Emerging Role of Olanzapine for Prevention and Treatment of Chemotherapy-Induced Nausea and Vomiting.

The prevention and treatment of chemotherapy-induced nausea and vomiting (CINV) continues to pose a challenge for clinicians. The development of 5-hydroxytryptamine (serotonin) antagonists and neurokinin-1 receptor antagonists (NK1 -RAs) have demonstrated significant improvements in acute and delayed CINV for highly and moderately emetogenic chemotherapy. Delayed and breakthrough CINV, however, continue to be difficult to manage despite available treatment agents. Randomized clinical trial data suggest that olanzapine, a second-generation thienobenzodiazepine, traditionally used in the treatment of manifestations of psychotic disorders, is an effective agent in these clinical settings. The short-term use of olanzapine has a favorable adverse event profile and was not associated with grade 3 or 4 toxicity in a phase III study. Olanzapine is recommended as an option within first-line prophylaxis for CINV in the National Comprehensive Cancer Network (NCCN) guidelines and is an option for treatment of refractory CINV in the Multinational Association of Supportive Care in Cancer/European Society for Medical Oncology and NCCN guidelines.

Welcome address by Chairman, Hospital Authority of Hong Kong: opening ceremony of the International Hospital Federation Congress--May 2001.

One of the significant features of Hong Kong is its public healthcare system, which provides universal, easily accessible and heavily subsidized medical care for all. The governing policy has been to ensure that no one is denied adequate medical care because of insufficient means through the provision of a comprehensive range of healthcare services funded from the public purse at extremely low fees to users. Over the past decade, the public hospital sector has been able to provide efficient and quality health services comparable to those of the industrialised nations. However, the reality today is that the public hospitals are facing many challenges that must be overcome and ways must be sought to mitigate the growing strains on the healthcare system and rebalance the healthcare economics. The recently published Consultation Document on Healthcare Reform, by Dr E K Yeoh, Secretary for Health & Welfare, proposes the introduction of a comprehensive range of short-term and long-term initiatives to revitalize and transform the healthcare system into a community-focused, patient-centred and knowledge-based integrated healthcare service with improved interface between the public and private sectors.

Achieving Internet-based efficiencies in a rural IDS: a case study.

After suffering payment cuts resulting from the Balanced Budget Act of 1997, Colorado-Fayette Medical Center (CFMC), a not-for-profit, rural integrated delivery system in Texas, wanted to reduce costs by gaining systemwide Internet access for its internal information system at a reasonable price. An application service provider affiliated with the Texas Hospital Association, helped CFMC achieve its goals for the project by performing a needs assessment, installing a wide-area network (WAN) with Internet access, and training staff. The new WAN enabled CFMC to improve its Web presence, allow radiologic image viewing at all sites, negotiate more favorable prices from vendors, implement electronic communication for staff members, and take advantage of on-line education opportunities. CFMC has found that the monthly fee paid to THN is offset by savings on long-distance calls, Internet service provider fees, and marketing and advertising costs.