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PubMed1998

Using artificial intelligence to automate remittance processing.

The consolidated business office of the Allegheny Health Education Research Foundation (AHERF), a large integrated healthcare system based in Pittsburgh, Pennsylvania, sought to improve its cash-related business office activities by implementing an automated remittance processing system that uses artificial intelligence. The goal was to create a completely automated system whereby all monies it processed would be tracked, automatically posted, analyzed, monitored, controlled, and reconciled through a central database. Using a phased approach, the automated payment system has become the central repository for all of the remittances for seven of the hospitals in the AHERF system and has allowed for the complete integration of these hospitals' existing billing systems, document imaging system, and intranet, as well as the new automated payment posting, and electronic cash tracking and reconciling systems. For such new technology, which is designed to bring about major change, factors contributing to the project's success were adequate planning, clearly articulated objectives, marketing, end-user acceptance, and post-implementation plan revision.

Accounts Payable and Receivable↗
PubMed2000

[Comparative clinico-immuno-chemical analysis of remittent and secondary-progressive course of multiple sclerosis].

Immunochemical monitoring of remittent and secondary-progressive course of multiple sclerosis (MS) was performed. Examination of 61 patients was performed during 3 years. Inflammatory cytokines: (IL-1, IL-2, IL-6, TNF-alpha), were measured in supernatants of the peripheral blood mononuclear cells while some neurospecific proteins (GFAP and alpha 2-GP), vesicular-cellular molecules of the adhesion (sVCAM-1) were estimated in blood serum. 50 healthy donors entered the control group. The results demonstrated a remaining functional tension of cell immunity and a decrease of the resistance of hematoencephalic barrier (HEB) at all MS stages. However, in secondary-progressive MS concentration of the sVCAM-1 in blood serum was elevated as compared with the control group, patients with remittent course and in clinical improvement. It is suggested that some functional alteration of HEB endothelium, manifest in constant pathologic expression of sVCAM-1 molecule, is one of the pathochemical mechanisms promoting progression of MS process.

Adolescent↗
PubMed1991

[A case report on tuberculosis with remittent fever after tonsillectomy in a patient under CAPD].

This report pertains to a case of chronic renal failure with remittent fever after tonsillectomy. The patient was 45-year-old female who had been undergoing continuous ambulatory peritoneal dialysis (CAPD) for five years. She was admitted to our hospital after being diagnosed as having pyrexia with tonsillitis. A tonsillectomy was performed. Although several symptoms and signs, such as fever, positive CRP and accelerated ESR, improved transiently by the seventh postoperative day, remittent fever and cervical lymph node swelling suddenly recurred after the eighth postoperative day. In spite of the antibiotic therapy, the fever continued for two weeks thereafter. A culture to check for acid-fast bacilli was negative, but on epithelioid cell granuloma with a small central abscess was found in the biopsy specimen of the lymph node. INH was prescribed to her. After three days of INH administration, the patient became afebrile. Patients with long-term dialysis are known to be very susceptible to tuberculous diseases. However, to date, there has been no report of tuberculosis being accompanied by a fever after a tonsillectomy. As it might be difficult to make a tubercular diagnosis on such a febrile patient, early antituberculous chemotherapy is recommended for patients with antibiotic-refractory fever.

Female↗
PubMed1984

Penicillamine and other remittive agents in rheumatoid arthritis: comparisons and interaction.

Penicillamine treatment of rheumatoid arthritis was compared with gold and other remittive agents by reviewing the literature and studying the patients in our penicillamine clinic with respect to their previous responses to chrysotherapy. Penicillamine compares well with other remittive agents with respect to efficacy and toxicity. Prior chrysotherapy does not determine or predict the subsequent efficacy of penicillamine . Patients who reacted adversely to gold tended to react adversely to penicillamine; proteinuria and rash tended to recur.

Anti-Inflammatory Agents↗
PubMed1991

The impact of the Gulf war on migration and remittances in Asia and the Middle East.

The author discusses the impact of the 1990 Gulf war on the migrant worker populations in the region, with a focus on migration and remittances in Asia and the Middle East. Both immediate and long-term effects are considered. "From the perspective of foreign migrant communities living in the Gulf...the war...was much more of a disaster for Arabs than for Asians....Arab migrant populations...were dramatically affected by the Gulf crisis. In contrast, the Asian migrant community was largely concentrated in Saudi Arabia and the [United Arab Emirates] and remained relatively less affected by the crisis. Subsequent polarization in the Arab world gives Asian labor-exporting countries an unexpected opportunity to increase their share of Gulf labor markets still further in the coming years." (SUMMARY IN FRE AND SPA)

Asia↗
PubMed1997

Refugee remittances: conceptual issues and the Cuban and Nicaraguan experiences.

