Pharmacoeconomics.

Today, spiraling costs of medical care coupled with limited resources have led to an explosive increase in the number of pharmacoeconomic analyses being carried out. The first step in a pharmacoeconomic analysis is to measure the costs and benefits of the therapeutic regimens being compared. Then one compares these costs and benefits by calculating a cost: benefit ratio for each regimen. Four types of economic analyses are commonly used for this purpose. While cost minimization analysis ignores the benefits and focuses only on costs of treatment, cost-effectiveness analysis measures costs in monetary terms and benefits or outcome in their natural clinical units. Cost benefit analysis on the other hand, places monetary values on both-costs and outcome of therapy. Finally, cost utility analysis measures costs in monetary terms, and outcome in a single utility-based unit of measurement. Utility based measures like quality adjusted life-years (QALY) measure the contribution made by the regimens to the patient's quality of life. Finally study designs generally used for generating data for a pharmacoeconomic analysis are mentioned, and concepts like marginal analysis, sensitivity analysis and discounting are explained in the context of health economics.

The use of cation-bound microsomes for studies of protein synthesis.

Low speed microsomes prepared by centrifuging at 30 times g for 10 minutes after interaction with Ca-2plus or Mg-2plus are comparable to high speed microsomes (105,000 times g) with respect to incorporation of 3-H-leucine in vivo, protein-synthesizing ability in vitro, and the pattern of ribosomal profiles on a linear sucrose density gradient. Low and high speed polyribosomes, i.e., those isolated with and without Ca-2plus or Mg-2plus from a postmitochondrial supernatant, also displayed similar protein-synthesizing capability in vitro and identical profiles on a linear sucrose density gradient. Other divalent cations, such as Ba-2plus, Ni-2plus, Co-2plus, Cu-2plus, Fe-2plus, Hg-2plus, Zn-2plus, and Sr-2plus, inhibited enzyme activities and depressed protein synthesis. Low speed microsomes may now be deemed suitable for all studies of microsomal function.

The Clinical Global Impression-Schizophrenia scale: a simple instrument to measure the diversity of symptoms present in schizophrenia.

OBJECTIVE: To describe the development and validation of the Clinical Global Impression-Schizophrenia (CGI-SCH) scale, designed to assess positive, negative, depressive and cognitive symptoms in schizophrenia. METHOD: The CGI-SCH scale was adapted from the CGI scale. Concurrent validity and sensitivity to change were assessed by comparison with the Positive and Negative Symptom Severity (PANSS) and Global Assessment of Functioning (GAF) scales. To evaluate inter-rater reliability, all patients were assessed by two clinicians. RESULTS: Symptoms were assessed in 114 patients. Correlation coefficients between the CGI-SCH and the GAF and PANSS scores were high (most above 0.75), and were highest for positive and negative symptoms. Reliability was substantial (intraclass correlation coefficient, ICC > 0.70) in all but one dimension (depressive dimension, ICC = 0.64). CONCLUSION: The CGI-SCH scale is a valid, reliable instrument to evaluate severity and treatment response in schizophrenia. Given its simplicity, brevity and clinical face validity, the scale is appropriate for use in observational studies and routine clinical practice.