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https://www.readbyqxmd.com/read/28646368/tnf%C3%AE-blockers-followed-by-continuation-of-sulfasalazine-and-methotrexate-combination-a-retrospective-study-on-cost-saving-options-of-treatment-in-spondyloarthritis
#1
Aswin M Nair, P Sandhya, Bijesh Yadav, Debashish Danda
High cost deters continuous use of tumor necrosis factor α blockers (TNFi) in developing countries. The objective of this study was to evaluate outcome and expenditure incurred in Spondyloarthritis (SpA) patients beyond a year of follow-up after receiving four doses of infliximab (IFX) over and above background therapy of methotrexate (MTX) and sulfasalazine (SSZ) combination. Electronic medical records were screened for patients with SpA satisfying the Assessment of Spondyloarthritis International Society (ASAS) criteria between 2008 and 2014...
June 23, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28646169/improving-dialysis-adherence-for-high-risk-patients-using-automated-messaging-proof-of-concept
#2
A Som, J Groenendyk, T An, K Patel, R Peters, G Polites, W R Ross
Comorbidities and socioeconomic barriers often limit patient adherence and self-management with hemodialysis. Missed sessions, often associated with communication barriers, can result in emergency dialysis and avoidable hospitalizations. This proof of concept study explored using a novel digital-messaging platform, EpxDialysis, to improve patient-to-dialysis center communication via widely available text messaging and telephone technology. A randomized controlled trial was conducted through Washington University-affiliated hemodialysis centers involving ESRD patients with poor attendance, defined as missing 2-6 sessions over the preceding 12 weeks...
June 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28645459/-hotline-for-zika-virus-experience-of-a-tropical-and-travel-medicine-unit
#3
Marta Díaz-Menéndez, Fernando de la Calle-Prieto, Marta Arsuaga, Elena Trigo, Concepción Ladrón de Guevara, Pablo Barreiro, Clara Crespillo, Mar Lago
The current outbreak of Zika virus has caused great social alarm, generated in part by the lack of information in the general population. In order to provide accurate and verified information, the Tropical and Travel Medicine Unit of Hospital Carlos III-La Paz (Madrid, Spain) established a hotline for Zika virus infection. We present the data concerning the first 6 months of operation of the telephone hotline. The predominant call profile consisted of women seeking information about the risk of acquiring the disease before travelling...
June 20, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/28644939/an-economic-analysis-of-mac-versus-walant-a-trigger-finger-release-surgery-case-study
#4
Jason L Codding, Suneel B Bhat, Asif M Ilyas
BACKGROUND: There has been recent interest in wide awake hand surgery, also referred to as "wide awake local anesthesia with no tourniquet" (WALANT) surgery. Using a model of single trigger finger release (TFR) surgery, a hypothesis was made that WALANT would result in decreased hospital time and cost than patients receiving sedation with monitored anesthetic care (MAC). METHODS: Consecutive cases of single TFR surgery with MAC were compared with WALANT. All surgeries were performed in the same manner, at the same facility, and by the same surgeon...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28644119/damage-control-plating-in-open-tibial-shaft-fractures-a-cheaper-and-equally-effective-alternative-to-spanning-external-fixation
#5
Paul S Whiting, Phillip M Mitchell, Aaron M Perdue, Arnold J Silverberg, Sarah E Greenberg, Rachel V Thakore, Vasanth Sathiyakumar, Hassan R Mir, William T Obremskey, Manish K Sethi
The purpose of this study was to evaluate damage control plating (DCP) as an alternative to external fixation (EF) in the provisional stabilization of open tibial shaft fractures. Through retrospective analysis, the study found 445 patients who underwent operative fixation for tibial shaft fractures from 2008 to 2012. Twenty patients received DCP or EF before intramedullary nailing with a minimum follow-up of 3 months. Charts and radiographs were reviewed for postoperative complications. Hospital charges were reviewed for implant costs...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28644101/safety-and-cost-efficiency-of-a-restrictive-transfusion-protocol-in-patients-with-traumatic-brain-injury
#6
Laura B Ngwenya, Catherine G Suen, Phiroz E Tarapore, Geoffrey T Manley, Michael C Huang
OBJECTIVE Blood loss and moderate anemia are common in patients with traumatic brain injury (TBI). However, despite evidence of the ill effects and expense of the transfusion of packed red blood cells, restrictive transfusion practices have not been universally adopted for patients with TBI. At a Level I trauma center, the authors compared patients with TBI who were managed with a restrictive (target hemoglobin level > 7 g/dl) versus a liberal (target hemoglobin level > 10 g/dl) transfusion protocol. This study evaluated the safety and cost-efficiency of a hospital-wide change to a restrictive transfusion protocol...
