Creating a business backbone. A first person recount of the planning process involved in laying the foundation of a successful rehabilitation clinic

Opening your own outpatient therapy center will likely seem an insurmountable task at times. Broken down into the stages of mission establishment, planning and goal setting, establishing financial viability, choosing equipment, promoting your product, and, finally, hiring staff, this task will become less onerous. Remember, it is your practice. True to your vision, and just like high school, be prepared for an emotional roller-coaster ride. Done correctly, this experience will be just as thrilling and ultimately much more gratifying.     

A national surveillance system for tracking tobacco news stories

BACKGROUND: Two of the major goals of tobacco prevention and control activities are to change social norms and influence policy. The news media can play an important role for achieving both goals. METHODS: The Centers for Disease Control and Prevention's Office on Smoking and Health created a surveillance system to track tobacco stories in the news media beginning in 2004. The system was developed based on reviewing lessons from previous news media tracking efforts, including defining the purpose of the system, using a parsimonious approach to sample media outlets, and attending to data-quality issues. Tobacco news stories were systematically identified and coded from ten newspapers, four news wire services, and seven national television networks. RESULTS: Findings indicated that from January 2004 through June 2005, tobacco-related stories were in selected major newspapers virtually every day. More than 70% of all newspaper stories contained one of only three main story themes: policy or regulation (31.0%), legal issues (23.8%), or health effects or statistics (18.1%). Television news stories on tobacco were much less common, but increased substantially during the first 6 months of 2005 compared to 2004. Health effects/statistics (50.5%) were the dominant theme for television, with policy/regulation a distant second (19.5%). CONCLUSIONS: Tobacco-related media coverage can be systematically tracked and characterized. These findings may have value to public health researchers and policymakers who wish to evaluate efforts to curb tobacco-related disease.     

Fodrin and band 4.1 in a plasma membrane-associated fraction of human neutrophils

Erythrocytes possess a well-characterized submembranous filamentous network which interacts with transmembrane glycoproteins and is composed primarily of spectrin, ankyrin, band 4.1, and short actin filaments. An analogous structure was recently described in platelets. Human polymorphonuclear leukocytes (PMNs) were examined for the presence and plasma membrane association of similar proteins. Isolated PMNs, free of contamination with erythrocytes or platelets, were disrupted by nitrogen cavitation and separated into subcellular organelles on a discontinuous Percoll gradient. Detergent lysates of plasma membrane vesicles, but not azurophilic or specific granules, contained insoluble actin filaments and associated proteins. Immunoblots of detergent-insoluble plasma membrane fractions contained proteins recognized by antibodies to brain fodrin and erythrocyte band 4.1, whereas blots probed with antibodies to erythrocyte spectrin and ankyrin were negative. Fodrin and band 4.1 were not detected in granule fractions, but some fodrin was present in the cytosol. The association of proteins related to fodrin and band 4.1 with the plasma membrane suggests that PMNs contain a submembranous skeleton structurally analogous to that of erythrocytes and platelets. The specific function of these proteins and their structural organization in human PMNs await further study.     

Fludarabine: a new agent with major activity against chronic lymphocytic leukemia

Fludarabine was used to treat 68 patients with previously treated chronic lymphocytic leukemia (CLL). Nine (13%) patients achieved a complete remission and 30 (44%) a partial remission. The response rates for Rai stages 0 to 2, 3, and 4 were 64%, 58%, and 50% respectively. Seventeen (43%) of the 40 Rai stage 1 to 3 patients and four (19%) of the Rai stage 4 patients returned to Rai stage 0. Survival was strongly correlated with the final Rai stage achieved. The survival of the 11 partial responders with residual disease consisting only of residual bone-marrow nodules was similar to the complete responders (36+ months) and superior to the other partial response patients (16 months). The response to fludarabine was rapid, with 36 (92%) of the 39 responders having achieved at least a partial response following the first three courses. Complete responses occurred in the blood, liver, spleen, and lymph nodes in 48% to 69% of the patients. Eradication of all disease in the bone marrow occurred in only 13% of the cases. Neutropenia and thrombocytopenia occurred in 56% and 25% of evaluable courses. Major infections occurred in 9% of evaluable courses and fevers of unknown origin or minor infections in 12% of courses respectively. Myelosuppression and infection were more common in patients with initial Rai stages 3 and 4 and in nonresponding patients. Other toxicity was mild. No CNS toxicity was noted.