The study has provided epidemiological data for public health surveillance of congenital heart defects in the Emilia-Romagna region. The creation of a system for the nationwide recording of congenital heart defects designed with regard to the sources of ascertainment, the diagnostic criteria, and the system of classification is emphasised.
Improvement in the short-term survival of patients with invasive aspergillosis (IA) (22, 24) is encouraging, but crude mortality rates remain high at Ͼ30% in patients with acute myeloid leukemia (AML) (24) and 57% in hematopoietic stem cell (HSCT) recipients (1). As a result, interest in prevention continues, with efficacy demonstrated for posaconazole in patients receiving induction-remission chemotherapy for AML/ myelodysplastic syndromes (MDSs) and high-risk allogeneic HSCT (allo-HSCT) recipients (7, 32). However, given incidence rates of invasive fungal diseases (IFDs) of 10 to 15% among patients with AML and HSCT recipients (5,17,23), nonselective prophylaxis has raised concerns regarding overtreatment and expenditure (9, 25) because the numbers of eligible patients are high and the duration of prophylaxis is potentially lengthy.Increasingly, the economic impact of IFDs has been considered in the clinical debate. One center, after determining the attributable mean IA-associated medical cost in AML/MDS patients to be €15,280 in association with a 30% institutional incidence, concluded that antimold prophylaxis was likely costbeneficial from the patient and hospital perspectives (29). Cost determination methods for IFDs have included gross costs (16,
Tumour-bearing mice spontaneously lose weight 8-9 weeks after implantation of a human hypernephroma, in spite of a normal food intake. Resting oxygen consumption was up to 40% higher in these animals than in sham-operated controls, but was significantly reduced by beta-adrenergic blockade with propranolol in the former group. The injection of noradrenaline caused a marked stimulation of the metabolic rate in all the animals, but the greatest response was seen in the cachectic mice. The brown-adipose-tissue mass was similar for both groups, but guanosine diphosphate binding to brown-adipose-tissue mitochondria (an index of thermogenic capacity) was significantly increased in tumor-bearing mice, and the injection of noradrenaline 1 h prior to sacrifice caused the greatest stimulation of binding in the cachectic group. These data suggest that the rapid weight loss of tumor-bearing animals may be due to a high metabolic rate which results from sympathetic stimulation of brown-adipose-tissue metabolism. The relevance of these results to cancer-induced cachexia in man is discussed.
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