Cost-effectiveness of white cell-reduction filters in treatment of adult acute myelogenous leukemia

The objective of this study was to compare the cost and cost- effectiveness of three transfusion strategies in the treatment of acute myelogenous leukemia: 1) the use of unfiltered pooled platelets until alloimmunization developed and of crossmatch-compatible single-donor platelets thereafter; 2) the use of filtered blood components until alloimmunization occurred and of crossmatch-compatible single-donor platelets thereafter; and 3) the use of single-donor platelets from the beginning. The data sources were English language articles on transfusion medicine in acute leukemia and the management of acute leukemia and review of the transfusion experience at the H. Lee Moffitt Cancer Center. The method was decision analysis with a software program for cost-effectiveness, sensitivity analysis, threshold evaluation, and Monte Carlo sensitivity analysis. In the basic models, the total costs of the first, second, and third strategies are, respectively, $12,557.14, $11,406.17, and $13,016.16 without bone marrow transplant and $14,002.72, $12,281.89, and $13,727.48 with bone marrow transplant. The threshold between the first and second strategies in regard to risk of refractoriness to filtered blood components and pooled platelets was 0.30 and 0.27, respectively, without bone marrow transplant and 0.28 and 0.40 with bone marrow transplant. According to a Monte Carlo sensitivity analysis of 500 samples, the second strategy is more cost- effective than the first in 76 percent of cases. It is concluded that the use of filtered blood components is unlikely to increase the cost of treatment.     

Trifluoracetylierung von aminosäureestern und dipeptidestern mit N-trifluoracetyl-polyamid 66.

N-Trifluoroacetyl-Polyamid 66 ( 1 ) is used for the trifluoroacetylation of amino acid- and dipeptide esters. Advantages and limitations of the polymeric reagent compared with low molecular trifluoroacetylating reagents are discussed. A mixture of amino acid methyl esters can be converted by 1 to the N-trifluoroacetyl derivatives, which are separated and identified by gas chromatography.     

Hydrophobic adsorption chromatography of colony-stimulating activities and erythroid-enhancing activity from the human monocyte-like cell line, GCT

The human cell line, GCT, secretes hemopoietins into serum-free culture medium. The conditioned medium contains activities that stimulate neutrophil-monocyte, macrophage, eosinophil, and erythroid colony growth in human marrow cultures. We have used hydrophobic adsorption chromatography to separate a neutrophil-monocyte colony-stimulating factor (CSF) from the other colony-stimulating activities. This hydrophobic CSF has no eosinophil-stimulating activity and is virtually devoid of erythroid-stimulating activity.     

Psychological responses to the needle-free Medi-Jector® or the multidose Disetronic® injection pen in human growth hormone therapy

The aim of the study was to test the hypothesis that daily administration of growth hormone using the Medi-Jector® results in fewer adverse psychological responses than needle injection with a multidose injection pen. The Medi-Jector is a needle-free injection device that can deliver growth hormone subcutaneously through jet injection. The group studied consisted of 18 children aged 10 y or over who were participating in a study of the bioequivalence and bioequipotence of the administration of growth hormone through jet injection or needle injection. Previously, all subjects had received growth hormone therapy with commercially available multidose injection pens. The study was designed as a prospective, randomized, two-period cross-over trial. A questionnaire was used to assess psychological responses such as non-compliance, opinion on ease of preparation, affective responses to administration and local side-effects, as well as overall preference. In addition, the subjects kept a diary during the study. The subjects found the Medi-Jector less offputting (p < 0:01), less painful with respect to both frequency (p <0.04) and intensity (p < 0.01) and less unpleasant (p < 0.05) than a multidose injection pen with a 28G needle (p <0.01). No difference in compliance was detected. Most subjects preferred the Medi-Jector for future use (p < 0.05). The mean score on a 1–10 point scale (10 is excellent) was 7.9 (SD 1.4) for the Medi-Jector and 6.8 (SD2.3) for the multidose injection pen (p <0.08). The prevalence of visible bruises each day was higher (p < 0.01) with the Medi-Jector (2.5, SD 2.1) than with the multidose injection pen (0.7, SD 1.1), but children showed indifferent affective responses to bruising. Thirteen out of 18 subjects decided to continue therapy with the Medi-Jector (p < 0.06). It is concluded that use of the Medi-Jector in growth hormone therapy tends to lead to fewer adverse psychological responses than a multidose injection pen with 28G needles.     

