Remote intervention engagement and outcomes in the Clinical Trials in Organ Transplantation in Children consortium multisite trial

Remote interventions are increasingly used in transplant medicine but have rarely been rigorously evaluated. We investigated a remote intervention targeting immunosuppressant management in pediatric lung transplant recipients. Patients were recruited from a larger multisite trial if they had a Medication Level Variability Index (MLVI) ≥2.0, indicating worrisome tacrolimus level fluctuation. The manualized intervention included three weekly phone calls and regular follow-up calls. A comparison group included patients who met enrollment criteria after the subprotocol ended. Outcomes were defined before the intent-to-treat analysis. Feasibility was defined as ≥50% of participants completing the weekly calls. MLVI was compared pre- and 180 days postenrollment and between intervention and comparison groups. Of 18 eligible patients, 15 enrolled. Seven additional patients served as the comparison. Seventy-five percent of participants completed ≥3 weekly calls; average time on protocol was 257.7 days. Average intervention group MLVI was significantly lower (indicating improved blood level stability) at 180 days postenrollment (2.9 ± 1.29) compared with pre-enrollment (4.6 ± 2.10), p = .02. At 180 days, MLVI decreased by 1.6 points in the intervention group but increased by 0.6 in the comparison group (p = .054). Participants successfully engaged in a long-term remote intervention, and their medication blood levels stabilized. NCT02266888.     

Communication Patterns Among Male Couples with Open and Monogamous Agreements

Archives of Sexual Behavior - Male couples in open relationships tend to have as equally fulfilling relationships as monogamous male couples; however, less is known about communication differences...     

Treatment of intra-abdominal infections: cost comparison of ampicillin/sulbactam and clindamycin/gentamicin

The cost of 2 g ampicillin/1 g sulbactam given IV piggyback qid was compared with 900 mg clindamycin admixed with 1.5 mg/kg gentamicin given IV piggyback tid for the treatment of perforated or gangrenous appendicitis in 116 patients. Fifty-eight ampicillin/sulbactam-receiving patients incurred greater costs for IV supplies (+104.6/patient vs +67.9/patient) and nursing administration costs (+16.5/patient vs +10.7/patient). On the other hand, pharmacist and technician preparation costs were greater for the 58 clindamycin/gentamicin-receiving patients (+15.4/patient vs +13.3/patient). The clindamycin/gentamicin-receiving patients also incurred additional changes for laboratory fees and pharmacokinetic monitoring--+18.7/patient and +36.1/patient, respectively. When incorporating all cost parameters, there were no statistically significant differences in mean total drug therapy costs between the two treatment regimens--+433.3 +/- +58.5/patient for ampicillin/sulbactam and +373.8 +/- +86.2/patient for clindamycin/gentamicin.     

Characterization of four newly established human colorectal adenocarcinoma cell lines from Chinese patients.

Four colon adenocarcinoma cell lines, CC-M2, CC-M3, CC-M4, and CC-M2NM, have been established from surgical specimens of 18 unselected patients without the use of "feeder" cells and additional growth factors (e.g., insulin, hydrocortisone, etc.) in the culture medium. The methods of primary cultivation of tissue explants are described. Studies of determination of morphology, growth curve, plating efficiency, chromosomal analysis, CEA and beta-HCG synthesis, and tumorigenicity, were done to characterize the cell lines. Significant variations have been found in one of the four cell lines, both in vitro and in vivo studies. There are distinct phenotypes in the established cell lines which may be useful in studying the cell differentiation and progression of colorectal cancer.     

Outsourcing. Health care organizations are considering strategic goals in making outsourcing decisions

More health care organizations are outsourcing the management of some or all of their information systems. Executives at many organizations that have tried outsourcing say it enables them to focus on core competencies, better allocate resources, get more information technology at less cost, share risks of implementing information technology with outsourcers and guarantee access to skilled labor. But the information technology outsourcing market remains relatively small in health care because many CIOs still are wary of turning over control of important functions to outsiders.     

Intracellular antigen determination by flow cytometry in leukaemic cells

Several fixation and permeabilization techniques that enable the flow cytometric analysis of the cell contents have been introduced in recent years. These methods allow sensitive detection of intracellular antigens that facilitates the diagnosis of certain diseases. We have undertaken in this study to evaluate a simple method of fixation and permeabilization using 2% paraformaldehyde and Tween 20. Intracellular antigens in three different leukaemia cases were analysed. We found that the method was reliable and easy. Intracellular kappa light chains were found in abundance in a case of plasma cell leukaemia. CD3 and CD22 were found in greater amount intracellularly than on the surface in pre-T-ALL and pre-pre B-ALL respectively.