A prospective study was carried out for 6 months to determine the efficacy of blood ordering routines for elective surgery. It was found that only 23% of procedures needed preoperative crossmatching of blood (transfusion index 'TI' greater than 0.5). There was an excessive over-ordering of blood for 77% of the operations (crossmatch/transfusion ratio greater than 2.5). In addition, the transfusion index for the latter group showed that there was no need to prepare blood preoperatively (TI less than 0.5). A transfusion tariff is worked out which abandons crossmatching for the majority of procedures (cholecystectomy, thyroidectomy and surgery for duodenal ulcer excluding gastrectomy). Instead a 'group and screen' policy is suggested.
A series of 39 new benzopyranopyrans and related compounds were synthesised and their antimycotic activity in vitro was evaluated against 4 species of human pathogenic yeasts which were insensitive to miconazole, isoconazole and tolnaftate. The minimum inhibitory concentrations (MICs) of these commercial compounds ranged between 50 and 150 µg/ml. Of the new compounds, 15 were active against 5 strains of Cryptococcus neoformans, while 9 more were active against 3 of these strains with an MIC of 6 µg/ml or lower. Similar MICs were shown by 5 compounds which were active against Candida albicans and 3 which were active against Trichosporon cutaneum. All the active compounds were found to be less toxic than the 3 commercial antimycotics, as judged by their LD50 values in mice. A number of deductions were made regarding the structural variations which resulted in the heterogeneity of response shown by the strains of C. neoformans tested in this series.
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