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Cost of treatment

Luis D Mazzuoccolo, Maria Noel Esposito, Paula C Luna, Sharon Seiref, Mirtha Dominguez, Cristina M Echeverria
BACKGROUND: Psoriasis is a chronic inflammatory disease that affects around 100 million people worldwide. The burden of disease is high, but more recent therapies show promising results. Clinicians need, however, more training in the use of such therapies. INTRODUCTION: Project ECHO® (Extension for Community Healthcare Outcomes) is structured around the promise of delivering medical education at a distance, empowering clinicians who operate in remote areas. The use of instant messaging services, such as WhatsApp® Messenger, has the potential to improve on the existing framework and bridge the existing gap of knowledge...
June 20, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Lindsay Carlton, Joseph R Maccio, Joseph G Maccio, Colin McGowan
BACKGROUND: The prevalence and cost of hip osteoarthritis (OA) is rising. Mechanical diagnosis and therapy (MDT) is an orthopedic classification and treatment system based on mechanical and symptomatic response to repeated and sustained end-range movements. There has been no investigation of the association between MDT and patients diagnosed with hip OA. CASE DESCRIPTION: This case report presents a 71-year-old female diagnosed with hip OA and matching the currently accepted clinical prediction rule (CPR) for symptomatic hip OA...
June 20, 2018: Physiotherapy Theory and Practice
P Horner, G Donders, M Cusini, M Gomberg, J S Jensen, M Unemo
At present, we have no evidence that we are doing more good than harm detecting and subsequently treating Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum colonisations/infections. Consequently, routine testing and treatment of asymptomatic or symptomatic men and women for M. hominis, U. urealyticum, and U. parvum is not recommended. Asymptomatic carriage of these bacteria is common and the majority of individuals do not develop disease. Although U. urealyticum has been associated with urethritis in men, it is probably not causal unless a high load is present (likely carriage in 40-80% of detected cases)...
June 20, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Aleksandra Liżewska-Springer, Alicja Dąbrowska-Kugacka, Ewa Lewicka, Łukasz Drelich, Tomasz Królak, Grzegorz Raczak
BACKGROUND: Catheter ablation (CA) is a well-known treatment option for patients with symptomatic drug-resistant atrial fibrillation (AF). Multiple factors have been identified to determine AF recurrence after CA, however their predictive value is rather small. Identification of novel predictors of CA outcome is therefore of primary importance to reduce health costs and improve long-term results of this intervention. The recurrence of AF following CA is related to the severity of left ventricular (LV) dysfunction, extend of atrial dilatation and fibrosis...
June 20, 2018: Cardiology Journal
Raúl Gomero-Cuadra, José Francia-Romero
Regulations regarding health at the workplace have generated expectations in the role played by sanitary authorities in Peru. Healthcare based on the treatment with biological agents may be a result of the lack of understanding of workplace health promotion (WHP). WHP is still a new concept that requires deepening; nevertheless, it is expected to give way to properly managed health and safety programs, reduced absenteeism, increased productivity, reduced healthcare costs, reduced legal problems, and safe and healthy work environments...
January 2018: Revista Peruana de Medicina Experimental y Salud Pública
J Peter Cegielski
Multidrug-resistant (MDR) tuberculosis (TB) emerged shortly after introduction of rifamycins in the 1960s; isoniazid resistance had already emerged by the mid-1950s. Without these two drugs, tuberculosis is very difficult and costly to treat, with unacceptably high rates of treatment failure, death, loss to follow-up, and no known preventive treatment. Global attention first focused on MDR TB in the early 1990s when nosocomial outbreaks with high case fatality rates were reported in many countries. Prevalence data for MDR TB on a global scale first became available in 1997...
January 2018: Revista Peruana de Medicina Experimental y Salud Pública
Sheila Viana Castelo Branco Gonçalves, Carlos Henrique Nery Costa
BACKGROUND: Pentavalent antimonials remain as the standard drugs in the treatment of cutaneous leishmaniosis. The high cost, difficult administration, long treatment time, toxicity and increasing morbidity are factors that limit the use of these drugs. OBJECTIVES: To describe the response to radiofrequency thermotherapy in the treatment of localized cutaneous leishmaniasis in Brazil, and to evaluate its safety and tolerability. METHODS: We conducted a non-comparative open trial with a total of 15 patients confirmed to have cutaneous leishmaniasis on parasitological examination...
