Allogeneic hematopoietic cell transplantation (HCT) is a potentially curative treatment for patients with hematological malignancies. However, is associated with substantial rates of morbidity and mortality. We and others have shown that malglycemia is associated with adverse transplant outcome. Therefore, improving glycemic control may improve transplant outcome. In this prospective study we evaluated the feasibility of using Glucommander (a Computer-Guided Glucose Management System; CGGM) in order to achieve improved glucose control in hospitalized HCT patients. Nineteen adult patients contributed 21 separate instances on CGGM. Patients were on CGGM for a median of 43 h. Median initial blood glucose (BG) on CGGM was 244 mg/dL, and patients on 20 study instances reached the study BG target of 100-140 mg/dL after a median of 6 h. After BG reached the target range, the median average BG level per patient was 124 mg/dL. Six patients had a total of 10 events of BG o 70 mg/dL (0.9% of BG measurements), and no patients experienced BG level o 40 mg/dL. The total estimated duration of BG o 70 mg/dL was 3 h (0.2% of the total CGGM time). In conclusion, our study demonstrates that stringent BG control in HCT patients using CGGM is feasible.

No abstract

The welfare of the marine environment of the U.S. West Coast of California, Oregon, and Washington is hindered by insufficient understanding of ecosystem dynamics and human pressures. Greater coordination, integration, and support of mutually identified research priorities across research organizations on the West Coast are necessary. This level of collaboration is essential to responding to regional ecosystem threats, such as the impacts of human occupation of coastal areas, over-harvesting of marine resources, and climate change. To address this need for collaboration and build on the accomplishments of existing research organizations, this article advocates the establishment of a West Coast regional marine research program (RMRP).