A cost-effectiveness analysis of screening methods for dysphagia after stroke.

Objective: To provide a cost-effectiveness analysis of dysphagia screening in the acute poststroke period with use of a videofluoroscopic swallowing study, a clinical bedside swallowing evaluation, or a combined approach.

Design: Decision-analysis model.

Methods: A decision-analysis model was used with information derived from multiple data sources, including meta-analyses and other relevant clinical studies.

Delivering health care on the streets: challenges and opportunities for quality management.

Street Medicine focuses on the health needs of unsheltered homeless through mobile teams that provide care in the locations where individuals are found. Innovative strategies are needed to manage the quality of care provided within the atypical clinical settings encountered. In our study, contextual elements and practices for managing quality of care were explored through qualitative analysis of program components presented at the 2007 and 2008 International Street Medicine Symposia.

Killer immunoglobulin-like receptor genotype in immune-mediated bone marrow failure syndromes.

Objective: Recent reports have shown that killer immunoglobulin-like receptors (KIR) and KIR ligand (KIR-L) genotype play a role in the pathophysiology of autoimmune disorders. Certain KIR/KIR-L combinations might convey a predisposition to immune-mediated bone marrow failure. Examining the genotypic makeup of human leukocyte antigen (HLA) class I (KIR-L) and KIR in patients with hematologic disorders could offer clues to immunogenetic risk factors for these diseases.

Pathologic clonal cytotoxic T-cell responses: nonrandom nature of the T-cell-receptor restriction in large granular lymphocyte leukemia.

T-cell large granular lymphocyte (T-LGL) leukemia is a clonal lymphoproliferation of cytotoxic T cells (CTLs) associated with cytopenias. T-LGL proliferation seems to be triggered/sustained by antigenic drive; it is likely that hematopoietic progenitors are the targets in this process. The antigen-specific portion of the T-cell receptor (TCR), the variable beta (VB)-chain complementarity-determining region 3 (CDR3), can serve as a molecular signature (clonotype) of a T-cell clone.