"This article assesses the notion that the determinants of remittances generated by refugee flows, particularly from Communist-inspired systems, are different from those associated with labor migrations....These differences have a major bearing on how labor migrants and refugees perceive their relationship with countries of origin. The propensity of labor migrants to dissociate themselves from the home country is considerably less than among refugees whose perceptions are mediated by opposition to the ruling regime and other factors, such as political relations between refugee-sending and refugee-receiving countries and whether or not there has been a regime change or one is expected to occur. The conceptual issues elaborated here are based on the Cuban-American experience, but also reflect an assessment of Nicaraguan emigration during the 1980s."

Americas↗
PubMed1985

International migration, remittances and real incomes: effects on the source country.

"This article deals with the impact of remittances from emigrants on real incomes for different groups in their country of origin in a two-by-two model with one traded and one nontraded good. It is shown that emigration does not necessarily raise the real income of the emigrants themselves. If the traded good is capital intensive, nonmigrant workers gain and capitalists lose, whereas if it is labor intensive, the outcome depends on what happens to the price of the nontraded good. The result of a rise is that capitalists gain and workers lose, while a fall has the opposite effect."

Demography↗
PubMed2004

The remittive effects of alefacept.

The duration of response to treatment with alefacept has been assessed in patients with moderate to severe chronic plaque psoriasis who responded to alefacept therapy in phase 2 and phase 3 clinical studies. In a phase 2 trial, duration of response was based on time to retreatment with alefacept. In two phase 3 studies, the more objective measure of maintenance of a > or =50% reduction from baseline Psoriasis Area and Severity Index (PASI 50) was used. Two patient subsets were analyzed: (1) those who achieved a PASI 75 at any time during the trials and (2) those who achieved a Physician Global Assessment of "clear" or "almost clear" at any time during the trials. Regardless of the criterion used or the route of alefacept administration (intravenous or intramuscular), the median duration of response to alefacept therapy ranged from 7 to 10 months across the three studies. Alefacept is a remittive therapy for psoriasis.

Alefacept↗
PubMed2002

Biosurgery supports granulation and debridement in chronic wounds--clinical data and remittance spectroscopy measurement.

BACKGROUND: Maggot therapy (biosurgery) has received increasing interest for the debridement of chronic wounds and for the improvement of wound healing. The purpose of this study was to investigate the clinical effects, side-effects, and possible mechanisms of action of biosurgery. METHODS: Biosurgery was used for debridement in 30 patients with chronic leg ulcers of mixed origin. The effect of a single application of maggots for 1-4 days was evaluated by a clinical wound score and contact-free spectroscopy. Side-effects were recorded. RESULTS: Debridement was rapid and selective. The wound secretion was temporarily increased. We observed a significant improvement of the wound score with a decrease from 13.5 +/- 1.8 to 6.3 +/- 2.7 (P < 0.001). The treatment was well tolerated in most patients. Twelve out of 30 patients reported temporary pain, but only two needed analgesic treatment. Other side-effects included venous bleeding in one patient. The remittance spectra showed an improvement of tissue oxygenation as revealed by the characteristic oxygen doublet peak (548 and 575 nm). CONCLUSIONS: Biosurgery is an effective and rapid treatment for the debridement of chronic wounds and the improvement of wound healing. A possible mode of action is the increase in tissue oxygenation. More studies are needed.

Adolescent↗
PubMed2003

Climatotherapy at the Dead Sea is a remittive therapy for psoriasis: combined effects on epidermal and immunologic activation.

