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Biomedical subjects

R Feldman

Publications and source records attributed to R Feldman.

At least 181 records · Page 10Linked to original sources
PubMed1984

Corporate benefit policies and health insurance costs.

We tested the hypothesis that health insurance premium costs per employee are lower for employee groups where multiple health plans are offered and the employer pays a level dollar amount of the chosen premium than for employee groups where these two conditions are not met. Proposed national legislation relies on these conditions to create a competitive health care market. Data on 56 employee groups in 1981 and 66 employee groups in 1982 were collected from two surveys of large employers in Minnesota. Regression analysis of premium data from both surveys rejected the hypothesis. Indemnity plans in multiplan groups were cheaper if the employer paid a level dollar contribution versus a level percent (including 100) contribution. However, groups offered only an indemnity plan had lower premiums than groups meeting the two legislative conditions. These findings apply to both individual and family coverage premiums and are not caused by systematic differences in benefit provisions, employee demographics or factors influencing loading charges. Our findings cast doubt on attempts to achieve health care competition by legislative changes in insurance options and contribution methods.

Deductibles and Coinsurance↗
PubMed1984

The acro-osteolysis (Hadju-Cheney) syndrome. Review of the literature and report of a case.

Acro-osteolysis ( Hadju - Cheney ) Syndrome is a rare disorder of bone metabolism characterized by progressive destruction of the distal phalangeal bone, curvature of the spine, aplasia of the facial sinuses, and persistence of the cranial sutures. The purpose of this manuscript is to focus on the description of the oro-facial and dental manifestations of the disorder.

Adult↗
PubMed1984

Penbutolol and molsidomine synergism in angina pectoris. A double blind ergometric trial.

In order to test the additional efficacy of the combination of a beta blocker (penbutolol 40 mg single dose) with molsidomine (2 mg single dose), a double blind cross-over trial was performed in 30 patients with stable angina pectoris. Stress tests were done before and 1 h after the beta blocker alone and the combination therapy. Some training effect could be detected on comparing results from the first and second days. Combined therapy showed a better response of resting systolic arterial pressure, resting and maximal diastolic pressure, heart rate gain (from rest to maximal effort) and particularly in the angina severity score. All of these variables changed significantly in comparison to the beta blocker alone, 46 out of 60 post-drug ergometric studies were negative; of the 14 positive tests, 11 followed the beta blocker and only 3 the combined therapy. The combination of a preload reducer molsidomine and a beta blocker may be adequate for patients only partially compensated or with cardiomegaly and/or a depressed ejection fraction.

Aged↗
PubMed1982

A decline in earning losses associated with a community-based cardiovascular disease prevention project.

Permanent and temporary disability pension award data and survey data were used to estimate the lower bound of earning losses related to cardiovascular disease during a community-based cardiovascular disease prevention program in Eastern Finland. Earning losses due to death totaled $39.94 million but were not affected by the project. Earning losses due to permanent disability totalled +29.01 million and were $4.25 million less than expected (p less than 0.025). Earning losses due to temporary disability were $10.91 million and were not affected by the project. Total earning losses attributable to cardiovascular disease during the project period were $79.86 million, and total decline in earning losses was +4.25 million. Project implementation costs were less than one per cent of total earning losses and were equal to approximately 17 per cent of the decline in these losses attributable to the project. The findings suggest that community-based heart disease prevention programs have the potential of more than paying for themselves through an associated decline in lost earnings.

Adolescent↗
PubMed1982

The frequency of a Norwalk-like pattern of illness in outbreaks of acute gastroenteritis.

Records of 642 outbreaks of acute gastroenteritis were reviewed to determine the proportion of outbreaks that were clinically and epidemiologically consistent with Norwalk-like virus infection. Using as our criteria stool cultures negative for bacterial pathogens, mean (or median) duration of illness 12-60 hours, vomiting in greater than or equal to 50 per cent of cases, and, if known, mean (or median) incubation period of 24-48 hours, we found that 23 per cent of waterborne outbreaks, 4 per cent of foodborne outbreaks, and 67 per cent, 60 per cent, and 28 per cent of outbreaks in nursing homes, in summer camps, and on cruise ships, respectively, satisfied the criteria for Norwalk-like pattern. Of 54 outbreaks that satisfied the criteria for Norwalk-like pattern, 14 were investigated for virus etiology. Ten of these (71 per cent) yielded serologic evidence of Norwalk-like virus infection. Norwalk-like viruses are probably an important cause of outbreaks of acute gastroenteritis. Investigation for Norwalk virus antibody in outbreaks that are clinically and epidemiologically consistent with Norwalk-like virus infection is likely to yield diagnostically useful results.

Acute Disease↗
PubMed1982

Physiological regulation of beta-receptors in man.

