197 resultados para Cost management
Resumo:
The optimal dosing schedule for melphalan therapy of recurrent malignant melanoma in isolated limb perfusions has been examined using a physiological pharmacokinetic model with data from isolated rat hindlimb perfusions (IRHP), The study included a comparison of melphalan distribution in IRHP under hyperthermia and normothermia conditions. Rat hindlimbs were perfused with Krebs-Henseleit buffer containing 4.7% bovine serum albumin at 37 or 41.5 degrees C at a flow rate of 4 ml/min. Concentrations of melphalan in perfusate and tissues were determined by high performance liquid chromatography with fluorescence detection, The concentration of melphalan in perfusate and tissues was linearly related to the input concentration. The rate and amount of melphalan uptake into the different tissues was higher at 41.5 degrees C than at 37 degrees C. A physiological pharmacokinetic model was validated from the tissue and perfusate time course of melphalan after melphalan perfusion. Application of the model involved the amount of melphalan exposure in the muscle, skin and fat in a recirculation system was related to the method of melphalan administration: single bolus > divided bolus > infusion, The peak concentration of melphalan in the perfusate was also related to the method of administration in the same order, Infusing the total dose of melphalan over 20 min during a 60 min perfusion optimized the exposure of tissues to melphalan whilst minimizing the peak perfusate concentration of melphalan. It is suggested that this method of melphalan administration may be preferable to other methods in terms of optimizing the efficacy of melphalan whilst minimizing the limb toxicity associated with its use in isolated limb perfusion.
Resumo:
Soil erosion in the Philippine uplands is severe. Hedgerow intercropping is widely advocated as an effective means of controlling soil erosion from annual cropping systems in the uplands. However, few farmers adopt hedgerow intercropping even in areas where it has been vigorously promoted. This may be because farmers find hedgerow intercropping to be uneconomic compared to traditional methods of farming. This paper reports a cost-benefit analysis comparing the economic returns from traditional maize farming with those from hedgerow intercropping in an upland community with no past adoption of hedgerows. A simple erosion/productivity model, Soil Changes Under Agroforestry (SCUAF), is used to predict maize yields over 25 years. Economic data were collected through key informant surveys with experienced maize farmers in an upland community. Traditional methods of open-field farming of maize are economically attractive to farmers in the Philippine uplands. In the short term, establishment costs are a major disincentive to the adoption of hedgerow intercropping. In the long term, higher economic returns from hedgerow intercropping compared to open-field farming are realised, but these lie beyond farmers' limited planning horizons.
Orofacial granulomatosis: A diagnostic problem for the unwary and a management dilemma. Case reports
Resumo:
Orofacial granulomatosis is a condition that, may be difficult to diagnose for those unfamiliar with the entity. This paper describes two cases and addresses the presentation, pathogenesis and treatment. The clinical recognition of his condition is important as is the subsequent investigation by an appropriate specialist. Management of patients needs to take into account the results of further investigations, the patient's expectations, and the severity of the condition.