June 23, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28643178/economic-evaluation-of-tobramycin-inhalation-powder-for-the-treatment-of-chronic-pulmonary-pseudomonas-aeruginosa-infection-in-patients-with-cystic-fibrosis
#7
Srilekha Panguluri, Praveen Gunda, Laurie Debonnett, Kamal Hamed
BACKGROUND: Chronic lung infection with Pseudomonas aeruginosa occurs in approximately 50% of patients with cystic fibrosis (CF). This infection further compromises lung function, and significantly contributes to the increased healthcare costs. OBJECTIVES: Inhaled tobramycin, used to manage P. aeruginosa infection in CF patients, is available as powder (tobramycin inhalation powder, TIP) and solution (tobramycin inhalation solution, TIS). Evidence suggests increased adherence with the use of TIP over TIS...
June 22, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28641996/impact-of-paliperidone-palmitate-versus-oral-atypical-antipsychotics-on-health-care-resource-use-and-costs-in-veterans-with-schizophrenia-and-comorbid-substance-abuse
#8
Patrick Lefebvre, Erik Muser, Kruti Joshi, Maral DerSarkissian, Rachel H Bhak, Mei Sheng Duh, Brian Shiner, Yinong Young-Xu
PURPOSE: Almost half of all patients diagnosed with schizophrenia have a history of substance abuse (SA). However, data on treatment of schizophrenia with paliperidone palmitate (PP) among patients with comorbid SA are limited. The objective of this study was to compare all-cause and SA-related health care resource utilization and costs in veterans with schizophrenia and co-occurring SA who were treated with PP versus oral atypical antipsychotics (OAAs). METHODS: Veterans Health Administration electronic health record data were used to conduct a retrospective longitudinal study in veterans with schizophrenia who initiated PP or OAA between January 1, 2010 and June 30, 2016, had ≥12 months of enrollment before treatment initiation (baseline), were diagnosed with SA, and had ≥1 Global Assessment of Functioning score during baseline...
June 19, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28641914/interactive-home-telehealth-and-burns-a-pilot-study
#9
Sean Hickey, Jason Gomez, Benjamin Meller, Jeffery C Schneider, Meredith Cheney, Shamim Nejad, John Schulz, Jeremy Goverman
OBJECTIVE: The objective of this study is to review our experience incorporating Interactive Home Telehealth (IHT) visits into follow-up burn care. METHODS: A retrospective review of all burn patients participating in IHT encounters over the course of 15 months was performed. Connections were established through secure video conferencing and call-routing software. Patients connected with a personal computer or tablet and providers connected with a desktop computer with a high-definition web camera...
