Voluntary screening program for prostate cancer: detection rate and cost

In a community-wide screening program conducted in Jacksonville, Florida, 564 participants received free screening for prostate cancer. Frequency of positive results of prostate-specific antigen measurement and digital rectal examination was comparable to that found in similar programs in other communities. The estimated cost for each participant was $231, and the cost to discover each cancer was $7,240. If one also includes initial therapy in cost estimates, then the cost per participant was $520, and the cost to find and treat each patient was $16,300. The value of screening for prostate cancer must be judged by treatment outcome and underlying costs.

Treatment of the anemia of chronic renal failure with subcutaneous recombinant human erythropoietin

PURPOSE

The purpose of this study was to determine the efficacy of recombinant human erythropoietin (rHuEPO) given subcutaneously three times/week in patients with chronic renal failure and anemia (predialysis).

PATIENTS AND METHODS

Eleven patients with predialysis chronic renal failure participated in a double-blind, placebo-controlled study of subcutaneously administered erythropoietin. For 12 weeks, patients received either rHuEPO 100 mu/kg body weight three times/week subcutananeously or a placebo. After 12 weeks of placebo, patients now also received rHuEPO in a dose up to 150 mu/kg three times/week until target hematocrit was achieved. Throughout the study, blood pressure was monitored closely and blood work was obtained regularly for hemoglobin, hematocrit, reticulocyte count, and iron profile determinations.

RESULTS

At 12 weeks, the hematocrit of the treated group had risen from 29% +/- 2% to 35% +/- 2% (p less than 0.001). The placebo group baseline hematocrit was 28% +/- 2% and at 12 weeks 26% +/- 2% After 12 weeks of rHuEPO therapy, the hematocrit of the prior placebo group was 32% +/- 2% (p less than 0.001 versus baseline). No significant change in biochemical parameters was noted. Mean blood pressure values were comparable before and after treatment. All protein ultimately required iron supplementation. In two patients, the rate of progression of renal failure appeared to increase as their hematocrit rose and rHuEPO was discontinued.

CONCLUSIONS

It is concluded that rHuEPO given subcutaneously is an effective and safe therapy for patients with chronic renal failure who are anemic and who are not receiving dialysis.

The work motivations of mothers with preschool children

This article provides a qualitative and quantitative analysis of the motivations for employment among a sample of 166 Sydney mothers, each of whom had at least 1 preschool-aged child. Mothers with high and moderate work attachment indicated a multiplicity of motives, of both an extrinsic (financial) and intrinsic (personal satisfaction, sense of achievement) nature. In contrast, the majority of women with low work attachment cited extreme financial need as the only possible reason that would impel them to enter the labor force. When asked which was, or would be, their most important reason for working, women with high work attachment endorsed more nonfinancial than financial reasons, women with moderate work attachment were about equally likely to give either reason, and women with low work attachment predominantly gave financial reasons. Husbands' perceptions of the reasons their wives were working, or would work, showed some, but not complete, agreement with those of their wives.

Antiplasmin activity of electrophoretically separated human serum fractions

The antiplasmin which migrates electrophoretically with the alpha(2) globulins preponderates in effect over that of the alpha(1) migrating antiplasmin. This preponderance persists at physiological pH value in vitro and the significance of this finding is discussed. No evidence has been obtained of the existence of anti-urokinase activity in antiplasmin-free serum fractions.