Blood transfusions during neoadjuvant chemotherapy for muscle-invasive urinary bladder cancer may have a negative impact on overall survival.

To evaluate the extent and plausible effects of blood transfusions given during cisplatin-based neoadjuvant chemotherapy (NAC) on overall survival in patients with muscle-invasive urothelial bladder cancer (MIBC) undergoing NAC and radical cystectomy (RC). Several studies have demonstrated a decreased survival for MIBC patients receiving allogenic peri- and postoperative blood transfusions in conjunction with RC. No studies have previously investigated the effects of blood transfusions during NAC.

Experimental validation of a new COMS-like 24 mm eye plaque for the treatment of large ocular melanoma tumors.

Purpose: A new Collaborative Ocular Melanoma Study (COMS)-like 24 mm eye plaque was experimentally characterized using physical and dosimetric measurements in preparation for clinical usage. The new eye plaque will enable surgeons and radiation oncologists to accommodate patients who have larger ocular melanoma tumors.

Methods And Materials: Physical measurement of the Modulay radius of curvature was performed using a FARO Edge, and the base thickness of the Silastic insert was measured with a depth gauge and Vernier caliper.

Prevalence of Sexual Assault Victimization Among College Men, Aged 18-24: A Review.

Purpose: The current review provides summary and evaluation of prevalence data for the sexual victimization of college men ages 18 - 24.

Methods: Potential studies were selected by searching electronic bibliographic databases. Studies were initially selected for inclusion if they (1) assessed prevalence rates of sexual victimization on college campuses and (2) were published in a scholarly journal (3) in the English language.

Instrumentation for electrochemical performance characterization of neural electrodes.

In an effort to determine the chronic stability, sensitivity, and thus the potential viability of various neurochemical recording electrode designs and compositions, we have developed a custom device called the Voltammetry Instrument for Neurochemical Applications (VINA). Here, we describe the design of the VINA and initial testing of its functionality for prototype neurochemical sensing electrodes. The VINA consists of multiple electrode fixtures, a flowing electrolyte bath, associated reservoirs, peristaltic pump, voltage waveform generator, data acquisition hardware, and system software written in National Instrument's LabVIEW.

Seed coordinates of a new COMS-like 24 mm plaque verified using the FARO Edge.

A 24 mm COMS-like eye plaque was developed to meet the treatment needs of our eye plaque brachytherapy practice. As part of commissioning, it was necessary to determine the new plaque's seed coordinates. The FARO Edge, a commercially available measurement arm, was chosen for this purpose.

The impact of the laboratory on disease management.

The laboratory has been an integral part of the continuum of care for centuries. It has been said that 60%-70% of critical decisions in diagnosis and treatment involve quantifiable laboratory data. Disease management (DM) outcomes can be influenced through effective use of this information.

Scaling of mammalian ethmoid bones can predict olfactory organ size and performance.

The relation between size and performance is central for understanding the evolution of sensory systems, and much interest has been focused on mammalian eyes and ears. However, we know very little about olfactory organ size (OOS), as data for a representative set of mammals are lacking. Here, we present a cranial endocast method for estimating OOS by measuring an easily accessible part of the system, the perforated part of the ethmoid bone, through which the primary olfactory axons reach the olfactory bulb.

Life and death on the coral reef: an ecological perspective on scholarly publishing in the health sciences.

Objective: Reflecting patterns evident in past Janet Doe lectures, the 2004 address draws on the foundations of biology to provide a model that offers insights into the advent of electronic publications and choices for the future.

Setting: The lecture sketches a picture of the fragile relationships found in complex ecosystems and illustrates how such interdependencies function in the environment of the coral reef.

Analysis: Deriving lessons from the marine world, the lecture then shifts to a description of similarities in the realm of scholarly publishing, the impact of digital innovations in the marketplace, and the controversies and choices inherent in open access publications.

The value of the laboratory professional in the continuum of care.