June 2018: Anais Brasileiros de Dermatologia
Daniel Jose Szor, Andre Roncon Dias, Marina Alessandra Pereira, Marcus Fernando Kodama Pertille Ramos, Bruno Zilberstein, Ivan Cecconello, Ulysses Ribeiro-Júnior
High levels of inflammatory markers and the neutrophil-lymphocyte ratio appear to be associated with worse overall survival in solid tumors. However, few studies have analyzed the role of the neutrophil-lymphocyte ratio in gastric cancer patients scheduled to undergo curative resection. In the present study, a systematic review and meta-analysis was performed to analyze the relationship between the neutrophil-lymphocyte ratio and overall survival in patients with gastric cancer submitted to curative resection and to identify the clinicopathological features (age, gender, tumor depth, nodal involvement and tumor differentiation) that are correlated with high neutrophil-lymphocyte ratios...
2018: Clinics
Gerardo Rosati, Nunzio Del Gaudio, Enrico Scarano, Rosa Anna Cifarelli, Lucia Altucci, Domenico Bilancia
RATIONALE: Regorafenib is an oral multikinase inhibitor and is approved as salvage therapy in the standard treatment of advanced colorectal cancer (CRC). Due to its limited efficacy, toxicity profile, and cost, it is necessary to identify those patients who may have the most benefit from regorafenib. In a previous case report, kinase insert domain receptor (KDR) mutation has been associated with exceptional clinical response (CR) in an elderly patient treated with a low dose of regorafenib; thus, it was hypothesized that it could represent a new predictive marker of drug response...
June 2018: Medicine (Baltimore)
Víctor Lago, Blas Flor, Luis Matute, Pablo Padilla-Iserte, Alvaro García-Granero, Marco Bustamante, Santiago Domingo
OBJECTIVE: Diverting ileostomy (DI) has been proposed to reduce the incidence and consequences anastomotic leakage after bowel resection. In colorectal cancer treatment, ghost ileostomy (GI) has been proposed as an alternative to DI. Our objective was to report the results of GI associated with colorectal resection in the treatment of ovarian cancer. MATERIALS AND METHODS: This is an observational pilot study performed in a single institution. The main objective sought was to report the results of GI associated with colorectal resection in the treatment of ovarian cancer: 26 patients were included...
June 19, 2018: International Journal of Gynecological Cancer
Aditya V Karhade, John Y Kwon
BACKGROUND: While investigations have been performed examining the quality of US-based cost-utility analyses for other orthopaedic subspecialties and have provided important insights, a similar analysis has not been performed examining the foot and ankle literature. METHODS: A systematic review of foot and ankle studies was conducted to identify cost-utility analyses published between 2000 and 2017. Of 687 studies screened by abstract, 4 cost-utility studies were identified and scored by the Quality of Health Economic Studies instrument...
June 1, 2018: Foot & Ankle Specialist
G Fernandez-Pajarin, B Ares-Pensado, A Sesar, J Iglesias-Canle, L Masa-Vazquez, A Castro
INTRODUCTION: Treatment with intraduodenal levodopa-carbidopa infusion is one of the three therapies currently available for advanced Parkinson's disease. It optimizes the benefit of antiparkinsonian treatment by counteracting the negative effect of erratic gastric emptying on the absorption of oral levodopa. The purpose is to describe our outpatient protocol of treatment establishment. PATIENTS AND METHODS: In our unit we have implemented a protocol for the treatment with intradoudenal levodopa-carbidopa infusion without admission based on the development of a multidisciplinary circuit among the Neurology Service, the Digestive Endoscopy Unit and the Home Hospitalization Unit...
July 1, 2018: Revista de Neurologia
Alec Samuels
This article considers different approaches with a view to reducing NHS legal costs and damages for clinical failures on the basis that these are out of control and reducing resources for the treatment of current and future patients.
