This study estimated the annual cost of blood transfusions in the UK during 1994/1995. The analysis was based on published data, information derived from interviews with relevant NHS personnel and a purpose-designed structured questionnaire of blood donors. The cost to the UKs blood transfusion services of providing blood and blood products for transfusion was 165.5 Pounds million in 1994/1995. During this period, 2.75 million conventional donations of whole blood and 144,000 apheresis donations of platelets and plasma were collected: 2.58 million units of red blood cells were issued, resulting in approximately 866,000 red blood cell transfusions; 334,000 units of fresh frozen plasma and 1.16 million units of platelets were issued, resulting in approximately 17,000 and 188,000 isolated plasma and platelet transfusions, respectively. Hospital resource use attributable to providing blood transfusions during 1994/1995 cost the NHS 52.6 Pounds million. In total, blood transfusions cost the NHS 218.2 Pounds million during 1994/1995. Of this, red blood cell transfusions accounted for 76% of the annual cost, isolated platelet transfusions 16%, isolated plasma transfusions 1% and other products 7%. Donors incurred direct costs of 3.1 Pounds million and indirect costs of 11.2 Pounds million were accrued due to lost productivity. Additionally, blood donors gave up 2.5 million hours of their leisure time donating blood.
The expected cost of palliative care in the UK healthcare setting ranged from approximately 2500 Pounds to 4000 Pounds (1500 Pounds to 6000 Pounds in the sensitivity analysis) depending on the length of survival after patients switch from weak to strong opioids. Since opioids account for only 2 to 8% of expected costs, factors other than economic issues, such as tolerability profile, patient preference and convenience of use, should form the basis of clinical decision-making between opioids with similar analgesic efficacy.
Treatment of 2-phenacylisoquinoliniurn bromide with ammonium acetate in acetic acid gave 5.1 O-dihydro-2phenylimidazo[l,2-6] isoquinoline (4) by cyclisation a t t h e 3-position of t h e isoquinoline ring. The mechanism of this reaction is discussed. On similar treatment 1 -phenacylquinolinuim bromide gave 4.5-dihydro-2-phenylimidazo[l,2-a]quinoline (8).225 Bath Road, Slough, Berkshire SL1 4AU
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