Acetylation and oxidation phenotypes in malignant lymphoma

Summary 101 white British adults with Hodgkin's disease or non-Hodgkin's lymphoma were phenotyped for acetylation status using dapsone and for oxidation status with debrisoquine prior to treatment. The frequencies of acetylation and oxidation phenotypes in these patients were compared with reference populations of normal subjects. No significant difference in phenotype frequency was found in the lymphoma patients. This suggests that neither of these metabolic polymorphisms for exogenous compounds is strongly associated with these malignancies. Owing to the small size of the study, however, an effect of these phenotypes could not be excluded.     

Adjusted hospital death rates: a potential screen for quality of medical care.

Increased economic pressure on hospitals has accelerated the need to develop a screening tool for identifying hospitals that potentially provide poor quality care. Based upon data from 93 hospitals and 205,000 admissions, we used a multiple regression model to adjust the hospitals crude death rate. The adjustment process used age, origin of patient from the emergency department or nursing home, and a hospital case mix index based on DRGs (diagnostic related groups). Before adjustment, hospital death rates ranged from 0.3 to 5.8 per 100 admissions. After adjustment, hospital death ratios ranged from 0.36 to 1.36 per 100 (actual death rate divided by predicted death rate). Eleven hospitals (12 per cent) were identified where the actual death rate exceeded the predicted death rate by more than two standard deviations. In nine hospitals (10 per cent), the predicted death rate exceeded the actual death rate by a similar statistical margin. The 11 hospitals with higher than predicted death rates may provide inadequate quality of care or have uniquely ill patient populations. The adjusted death rate model needs to be validated and generalized before it can be used routinely to screen hospitals. However, the remaining large differences in observed versus predicted death rates lead us to believe that important differences in hospital performance may exist.     

Occupational health nursing education. Curricular content in baccalaureate programs

It is important that occupational health nursing content be offered in academic institutions to support the scope of practice in the specialty. Less than 50% of the schools responding (N = 215) included content specific to occupational health nursing concepts and practice, related fields of knowledge, and management of the occupational health unit. Occupational health nurses in practice settings and educational institutions should collaborate on the development of occupational health content in nursing school curricula.     

Age-related shrinkage of cortically projecting cholinergic neurons: A selective effect

The number and size of basal forebrain neurons that provide the cholinergic innervation for the cerebral cortex, amygdala, and hippocampus were studied in young and aged mice. The results showed that these neurons became substantially smaller with increasing age. This effect was relatively selective, since the immediately adjacent cholinergic neurons in the striatum did not show a change of similar magnitude. The shrinkage of these basal forebrain neurons may account for the decline of cholinergic innervation that occurs with age. In the material that we examined, aging did not influence the number of cholinergic neurons in the basal forebrain, only their size. It seems, therefore, that the age-related changes in cholinergic function (and their putative behavioral consequences) are not associated with a substantial component of irreversible cell death.     

Measurement of concentrations of the histamine H1 receptor antagonist temelastine in biological fluids

A high-performance liquid chromatographic analysis of temelastine in biological fluids with UV detection at 229 nm is presented. The method involves ether extraction followed by re-extraction into phosphoric acid and chromatography on a reversed-phase column. The method has a lower limit of detection of 0.05 mg L-1 and is adequate for use in pharmacokinetic studies following oral administration.