Filariasis and erisipela in Santo Domingo

Protein complexes present different degrees of stability. We have previously described a glycoprotein from Bacillus thuringiensis that appeared as a multimer unable to be dissociated by the usual SDS-containing sample buffers of pH 6.8. In order to dissociate the complex, a SDS-containing sample buffer of pH 9 was described. In the present report three additional protein complexes with different degrees of stability and the effect of that dissociating sample buffer are described. The study of SDS critical micellar concentration values as a function of pH explains the improvement of dissociating properties at pH 9.     

The teaching of physical examination in undergraduate nursing schools in the city of Sao Paulo]

The present study is an exploratory survey attempting to get the point of view of the faculty of subjects considered responsible by teaching physical examination in the nursing undergraduate schools of S?o Paulo city that were selected for this study. The goals were: to detect the situation of teaching of propaedeutics basis; to identify factors that make them difficult; and to identify the recommendations of the faculty for the improvement of teaching and its implementation. The population studied was formed by 39 faculty of the subjects considered responsible by teaching physical examination. Results show us there is not a specific subject to teach physical examination, although it is taught mainly in Fundamental Nursing; faculty are not entirely prepared to teach physical examination. To improve teaching of physical examination, the faculty suggest enhancing their knowledge and skills as well as to create a specific subject to teach physical examination with sufficient hours according to the content.     

Sulfation of endogenous compounds and xenobiotics--interactions and function in health and disease

Sulfation is a major detoxication mechanism for endogenous compounds and xenobiotics performed by a family of sulfotransferase isoenzymes. Understanding the normal cellular functions of these different sulfotransferases and the way in which endogenous and exogenous factors are able to influence their activity and expression will provide us with the information necessary to develop novel therapeutic strategies for conditions where sulfation may be implicated. This concept is discussed and is illustrated by examples including adverse drug reactions, fetal development and cancer.     

The relation of job satisfaction and degree of openness about one''s sexual orientation for lesbians and gay men

Previous studies have shown that cardiovascular patients benefit from exercise. The explanations are partly physical and partly psychological, yet evidence for the latter is contradictory, possibly because only selected samples start and maintain prolonged exercising. The authors examined psychological effects of short-term exercise started as soon as possible after myocardial infarction, focusing on the motivation for health of 62 male and female patients who had had a myocardial infarction 7 to 10 days earlier. Patients were divided into those who exercised for a week in a recovery camp, those who merely stayed for a week in the camp, and those who did not stay in the camp. Results of before and after tests indicated that two scores of the motivation for health (goals and norms) of patients in the exercise group increased, even when complications, former exercising, and infarct location were considered. A month later, 53 of the patients completed a cardiological adjustment questionnaire. The exercise group scored higher than the others on 8 of 9 domains, including subjective health state, sexuality, and work. Even short-term supervised exercise, if done immediately after infarction, has a great potential for beneficial psychological effects, the authors concluded.     

What are cancer patients willing to pay for prophylactic epoetin alfa? A cost-benefit analysis

BACKGROUND: Anemia, one of the most common complications of cancer chemotherapy, has been managed with red blood cell (RBC) transfusions. As an alternative, the agent epoetin alfa has the potential to reduce the transfusion requirements of patients receiving cancer chemotherapy. To estimate the value that cancer patients place on the drug, an economic analysis using the concept of willingness to pay (WTP) was conducted. METHODS: The method of WTP was used within the framework of a classical cost-benefit analysis to estimate the net cost or benefit of administering prophylactic epoetin alfa to cancer patients. This estimate included the direct cost of epoetin alfa administration and savings secondary to reduced RBC transfusions. A cohort of 100 cancer patients who received or were scheduled to receive cisplatin or noncisplatin chemotherapy (50 per group) were then interviewed to measure the maximum WTP (net benefit) that they experienced with epoetin alfa. RESULTS: Regarding the benefits they would experience after 3 months of epoetin alfa administration, patients receiving cisplatin and noncisplatin therapy stated that they would be willing to pay an average of 587 U.S. dollars (U.S.$587) (95%CI: $300-$875) and U.S.$613 (95%CI: $324-$902), respectively. These benefits were then subtracted from the total cost of the drug when administered to patients receiving cisplatin (U.S.$3530) and noncisplatin (U.S.$3653) therapy. This produced a net incremental treatment cost of U.S.$2943 (95%CI: $2655-$3230) and U.S.$3039 (95%CI: $2750-$3328) for the respective treatment groups. CONCLUSIONS: The results of the current study suggest that the routine administration of epoetin alfa to cancer patients receiving myelosuppressive chemotherapy is a highly resource-intensive treatment policy with modest benefit to patients. Additional research is required to identify high risk patient subgroups who would benefit most from the drug. [See editorial on pages 2427-9, this issue.]