Search PubMed⌕ Search

Biomedical subjects

R D King

Publications and source records attributed to R D King.

90 records · Page 5Linked to original sources
PubMed1974

Trichophytin extraction: biological comparison of trichophytin extracted from Trichophyton mentagrophytes grown in a complex medium and a defined medium.

The extraction of antigens (trichophytin) from Trichophyton mentagrophytes var. asteroides grown in both a complex medium and a defined medium proved to be reproducible and feasible. These extracts were first evaluated by skin testing in both infected and noninfected guinea pigs. Further evaluation and standardization was accomplished in selected humans by comparing these antigens to a trichophytin known to elicit allergic reactions to the dermatophytes. The trichophytins produced by this extraction procedure gave no false positive (or negative) skin test reactions. These antigens did, however, reliably elicit allergic sensitivity of both the immediate and delayed type. The potency of both complex and defined media antigen was shown to be equal to that of the standard trichophytin.

Acetone↗
PubMedDate not supplied

Effects of hypothermia on short latency somatosensory evoked potentials in humans.

Short latency somatosensory evoked potentials (SSEPs) elicited by median nerve stimulation were monitored in 14 adult patients undergoing cardiac surgery under cardiopulmonary bypass and induced hypothermia. SSEPs were recorded at 1-2 degrees C steps as the body temperature was lowered from 37 degrees C to 20 degrees C to determine temperature-dependent changes. Hypothermia produced increased latencies of the peaks of N10, P14 and N19 components, the prolongation was more severe for the later components so that N10-P14 and P14-N19 interpeak latencies were also prolonged. The temperature-latency relationship had a linear correlation. The magnitude of latency prolongation (msec) with 1 degree C decline in temperature was 0.61, 1.15, 1.56 for N10, P14 and N19 components, respectively, and 0.39 and 0.68 for interpeak latencies N10-P14 and P14-N19, respectively. The rise time and duration of the 3 SSEP components increased progressively with cooling. Cortically generated component, N19, was consistently recordable at a temperature above 26 degrees C, usually disappearing between 20 degrees C and 25 degrees C. On the other hand, more peripherally generated components, N10 and P14, were more resistant to the effect of hypothermia; P14 was always elicitable at 21 degrees C or above, whereas N10 persisted even below 20 degrees C. The amplitude of SSEP components had a poor correlation with temperature; there was a slight tendency for N10 and P14 to increase and for N19 to decrease with declining temperature. Because incidental hypothermia is common in comatose and anesthetized patients, temperature-related changes must be taken into consideration during SSEP monitoring under these circumstances.

Adult↗
PubMedDate not supplied

Are provider integrated delivery systems the final step to integration?

Provider integrated delivery systems are not the final step to full-fledged integration, states author R. Daniel King, president of Medi-Call of St. Louis Inc. While a PIDS is on the way, true interdependent integration takes place when the community joins with the integrated system to represent all phases of the health care continuum and assumes some of the responsibility for planning. These community integrated delivery systems (CIDS) should be the aim of integration.

Community Health Planning↗
PubMedDate not supplied

The 'Fulcrum for Quality'. The physics of provider reform: six key variables to achieve 'MEDQIC'.

As health care providers move from a fee-for-service, revenue-driven system to total capitation, the need to focus on achieving the most efficient delivery of quality integrated care will be paramount to survival. The energy to survive a totally capitated reimbursement system will depend on the degree that a provider is able to evolve from a revenue-driven to a quality-driven organizational culture. This evolution is going to be very difficult for many health care providers who are committed to a managing money mentality rather than a managing quality mentality to achieve the "bottom line" and regard human resources as expendable and quality as unmeasureable rhetoric. The "Fulcrum for Quality" demonstrates how six key variables change when moving from a fee-for-service to a capitated reimbursement system: reimbursement methodology, utilization, operational expenses, information systems, management and communication. In a fee-for-service system, providers experience minimal restrictions on the revenue limits they could achieve. Consequently, inefficiencies and poor quality had little to do with a provider's ability to increase profits. Under a totally capitated system that limits revenue, providers will experience that quality and efficiencies directly affect profits. The "Fulcrum for Quality" discusses the transformation of the six key variables and the changes a medical practice manager will need to make in order to achieve the most efficient delivery of quality integrated care.

Capitation Fee↗