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Biomedical subjects

B R Jackson

Publications and source records attributed to B R Jackson.

15 recordsLinked to original sources
PubMed2003

The cost-effectiveness of NAT for HIV, HCV, and HBV in whole-blood donations.

BACKGROUND: The risk of viral infection associated with blood transfusion is lower than ever before because of aggressive screening and testing practices. NAT technology has lowered that risk even further but at an additional cost to the health-care system. STUDY DESIGN AND METHODS: Marginal cost-effectiveness of NAT for HIV, HCV, and HBV in whole-blood donations was calculated with a previously published Markov decision model. This model was updated with disease incidence data from all 2001 American Red Cross whole-blood donations as well as window-period data from the Retrovirus Epidemiology Donor Study (REDS). RESULTS: Whole-blood donation NAT for HIV and HCV is expected to cost between 155 US dollars million (minipool NAT) and 428 million US dollars(single-donation NAT) per year in the US and avert 4 to 7 HIV infections and 56 to 59 HCV infections. Adding HBV NAT would be expected to avert 9 to 37 HBV infections at an additional cost of between 39 million US dollars and 130 million US dollars per year. Overall, NAT would cost between 4.7 million US dollars and 11.2 million US dollars per quality-adjusted life-year saved. Discontinuing HIV p24 antigen and HBc testing would offset this somewhat. CONCLUSIONS: The cost-effectiveness of whole-blood NAT is poor. The testing cost would need to decrease significantly to bring the cost-effectiveness in line with most other accepted medical practices.

Blood Donors↗
PubMed2000

The cost-effectiveness of postoperative recovery of RBCs in preventing transfusion-associated virus transmission after joint arthroplasty.

BACKGROUND: The return of joint drainage after hip and knee arthroplasty is a widely used but expensive blood-conservation technique. STUDY DESIGN AND METHODS: A Markov decision analysis model was used to evaluate the cost-effectiveness of postoperative RBC recovery in preventing viral complications of allogeneic transfusion. RESULTS: In the baseline analysis, using an RBC-recovery device saves 5 quality-adjusted minutes of longevity at an average incremental cost of $53. This corresponds to $5.7 million per quality-adjusted life year. This figure was most sensitive to the direct cost differences of allogeneic versus recovered RBCs and to the volume of RBCs recovered per device. Such devices would save health care resources if they cost less than $73 or if they were applied only in cases where joint drainage was between 600 and 1100 mL. CONCLUSION: For most clinical situations, postarthroplasty RBC recovery does not appear to be as cost-effective as most other medical interventions. Clinical attention should be directed toward developing protocols for the preferential use of postoperative RBC-recovery devices in situations where they provide the greatest benefit.

Arthroplasty, Replacement, Hip↗
PubMed1999

Chromatographic resolution, chiroptical characterization and preliminary pharmacological evaluation of the enantiomers of butibufen: a comparison with ibuprofen.

Enantiomeric resolution of butibufen has been achieved on a cellulose tris(3,5-dimethylphenylcarbamate) chiral stationary phase with hexane-isopropanol-trifluoroacetic acid, 100:1.2:0.02 (v/v/v) as mobile phase at a flow rate of 1.0 mL min(-1). Semi-preparative isolation of the enantiomers then chiroptical characterization indicated that the order of elution was (-)-R- before (+)-S-butibufen. When tested for their effects on the cyclooxygenase and 5-lipoxygenase pathways of eicosanoid metabolism in calcium ionophore-activated rat peritoneal leukocytes it was found that (+)-S-butibufen inhibited generation of thromboxane B2 (TXB2) and prostaglandin E2 (PGE2) (cyclooxygenase pathway), with an IC50 of 1.5 microM (approx.), whereas the (-)-R enantiomer was essentially inactive. Neither enantiomer inhibited the 5-lipoxygenase pathway. In this regard, (+)-S-butibufen was approximately five times less potent as a cyclooxygenase inhibitor than (+)-S-ibuprofen. These results show the enantiomeric specificity and pathway selectivity of this novel non-steroidal anti-inflammatory drug.

Animals↗
PubMed1997

A decision support system for microbiology quality control.