BACKGROUND: The beneficial effect of climatotherapy at the Dead Sea (CDS) for psoriasis has been established clinically but there is a striking lack of studies assessing its in vivo effect at the molecular and cellular levels. OBJECTIVE: We sought to study the response of activated immunologic cells and keratinocytes in psoriatic lesions to CDS. METHODS: A total of 27 patients with chronic, stable, plaque-type psoriasis treated with CDS for 28 consecutive days were evaluated with the Psoriasis Area and Severity Index score and quantitative histologic measures. RESULTS: After 4 weeks of treatment, the overall Psoriasis Area and Severity Index score decreased by 81.5%. Complete clearance was achieved in 48% of the patients, and moderate to marked improvement in 41%. The average duration of remission was 3.3 months. Histologically, there was an overall reduction in malpighian layer thickness by 63.4%, and keratinocyte hyperplasia, assessed by Ki-67 cell cycle antigen expression, decreased by 78%; residual cell proliferation was confined mainly to the basal layer. These changes were accompanied by normalization of keratin 16 expression in 90% of the patients. T lymphocytes were almost totally eliminated from the epidermis (depletion of >90% of CD3(+) and CD25(+) cells), with only a low number remaining in the dermis (depletion of 69.4% of CD3(+) cells and 77.4% of CD25(+) cells). This reduction in activated T cells was accompanied by a marked reduction in HLA-DR expression by epidermal keratinocytes. CONCLUSIONS: CDS is a highly effective and remittive treatment for moderate to severe plaque-type psoriasis, leading to a reversal of both pathologic epidermal and immunologic activation.

Adult↗
PubMed1979

Remittent painful ophthalmoplegia: the Tolosa-Hunt syndrome? A report of seven cases and review of the literature.

Seven patients with remittent painful ophthalmoplegia for which no specific local cause was found were seen during a period of five years. One had coincidental rheumatoid arthritis, and another had actinomycosis of the ipsilateral middle ear and contralateral parotid gland. The other five had no evidence of generalised autoimmune disease nor any other systemic disorder, two having separate episodes affecting each side. A history of relapsing and remitting painful ophthalmoplegia is suggestive of the Tolosa-Hunt syndrome, but it is rarely possible to confirm that the lesion in the cavernous sinus is the result of non-specific granulomatous infiltration so that the diagnosis remains one of exclusion. Carotid arteriography may show narrowing of the intracavernous part of the internal carotid artery. Orbital venography may also be helpful, particularly when the carotid arteriogram is normal. We believe that the Tolosa-Hunt syndrome is more common in England than is generally realised, but that its clinical features do not necessarily indicate a single pathological entity. Its recognition is important since the response to steroids, although not specific, is rapid in most patients, and the prognosis for complete recovery is relatively good.

Actinomycosis↗
PubMed1993

Pregnancy and multiple sclerosis: a longitudinal study of 125 remittent patients.

The relationship between pregnancy and multiple sclerosis (MS) was assessed in a clinic-based, prospectively followed, population of 125 patients with a remittent onset of MS who had been followed for a mean (SD) of 10.3 (0.1) years. Thirty three women had a total of 49 pregnancies of which 32 had been full term and 17 terminated. There was a three-fold increase in the relapse rate per year during the first three months following delivery, compared with the baseline period of the same patients [1.62(0.38) vs 0.51(0.08) p = 0.05]. During pregnancy itself, the relapse-rate was not different from baseline. The overall relapse rate of the pregnancy group was lower than that of a control group without pregnancies after MS onset, but similar to that of patients who had children after MS onset, but no pregnancy during follow up. Pregnancy did not lead to increased disability. These results confirm that post partum increase in relapse rate is the main event related to pregnancy in MS and underline the difficulties of undertaking prospective studies in this field.

Adult↗
PubMed1996

Treatment of relapsing-remittent multiple sclerosis with recombinant human interferon-alfa-2a: design of a randomised, placebo-controlled, double blind trial in Norway.

A multicentre, randomised, double-blind, placebo controlled study to evaluate the efficacy and safety of 4.5 and 9.0 MIU recombinant human interferon alfa-2a (Roferon-A) given thrice weekly in patients with relapsing-remittent multiple sclerosis is described. The patients are treated for 6 months followed by a 6 months drug-free period. The primary objective is to determine new disease activity analysed by monthly MRI with gadodiamide (GdDTPA-BMA, Omniscan). The study is conducted at eight centers in Norway and is completed in January 1996.

Contrast Media↗
PubMed2002

Selective targeting of T cell subsets: focus on alefacept - a remittive therapy for psoriasis.

