyte infiltration, and increased vascularization of the subsynovial region.

Animals↗
PubMedDate not supplied

Submaximal oxygen pulse divided by body weight during incremental exercise test.

The purpose of this study was to examine whether submaximal oxygen pulse divided by body weight (O2 pulse/BW) during an incremental exercise test discriminated between trained and untrained men, correlated to left ventricular ejection fraction (LVEF) at rest in post-myocardial infarction patients, and was sensitive and specific in detecting ventricular dysfunction and mild ventricular dysfunction with myocardial ischemia during exercise. Forty-three trained men, 44 untrained men, and 21 post-myocardial infarction patients pedaled a cycle ergometer, with O2 consumption, heart rate, and myocardial ischemia monitored during the exercise test. Work rate started at 10 W and increased 10 W/min stepwise; the O2 pulse and O2 pulse/BW at 10 through 120 W were calculated. The LVEF of the patients was measured at rest using radionuclide ventriculography three weeks after myocardial infarction. The results revealed that O2 pulse/BW was significantly different between trained and untrained men at 80, 90, 100, 110, and 120 W, whereas O2 pulse was significantly different only at 110 and 120 W. Oxygen pulse/BW at 10 W, as well as 30 through 120 W, significantly correlated to LVEF in the patients. The three patients with ventricular dysfunction (LVEF, < 40%) plus the two patients with mild ventricular dysfunction (LVEF between 40 and 50%) and ST segment depression during exercise all had submaximal O2 pulse/BW significantly lower than untrained men (sensitivity, 100%). Among the 11 patients with normal ventricular function (LVEF, > 50%) plus the 5 patients with mild ventricular dysfunction but no ST segment depression, 13 patients did not have submaximal O2 pulse/BW significantly lower than untrained men (specificity, 81%).

Adult↗