Giant cell hepatitis associated with direct Coombs' test-positive hemolytic anemia is a rare condition of childhood and the pathogenesis remains unclear. An autoimmune activation and loss of self-tolerance in these patients may be the underlying pathology related to the response of some of the patients to immunosuppressive treatment. Herein, we report the clinical presentation and course of thr...

This study sought to elucidate the mechanism by which human red cells, in a variety of clinical settings, become coated in vivo with autologous complement components in the absence of anti-red cell autoantibodies demonstrable by standard methods. By means of a newly developed complement-fixing antibody consumption test, previously undetectable red cell-bound gammaG globulin could be detected an...

BACKGROUND As studies evaluating substitution of care have revealed only limited evidence on cost-effectiveness, a trial was conducted to evaluate nurse practitioners as a first point of contact in Dutch general practices. AIM To estimate costs of GP versus nurse practitioner consultations from practice and societal perspectives. DESIGN OF STUDY An economic evaluation was conducted alongsid...

OBJECTIVE To compare costs of diagnosis and annual treatment of osteoporosis and hip fracture between the Instituto Nacional de Rehabilitación (INR) and the protocol used by the Seguro Popular de Salud (SPSS). METHODS Direct costs gathered in a prospective study with real cases at the INR are presented, and then this data is re-analyzed with the methodology and protocol for the SPSS to estima...

AIM In the Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure (EMPHASIS-HF), aldosterone blockade with eplerenone decreased mortality and hospitalisation in patients with mild symptoms (New York Heart Association class II) and chronic systolic heart failure (HF). The present study evaluated the cost-effectiveness of eplerenone in the treatment of these patients in t...

BACKGROUND With milestones-based assessment, there is an increased need for tools to facilitate direct observation of clinical trainees. This study was designed to compare a Mini-CEX tool to new direct observation tools (DOTs) linked to internal medicine milestones. METHODS A web based survey was used to examine satisfaction and usefulness of DOTs compared to the Mini-CEX. Residents and prece...

The historical total ozone measurements taken with Dobson Spectrophotometer #8 at Longyearbyen (78.2 N, 15.6 E), Svalbard, Norway, in the period 1950– 1962 have been re-analyzed and homogenized based on the original measurement logs, using present-day procedures. In lack of sufficient calibration information, an empirical quality assessment was performed, based on a climatological comparison wi...

Five type II kerogens, shown by elemental analysis and Rock-Eval pyrolysis to represent a gradient of thermal maturity, were further characterized using a range of solid-state 13C NMR spectroscopic techniques. 13C cross polarization (CP) NMR spectra of the kerogens confirmed the well-established pattern of increasing aromaticity with increasing thermal maturity. Spin counting showed that CP obs...

BACKGROUND When recommending the adoption of a new surgical intervention as opposed to maintaining an old one, surgeons need to consider the opportunity cost, which is the value of the forgone benefits. To inform these decisions, surgeons can use economic analyses of surgical practices. Unfortunately, economic analyses conducted alongside randomized controlled trials in surgery are rare. OBJE...

0.1% Protamine sulphate in normal (0.85% w/v) saline has been used as a diluent in Brucella serology instead of saline as such. The use of protamine sulphate in this concentration has obviated the need for performing the modified Coombs test to detect non-agglutinating Brucella antibodies. This method has been used in the Microbiological Diagnostic Unit of the University of Melbourne in the rou...