Biomedical subjects
Publications and source records attributed to T M Jones.
In Denmark, federal control of medicine began as early as 1890. Last year the American College of Medical Group Administrators studied the evolution of that country's health care system and found that it may well have predictive value for American health care planners.
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A gas chromatographic headspace method has been developed for the determination of choline in liquid and powder formula products. Choline undergoes the Hofmann elimination reaction during a 24 h, 120 degrees C alkaline digestion. Volatile trimethylamine (TMA) is produced and equilibrates between the liquid and vapor phase (headspace). A 50 microL headspace sample is chromatographed on a 28% Pennwalt 223-4% KOH column, with flame ionization detection. Choline is indirectly quantitated by comparing sample TMA peaks with peaks for a reference standard. Ethyl ether is used as an internal standard. Compared with previous methods, this procedure offers improved precision (7.7-9.6% relative standard deviation (RSD], accuracy, and specificity of both free and bound forms of choline. Estimated analysis rate using manual injection is 160 samples/week, requiring 35 work-hours. Automation of this procedure, using a commercially available headspace analyzer, resulted in a further improvement in precision (1.60-6.91% RSD) and a throughput of 400 samples/week.
A multicenter, investigator-blinded, randomized, parallel-group study was conducted to compare oral levofloxacin 500 mg once/day for 14 days with clarithromycin 500 mg twice/day for 14 days in the treatment of acute bacterial sinusitis. Of 216 adult outpatients randomized to treatment, 190 were evaluable for efficacy. The primary efficacy measure was clinical response, based on resolution of signs and symptoms 2-5 days after therapy. A secondary efficacy measure was relapse rate 1 month after therapy. Among evaluable patients, clinical success rates (cured or improved) were 96.0% and 93.3% for levofloxacin (L) and clarithromycin (C), respectively (95% CI -9.2%, 3.7%). The confidence interval (CI) for treatment difference (C-L) included zero and its upper limit was less than 15%, indicating that levofloxacin was as effective as clarithromycin. In all, 4.1% of patients receiving levofloxacin and 7.2% receiving clarithromycin had a relapse of symptoms 1 month after therapy (95% CI-12.2%, 3.2%). Long-term success (initial success, absence of relapse at 1 month, no further antibacterial therapy 2-5 days after therapy) was 79.2% in the levofloxacin group and 76.4% in the clarithromycin group (95% CI -14.7%, 9.0%). Based on investigator-assessed treatment-emergent adverse events, overall tolerability of the drugs was similar, except for a higher frequency of taste perversion and diarrhea in the clarithromycin group. Levofloxacin had an advantage over clarithromycin based on two quality-of-life (QOL) parameters: number of times taking other drugs for targeted medical conditions and mean total cost of these drugs. No statistical significance was found in other QOL variables. These findings suggest that the efficacy and tolerability of levofloxacin 500 mg once/day are comparable with those of clarithromycin 500 mg twice/day in the treatment of acute bacterial sinusitis.