Advances in cardiology and escalating costs to the patient: a view from the government.

Abstract

It is important to note that in selecting the alternative relating to medical treatments and equipment, the respondents not only evinced an unfounded belief that advances in medical technology are the primary source of escalating medical costs, but also implicitly accepted the concept that new medical treatments and equipment are necessarily more expensive. This implication warrants examination since there are instances in which advances in research and technology actually lead to reduced costs. In performing our examination, we will first draw on the wisdom of Lewis Thomas, who in The Lives ofa Cell discussed the cost-effectiveness of three levels of "technology of medicine."7 We will then consider a number of advances in the treatment of heart diseases in the context of economist Burton Weisbrod's graphic representation of the historical relationship between health expenditures and the state of medical technology (figure 2).

Cardiopulmonary bypass and the adaptive immune system: perspectives on T cell function

“…There is a decrease in CD3, CD4 and CD8 cells with a reversal of the normal CD4/CD8 ratio. Such changes are maximal on postoperative day 1 and remain low for approximately 1 week.48,SO-S2 T lymphocytes are significantly reduced in numbers (relative and absolute35). That T cell mitogenic and proliferative functional impairment is not related to a quantitative defect per se has been demonstrated by Sal028, and Roth.3s Evidence has so far been presented that the capacity to counteract microbial infection by the innate immune system is reduced in patients following cardiac operation due to a waste of complement factors,6,10,11 and a decrease in the cellular elements of the innate immune response, e.g.…”