Serum cholesterol levels in neutropenic patients with fever

Hypocholesterolemia, which often accompanies infectious diseases has been suggested to serve as a prognostic marker in hospitalized patients. Even though patients with chemotherapyinduced leukopenia are at high risk of infection and mortality, only limited information is available on serum cholesterol levels in these patients. We therefore measured serum cholesterol levels in 17 patients with hematological malignancies during chemotherapyinduced neutropenia and correlated it with clinical outcome. Patients with fever (>38.5 degreesC) showed a significant decrease in serum cholesterol levels within 24 hours. Eight days after onset of the fever nonsurvivors had significantly lower serum cholesterol levels (median 2.09 mmol/l, range 0.492.79, n=6) compared to survivors (median 3.23 mmol/l, range 1.684.86, n=11). Cholesterol levels in survivors returned to baseline levels at the time of discharge from the hospital. At the onset of fever, serum levels of inflammatory cytokines interleukin-6, tumor necrosis factor (TNF) and soluble TNF receptors p55 and p75 were elevated in all patients, but only TNF and TNF receptor p75 levels were significantly different in survivors and nonsurvivors. Our data suggest that a decrease in serum cholesterol levels is a prognostic marker in neutropenic patients with fever. Release of inflammatory cytokines may in part be responsible for hypocholesterolemia in these patients

Applications of Behavioral Economics in Philanthropy: Understanding Loss Aversion and Risk Tolerance in Grantmaking

This paper considers how individuals incorporate in philanthropy unavoidable considerations of loss and risk in decisions which are made under conditions of uncertainty, albeit tested by means of a "laboratory" experiment employing hypotheticals based on grant?making choices. Are natural and fundamental behavioral patterns exhibited in personal decision?making carried over into decisions made in the philanthropic context, or do new behaviors emerge when one moves from personal choices to philanthropic ones

Fauna of USSR: BIRDS. Volume II No 3, CHARADRIIFORMES, Suborder ALCAE

The present volume on the Fauna of the USSR deals with birds of the suborder Alcae and has appeared after a considerable interval. Like the four preceding parts (published between 1937 and 1947 and devoted to the study of birds) it is based mainly on investigations of collected material kept at the Zoological Institute of the Academy of Sciences of the USSR* (referred to in the text both as ZIN AN or the Zoological Institute). The various chapters of the book are written in the same order as are the previous parts. With respect to individual features, considerably more attention is paid to functional- morphological analysis as well as to a more elaborate characterization of species; the plumage is also described in greater detail with regard to seasonal changes and age differences. The attached bibliography, though not complete, nevertheless contains the most important works on the subject. The photographs were provided by K. A. Yudin and the drawings prepared by N. N. Kondakov and V. S. Rozhdestvenskaya. To the suborder Alcae belong sea birds which are closely related to gulls but are adapted to aquatic conditions to a much greater extent and are less associated with terrestrial and aerial life. Alcae, which feed exclusively on pelagic animals and predominantly on fish, have become highly specialized in swimming, diving and moving swiftly under water by means of their wings. This is extremely useful for catching prey. Adaptation to underwater swimming brought about some essential structural modifications in the Alcae during the formative period of the group, particularly in the structure and distribution of the feather cover, the morphology of almost every skeletal part, and in certain muscular systems and internal organs. Alcae have streamlined bodies--narrow and elongated; the wings are short and generally narrow. These features greatly facilitate underwater movement in a relatively dense medium. The tail is short (Figure 1). In flight and diving the legs are stretched backward and function as steering and brake apparatus, thus compensating to some extent for the shortness of the tail feathers. The three front toes (especially the middle one) are comparatively long and are united by swimming membranes, which reach the front edges of the distal phalanges or half of the toe length; the hind toe is either absent or rudimentary. For a short biography of the author, see http://birdsmongolia.blogspot.com/2012/02/elizabethv.htm

Level of evidence used in recommendations by the National Comprehensive Cancer Network (NCCN) guidelines beyond Food and Drug Administration approvals.

BackgroundA previous analysis of 113 National Comprehensive Cancer Network® (NCCN®) recommendations reported that NCCN frequently recommends beyond Food and Drug Administration (FDA)-approved indications (44 off-label recommendations) and claimed that the evidence for these recommendations was weak.MethodsIn order to determine the strength of the evidence, we carried out an in-depth re-analysis of the 44 off-label recommendations listed in the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®).ResultsOf the 44 off-label recommendations, 14 were later approved by the FDA and/or are supported by randomized controlled trial (RCT) data. In addition, 13 recommendations were either very minor extrapolations from the FDA label (n = 8) or were actually on-label (n = 5). Of the 17 remaining extrapolations, 8 were for mechanism-based agents applied in rare cancers or subsets with few available treatment options (median response rate = 43%), 7 were based on non-RCT data showing significant efficacy (>50% response rates), and 2 were later removed from the NCCN Guidelines because newer therapies with better activity and/or safety became available.ConclusionOff-label drug use is a frequent component of care for patients with cancer in the United States. Our findings indicate that when the NCCN recommends beyond the FDA-approved indications, the strength of the evidence supporting such recommendations is robust, with a significant subset of these drugs later becoming FDA approved or supported by RCT. Recommendations without RCT data are often for mechanism-based drugs with high response rates in rare cancers or subsets without effective therapies

Indigenous Contributions to City Planning in New Spain

This article questions the traditional historiography on town planning in sixteenth-century New Spain (Mexico) with reference to the notion that towns founded in New Spain were the concretion of Renaissance models. With reference to specific cases it deals with the reuse of existing settlements, the reorganization of population on a territorial scale, and the use of the grid plan arguing the relevance of understanding local precedents in order to comprehend the new urban expressions as hybrid forms. Reference is made to scale and use in defending the indigenous contributions to the making of towns in New Spain. In closing it is suggested that research be done on flows from America to Europe with reference to the appearance of large public squares in the seventeenth and eighteenth centuries

Household food insecurity positively associated with increased hospital charges for infants

Objective: To test whether household food insecurity (HFI) was associated with total annual hospitalization charges, annual days hospitalized, and charges per day, among low-income infants (months) with any non-neonatal hospital stays. Methods: Administrative inpatient hospital charge data were matched to survey data from infants\u27 caregivers interviewed 1998-2005 in emergency departments in Boston and Little Rock. All study infants had been hospitalized at least once since birth; infants whose diagnoses were not plausibly related to nutrition were excluded from both groups. Log-transformed hospitalization charges were analyzed, controlling for site fixed effects. Results: 24% of infants from food-insecure households and 16% from food-secure households were hospitalized \u3e2 times (P=0.02). Mean annual inpatient hospital charges ($6,707 vs$5,735; P Conclusion: HFI was positively associated with annual inpatient charges among hospitalized low income infants. Average annual inpatient charges were almost $2,000 higher (inflation adjusted) for infants living in food-insecure households. Reducing or eliminating food insecurity could reduce health services utilization and expenditures for infants in low-income families, most of whom are covered by public health insurance

On the generality of the Cohen and Glashow constraints on the neutrino velocity

We discuss the kinematic limits for the process \nu_\mu \rightarrow \nu_\mu + e^+ + e^- in the assumption that neutrinos are superluminal. We derive our results by assuming that: i) it exists one reference frame in which energy and momentum are conserved; ii) the Hamilton-Jacobi equation v=dE/dp is valid; iii) the present experimental information on the neutrino velocity at different energies are correct. We show that the considered process cannot be avoided unless very peculiar neutrino dispersion laws are assumed.Comment: 5 page