Manual review of antibiotic sensitivity testing results is an essential component of a microbiology laboratory's quality control process. Such review is tedious and prone to human error, however. An expert system is described that remembers which susceptibility patterns are considered typical or atypical by expert reviewers, then uses these to prescreen future isolates. It uses a similarity function to allow matching against this library when two patterns are close, but not identical. Use of this system allows more efficient and reliable review of the laboratory's antibiotic sensitivity testing results.

Decision Support Systems, Clinical↗
PubMed1992

Evaluation of accuracy and reproducibility of peak flowmeters at 1,400 m.

Peak flow meters provide physicians and patients with objective measures about changes in pulmonary obstruction. We evaluated eight models of peak flowmeters and measured their accuracy and reproducibility with methods recently recommended by the National Asthma Education Program (NAEP). Waveforms from the American Thoracic Society's spirometer testing set were used to drive a computer-controlled syringe. Testing was done at Salt Lake City at an altitude 1,400 m. It appears that the original Wright peak flowmeter has been used as the "de facto" standard. We found that the original Wright peak flowmeter overestimated flows in its midrange; and, as a consequence, most of the other peak flowmeters also overestimated peak flows. The overestimation of peak flows may have been understated because of the 1,400-m altitude testing site. To the credit of the instrument manufacturers, we were pleasantly surprised with the quality, accuracy, and reproducibility of presently available peak flowmeters; however, as a result of our testing, we suspect that with little effort, manufacturers of peak flowmeters could improve the accuracy of their devices. Standardized testing methods and equipment should make the task of peak flowmeter design, manufacture, and testing even easier. We trust that manufacturers of peak flowmeters will respond appropriately and improve their instruments.

Adult↗
PubMed1987

Eye protectors for squash players.

Eye injuries have occurred to squash players wearing commercial open-type eyeguards, suggesting inadequacies in their design. This study reports experimental observations on the deformation of high velocity squash balls at an aperture simulating an open-type of eyeguard. Open eyeguards were shown to be inadequate in preventing eye trauma by ball-strike. Recommendations for improvement of eyeguard design have been made.

Athletic Injuries↗
PubMed1982

The diagnosis of colonic obstruction.

The most common cause of colonic obstruction is adenocarcinoma, followed by diverticulitis, volvulus, and a variety of miscellaneous causes. Most signs and symptoms, from whatever cause, consist of abdominal pain with distention and the inability to pass flatus or stool. The clinical diagnosis is confirmed by x-ray studies. Plain films of the abdomen in various positions, chest films, and the addition of contrast studies verify the cause of the obstruction in most instances. The differentiation between neoplasm and diverticulitis causing the obstruction can be difficult or impossible at times, and may become apparent only after the obstruction begins to resolve with conservative management, or the cause is discovered at surgery. The history of previous abdominal or pelvic irradiation, surgery, and inflammatory bowel disease often causes difficulty in the differential diagnosis.

Adenocarcinoma↗
PubMed1980

Iridium implants in treatment of anorectal carcinoma.

A technique is described for the use of iridium-192 implants, combined with external irradiation, in the treatment of primary anorectal malignancy. The method allows large doses of radiation to the primary growth, regional infiltration and extensions, with much lower doses to the surrounding normal tissues and organs. Acceptable criteria for conservative local treatment of selected primary anorectal carcinomas are established. For the poor risk patient, the patient who refuses operation, and those having primary or recurrent carcinoma with distant metastases, this method of treatment offers maximum benefit, palliation, and acceptable complication rates. With judicious selection of patients and careful attention to volume of tissue treated, total dose, and fractionalization, serious complications should be substantially reduced.

Aged↗
PubMed1978

Primary treatment of carcinoma of the lower rectum and anal canal by a combination of external irradiation and interstitial implant.

Ten patients with carcinoma of the anorectum were treated with a combination of external irradiation and after-loading interstitial 192Ir implant, which seems to be effective in controlling relatively small cancers of the anorectum and providing effective palliation of extensive lesions. Five of the 10 patients remain free of tumor after a minimum follow-up of 15 months. Four of the 10 were treated with one interstitial implant and 4,000--5,000 rads of external irradiation and 6 were treated with the same amount of irradiation and two implants. When two implants were used, complications were minimal.

Adenocarcinoma↗