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Based on the study of the bactericidal activity of the purulent fluid and cytograms of 55 patients with suppurative processes and 19 patients with sepsis the authors explain the character of the antimicrobial "struggle" of the macroorganism in the infected wound and formation of septicopyemic metastases during sepsis. A test for diagnosing sepsis is suggested. 相似文献
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Delea TE Hagiwara M Thomas SK Baladi JF Phatak PD Coates TD 《American journal of hematology》2008,83(4):263-270
Deferoxamine mesylate (DFO) reduces morbidity and mortality associated with transfusional iron overload. Data on the utilization and costs of care among U.S. patients receiving DFO in typical clinical practice are limited however. This was a retrospective study using a large U.S. health insurance claims database spanning 1/97-12/04 and representing 40 million members in >70 health plans. Study subjects (n = 145 total, 106 sickle cell disease [SCD], 39 thalassemia) included members with a diagnosis of thalassemia or SCD, one or more transfusions (whole blood or red blood cells), and one or more claims for DFO. Mean transfusion episodes were 12 per year. Estimated mean DFO use was 307 g/year. Central venous access devices were required by 20% of patients. Cardiac disease was observed in 16% of patients. Mean total medical costs were $59,233 per year including $10,899 for DFO and $8,722 for administration of chelation therapy. In multivariate analyses, potential complications of iron overload were associated with significantly higher medical care costs. In typical clinical practice, use of DFO in patients with thalassemia and SCD receiving transfusions is low. Administration costs represent a large proportion of the cost of chelation therapy. Potential complications of iron overload are associated with increased costs. 相似文献
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Linda Abetz Diana Rofail Polyxane Mertzanis Rebecca Heelis Kathleen Rosa Crystal Tellefsen Aude Roborel de Climens Christopher McBurney Simu Thomas 《Advances in therapy》2009,26(6):627-644
Introduction Management of patients with Alzheimer’s Disease (AD) can exert a substantial burden upon caregivers. As new modes of treatment
administration are developed, it is important to assess caregiver satisfaction and preference in a standardized manner. This
study describes the development of the Alzheimer’s Disease Caregiver Preference Questionnaire (ADCPQ) to assess AD caregivers’
satisfaction with and preference for patch or capsule treatments in AD patients.
Methods Twenty-five published articles (1987-2002) were reviewed to identify potential ADCPQ domains. Three caregiver focus groups
(n=24) were conducted to develop a first draft of the questionnaire. After evaluating the acceptance of ADCPQ to caregivers
through in-depth interviews (n=10), its psychometric properties were assessed using data from 986 patients enrolled in a multicenter, randomized, double-blind,
four-arm, placebo- and active-controlled, 24-week trial.
Results Focus groups indicated that caregivers expressed dissatisfaction with current AD treatment routines including limitations
related to: efficacy, administration schedule, number of pills, adherence to treatment, side effects, and taking pills. In-depth
interviews with caregivers found the ADCPQ to be comprehensible with an acceptable layout. The resultant ADCPQ comprises three
modules: A) baseline, 11 items assessing treatment expectations; B) week 8, 33 items on satisfaction and preferences with
treatment options; C) week 24, 10 items assessing overall opinions of treatment options. Missing data per item was low (≤0.3%)
and domain internal consistency reliability was good (0.71–0.91). Preference items were also valid when evaluating concordance
and discordance between convenience and satisfaction patch and capsule domain scores.
Conclusion AD treatment puts a significant strain on caregivers. New modes of treatment delivery may be less burdensome to caregivers,
thereby increasing satisfaction and potential treatment adherence. The ADCPQ was well accepted by AD caregivers and its domains
demonstrated satisfactory psychometric properties. The ADCPQ is a useful tool to understand caregiver preferences for patch
versus oral therapies in AD. 相似文献
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Dargaud Y Trzeciak MC Meunier S Angei C Pellechia D Négrier C Vinciguerra C Dargaud Y 《British journal of haematology》2003,123(2):342-345
Activated protein C (APC) resistance phenotype/genotype discrepancy is a very rare event. The objective of this study was to characterize the molecular mechanisms in two cases of APC phenotype/genotype discrepancy. An approach using direct sequencing of each exon and splicing junctions of the factor V gene showed that two novel factor V null mutations combined with heterozygous factor V Leiden mutation were responsible for this discrepancy. Our results suggest the necessity to use both phenotypic and genotypic analyses in some cases to determine an accurate diagnosis. 相似文献
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Dorokhina NA Savchenko AA Chesnokov AB Polonskaia ZhG Ol'khovskiĭ IA Shakina NA 《Klinicheskaia laboratornaia diagnostika》2001,(1):39-43
Functional activity of blood leukocytes of normal subjects and patients with herpesvirus infection was studied by the chemiluminescent method in vitro with specific antigenic preparations (tick-borne encephalitis vaccine, ADPT vaccine, and herpetic vaccine). Functional response of blood leukocytes to vaccine preparations is specific and depends on the antigen and metabolic status of cells of recipients. The range of chemiluminescent response of blood leukocytes is wide: no changes in tick-borne encephalitis vaccine, weak response to herpetic vaccine, and pronounced changes in functional activity in response to ADPT vaccine. Testing with different doses of specific inducers helps additionally evaluate the metabolic reserve of blood leukocytes. A pronounced response of leukocytes to specific antigenic preparations in vitro (e.g. to ADPT vaccine) prompts development of methods for predicting the reaction of nonspecific reactivity system to vaccination. 相似文献
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Delea TE Edelsberg J Sofrygin O Thomas SK Baladi JF Phatak PD Coates TD 《Transfusion》2007,47(10):1919-1929
BACKGROUND: Patients with thalassemia major require iron chelation therapy (ICT) to prevent complications from transfusional iron overload. Deferoxamine is effective, but requires administration as a slow continuous subcutaneous or intravenous infusion five to seven times per week. Deferiprone is a three-times-daily oral iron chelator, but has limited availability in the United States. Deferasirox is a once-daily oral iron chelator that was approved in the United States in 2005 for patients older than 2 years of age with transfusional iron overload. STUDY DESIGN AND METHODS: Published evidence on rates of compliance with ICT and the association between compliance, and the incidence and costs of complications of iron overload, in patients with thalassemia major was reviewed. RESULTS: A total of 18 studies were identified reporting data on compliance with ICT, including 7 that examined deferoxamine only, 6 that examined deferiprone only, and 5 that compared deferoxamine and deferiprone; no studies reporting compliance with deferasirox were identified. In studies of deferoxamine only, estimated mean compliance ranged from 59 to 78 percent. Studies of deferiprone generally reported better compliance, ranging from 79 to 98 percent. Results of comparative studies of deferoxamine and deferiprone suggest that compliance may be better with oral therapy. Numerous studies demonstrate that that poor compliance with ICT results in increased risk of cardiac disease and endocrinopathies, as well as lower survival. Although data on the costs of noncompliance are limited, a recent model-based study estimated the lifetime costs of inadequate compliance with deferoxamine to be $33,142. CONCLUSIONS: Inadequate compliance with ICT in thalassemia major is common and results in substantial morbidity and mortality, as well as increased costs. 相似文献
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