The costs of heparin-induced thrombocytopenia: a patient-based cost of illness analysis.

UNLABELLED: SUMMARY BACKGROUND AND OBJECTIVES: Due to the complexity of heparin-induced thrombocytopenia (HIT), currently available cost analyses are rough estimates. The objectives of this study were quantification of costs involved in HIT and identification of main cost drivers based on a patient-oriented approach. METHODS: Patients diagnosed with HIT (1995-2004, University-hospital Greifswald, Germany) based on a positive functional assay (HIPA test) were retrieved from the laboratory records and scored (4T-score) by two medical experts using the patient file. For cost of illness analysis, predefined HIT-relevant cost parameters (medication costs, prolonged in-hospital stay, diagnostic and therapeutic interventions, laboratory tests, blood transfusions) were retrieved from the patient files. The data were analysed by linear regression estimates with the log of costs and a gamma regression model. Mean length of stay data of non-HIT patients were obtained from the German Federal Statistical Office, adjusted for patient characteristics, comorbidities and year of treatment. Hospital costs were provided by the controlling department. RESULTS AND CONCLUSIONS: One hundred and thirty HIT cases with a 4T-score >or=4 and a positive HIPA test were analyzed. Mean additional costs of a HIT case were 9008 euro. The main cost drivers were prolonged in-hospital stay (70.3%) and costs of alternative anticoagulants (19.7%). HIT was more costly in surgical patients compared with medical patients and in patients with thrombosis. Early start of alternative anticoagulation did not increase HIT costs despite the high medication costs indicating prevention of costly complications. An HIT cost calculator is provided, allowing online calculation of HIT costs based on local cost structures and different currencies.

Comment on "Post-wildfire logging hinders regeneration and increases fire risk".

Donato et al. (Brevia, 20 January 2006, p. 352) concluded that logging after wildfire kills natural regeneration and increases fire risk. We argue that their paper lacks adequate context and supporting information to be clearly interpreted by scientists, resource managers, policy-makers, and the public.

New ways of determining structural groups in brown coals and their bioconversion products by FT IR spectroscopy.

New methods of determining the structural groups -COOH and -CH2- have been developed. The investigation of carboxyl groups is possible both after derivatization with p-fluorophenacylbromide and by quantitative interpretation of the Fourier transform infrared (FT IR) spectra. There exists a linear relationship between the results of these two methods that is generally valid for the analysis of all brown coal components. The maximum extinction coefficient of the symmetric stretching vibration band of the CH2 groups has been determined using model substances. This allows quantification of this structural group directly from the FT IR spectrum. The results agree with the contents of methylene groups as determined by 13C-cross polarization-magic angle spinning nuclear magnetic resonance (13C CPMAS NMR) spectroscopy. Using these methods, the COOH and CH2 groups contained in brown coals of the North Rhine region and in their bioconversion products have been quantified.

Effect of high-energy electron irradiation of chicken meat on thiobarbituric acid values, shear values, odor, and cooked yield.

Experiments were conducted to determine whether electron-beam irradiation would affect shear values, yield, odor, and thiobarbituric acid (TBA) values of chicken tissues. Broiler breasts (pectoralis superficialis) and whole thighs were irradiated with an electron-beam accelerator at levels to produce adsorbed doses of 100, 200, and 300 krads on the surface of the sample. The thigh samples were stored for 2, 4, and 8 days before testing for TBA values. The depth to which the radiation had penetrated the pectoralis superficialis muscle was also determined. Radiation penetrated 22 mm into slices of pectoralis superficialis muscle when 100 krad was absorbed by the surface of the tissue. The dose absorbed beneath the tissue surface to a depth of 10 mm was larger than the dose absorbed at the surface. The absorbed dose decreased as the depth of penetration increased. For cooked breast tissue, the shear values and moisture content were not affected by the absorbed radiation. Cooking losses of aged breast tissue were not affected by irradiation, but cooking losses were reduced in breast tissue that had not been aged. Irradiating uncooked thigh and uncooked breast samples produced a characteristic odor that remained after the thighs were cooked but was not detectable after the breast samples were cooked. With two exceptions, no significantly different TBA values were found that could be attributed to irradiation.

