Admission base deficit predicts transfusion requirements and risk of complications.

Background: Trauma center resource management could be facilitated by a readily available indicator of resource consumption. This marker should identify patients more likely to require transfusion and intensive care services and to develop complications. Base deficit (BD) has been shown to be a valuable indicator of shock, abdominal injury, fluid requirements, efficacy of resuscitation, and to be predictive of mortality after trauma.

Evaluating the cost-effectiveness of treatment with third-generation cephalosporins.

Spreadsheet computer software was used to compare the estimated global treatment costs of the third-generation cephalosporins, cefotaxime and ceftriaxone, in the management of pneumonia using treatment schedules taken from current studies. Included in the analysis were not only acquisition costs, but also costs that contribute to total expenses for a course of treatment, such as those of (a) preparation and administration (disposable supplies, nursing, and pharmacy time), (b) projected laboratory costs to monitor for hypoprothrombinemia, and (c) complication costs (diarrhea, superinfection, pseudocholelithiasis, and so on). The cost analysis was performed using United States trial-derived factors.

Bleeding Meckel's diverticulum in an adult.

The 99mtechnetium pertechnetate nuclear red blood cell scan proved to be a valuable diagnostic tool in localizing the site of bleeding, from a Meckel's diverticulum, in a 41-year-old man. When peptic ulcer or colorectal disease has been excluded by panendoscopy, bleeding Meckel's diverticulum remains a diagnostic consideration, even in adults. We provide a 20-year list of bleeding Meckel's diverticula reported in adults, along with a brief discussion.

Computer modelling antibiotic therapy costs. Impact of therapeutic range.

Computer modelling techniques were used to examine the economic consequences of intravenous chemotherapy of serious infection. Acquisition cost of the drug was found to be a poor predictor of global cost, since inclusion of the preparation and administration costs and projected laboratory and drug complication costs narrow, or even reverse, apparent cost differentials between drugs. Thus, the cost per day for acquisition/total treatment (in US dollars) are: penicillin $5/$30, gentamicin $1/$46, amikacin $26/$63, clindamycin $38/$57, metronidazole $12/$20 and cefotaxime $47/$60.