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Background and objectives: Due to the complexity of heparin-induced thrombocytopenia (HIT), currently available cost analyses are rough estimates. The objectives of this study were quantification of costs involved in HIT and identification of main cost drivers based on a patient-oriented approach. Methods: Patients diagnosed with HIT (1995–2004, University-hospital Greifswald, Germany) based on a positive functional assay (HIPA test) were retrieved from the laboratory records and scored (4T-score) by two medical experts using the patient file. For cost of illness analysis, predefined HIT-relevant cost parameters (medication costs, prolonged in-hospital stay, diagnostic and therapeutic interventions, laboratory tests, blood transfusions) were retrieved from the patient files. The data were analysed by linear regression estimates with the log of costs and a gamma regression model. Mean length of stay data of non-HIT patients were obtained from the German Federal Statistical Office, adjusted for patient characteristics, comorbidities and year of treatment. Hospital costs were provided by the controlling department. Results and conclusions: One hundred and thirty HIT cases with a 4T-score ≥4 and a positive HIPA test were analyzed. Mean additional costs of a HIT case were 9008 €. The main cost drivers were prolonged in-hospital stay (70.3%) and costs of alternative anticoagulants (19.7%). HIT was more costly in surgical patients compared with medical patients and in patients with thrombosis. Early start of alternative anticoagulation did not increase HIT costs despite the high medication costs indicating prevention of costly complications. An HIT cost calculator is provided, allowing online calculation of HIT costs based on local cost structures and different currencies.

Experiments designed to determine the accuracy of the Corning Immophase Free T4assay revealed that there was a marked perturbation of thyroxine binding to the serum proteins during the assay; binding of 125I-T4to the immobilised T4antibody in the absence of merthiolate increased considerably with buffer dilution of serum; and the free thyroxine concentration declined significantly during pregnancy. These changes in measured fT4were not observed with an equilibrium dialysis-radioimmunoassay procedure. The assay was precise, easily performed, and as effective as the free thyroxine index (FTI) in diagnosing thyroid disease. We conclude that the assay does not provide an accurate quantitative estimation of serum fT4concentration in samples with elevated TBG concentration and that the kinetic principles on which the assay is based are altered as serum binding-protein concentration is reduced (serum dilution). Both FTI and fT4(Corning) data in pregnant patients should be interpreted with caution and with reference to clinical symptomatology and other thyroid function tests.

With multichannel detection, in situSurface-Enhanced Raman spectroscopy (SERS) is demonstrated to provide a viable and valuable means of examining adsorption and reactions at transition metal surfaces in gas phase environments, especially at high pressures and elevated temperatures of relevance to heterogeneous catalysis where other vibrational techniques are of limited utility. In fact, an enticing virtue of SERS is the ability to acquire time-resolved spectra; with the advent of charge-coupled device (CCD) technology, real-time sequences even in the subsecond time regime are now becoming straightforward.

No abstract.

The clinical value of free thyroxine index, thyroxine/thyroxine binding globulin ratio, and free thyroxine concentration were compared in 46 pregnant patients. Overall the free thyroxine index was the best diagnostic index. Pregnancy induced changes in levels of free thyroxine and the thyroxine/thyroxine binding globulin ratio, which gave rise to interpretative problems in some pregnant subjects.

Laser-zone melting of YBCO is described. High temperature gradients of several 100 K/mm allow interesting process rates of about some mm/h. Grain selection is detected by optical microscopy. Phase analyses are made by EDX and XRD.