The purpose of this study was to investigate the immediate and delayed effects of plasma donation and blood donation on responses in exhaustive, severe-intensity exercise. Nineteen young men and women performed exhaustive cycle ergometer tests at ∼3.3 W·kg(-1) before and then 2 h, 2 days, and 7 days after withdrawal of either 8-10 mL·kg(-1) (∼700 mL) of plasma (n = 10) or 1 unit (450 mL) of whole blood (n = 9). Time to exhaustion was significantly (p < 0.05) decreased after the removal of plasma (-11% after 2 h) and after the removal of blood (-19% after 2 h and -7% after 2 days). Maximal oxygen uptake (.VO(2max)) was not affected by plasma donation, but .VO(2max) was reduced following blood withdrawal (-15% after 2 h, -10% after 2 days, and -7% after 7 days) presumably because of effects on blood volume, total haemoglobin content, and haemoglobin concentration. The kinetics of the oxygen uptake (.VO2) response was not affected by either intervention. Two measures of anaerobic capacity, postexercise blood lactate concentration, and maximal accumulated oxygen deficit were reduced (-14%, -15%, respectively) 2 h after plasma donation, but neither was affected by blood donation. Removal of plasma and removal of blood have different effects on blood constituency, on the .VO2 response, and on performance. Plasma donation appears to affect exercise performance because of reduced anaerobic capacity, whereas blood donation affects performance because of lowered .VO(2max).

The measurement of trace levels of bisphenol A (BPA) leached out of household plastics using solid-phase microextraction (SPME) with gas chromatography−mass spectrometry (GC−MS) is reported here. BPA is an endocrine-disrupting compound used in the industrial manufacture of polycarbonate plastic bottles and epoxy resin can liners. This experiment allows students to use modern instrumentation and analytical techniques to investigate a timely and relevant issue involving the contamination of food products by a packaging component. The impact of handling conditions and container type on the quantity of BPA released from the plastics is explored. This experiment is suitable for an undergraduate analytical chemistry or instrumental analysis course and requires two, 3-h laboratory periods to complete.

PURPOSE: High-dose methotrexate (HD-MTX) is commonly used for the treatment of osteosarcoma or for CNS involvement in lymphoproliferative neoplasms. It is often given in the inpatient setting because of monitoring requirements after administration. We conducted a process improvement initiative to change our institutional discharge criteria for HD-MTX from 0.05 µmol/L to ≤ 0.1 µmol/L to reduce cost and length of stay (LOS) for this patient population. METHODS: After an assessment of drivers of LOS among patients receiving HD-MTX, we identified discharge criteria as an actionable factor. We developed a workflow to discharge patients with 3 days of oral leucovorin and sodium bicarbonate when the methotrexate level reached ≤ 0.1 µmol/L. Patient demographics, chemotherapy regimen, cycle, dose, and LOS data were collected for a 7-month period before and a 4-month period after the intervention. Cost savings were estimated on the basis of the daily cost of a hospital bed at the institution. RESULTS: Mean LOS for the pre-intervention and postintervention group was 4.84 days (n = 49) and 3.67 days (n = 42), respectively, resulting in a 24.4% reduction in LOS, with a mean ratio of 0.756 (95% CI, 0.615 to 0.927; P = .007). Reduced LOS resulted in a decrease in cost of $1,828.73 per admission, with a 4-month savings of $76, 806.56 and projected annualized savings of $230,419.67. No patient experienced complications because of the change in discharge criteria. CONCLUSION: Liberalizing discharge criteria for HD-MTX was feasible and safe and reduced cost. Additional efforts to reduce LOS for elective chemotherapy admissions or to safely transition some of these complex regimens to the home setting are currently underway at our institution.

30 Background: High-dose methotrexate (HDMTX) is administered for the treatment of primary central nervous system (CNS) lymphoma (PCNSL), leptomeningeal metastases, and osteosarcoma, as well as CNS prophylaxis in patients with high-risk lymphoma and leukemia. Treatment is typically administered in an inpatient setting to enable aggressive hydration, urinary alkalinization, and frequent lab monitoring given the risk of acute kidney injury. Multiple pediatric centers have published experiences with outpatient administration of HDMTX. We aim to determine the toxicity rate in adult patients at SKCC receiving HDMTX to identify a population in which to pilot an outpatient HDMTX program. Methods: We performed a retrospective review of all patients receiving inpatient HDMTX at SKCC between January 1, 2018 and October 31, 2019. Results: Seventy-three patients (52% male) with median age of 60 years (range 22-81) received 255 cycles total of HDMTX. Diagnoses include PCNSL/vitreoretinal lymphoma (n=22), diffuse large B-cell lymphoma (n=17), B-cell acute lymphoblastic leukemia (n=16) and other diagnoses (n= 18). Thirty-one cycles were administered as CNS prophylaxis and 224 cycles as treatment, with a median prophylactic dose of 3.5 g/m2 (range 1-3.5) and median treatment dose of 3.5 g/m2 (range 0.25-12). The most common toxicity was acute kidney injury at a median day 3 of the cycle (range 1-7). See the table for details. Conclusions: Acute kidney injury occurred more often in the treatment group compared to prophylaxis group. Of all patients with AKI in the treatment group, 45% had a diagnosis of PCNSL. In the prophylactic group, only 21% of patients (3/14) experienced AKI of which all resolved. Of all AKI events, 90% were Grade 2 and 90% resolved. Based on these results, we plan to pilot an outpatient HDMTX program in patients receiving prophylactic HDMTX to determine its effect on patient quality of life and cost of care. [Table: see text]