CPOM: alleviating the demand for ICU beds.

Technology is adapting to health care's changing environment as more acutely ill patients, including those with respiratory risks, are being placed on the general care units. Centralized noninvasive pulse oximetry, a method to measure oxygen saturation, provides a relatively inexpensive, efficient means to serve a broader spectrum of patients.

The economic value of contraception: a comparison of 15 methods.

OBJECTIVES: The purpose of the study was to determine the clinical and economic impact of alternative contraceptive methods. METHODS: Direct medical costs (method use, side effects, and unintended pregnancies) associated with 15 contraceptive methods were modeled from the perspectives of a private payer and a publicly funded program. Cost data were drawn from a national claims database and MediCal. The main outcome measures included 1-year and 5-year costs and number of pregnancies avoided compared with use of no contraceptive method. RESULTS: All 15 contraceptives were more effective and less costly than no method. Over 5 years, the copper-T IUD, vasectomy, the contraceptive implant, and the injectable contraceptive were the most cost-effective, saving $14,122, $13,899, $13,813, and $13,373, respectively, and preventing approximately the same number of pregnancies (4.2) per person. Because of their high failure rates, barrier methods, spermicides, withdrawal, and periodic abstinence were costly but still saved from $8933 to $12,239 over 5 years. Oral contraceptives fell between these groups, costing $1784 over 5 years, saving $12,879, and preventing 4.1 pregnancies. CONCLUSIONS: Contraceptives save health care resources by preventing unintended pregnancies. Up-front acquisition costs are inaccurate predictors of the total economic costs of competing contraceptive methods.

Nephrotic syndrome associated with ant bite.

A 3-year-old child experienced edema of the face and extremities approximately 2 weeks after being stung on the legs, scrotum, and penis by "fire ants" (Solenopsis invicta). After diagnosis of idiopathic minimal-change nephrotic syndrome and treatment with steroids, the edema rapidly disappeared. Follow-up 3 years after his hospitalization showed no recurrence of nephrotic syndrome. We have correlated this case with previously published reports of the causal relationship of allergy to nephrotic syndrome, but we are unaware of any previously published correlation between ant bite and nephrotic syndrome.

Effect of ethanol on the immune system in mice.

Mice were injected with ethanol (2.5 g/kg body wt., i.p.) 1-3 times daily for 17 days or 3 times daily for 49 days. The primary and secondary antibody titers to sheep red blood cells were determined. In addition, microhematocrits, white blood cell counts, white blood cell differential counts, and organ-to-body-weight ratios were determined. Despite continuous large doses of ethanol, the ethanol-treated mice responded as well as saline-treated controls in all parameters tested. The results of this study are discussed in the context of other studies on the effects of ethanol on the immune system.