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PubMed2002

Establishing the feasibility of performance measures for alcohol and other drugs.

The Washington Circle (a multiple-disciplinary group of providers, researchers, managed care representatives, and public policy representatives) examined three performance measures for alcohol and other drug (AOD) services. These measures, which were developed and applied to managed care organizations' administrative data for their commercial enrollees, are: (a) identification, the percent of adult enrollees with AOD diagnoses; (b) initiation, the percent of adults with an inpatient AOD admission or with an index outpatient visit for AOD abuse or dependence and any additional AOD services within 14 days of identification; and (c) engagement, the percent of adults diagnosed with AOD disorders that receives two additional AOD services within 30 days of the initiation of care. We conclude that using administrative databases to compare managed care organizations' performance is feasible, meaningful and informative. The article discusses issues in interpreting performance measures in several areas: organizational structure of alcohol and other drug services, information available for measurement, and computational issues.

Adult↗
PubMed1996

Effects of 3,6-dimethylpyrazine-2-thiol on reproductive and accessory reproductive organs in male rats.

The weights of prostate and seminal vesicle were decreased by treatment with 3,6-dimethylpyrazine-2-thiol(3,6-DMP-SH) but the weights of testes and the plasma testosterone levels were not changed. The recovery of the weight of prostate and seminal vesicles of testosterone-treated orchidectomized rats were inhibited by treatment with 3,6-DMP-SH. Direct injection of 3,6-DMP-SH into accessory reproductive organs also induced the decrease in the weight of relevant organs. Administration of oxendrone or chlormazinone along with 3,6-DMP-SH decreased the weights of accessory reproductive organs more than administration of only one substance. In vitro uptake of testosterone into prostate and seminal vesicle were blocked by the presence of 3,6-DMP-SH. These results suggest that 3,6-DMP-SH directly inhibited testosterone uptake into the accessory reproductive organs.

Androgen Antagonists↗
PubMed1989

[The synthesis of estradiol and progesterone receptors in relation to the biological effects of sex hormones in ovariectomized rats].

The concentration of the estradiol and progesterone receptors in cytosol increased within a week after ovariectomy in rats, the nucleic concentration of receptors sharply diminishing. The uterus atrophy following ovariectomy in associated with a reduction of both nucleic and cytosol receptors in the organ. Administration of estradiol (1 mg) restored the organ mass and the character of hormonal reception within a week. Progesterone and clomyphen exerted some uterotropic effect. Ovariectomy reduced the creatinkinase activity by 2.9 times and the peroxydase activity by 13 times. Two types of synthesis of female sex hormones receptors seem to exist in the rat uterus: the constitutional type depending on no hormonal effects and the induced one depending on the sex steroids, estradiol in particular.

Animals↗
PubMed2002

Taking care of business: HMOs that spend more on administration deliver lower-quality care.

The authors analyzed health maintenance organizations' administrative costs and quality measures from the National Committee for Quality Assurance's Quality Compass database for the years 1997-2000. HMOs with higher administrative overhead had consistently worse quality scores in univariate analysis. Multivariate analyses controlling for geographic region (all years) and HMO model type (1997 and 1998 analyses only) confirmed that higher administrative costs were associated with lower quality. Excess HMO bureaucracy is not only wasteful but harmful.

Adolescent↗
PubMed1999

Anticancer drugs inhibit induction of NO synthase in rat in vivo.

Nitric oxide (NO), synthesized by inducible NO synthase (iNOS) in immunoreactive cells, plays important roles in their activities such as bactericidal and tumoricidal functions. We examined the distribution of iNOS and evaluated the effects of anticancer drugs, 4'-epi-doxorubicin (EPI-DXR) and mitomycin C (MMC), on iNOS induction by lipopolysaccharide in rats. Ascites cells and bone marrow showed the highest induction of iNOS in the tested organs. Administration of EPI-DXR to rats strongly inhibited iNOS induction in lung, ascites, and bone marrow, but only slightly in liver and spleen. MMC administration inhibited the induction in the most immune reactive organs.

Animals↗
PubMed2002

Provision of sexual health services to adolescent enrollees in Medicaid managed care.

OBJECTIVES: This Seattle project measured sexual health services provided to 1112 Medicaid managed care enrollees aged 14 to 18 years. METHODS: Three health maintenance organizations (HMOs) that provide Medicaid services for a capitated rate agreed to participate. These included a non-profit staff-model HMO, a for-profit independent practice association (IPA), and a non-profit alliance of community clinics. Analyses used health maintenance organizations' administrative data, chart reviews, and Medicaid encounter data. RESULTS: Health maintenance organizations provided primary care to 54% and well care to 20% of Medicaid enrollees. Girls were more likely than boys to have their sexual history taken or to be given condom counseling. Only 27% of sexually active girls were tested for chlamydia, with significantly lower rates of testing among those who spoke English as a second language. The nonprofit staff-model plan outperformed the for-profit independent practice association on most measures. CONCLUSIONS: Substantial room for improvement exists in sexual health services delivery to adolescent Medicaid managed care enrollees.

Adolescent↗
PubMed2006

Erythropoietin reduces the development of nonseptic shock induced by zymosan in mice.

OBJECTIVE: Erythropoietin is a potent stimulator of erythroid progenitor cells, and its expression is enhanced by hypoxia. In the present study, we investigated the effects of erythropoietin (1000 IU/kg subcutaneously) on the development of nonseptic shock caused by zymosan. DESIGN: Prospective, randomized study. SETTING: University-based research laboratory. SUBJECTS: Male CD mice. INTERVENTIONS: Mice received either intraperitoneally zymosan (500 mg/kg, administered intraperitoneally as a suspension in saline) or vehicle (0.25 mL/mouse saline). Erythropoietin was administered at the dose of 1000 IU/kg subcutaneously, 1 and 6 hrs after zymosan administration. Organ failure and systemic inflammation in mice was assessed 18 hrs after administration of zymosan and/or erythropoietin. MEASUREMENTS AND MAIN RESULTS: Treatment of mice with erythropoietin (1000 IU/kg subcutaneously, 1 and 6 hrs after zymosan administration) attenuated the peritoneal exudation and the migration of polymorphonuclear cells caused by zymosan. Erythropoietin also attenuated the lung, liver, and pancreatic injury and renal dysfunction caused by zymosan as well as the increase in myeloperoxidase activity caused by zymosan in the lung and intestine. Immunohistochemical analysis for nitrotyrosine and poly(ADP-ribose) revealed positive staining in lung and intestine tissues obtained from zymosan-treated mice. The degree of staining for nitrotyrosine and poly(ADP-ribose) was markedly reduced in tissue sections obtained from zymosan-treated mice, which received erythropoietin. In addition, administration of zymosan caused severe illness in the mice characterized by a systemic toxicity, significant loss of body weight, and a 70% mortality rate at the end of observation period (7 days). Treatment with erythropoietin significantly reduced the development of systemic toxicity, the loss in body weight, and the mortality caused by zymosan. CONCLUSIONS: This study provides evidence, for the first time, that erythropoietin attenuates the degree of zymosan-induced nonseptic shock in mice.

Animals↗