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Adam Lillicrap, Scott Belanger, Natalie Burden, David Du Pasquier, Michelle R Embry, Marlies Halder, Mark A Lampi, Lucy Lee, Teresa Norberg-King, Barnett A Rattner, Kristin Schirmer, Paul Thomas
The need for alternative approaches to the use of vertebrate animals for hazard assessment of chemicals and pollutants has become of increasing importance. It is now the first consideration when initiating a vertebrate ecotoxicity test, to ensure that unnecessary use of vertebrate organisms is minimized wherever possible. For some regulatory purposes, the use of vertebrate organisms for environmental risk assessments has been banned; in other situations, the number of organisms tested has been dramatically reduced or the severity of the procedure refined...
November 2016: Environmental Toxicology and Chemistry
Jessica Gundy Cuneo, M Scott DeBerard, Anthony J Wheeler
STUDY DESIGN: This study was a retrospective-cohort design involving a review of patient medical and cost records and a 2-year post surgery follow-up outcome survey. OBJECTIVE: To evaluate the functional and cost outcomes associated with recent lumbar fusion surgeries in Utah workers and compare these outcomes with a comparable prior study cohort. SUMMARY OF BACKGROUND DATA: Lumbar fusion performed on injured workers has dramatically increased over the past two decades and this likely coincided with the increased use of more advanced surgical instrumentation...
October 24, 2016: Spine
Alexander Chern, Jacob B Hunter, Marc L Bennett
OBJECTIVE: To determine if cranioplasty techniques following translabyrinthine approaches to the cerebellopontine angle are cost-effective. STUDY DESIGN: Retrospective case series. PATIENTS: One hundred eighty patients with available financial data who underwent translabyrinthine approaches at a single academic referral center between 2005 and 2015. INTERVENTION: Cranioplasty with a dural substitute, layered fat graft, and a resorbable mesh plate secured with screws Main Outcome Measures: billing data was obtained for each patient's hospital course for translabyrinthine approaches and postoperative cerebrospinal fluid (CSF) leaks...
October 21, 2016: Otology & Neurotology
N Vos de Wael
There is a growing interest in the cost-effectiveness of psychiatry in general. How do client organisations regard this growing interest?<br/> AIM: To discuss the cost-effectiveness of psychiatry in general seen from the perspective of the patient/civilian and his or her environment.<br/> METHOD: A critical appraisal of cost-effectiveness in psychiatry on the basis of a case-study and relevant developments in society.<br/> RESULTS: The increasing interest in the cost-effectiveness of psychiatry should be seen as a positive development, but we must be aware of the complexity of the factors involved and of the complications that are linked to this increased interest...
2016: Tijdschrift Voor Psychiatrie
P P T Jeurissen, B A Ravesteijn, R T J M Janssen, M A C Tanke
After a decade of robust growth in spending, Dutch mental healthcare is on a more stricter budgetary path since 2012. High prevalence of illness and limited spending, imply the need for efficient mental healthcare delivery.<br/> AIM: To advise how mental health care can be managed more efficiently. There will also have to be more differentiation between mild and serious psychiatric illnesses.<br/> METHOD: Review of academic articles and policy studies.<br/> RESULTS: With regard to the treatment of fairly common disorders, more attention needs to be given to integrated basic care and e-health...
2016: Tijdschrift Voor Psychiatrie
Johannes A Govaert, Marc J P M Govaert, Marta Fiocco, Wouter A van Dijk, Rob A E M Tollenaar, Michel W J M Wouters
: Background Due to increasing healthcare costs, discussions regarding increased hospital costs when operating on high-risk patients is rising. Therefore, the aim of this study was to analyze if oldest-old colorectal cancer patients have a greater impact on hospital costs than their younger counterparts. METHODS: All colorectal cancer procedures performed in 29 Dutch hospitals between 2010 and 2012 and listed in the Dutch Surgical Colorectal Audit were analyzed...
