[Assessment of criteria for forming follow-up groups of patients at high risk for ulcerogenesis in ambulatory care]. / Otsenka kriteriev formirovaniia grupp nabliudeniia sredi lits s faktorami vysokogo riska ul'tserogeneza v usloviiakh polikliniki.

A method of clinico-laboratory examinations to reveal persons at high risk for the development of duodenal ulcer, suitable for wide use during prophylactic medical screenings was devised. The rise of the levels of serum pepsinogen-I, pepsin and hexosamines in the urine, being of prognostic importance as applicable to ulcerogenesis, was the most significant indicator in screening risk group patients. During 3 to 5 years of the screened group follow-up and carrying out health measures, peptic ulcer was ascertained in 8.4% of the patients with chronic gastroduodenitis. Of these, 66.6% had initially suffered from pylorobulbitis. It is shown that there is a real opportunity of preventing ulcer formation in patients with chronic primary gastroduodenitis under outpatient conditions.

The infusion center: a model for outpatient parenteral antibiotic therapy.

Outpatient parenteral treatment of infectious diseases has developed from primitive beginnings to its present state as the standard of care in many areas. The large infusion center described here is headed by physicians who specialize in infectious diseases and occupies a free-standing building where the pharmacy, laboratory, physicians' offices, examination rooms, and finance departments are centralized for efficiency, flexibility, and convenience. Each patient is seen by a physician, pharmacist, and nurse; these health care professionals share data about the patient and offer 24-hour coverage of questions and emergencies. Treating a wide variety of diseases, physicians utilize their experience and the center's intercommunication system to choose drugs most suitable for outpatient use and to carry on research. Costs in the center run between 50% and 60% lower than those in the hospital. Reimbursement, although difficult in the past, has improved considerably, but some third-party payers, including Medicare, have not reimbursed for outpatient intravenous antibiotic therapy.

Adolescents & AIDS. Three Michigan physicians reach out to educate youth about AIDS/HIV.

Three Michigan doctors are taking promising new approaches to bring home the tough health care issues facing adolescents in the 1990's--most importantly, AIDS. All three approaches, which range from a school-based clinic to a questionnaire, attempt to solve specific, and difficult problems--like HIV infection--by improving the broader health care education and treatment needs of all adolescents. Only one of the approaches singles out HIV infection as its sole target. But all three provide new avenues to deal with this problem--avenues adolescents are willing and capable of traveling.

How to initiate and operate a low-cost screening mammography center.

An in-depth "how-to" report on initiating and operating a low-cost screening mammography facility is presented. It is based on a successful program of this type in Charlotte, North Carolina, and includes information on feasibility determination, financial analysis, site selection and preparation, equipment, public relations, promotion, and operational details. The authors believe that use of such a model, with modification as necessary, should result in a successful program and a valuable community service.