Pharmaceutical services in the treatment of hemophiliac patients.

Pharmaceutical services in the treatment of hemophiliac patients in Sweden are described. To prevent arthropathy and improve quality of life, patients with severe hemophilia receive prophylactic treatment. Hemophiliac patients are referred for diagnosis, treatment, and follow-up to one of three hemophilia treatment centers. Patients are seen once or twice yearly for routine checkups. A new system for the distribution of antihemophilic factor and factor IX has been implemented to improve availability and reduce risks and costs. Patients registered at a center receive antihemophilic factor or factor IX from the corresponding hospital pharmacy. The number of different manufactured batches to which a patient can be exposed is restricted, and complete distribution data are recorded for each patient, enabling follow-up studies and facilitating withdrawals of faulty batches. Distribution of emergency kits to patients who do not receive supervised home therapy ensures the availability of treatment for bleeding episodes. Two studies performed to explore ways to reduce drug waste led to improvements in patient information, product guidelines, and equipment and a better understanding of the problems associated with product changes. Specialized pharmaceutical services in Sweden contributed to successful hemophilia treatment and reduced its cost.

New intravesical contrast medium for CT: preliminary studies with arachis (peanut) oil.

Computed tomography is recognized as a valuable adjunct to clinical staging of bladder carcinomas, with a diagnostic accuracy of 70%-80%. Technique modifications in order to improve the diagnostic results include the use of various intravesical contrast agents. All hitherto described contrast agents suffer from drawbacks, either due to insufficient contrast resolution or to partial volume effect. Arachis (peanut) oil has been used in 69 patients and seems to meet many of the demands that can be made on a good intravesical contrast agent. Both bladder wall and tumor are well delineated, and diffuse and local thickening of the wall can be appreciated., The oil is nonhygroscopic and may therefore be used together with other contrast agents, if necessary.