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Biomedical subjects

R Gonzales

Publications and source records attributed to R Gonzales.

78 records · Page 5Linked to original sources
PubMedDate not supplied

Impact of reducing antibiotic prescribing for acute bronchitis on patient satisfaction.

CONTEXT: Using a patient and clinician educational intervention, we successfully reduced antibiotic use for uncomplicated acute bronchitis. The impact of this intervention on patient satisfaction is not known. OBJECTIVE: To evaluate whether a strategy for reducing antibiotic use in acute bronchitis affects satisfaction among adult patients. DESIGN: Telephone survey administered 1 to 4 weeks after an office visit for acute bronchitis. SETTING: Two outpatient clinics belonging to a group-model HMO in the Denver, Colorado, metropolitan area. The intervention clinic had received a patient and office-based educational intervention that successfully reduced antibiotic prescribing for acute bronchitis during the previous winter. The control clinic received only the office-based materials, an intervention that did not reduce antibiotic prescribing. OUTCOME: Overall satisfaction with the episode of care. RESULTS: Antibiotics were prescribed to 64% and 85% of survey respondents at the intervention (n = 102) and control clinics (n = 164), respectively (P < 0.001). Patient satisfaction with the visit did not differ between intervention and control clinics (69% of intervention and 63% of control clinic patients reported very good or excellent satisfaction, P > 0.2). After adjustment for patient age, sex, duration of illness before the visit, reason for visit, and clinician specialty, there was no difference between intervention and control clinics in the proportion of patients reporting very good or excellent satisfaction (adjusted relative risk for high satisfaction at the intervention clinic, 1.1 [95% CI, 0.81 to 1.3]). CONCLUSION: A patient- and clinician-oriented educational intervention that reduces antibiotic treatment of adults with uncomplicated acute bronchitis does not appear to reduce satisfaction with care.

Acute Disease↗
PubMedDate not supplied

In vitro continuous wave Doppler gradients of mechanical valves in less than optimal orientations.

Continuous wave Doppler ultrasound is a noninvasive method of determining transvalvular gradients that may overestimate the gradients of prosthetic valves. It is theorized that a valve rotated or tilted in its annulus will create abnormally high velocities that calculate into derived gradients that are greater than those actually present. An in vitro apparatus was constructed to analyze the velocities and the actual and derived gradients of prosthetic valves in less than optimal orientations. Continuous flow studies of a 27 mm Omniscience prosthesis indicated good agreement between the actual and derived gradients with the valve's major orifice oriented toward the aorta's larger radius. These values increase as the valve is tilted to decrease its net opening angle. When the valve is rotated 180 degrees, the Doppler gradients tend to overestimate the actual pressure drops. These data indicate that certain valve misorientations create velocities that overestimate the transvalvular gradients.

Blood Flow Velocity↗
PubMedDate not supplied

[Characteristics of insulin secretion in persons with glucose tolerance disorders and in patients with type II diabetes mellitus].

Insulin secretion was studied in comparison with the glucose level in persons with disturbed glucose tolerance and in patients with type II diabetes mellitus using a glucose tolerance test and with regard for an obesity degree (the body weight index). The hyperinsulinism incidence in these groups was determined versus that of the controls. The correlation between a high insulin response and the glucose level was absent. Insulin-red blood cell binding was studied in patients with hyperinsulinism and disorder of this process was demonstrated. The hyperinsulinism rate decreased after the body weight index and the glucose level returned to normal.

Adult↗