Previous studies have shown that pharmacological doses of agonists can down-regulate beta receptors. We have shown that alteration of catecholamines within the physiological range is associated with modulation of beta receptor density. The stimulus used to alter catecholamine concentrations in vivo was change in sodium intake. In addition, administration of the beta blocker, propranolol, raised beta receptor density and the rise in receptor density was proportional to the pretreatment catecholamine concentrations. It appears that beta receptors in vivo are in a chronic state of down regulation and that this degree of down regulation parallels the catecholamine concentrations.

Adrenergic beta-Antagonists↗
PubMed1982

Epidemiology of Norwalk gastroenteritis and the role of Norwalk virus in outbreaks of acute nonbacterial gastroenteritis.

Outbreaks of Norwalk gastroenteritis, which may involve persons of all ages, occur during all seasons and in various locations. Waterborne, foodborne, and person-to-person modes of transmission have been described, and secondary person-to-person transmission is common. Outbreaks generally end in about 1 week; longer outbreaks occur only when new groups of susceptible persons are introduced, usually in the setting of a persistent common source of infection. The illness is generally mild and characterized by nausea, vomiting, diarrhea, and abdominal cramps. Vomiting is the predominant symptom among children, whereas diarrhea is commoner among adults. Forty-two percent of 74 outbreaks of acute nonbacterial gastroenteritis investigated by the Centers for Disease Control from 1976 to 1980 were attributed to the Norwalk virus. The rest resembled Norwalk outbreaks clinically and epidemiologically and were probably caused by 27-nm viral agents similar to the Norwalk virus.

Acute Disease↗
PubMed1981

Evaluation of the effect of pentobarbitone anaesthesia on the plasma potassium concentration in the rabbit and the dog.

The purpose of these studies was to determine the reasons for the hypokalaemia observed in rabbits studied in our laboratory. The rabbits consumed standard rabbit chow which is rich in potassium and remained in potassium balance. Hypokalaemia was only observed following anaesthesia. A number of additional investigations were undertaken to clarify the mechanisms involved. The hypokalaemia could not be attributed to technical factors, alkalaemia, hyperinsulinaemia or hyperaldosteronism, but seemed to be a function of anaesthesia. This effect of pentobarbitone anaesthesia was not unique to the rabbit, as similar changes also occurred in the anaesthetized dog. The findings reported in this paper have significant implications with respect to the interpretation of plasma potassium concentrations in anaesthetized subjects or animals.

Acid-Base Equilibrium↗
PubMed1981

Genetic structure, transforming sequence, and gene product of avian sarcoma virus UR1.

We analyzed the genetic structure and gene products of the newly isolated avian sarcoma virus UR1, which recently has been shown to be replication defective and to contain no sequences homologous to the src gene of Rous sarcoma virus. The sizes of the genomic RNAs of UR1 and its associated helper virus, UR1AV, were determined to be 29S and 35S (5.9 and 8.5 kilobases), respectively, by gel electrophoresis and sucrose gradient sedimentation. RNase T1 oligonucleotide mapping of purified viral RNAs indicated that UR1 RNA contains eight unique oligonucleotides in the middle of the genome and shares four 5'-terminal and three 3'-terminal oligonucleotides with UR1AV RNA. The unique sequences of UR1 and Fujinami sarcoma virus were found to be closely related to each other by molecular hybridization of UR1 RNA with DNA complementary to the unique sequence of Fujinami sarcoma virus RNA, but minor differences were found by oligonucleotides fingerprinting. In the regions flanking the unique sequences, UR1 and Fujinami sarcoma viral RNAs contain distinct oligonucleotides, which are shared with oligonucleotides of the respective helper viral RNAs. Cell transformed with UR1 produce a single 29S RNA species which contains a UR1 unique sequence; this species is most likely the mRNA coding for the transforming protein. In UR1-transformed cells, a phosphoprotein fo 150,000 daltons (p150) was detected by immunoprecipitation with antiserum against gag proteins. p150 was associated with a protein kinase activity that was capable of phosphorylating p150 itself, immunoglobulin G of antiserum, and a soluble substrate, alpha-casein. This enzyme transferred phosphate exclusively to tyrosine residues of substrates in vitro, but p 150 labeled in vivo with 32P contained both phosphoserine and phosphotyrosine. The in vitro kinase reaction was not affected by the presence of cyclic AMP or cyclic GMP and strongly preferred Mn2+ over Mg2+. Thus, the properties of UR1 protein are almost identical to those of Fujinami sarcoma virus protein.

Alpharetrovirus↗
PubMed1981

Blue Cross market share, economies of scale, and cost containment effort.

This paper examines two components of the hospital insurance market structure-market share and the absolute number of enrollees in Blue Cross plans-to ascertain whether market structure affects the willingness of Blue Cross plans to use cost control measure. Empirical estimates show that larger plans are more likely to use prospective reimbursement, pre-admission testing, and concurrent review. Market share, however, has a positive effect only on concurrent review. We suggest that there are economies of scale to cost control efforts, but that high market share generally does not lead to increased cost-consciousness.

Blue Cross Blue Shield Insurance Plans↗