The economic cost of a streptococcal tonsillitis episode

OBJECTIVE: To estimate the cost of a streptococcal tonsillitis episode from the data of a questionnaire. SETTING: Five primary health centres in the west of Sweden. PARTICIPANTS: 101 consecutive patients treated for streptococcal tonsillitis. MAIN OUTCOME MEASURE: The cost estimation included costs for physician visit and drug, travel costs to and from the primary health centre, cost of lost production resulting from the patient's or the guardian's absence from work for physician visit or sick-leave, and cost of telephone consultation with a physician or nurse. RESULTS: The period of illness was on average seven days, time to recovery after treatment five days, and the mean period of sick-leave 2.5 days. The total cost of a tonsillitis episode was about SEK 3,300 (385 USD). Of this sum, the cost for the antibiotic accounted for only 3% and loss of production for 75%. CONCLUSION: Differences in the cost of drugs only have a minor influence on the total cost, while factors causing loss of production, such as efficacy and side effects of the drug, have a greater influence. Economic evaluation of pharmaceuticals will be more relevant in the future, and in the search for the most effective treatment, cost effective studies will be integrated with clinical trials.     

Oxysterol incorporation into rat aorta resulting in elastin compositional changes

The incorporation of dietary cholestan-3β, 5α, 6β-triol (triol) into rat thoracic aortic tissue and changes in amino acid composition of the elastin were investigated to identify the cytotoxic properties of the triol. Weanling male Sprague-Dawley rats were fed the following diets for three months: (i) normal chow, (ii) normal chow with 1% (w/w) cholesterol added, or (iii) normal chow with 0.9% (w/w) cholesterol and 0.1% (w/w) triol added. Triol levels in the blood and in the thoracic aortic tissue were measured. Compositional changes of elastin were also determined. After three months on the triol-containing diet, triol was found in the thoracic aorta but was not detected in the blood. Amino acid analyses of the aortic tissue elastin revealed that the proline levels in the triol-fed animals were significantly greater than in the other two diet groups, while the elastin levels of leucine, aspartate, arginine, and phenylalanine decreased significantly. The mechanism for these observed changes induced by triol may reflect alternate splicing of elastin messenger ribonucleic acid (mRNA) resulting in structural changes in the elastin molecule. Dietary triol does contribute to tissue triol content and is associated with aortic elastin compositional changes. How these changes may contribute to the development of cardiovascular disease is not known.     

Comparison of Nonenzymatic Browning Kinetics in Spray-dried and Freeze-dried Carbohydrate-based Food Model Systems

ABSTRACT: Nonenzymatic browning (NEB) rates of amorphous, carbohydrate-based, freeze-dried and spray-dried food model systems containing L-lysine and D-xylose as reactants (5% w/w) were investigated at different temperatures (40 °C, 50 °C, 60 °C, 70 °C, 80 °C, 90 °C). Samples were exposed to various relative vapor pressure levels (11%, 23%, and 33%) to adjust water contents. Water sorption was determined gravimetrically, and data were modeled using the Brunauer-Emmett-Teller and Guggenheim-Anderson-deBoer equations. Glass transition, T_g, was observed by differential scanning calorimetry. NEB was followed spectrophotometrically. The surface structures of freeze-dried and spray-dried models were observed by scanning electron microscopy. The freeze-dried samples and the spray-dried samples showed different surface structures and slight differences in thermal behavior. Crystallization of component sugars in the freeze-dried samples was slightly more delayed than in spray-dried samples. The glass transition temperatures in spray-dried samples were higher than those of the freeze-dried samples at the same water activity. The temperature dependence of NEB rate in both systems followed the Arrhenius kinetics, but the activation energies were different. Williams-Landel-Ferry equation could be used to model the NEB kinetics in the freeze-dried system, but for the spray-dried system, negative constant values were not within the allowable range.     

Water sorption isotherms of freeze-dried milk products: applicability of linear and non-linear regression analysis in modelling

Summary  Water sorption of various freeze-dried milk products was modelled using several water sorption isotherm models, most of which proved to be applicable. Sorption models were fitted to experimental data using linear and non-linear regression analysis. Both methods gave almost the same prediction of water sorption when the model had a good fit. The GAB model was considered to be the most applicable in predicting water sorption in practical applications, as the use of one universal model is desirable. Time-dependent changes, e.g. lactose crystallization above glass transition, were taken into account in the water sorption modelling. Water contents and relative humidities which allowed changes in physico-chemical properties were not included in the modelling, because of unsteady amounts of sorbed water.     