Psoriasis is an immune-mediated disease in which memory-effector (CD45RO+), skin-homing T cells play a key role in driving the disease process. Available therapies are often poorly tolerated, none are curative and most only suppress disease symptoms without attacking the underlying cause of the illness. Alefacept (Ameviv, Biogen, Inc.) is a fully human lymphocyte function associated antigen-3/immunoglobulin G1 fusion protein that targets memory-effector T cells by binding CD2 on the T cell and Fc phi receptor III IgG receptors on accessory cells, thereby preventing T cell activation and proliferation and causing selective T cell apoptosis. To date, alefacept has been studied in moderate-to-severe chronic plaque psoriasis and in a pilot study of psoriatic arthritis. In chronic plaque psoriasis, alefacept produced significant and sustained improvements in psoriasis symptoms. There was no evidence of disease rebound or worsening of psoriasis following treatment cessation. Multiple courses provided consistent efficacy, with a trend for more rapid and greater clinical improvement in subsequent courses. Alefacept reduced circulating CD4+ and CD8+ memory-effector T cells, with relatively no change in naive (CD45RA+) T cells or B cells. Alefacept also reduced IFN-phi-secreting Tcells in lesional biopsies of psoriatic skin. These reductions all correlated with the observed clinical effect. Alefacept was well-tolerated throughout these studies, with a side effect profile similar to placebo. There was no evidence of generalised immunosuppression or increased risk of infection or malignancy. Alefacept did not alter the primary or acquired immune response in psoriatic patients. Clinical data obtained to date support the use of alefacept as a safe and remittive therapy for psoriasis.

Alefacept↗
PubMedDate not supplied

[Tolerance to interferon beta-1b amongst patients with remittent recurrent multiple sclerosis after more than one year of treatment].

INTRODUCTION: Interferon beta-1b modifies the natural history of the remittent recurrent forms of multiple sclerosis. An analysis was made of its efficiency, tolerance and adverse effects on patients with over one year of treatment. MATERIAL AND METHODS: 16 patients were studied (10 women, 6 men) with ages between 19 and 51 years, incapacity scale (EDSS) 2.61 +/- 1.07 and an annual rate of outbreaks before treatment of 1.65 +/- 0.25, who received 4 MUI/48 h/s.c. of interferon beta-1b x 15 days, afterwards continuing with 8 MUI/48 h/s.c. Corticoids were associated in four cases. Biochemical controls and mass neurological evaluations were carried out as well as a watch being kept for clinical and analytical secondary effects. RESULTS: The annual rate for outbreaks was 0.68 +/- 0.29. Amongst the most frequent adverse effects the pseudoflu syndrome was notable (87%), with an average duration of 10.46 +/- 1.4 weeks, well tolerated with paracetamol. The local reactions (87%) were light and not related to the zone of injection. The patients experienced a sensation of fatigue following the injection in 50% of the cases, although in only one case did this reach a moderate intensity. Analytical alterations were found to be 43.7%, always within the margins of grade 1 of the clinical toxicity scale. With one patient developed an acute depressive syndrome, during which treatment was interrupted, later restarted at half the maintenance dosage. CONCLUSIONS: In our series, just as in other studies, pseudoflu syndrome and local reactions were the most frequent secondary effects. Both complications are light, of brief duration and well tolerated by the patients.

English Abstract↗
PubMed1992

Coping and maintenance strategies of spontaneous remitters from problem use of alcohol and heroin in Switzerland.

A short review of the literature is followed by data from a Swiss study on spontaneous remission from problem use of alcohol and heroin conducted in 1988. The analysis of the collected life histories led to the identification of a motivation phase, a stage of decision implementation, and a struggle for maintenance as the major sequence of the autoremission process. The discussion focuses on the "tools" which remitters use to put their decision into practice. The coping mechanisms identified are "diversion," "self-monitoring," and "distancing." In relation to the maintenance phase, the perception of possible relapse situations and intuitive predictions of the subjects and collaterals are analyzed.

Adaptation, Psychological↗
PubMed1992

Taming the remittance beast electronically.

The next step in coralling the back-office-beast is automating remittance processing. Before taking any steps in that direction, healthcare providers need to establish new procedures for cash management and patient accounting. Opportunities exist for related uses of electronic data interchange (EDI), which will provide additional benefits but will also trigger fundamental changes in the way healthcare providers do business.

California↗
PubMed1995

Implementing the Medicare electronic remittance advice.

Some hospitals have delayed converting to the electronic remittance advice recently implemented by the Health Care Financing Administration because the process is unfamiliar and because the electronic data interchange (EDI) translation software is expensive. However, the University of Pittsburgh Medical Center (UPMC) found that it could begin to reap the benefits of EDI technology by using existing software and hardware along with a common-sense approach to implementation. As a result, UPMC has begun an organizationwide EDI initiative designed to reduce costs and improve cash flow.

Centers for Medicare and Medicaid Services, U.S.↗