Introducing managed care in Switzerland: impact on use of health services

The objectives of this study were to assess changes in the self-reported use of health care services after gatekeeping by general practitioners and a global budget were introduced in the health insurance plan for students at the University of Geneva, Switzerland, in October 1992. A random sample of 336 members of the University plan answered questions about their use of health care services during the year before (1992) and the year after (1993) the introduction of managed care. Similar data were collected among a random sample of 300 members of a comparison plan. All participants were 18–44 y old in 1992, spoke French and lived in Geneva. The proportion of insurees who visited specialists decreased by 10% in the University plan between 1992 and 1993 and remained unchanged in the comparison group. The proportion of insurees who visited general practitioners increased by 12% in the University plan and remained unchanged in the comparison group. No effects on the total number of health care visits, on hospitalisations or on use of medications were detected. The introduction of gatekeeping and of a global budget managed by physicians was associated with a transfer of patient visits from specialists to general practitioners.     

全硬盘自动播出网络系统探析

介绍了吉安电视台全硬盘自动播出网络系统设计指导思想及系统构成,该系统采用网络技术实现资源共享,采用多级安全措施确保安全播出.     

The effects of treatment with growth hormone alone or in combination with oxandrolone in a group of Turner's syndrome children. A preliminary study

The authors analyzed the clinical and psychological effects of GH (group 1) and GH plus oxandrolone (group 2) in a group of 11 Turner girls aged 6.3-14 years. The results showed a significant improvement of posttreatment height velocity vs pretreatment height velocity for both study groups. No significant differences were found between the two groups. A girl of group 2 manifested a defect of sexual identification.     

Effects of bromocriptine on bone maturation in tall adolescents. Comparison of the Greulich-Pyle and Tanner TW 2 RUS methods

The effect of bromocriptine 7.5 mg/day for 8 to 14 months on bone maturation has been studied in 33 excessively tall adolescents (25 females and 8 males aged 11 to 16 years, at pubertal stages P2 - P3), using comparatively the atlas of Greulich and Pyle and the RUS method of Tanner and Whitehouse. With the Greulich and Pyle evaluation, bone age was very significantly increased during treatment: p less than 0.001 in females, p less than 0.01 in males. The RUS method gave significantly greater evaluation of bone age (p less than 0.001), so that the treatment-induced acceleration of bone maturation was less significant: p less than 0.01 in females, NS in males. These data confirm that bromocriptine in constitutionally tall adolescents acts mainly through an increase of pubertal bone maturation. Moreover they point out once again the difficulties and discrepancies of height prediction.     

Skeletal imaging effects of pamidronate therapy in osteosarcoma patients

Background  

After observing metaphyseal changes in pediatric and young adult patients with osteosarcoma who were treated with pamidronate, we initiated a retrospective study to identify bone findings on computed radiography of the chest and extremities, chest CT, extremity MRI, and radionuclide bone scans in this population.     

Micronuclei Assay in Exfoliated Buccal Cells from Individuals Exposed to Arsenic in Argentina

Drinking arsenic (As)-laden water for a long time affects a population’s health and leads to chronic hydroarsenicism, which is associated with an increased incidence of different types of cancer. To determine the potential genotoxic risk associated with different degrees of environmental exposure to inorganic As by way of drinking water, micronuclei (MN) frequency in exfoliated buccal cells was evaluated in Argentina among rural populations of Santiago del Estero and urban populations of Buenos Aires. The exposed group in Santiago del Estero (La Firmeza and Santos Lugares localities) showed a significant increase in MN frequency in epithelial cells compared with controls (Monte Quemado and Urutau localities) (p = 0.0005). With regard to the Buenos Aires groups, Navarro individuals (the exposed group) exhibited a significant difference compared with controls (Ciudad Autónoma de Buenos Aires) (p = 0.0002). Comparison of MN frequencies between Santiago del Estero and Buenos Aires individuals showed that genotoxic effects of As in drinking water exhibit variation between rural and urban groups, probably due to individual susceptibility being an important incidence factor. The results clearly show that MN assay in buccal mucosa cells is an ideal methodology with which to measure potential genetic risk related to environmental As exposure in humans.