Preview When a patient presents with involuntary weight loss, the etiologic considerations can be overwhelming. To plan a cost- effective workup, physicians need to be aware of the most common causes of weight loss and the tests that yield the most pertinent data. Drs Wise and Craig review the clinical studies on unintentional weight loss and suggest an initial approach to management.
Bivalirudin use was associated with both improved clinical outcomes and decreased hospital costs in this large "real-world" database. To our knowledge, this study is the first to demonstrate the ideal comparative effectiveness end-point of both improved clinical outcomes with decreased costs in PCI.
Seventy-one women with far-advanced breast cancer resistant to standard chemotherapeutic agents were administered mitomycin C using an intermittent high dose schedule. One group consisted of 54 patients with measurable metastatic tumor; a second group consisted of 18 patients with nonmeasurable osseous metastases. Objective response rate in group 1 was 26% for an average duration of 2 1/2 months. Subjective response rate in group 2 was 44% for an average duration of 3 months. Response and toxicity data were similar to those of studies employing the less convenient protracted low-dose schedule. Prior treatment with other alkylating agents did not adversely affect response. Further investigation into the role of mitomycin in combination chemotherapy programs is recommended.
The tracking of public opinion can be a critical component of antitobacco campaigns, such as efforts to enact citywide Clean Indoor Air legislation. Grassroots tobacco control coalitions that work locally to promote smoke-free environments typically encompass individuals from a wide range of public health fields. Although knowledgeable, volunteer groups lack the financial resources to evaluate the impact of local efforts or determine their community's level of support for potential legislation. The steps taken by a grassroots organization to conduct a public opinion survey are outlined, including methodological, analytical issues, and resource requirements. A valid survey can be completed in 4 months with minimal financial resources. Individuals willing to voluntarily administer and analyze a survey can be identified at the local level. Results of a tobacco-related public opinion survey can be instrumental in the promotion of smoke-free environments and an effective tool in attracting media coverage.
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