Isometric abdominal muscle training and G tolerance

Methods to increase G tolerance of pilots flying high-performance aircraft are of vital importance. Straining maneuvers to increase G tolerance involve abdominal muscles, and high intra-abdominal pressures (IAP) are recorded during G exposure. This study was carried out to examine the effects of an 11-week abdominal muscle training program on maximal IAP, G tolerance and muscle strength/endurance in 10 fighter pilots. G tolerance was measured in a human centrifuge using simulated aerial combat maneuvers (ACM). The pilots had a higher maximal IAP before training than a control group. G tolerance, maximal IAP, and maximal peak torque of knee extensors were not changed by the training. In contrast, leg muscle endurance increased (p less than 0.01) and ratings of local perceived exertion decreased (p less than 0.01). Static endurance of the knee extensors was positively correlated (p less than 0.05) with G tolerance. It is concluded that the present abdominal training program, employed in experienced fighter pilots, is not sufficient to increase IAP or G tolerance.     

广东省4个月婴儿生长状况与喂养模式调查

在广东省的城乡对７７７名４个月的婴儿进行了生长状况与喂养模式的现况调查，与ＷＨＯ推荐的ＮＣＨＳ体格生长标准比较，城市婴儿４个月时其身长与体重的发育良好，而农村婴儿的身长和体重则低于参考标准，也低于同龄的城市婴儿。６４％城市婴儿和９９％的农村婴儿在４个月时仍喂哺母乳，７７％的城市婴儿和５９％的农村婴儿４个月前已经添加了辅助食品，辅助食品的种类有明显的城乡差别，农村辅食质量次于城市。母乳喂养有利于城乡４个月婴儿的体重生长，４个月前添加辅食影响农村婴儿体重生长。应继续在广东城乡提倡母乳喂养，不提倡过早添加辅食，应提高农村婴儿的断奶过渡食品的质量。     

Fatigue and EMG of Repeated Fast Voluntary Contractions in Man

A fatigue test consisting of repeated fast maximal contractions of the left quadriceps muscle in an isokinetic apparatus was performed by 12 healthy male subjects (19–25 yrs). EMG signals were recorded from the surface of the left vastus lateralis muscle, from which also biopsies were obtained for muscle fibre classification. Only minor changes were observed in the EMG variables despite a decrease in muscle strength performance, in terms of peak torque, work and power to about 50% of initial values after 100 contractions. The concomitantly obtained positive correlation between the increase in EMG/torque ratio and the individual percentage of fast twitch (FT) muscle fibres indicated that local factors in the muscle, primarily in the FT fibres, were causing the development of fatigue during repeated dynamic contractions with high power outputs.     

Patients' attitudes regarding out-of-hospital blood transfusion

BACKGROUND: While the administration of blood transfusions outside of the hospital has become more prevalent, little is known about patients' attitudes regarding this practice. STUDY DESIGN and METHODS: Twenty- nine adult patients who regularly received blood transfusions in a hospital's outpatient clinic and had never received home transfusions were surveyed. Linear analogue and categorical monetary scales were used to evaluate their responses to a series of questions. RESULTS: At the time of the survey, 27 study participants (93%) did not want home transfusions, and 21 (72%) thought home transfusions posed a greater risk than hospital based transfusion. More than half (56%) of the participants were unwilling to pay more for a home transfusion for themselves than for an outpatient hospital-based transfusion. Participants were willing to pay more for a home blood transfusion for a hypothetical patient requesting transfusions at home. The lack of available transportation and poor patient health were identified as important factors in determining how much more they would be willing to pay for transfusions at home. CONCLUSION: While blood transfusions at home may become more accessible, many patients may prefer to receive their transfusions in the hospital, probably because home transfusions are thought to pose a greater risk. A patient's health and the availability of transportation were determined to be important factors in decisions about how much more money to spend for transfusions at home than for those in an outpatient hospital setting.