Effects of high-energy electron irradiation of chicken meat on Salmonella and aerobic plate count.

Four experiments were used to determine the effects of high-energy irradiation on the number of aerobic microorganisms and Salmonella on broiler breasts and thighs. Irradiation ranging from 100 to 700 kilorads (krads) was provided by a commercial-scale, electron-beam accelerator. Irradiation of broiler breast and thigh pieces with electron beams at levels of 100, 200, 300, 400, 500, and 600 krads showed that levels as low as 100 krads would eliminate Salmonella. When 33 thighs were tested after irradiation at 200 krads, only one thigh tested presumptive positive. The total number of aerobic organisms was reduced by 2 to 3 log10 cycles at irradiation levels of 100, 200, 300, 400, 500, 600, and 700 krads. Increasing the dose above 100 krads gave little if any additional benefit.

Social relationships, psychosocial adaptation, and intrainstitutional relocation of elderly men.

The intrainstitutional relocation of 40 men aged 53 to 91 years was studied in relation to social integration, and to behavioral and self-report measures of psychosocial adaptation. In both longitudinal and time-lag analyses of pre- and postrelocation data, relocated men scored lower on the attitude toward aging dimension (PGC Morale Scale, Lawton, 1975), had fewer friends, and evidenced better communication behavior (p less than .01) than did unrelocated men. The more sociable men showed more change after relocation than did men who were less sociable.

Psychosocial development and subjective well-being in an age cross-section of adults.

Though often cited, Erikson's theory has been relatively neglected in empirical studies of adult development, partly because few measures operationalize his psychosocial constructs. The present research examined the internal consistency and construct validity of an expanded version of the Inventory of Psychosocial Development (E-IPD) which included the generativity and ego integrity scales created by Boylin et al. [1]. Participants were seventy-nine adults with a mean age of forty-two and mean educational level of fifteen years. Total E-IPD scores were found to have high internal consistency but many individual stage scales did not. Men's E-IPD scores showed discriminant validity with respect to social desirability and women's E-IPD scores showed convergent validity with a measure of subjective well-being. Psychosocial development scores were largely unrelated to age, indicating that the E-IPD may have little validity as a measure of adult development.

Friendship, social interaction and subjective well-being of older men in an institutional setting.

The relationship of informal social interaction to subjective well-being of older adults was investigated using the PGC Morale Scale, the MACC Behavioral Adjustment Scale, and a sociometric interview which provided measures of peer friendship and frequency of social interaction. Respondents were fifty-four males aged fifty-two to ninety years, who were residents of a Veterans Administration domiciliary. The predicted positive correlation was obtained between morale and frequency of social interaction with persons outside the institution, but men's friendships within the institution were not related to morale. As expected, men who reported overall change in frequency of social interaction scored substantially lower on the PGC Morale Scale than those who perceived no change. Behavioral adjustment ratings of participants made by a staff member were positively correlated with friendship and social interaction scores. The results were thus consistent with a continuity model of aging, in which maintenance of accustomed levels of social interaction is related to subjective well-being.

Cognitive egocentrism in institutionalized adult males.

Spatial egocentrism and its relationships to discrimination ability and communicative egocentrism were investigated in a sample of 80 adult males from a single institutional setting. The participants ranged in age from 33 to 83 years. As predicted, no significant age differences were obtained on any of the three dependent measures. However, significant effects of order of task presentation indicated that the experimental procedure influenced performance on the spatial and communicative egocentrism and discrimination tasks. The findings, which provide support for the Piagetian position of maintenance of operational level through the life-span, were discussed in terms of social and affective factors which may influence adult performance on cognitive tasks.