June 19, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28641703/a-randomised-controlled-trial-to-assess-the-cost-effectiveness-of-intensive-versus-no-scheduled-follow-up-in-patients-who-have-undergone-resection-for-colorectal-cancer-with-curative-intent
#10
David Mant, Alastair Gray, Siân Pugh, Helen Campbell, Stephen George, Alice Fuller, Bethany Shinkins, Andrea Corkhill, Jane Mellor, Elizabeth Dixon, Louisa Little, Rafael Perera-Salazar, John Primrose
BACKGROUND: Intensive follow-up after surgery for colorectal cancer is common practice but lacks a firm evidence base. OBJECTIVE: To assess whether or not augmenting symptomatic follow-up in primary care with two intensive methods of follow-up [monitoring of blood carcinoembryonic antigen (CEA) levels and scheduled imaging] is effective and cost-effective in detecting the recurrence of colorectal cancer treatable surgically with curative intent. DESIGN: Randomised controlled open-label trial...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28641362/estimating-the-potential-cost-of-a-high-dose-immune-tolerance-induction-iti-therapy-relative-to-the-cost-of-a-combined-therapy-of-a-low-dose-iti-therapy-with-bypassing-agent-prophylaxis
#11
G Kenet, A Oladapo, J D Epstein, C Thompson, A Novack, D J Nugent
INTRODUCTION: The International Immune Tolerance Study (I-ITI) demonstrated comparable success rates between low (FVIII 50 IU/kg/TIW) and high dose (FVIII 200 IU/kg/day) regimens. While costlier, the high dose ITI regimen achieved shorter time-to-treatment success with fewer bleeding episodes compared to the low dose ITI regimen. Adding bypassing agent prophylaxis (BAP) to a low dose ITI regimen may reduce bleeding while still being less costly than high dose ITI. AIM AND METHODS: An economic model was developed to compare high dose ITI to low dose ITI with BAP...
June 22, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28641219/comparison-of-brand-versus-generic-antiepileptic-drug-adverse-event-reporting-rates-in-the-u-s-food-and-drug-administration-adverse-event-reporting-system-faers
#12
Md Motiur Rahman, Yasser Alatawi, Ning Cheng, Jingjing Qian, Annya V Plotkina, Peggy L Peissig, Richard L Berg, David Page, Richard A Hansen
OBJECTIVE: Despite the cost saving role of generic anti-epileptic drugs (AEDs), debate exists as to whether generic substitution of branded AEDs may lead to therapeutic failure and increased toxicity. This study compared adverse event (AE) reporting rates for brand vs. authorized generic (AG) vs. generic AEDs. Since AGs are pharmaceutically identical to brand but perceived as generics, the generic vs. AG comparison minimized potential bias against generics. METHODS: Events reported to the U...
June 13, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28641177/a-30-year-history-of-mpan-case-from-russia
#13
M Selikhova, E Fedotova, S Wiethoff, L V Schottlaender, S Klyushnikov, S N Illarioshkin, H Houlden
We present a patient with progressive spastic ataxia, with dystonia and anarthria undiagnosed until detailed genetic analysis revealed an MPAN mutation. Highlighting the worldwide MPAN distribution, a 30year history of absent diagnosis and the impact and cost saving of an early but detailed genetic analysis in complex progressive movement disorders, particularly the anarthric NBIA group.
June 2, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28641050/thrifty-females-frisky-males-winter-energetics-of-hibernating-bats-from-a-cold-climate
#14
Zenon J Czenze, Kristin A Jonasson, Craig K R Willis
Mammalian hibernation consists of energy-saving torpor bouts (periods of controlled reduction in body temperature [Tb]) interspersed with brief arousals to normothermic Tb. Frequency and duration of torpor bouts and arousals can affect winter survival and are thought to be influenced by an optimization balancing the energetic benefits of prolonged torpor against the physiological and ecological costs (e.g., accumulation of metabolic wastes). Female little brown bats (Myotis lucifugus) spend their fat reserves more slowly than males during winter, presumably so they can emerge from hibernation in good condition to initiate pregnancy...
July 2017: Physiological and Biochemical Zoology: PBZ
https://www.readbyqxmd.com/read/28640722/stroke-ineffective-tube-securement-reduces-nutrition-and-drug-treatment
#15
Sophie Brazier, Stephen J Taylor, Kaylee Allan, Rowan Clemente, Deirdre Toher
Stroke patients with dysphagia often depend on nutrition, hydration and medication via nasogastric (NG) feeding tubes. Securing tubes using tape is associated with repeated tube loss. In this study, the authors determined cause and effect by auditing tube placement methods, delays incurred, duration and costs. Of 202 NG tube placements in 75 patients, 67 placements occurred in 17 patients over a full course of enteral nutrition (EN) and 40 of these placements were tracked. Tubes were secured by tape in 100%, mittens 31% and special observation 5...