October 25, 2016: Journal of Surgical Oncology
Saturnin Bertrand Nguenda Anya, Atanase Yene
This paper seeks to identify the determinants of the choice of treatment of pregnant women in Cameroon. Theoretically, the methodology is based on a discrete choice model with random utility. Empirically, the econometric specification is a Nested Multinomial Logit Model. The data used comes from the Demographic Health Survey (DHS) organized in 2011 by the National Institute of Statistics. The results reveal that uneducated women or those having only a primary education prefer to meet the traditional midwives than seek modern maternal health services...
December 2016: Health Economics Review
Anthony J Hatswell, Nick Freemantle, Gianluca Baio
BACKGROUND: Pharmaceuticals are usually granted a marketing authorisation on the basis of randomised controlled trials (RCTs). Occasionally the efficacy of a treatment is assessed without a randomised comparator group (either active or placebo). OBJECTIVE: To identify and develop a taxonomic account of economic modelling approaches for pharmaceuticals licensed without RCT data. METHODS: We searched PubMed, the websites of UK health technology assessment bodies and the International Society for Pharmacoeconomics and Outcomes Research Scientific Presentations Database for assessments of treatments granted a marketing authorisation by the US Food and Drug Administration or European Medicines Agency from January 1999 to May 2014 without RCT data (74 indications)...
October 24, 2016: PharmacoEconomics
Cecilia Saldías, Stijn Speelman, Pay Drechsel, Guido Van Huylenbroeck
Most cities in developing countries fail to treat their wastewater comprehensively. Consequently, farmers downstream use poor-quality water for irrigation. This practice implies risks for farmers, consumers and the environment. Conversely, this water supply supports the livelihood of these farmers and other stakeholders along the value chains. Linking safer options for wastewater management with irrigation could therefore be a win-win solution: removing the risks for society and maintaining the benefits for farmers...
October 24, 2016: Ambio
B Büttner, A Mansur, M Bauer, J Hinz, I Bergmann
Unilateral spinal anesthesia is a cost-effective and rapidly performed anesthetic technique. An exclusively unilateral block only affects the sensory, motor and sympathetic functions on one side of the body and offers the advantages of a spinal block without the typical adverse side effects seen with a bilateral block. The lack of hypotension, in particular, makes unilateral spinal anesthesia suitable for patients with cardiovascular risk factors e. g. aortic valve stenosis or coronary artery disease. Increasing numbers of surgical procedures are now being performed on an outpatient basis...
October 24, 2016: Der Anaesthesist
Tyler Shelby, Tuhina Banerjee, Jyothi Kallu, Shoukath Sulthana, Irene Zegar, Santimukul Santra
Rapid detection and diagnosis of pathogenic strains of influenza is necessary for expedited treatment and quicker resolutions to the ever-rising flu pandemics. Considering this, we propose the development of novel magnetic relaxation nanosensors (MRnS) for the rapid detection of influenza through targeted binding with hemagglutinin. 2,6- and 2,3-sialic acid ligands and entry blocker peptides are conjugated to iron oxide nanoparticles to create functional MRnS. Positive detection of various hemagglutinin variants (H1 and H5) is possible with protein concentrations as little as 1...
October 25, 2016: Nanoscale
Kai Chen, Minjie Ni, Minggang Cai, Jun Wang, Dongren Huang, Huorong Chen, Xiao Wang, Mengyang Liu
Environmental monitoring is fundamental in assessing environmental quality and to fulfill protection and management measures with permit conditions. However, coastal environmental monitoring work faces many problems and challenges, including the fact that monitoring information cannot be linked up with evaluation, monitoring data cannot well reflect the current coastal environmental condition, and monitoring activities are limited by cost constraints. For these reasons, protection and management measures cannot be developed and implemented well by policy makers who intend to solve this issue...