The community laboratory often is relegated to the subterranean levels of the hospital, and it feels, at times, that the laboratory profession has been put in the basement as well. It is incumbent upon those of us who work in the clinical laboratory to ensure that the daily contributions made by the laboratory to the lives of our patients are not overlooked by our colleagues or by the future generation of laboratorians. We can expand our parochial view of the laboratory and begin to understand and to achieve the institutional goals of cost-effective patient care.

Joint venture versus outreach: a financial analysis of case studies.

Medical centers across the country are facing cost challenges, and national commercial laboratories are experiencing financial declines that necessitate their capturing market share in any way possible. Many laboratories are turning to joint ventures or partnerships for financial relief. However, it often is in the best interest of the patient and the medical center to integrate laboratory services across the continuum of care.

The electronic medical record: implications for the laboratory.

This article describes experiences over the past 5 years with the application of a computerized patient record system and an electronic result inquiry system at Mayo Clinic. These systems now handle 56,000 results and 170,000 inquiries daily--94% relating to the laboratory. The goal of aligning laboratory services with clinical objectives is outlined with an emphasis on converting data into information and knowledge that can be used to improve patient care.

The Academy of Health Information Professionals: a review of the first five years.

The Medical Library Association (MLA) has provided its members with a credentialing program since 1949. This article reports on a five-year review of the current program, the Academy of Health Information Professionals. The review included an analysis of the financial basis of the academy and the use of three different survey instruments designed to gather input from MLA members and other opinion leaders.

Why is the laboratory an afterthought for managed care organizations?

Market forces have dramatically influenced the environment in which healthcare is delivered, but these changes do not need to be interpreted negatively by community laboratorians. Only total vertical integration of laboratory medicine can control episode-of-care cost. Opportunities also exist for horizontal integration with community partners to provide geographical coverage and to compete favorably for managed care contracts.

Total cost reduction in the laboratory: a team effort.

The laboratory has been seen as a revenue source and its product a commodity. In fact, good laboratories have always provided more of a service. As health care strives to reduce the cost of an episode of care, the laboratory may, ironically, incur additional costs to provide testing that contributes to earlier diagnosis and decreased length of stay.

Quantifying bone and liver alkaline phosphatase by the resolution of two-component inactivation data obtained with a centrifugal analyzer.

In this method we use a linear equation to resolve two-component decay data from the urea inactivation of mixtures of alkaline phosphatase (EC 3.1.3.

Pediatric reference intervals for 19 biologic variables in healthy children.

We defined age- and sex-specific reference intervals for 19 biologic variables in serum samples from healthy children, 1 to 22 years of age, using common laboratory equipment. Upper and lower reference intervals were defined as the estimated 2.5 and 97.

Interaction of immobilized anti-salivary amylase antibody with human macroamylases: implications for use in a pancreatic amylase assay to distinguish macroamylasemia from acute pancreatitis.

We examined the ability of an immobilized antibody to salivary amylase (Clin Chem 1985;33:1283-8) to react with amylase in macroamylasemic sera. The antibody removed 50% (SD 23%) of the total amylase activity from 39 macroamylase sera, a percentage indistinguishable (P greater than 0.75) from the percentage removed from concurrently analyzed sera from healthy volunteers (49%, SD 11%).

A user's classification of problems identified by proficiency testing surveys.

Laboratory results judged as unacceptable in external proficiency surveys do not always signal laboratory testing problems. This is a report of the results of a user's investigation of the proficiency testing flags encountered in our laboratory from three survey programs over a two-year period. The survey programs were administered by the College of American Pathologists, the Centers for Disease Control, and the State of New York.

Macroenzyme as a cause of unexplained elevation of aspartate aminotransferase.

Aspartate aminotransferase (AST) can exist as a macroenzyme by forming a complex with an immunoglobulin. This immunoglobulin-complexed macromolecule can cause an elevation in serum AST activity, which may be detected on routine blood chemistry analysis and erroneously considered to indicate the presence of liver disease. Clinicians should be aware of this phenomenon so patients are not subjected to unnecessary procedures.