January 1, 2018: Medico-legal Journal
Kathleen Mary Noon, Stephen Maxwell Montgomery, Nicholas Adlard, Michel Anton Kroes
OBJECTIVES: Specific economic model types often become de facto standard for health technology appraisal over time. Markov and discrete event simulation (DES) models were compared to investigate the impact of innovative modelling on cost-effectiveness of disease-modifying therapies (DMTs) in relapsing-remitting multiple sclerosis (RRMS). Fingolimod was compared to dimethyl fumarate (DMF; in highly-active [HA] RRMS), alemtuzumab (in HA RRMS), and natalizumab (in rapidly-evolving severe RRMS)...
June 20, 2018: Journal of Medical Economics
Jacqueline S Birks, Richard J Harvey
BACKGROUND: Alzheimer's disease is the most common cause of dementia in older people. One approach to symptomatic treatment of Alzheimer's disease is to enhance cholinergic neurotransmission in the brain by blocking the action of the enzyme responsible for the breakdown of the neurotransmitter acetylcholine. This can be done by a group of drugs known as cholinesterase inhibitors. Donepezil is a cholinesterase inhibitor.This review is an updated version of a review first published in 1998...
June 18, 2018: Cochrane Database of Systematic Reviews
Fredrik Salvesen Haukaas, Audun Ohna, Tania Krivasi
AIMS: To evaluate the cost-effectiveness of obinutuzumab in combination with bendamustine followed by obinituzumab maintenance (Obin-Benda) compared to bendamustine alone (Benda) in patients with refractory follicular lymphoma (FL) in a Norwegian setting. METHODS: A three-state area-under-the-curve (AUC) model was developed. The states included were progression-free-survival (PFS), progressed disease (PD), and death. Each state had costs and utilities assigned to it...
June 19, 2018: Applied Health Economics and Health Policy
R Pisters, M Ilhan, L F Veenstra, B C G Gho, M Stein, J C A Hoorntje, S Rasoul
OBJECTIVES: To compare fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) measurements in an all-comer patient population with moderate coronary artery stenoses. BACKGROUND: Visual assessment of the severity of coronary artery stenoses is often discordant in moderate lesions. FFR allows reliable functional severity assessment in these cases but requires adenosine-induced hyperaemia with associated additional time, costs and side effects. The iFR is a hyperaemia-independent index...
June 19, 2018: Netherlands Heart Journal
Line Pickering, Poul Jennum, Rikke Ibsen, Jakob Kjellberg
We estimated the long-term socioeconomic consequences and health care costs of Neisseria meningitidis meningitis (NM). The prospective cohort study included Danish individuals with onset of NM in childhood and adolescence, diagnosed between 1980 and 2009. Health care costs and socioeconomic data were obtained from nationwide administrative and health registers. Two thousand nine hundred two patients were compared with 11,610 controls matched for age, gender, and other sociodemographic characteristics. In the follow-up analysis at the age of 30 years, 1028 patients were compared with 4452 controls...
June 20, 2018: European Journal of Pediatrics
Michael R Kraus, Henning Kleine, Stefanie Thönnes, Marc Pignot, Yuri Sanchez Gonzalez
INTRODUCTION: German data regarding the economic burden of chronic hepatitis C (CHC) and potential benefits of CHC treatment are limited. To address this issue, we evaluated the role of treatment in mitigating the economic burden of hepatic and extrahepatic complications (EHCs) from CHC virus infection in Germany. METHODS: This retrospective, cross-sectional study used claims data from the Betriebskrankenkasse German sickness fund (2007-2014) to assess the medical costs of hepatic complications and EHCs, including conditions that are prevalent and behavioral factors associated with CHC...
June 19, 2018: Infectious Diseases and Therapy
Jeremy Truntzer, Kevin Mertz, Sara Eppler, Kevin Li, Michael Gardner, Robin Kamal
BACKGROUND: In distal radius fracture repair, complications often lead to reoperation and increased cost. We examined the trends and complications in open reduction internal fixation of distal radius fractures across hand specialist and non-hand specialist surgeons. METHODS: We examined claims data from the Humana administrative claims database between 2007 and 2016. International Classification of Disease, 9th Edition and Current Procedural Terminology codes were searched related to distal radius fractures repaired by open reduction internal fixation...
June 19, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
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