June 22, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28639869/economic-burden-of-inpatient-admission-of-ankle-fractures
#16
Justin D Stull, Suneel B Bhat, Justin M Kane, Steven M Raikin
BACKGROUND: Ankle fractures are among the most prevalent traumatic orthopaedic injuries. A large proportion of patients sustaining operative ankle fractures are admitted directly from the emergency department prior to operative management. In the authors' experience, however, many closed ankle injuries may be safely and effectively managed on an outpatient basis. The aim of this study was to characterize the economic impact of routine inpatient admission of ankle fractures. METHODS: A retrospective review of all outpatient ankle fracture surgery performed by a single foot and ankle fellowship-trained surgeon at a tertiary level academic center in 2012 was conducted to identify any patients requiring postoperative inpatient admission...
June 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28639259/the-cost-effectiveness-of-three-interventions-for-providing-preventive-services-to-low-income-children
#17
Ben Johnson, Nicoleta Serban, Paul M Griffin, Scott L Tomar
OBJECTIVE: We evaluated the impact of loan repayment programmes, revising Medicaid fee-for-service rates, and changing dental hygienist supervision requirements on access to preventive dental care for children in Georgia. METHODS: We estimated cost savings from the three interventions of preventive care for young children after netting out the intervention cost. We used a regression model to evaluate the impact of changing the Medicaid reimbursement rates. The impact of supervision was evaluated by comparing general and direct supervision in school-based dental sealant programmes...
June 21, 2017: Community Dentistry and Oral Epidemiology
https://www.readbyqxmd.com/read/28638625/early-eculizumab-use-in-atypical-haemolytic-uraemic-syndrome-in-a-jehovah-s-witness-refusing-blood-products
#18
May Al-Shaghana, Andrew Bentall, Mark D Jesky, William Lester, Graham Lipkin
Thrombotic microangiopathy (TMA) is characterized by microscopic angiopathic haemolytic anaemia, thrombocytopenia and organ injury. Supportive therapies include the use of blood products. Recently the terminal complement inhibitor eculizumab has been approved in atypical haemolytic uraemic syndrome (aHUS) in some countries. We report the case of a 23-year-old female Jehovah's Witness presenting with vaginal haemorrhage from thrombocytopaenia, severe anaemia (nadir Hb 28 g/L) and anuric acute kidney injury with TMA secondary to aHUS...
June 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28638451/antiemetic-effectiveness-and-cost-saving-of-aprepitant-plus-granisetron-is-superior-to-palonosetron-in-gastrointestinal-cancer-patients-who-received-moderately-emetogenic-chemotherapy
#19
Haruka Toda, Hitoshi Kawazoe, Akiko Yano, Yuji Yamamoto, Yuji Watanabe, Yasunori Yamamoto, Yoichi Hiasa, Yoshihiro Yakushijin, Akihiro Tanaka, Hiroaki Araki
Purpose The therapeutic benefit of a three-drug combination of antiemetics has not been established in moderately emetogenic chemotherapy (MEC). The aim of this study was to compare the antiemetic effectiveness and cost-saving of palonosetron plus dexamethasone (control group) with aprepitant, granisetron, and dexamethasone (study group) in cancer patients who received MEC. Methods We switched the standard antiemetic treatment from the control group to the study group in gastrointestinal cancer patients who received MEC after October 2015...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28638417/development-and-validation-of-a-decision-making-stratification-algorithm-to-optimize-the-use-of-rapid-diagnostic-testing-for-patients-with-staphylococcus-bacteremia
#20
Thamer A Almangour, Abdullah A Alhifany, Deanne E Tabb
PURPOSE: To evaluate whether introducing rapid diagnostic testing in conjunction with implementing a stratification algorithm for testing eligibility would be an appropriate clinical and cost saving approach. METHOD: An internal concurrent 4-month observational study was performed. Positive blood cultures continued to be worked up in accordance with standard of care. An additional call to the infectious disease (ID) pharmacy service occurred for all positive blood cultures with Gram-positive cocci in clusters (GPCC)...
2017: Canadian Journal of Infectious Diseases & Medical Microbiology
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