A comparison of subcellular element concentrations in frozen-dried, plastic-embedded, dry-cut sections and frozen-dried cryosections

Biological X-ray microanalysis of diffusible elements within cellular and subcellular compartments requires preparation methods to retain electrolytes in the compartments they occupied in vivo. X-ray microanalysis of frozen-dried, plastic-embedded samples has been used to quantitate electrolytes at the cellular level. We have compared the subcellular elemental distribution in dry cut sections from such samples with that in ultrathin frozen-dried cryosections. Rat pancreases were quench-frozen onto a helium-vapor-cooled copper block. Cryosections were cut at 130-150 K, transferred using a Gatan cold stage, frozen-dried in the column and analysed at 190 K. Tissue fragments were frozen-dried at 190 K, and cut on a dry knife at 293 K. Both samples provided images permitting unambiguous identification of all major compartments except the Golgi complex. Intracellular potassium-to-sodium ratios obtained on frozen-dried plastic-embedded sections were lower than for cryosections (e.g. 1.77 in basal cytoplasm in plastic sections as compared to 4.34 for cryosections) and varied with the pre-embedding procedure (e.g. 1.77 in formaldehyde-fixed as compared to 2.87 in osmium-fixed plastic sections). Potassium gradients between adjacent organelles were large in cryosections and insignificant in plastic-embedded material. Higher cytoplasmic phosphorus, potassium and sulfur concentrations were observed in cryosections. Therefore, a redistribution of electrolytes and covalently bound elements occurred subcellularly in the plastic sections. Calcium was quantifiable in most organelles in cryosections but the plastic lowered sensitivity too much to permit routine calcium quantification. We conclude that in our hands frozen-dried, plastic-embedded samples were compromised and provided lower sensitivity than cryosections.(ABSTRACT TRUNCATED AT 250 WORDS)     

Solar energy transmittance of translucent samples: A comparison between large and small integrating sphere measurements

Optical transmittance and reflectance of a translucent plastic PTFE film have been measured over the solar wavelength range using different integrating spheres. The same sample has been measured with small and large spheres and the total solar transmittance has been obtained from both broad band measurements and from integration of spectral data. The fact that the sum of reflectance and transmittance often exceeds 100% shows that all types of spheres tend to overestimate the transmittance of this highly scattering sample. This error can be attributed to the sphere geometry in combination with the light scattering properties of the sample, and unless proper correction of recorded data is carried out the error may be as large as 5–10%. Some specific errors are presented and an approximate correction procedure is suggested.These results show that there is a need for a transmittance standard which can be used to calibrate integrating spheres. Such a standard with negligible thickness would be especially useful for measurements with large, broadband integrating spheres, but would also be helpful for the correct handling of data from small spectral instruments.     

Absorption and urinary excretion of the coffee diterpenes cafestol and kahweol in healthy ileostomy volunteers

Epidermal growth factor (EGF) has been found to induce enhanced gap junctional intercellular communication (GJIC) in the human kidney epithelial cell line K7. This is in contrast to what is reported for other cell types, which all show decreased GJIC in response to EGF. In the present study it is shown that 12-O-tetradecanoylphorbol-13-acetate (TPA) and EGF induce similar phosphorylation pattern of the gap junction protein connexin43 (Cx43) in K7 cells, although their effects on GJIC are opposite. Tyrosine phosphorylation of a 42 kD protein was observed to be induced concomitantly with phosphorylation of Cx43. EGF was however found to induce only serine phosphorylation of Cx43, indicating that the tyrosine kinase activity of the EGF receptor was not directly affecting the gap junction protein. The 42 kD protein phosphorylated on tyrosine was identified to be a mitogen activated protein (MAP) kinase. Both EGF and TPA was found to activate MAP kinase in these cells. Phosphorylation of Cx43 and enhancement of GJIC in response to EGF occurred with difference in time course. Phosphorylation of Cx43 was completed within 15 min, while the enhanced GJIC appeared 2-3 h later. It is therefore possible that regulation of synthesis or transport of Cx43 is responsible for the increase in GJIC, rather than direct involvement of Cx43 phosphorylation. This is in support of our previous finding that protein synthesis is necessary for EGF induced upregulation of GJIC in K7 cells.     

An interactive computer program for randomization analysis of response curves with facilities for multiple comparisons.

An interactive Fortran program, MUCRA, is presented. The program can perform randomization analysis of a completely randomized or randomized-blocks design extended to growth and response curves. A single-step Scheffé-type procedure as well as the Peritz's closed step-down procedure have been implemented which control the familywise type I error-rate. In general, MUCRA is suitable as a computer tool for a distribution-free analysis of variance with repeated measures. The use of MUCRA is demonstrated by analyzing the effects oxprenolol and atenolol have on exercise heart rate. Oxprenolol is a non-selective beta-blocker with moderate intrinsic sympathomimetic activity (ISA), given by the Oros delivery system. Atenolol is a beta 1-selective blocker without ISA. A randomized placebo-controlled crossover design was used to compare the effects of the beta 1-blockers on heart rate during a progressive maximal exercise test on a bicycle ergometer. Application of the Scheffé-type procedure showed that the two drugs significantly (alpha = .05) reduce the heart rate during the exercise test at the three prechosen times (2, 5, and 24 hr) after intake. The reduction from atenolol is more pronounced than from oxprenolol Oros at 2 and 5 hr.     

MR of the heart under pharmacologic stress

Magnetic resonance imaging is one method for assessing cardiac function and perfusion at rest and under stress conditions. In this article, the potential of stress magnetic resonance imaging for evaluating ischemic heart disease is reviewed, and technical aspects of some developments that may contribute to comprehensive magnetic resonance imaging assessment of heart disease under rest and stress are discussed.