Economic efficiency of gate-keeping compared with fee for service plans: a Swiss example.

Study Objective: The impact of isolated gate-keeping on health care costs remains unclear. The aim of this study was to assess to what extent lower costs in a gate-keeping plan compared with a fee for service plan were attributable to more efficient resource management, or explained by risk selection.

Design: Year 2000 costs to the Swiss statutory sick funds and potentially relevant covariates were assessed retrospectively from beneficiaries participating in an observational study, their primary care physicians, and insurance companies.

Pharmacokinetic and pharmacodynamic interaction of single doses of valsartan and atenolol.

Objective: Valsartan (V), a specific inhibitor of the angiotensin II receptor subtype, AT1, has been developed for treatment of hypertension. Combination therapy with a beta-adrenoceptor blocking agent might be considered in cases with insufficient efficacy of V alone. Therefore, an interaction trial was performed to evaluate the effects of co-administration of V on the pharmacokinetics of atenolol (A), and vice versa, and to monitor the pharmacodynamic response of plasma angiotensin II (ANG II) concentrations and plasma renin activity (PRA), as well as of heart rate and blood pressure, under resting and exercise conditions.

Pharmacokinetic and pharmacodynamic interaction of single oral doses of valsartan and furosemide.

Objective: Pharmacokinetic and pharmacodynamic interactions between single oral doses of valsartan (160 mg) and furosemide (40 mg) were investigated in an open, randomized, three-period crossover study in twelve healthy male subjects.

Methods: A washout period of one week was observed between treatments. Pharmacokinetic measurements included plasma concentrations of valsartan and furosemide, and urinary excretion of the latter.

CGP 36742: the first orally active GABAB blocker improves the cognitive performance of mice, rats, and rhesus monkeys.

The learning capacity of experimental animals in cognitive tests can be improved by blockade of the GABAB receptors. After treatment with the GABAB antagonist CGP 36742, mice performed better in a passive-avoidance test; rats did likewise in a partner-recognition test, and rhesus monkeys also in a "conditional spatial color" task. The effects demonstrated in these three different species and covering diverse manifestations of learning and memory give reason to hope that this new active principle may prove therapeutically useful.

Antialdosterones: incidence and prevention of sexual side effects.

The use of spironolactone in the treatment of hypertension has been limited by the occurrence of sexual side effects, mainly menstrual disturbances in women and gynaecomastia in men. In order to minimize this limitation on the use of an effective potassium-sparing antihypertensive agent, two strategies can be proposed: (1) A decrease in the daily dose of spironolactone. In 182 patients with essential hypertension treated with spironolactone alone for a mean follow-up period of 23 months, daily doses of 75-100 mg were as effective on blood pressure as doses of 150-300 mg.