2016: BioMed Research International
John Samaan, Gerardo F Ferrer, Boye Akinyemi, Patricia Junquera, Juan Oms, Rhaisa Dumenigo
Introduction. Marijuana has been used for its psychotropic effects including enhanced relaxation and perceptual alterations. However, the use of synthetic marijuana (SM) leads to more frequent and drastic side effects than the typical use of regular marijuana, owing to the fact that SM has a shorter duration and an earlier peak of action. Despite all the potential adverse health effects associated with SM use, current health policies on SM are very limited. It is believed that the popularity of SM has increased, due to its easy accessibility in the US and lack of detection in typical urine drug screens for THC...
2016: Case Reports in Psychiatry
Navid Alem, Joseph Rinehart, Brian Lee, Doug Merrill, Safa Sobhanie, Kyle Ahn, Ran Schwarzkopf, Maxime Cannesson, Zeev Kain
BACKGROUND: Efforts to mitigate costs while improving surgical care quality have received much scrutiny. This includes the challenging issue of readmission subsequent to hospital discharge. Initiatives attempting to preclude readmission after surgery require planned and unified efforts extending throughout the perioperative continuum. Patient optimization prior to discharge, enhanced disease monitoring, and seamless coordination of care between hospitals and community providers is integral to this process...
2016: Perioperative Medicine
Matthew J Gazzellone, Mehdi Zarrei, Christie L Burton, Susan Walker, Mohammed Uddin, S M Shaheen, Julie Coste, Rageen Rajendram, Reva J Schachter, Marlena Colasanto, Gregory L Hanna, David R Rosenberg, Noam Soreni, Kate D Fitzgerald, Christian R Marshall, Janet A Buchanan, Daniele Merico, Paul D Arnold, Stephen W Scherer
BACKGROUND: Obsessive-compulsive disorder (OCD) is a heterogeneous neuropsychiatric condition, thought to have a significant genetic component. When onset occurs in childhood, affected individuals generally exhibit different characteristics from adult-onset OCD, including higher prevalence in males and increased heritability. Since neuropsychiatric conditions are associated with copy number variations (CNVs), we considered their potential role in the etiology of OCD. METHODS: We genotyped 307 unrelated pediatric probands with idiopathic OCD (including 174 that were part of complete parent-child trios) and compared their genotypes with those of 3861 population controls, to identify rare CNVs (<0...
2016: Journal of Neurodevelopmental Disorders
Jim Junhui Huang, Gagarin Bunjamin, Edwin Sianguan Teo, Deric Boonhuat Ng, Yuan Kun Lee
BACKGROUND: The design of photobioreactor (PBR) for outdoor mass cultivation of microalgae determines the distribution of solar irradiance among cells in the culture, mode of agitation, mass transfer efficacy, and energy consumption, thus determines the productivity of the system and the cost of production. In this study, the concept of a floating photobioreactor with rotation function is proposed. Dunaliella tertiolecta, a model microalga, cultured in the attached vessels was evaluated...
2016: Biotechnology for Biofuels
Antonio J Salazar, Javier A Romero, Oscar A Bernal, Angela P Moreno, Sofía C Velasco, Xavier A Díaz
Objective. The aim of this study was to evaluate and compare the clinical performance of different alternatives to implement low-cost screening telemammography. We compared computed radiography, film printed images, and digitized films produced with a specialized film digitizer and a digital camera. Material and Methods. The ethics committee of our institution approved this study. We assessed the equivalence of the clinical performance of observers for cancer detection. The factorial design included 70 screening patients, four technological alternatives, and cases interpreted by seven radiologists, for a total of 1,960 observations...
2016: International Journal of Telemedicine and Applications
Anthony O Meka, Joseph N Chukwu, Charles C Nwafor, Daniel C Oshi, Nelson O Madichie, Ngozi Ekeke, Moses C Anyim, Chukwuka Alphonsus, Obinna Mbah, Glory C Uzoukwa, Martin Njoku, Kentigern Ntana, Kingsley N Ukwaja
BACKGROUND: Delayed diagnosis of Buruli ulcer can worsen clinical presentation of the disease, prolong duration of management, and impose avoidable additional costs on patients and health providers. We investigated the profile, delays in diagnosis, duration of hospitalisation, and associated factors among patients with Buruli ulcer in Nigeria. METHODS: This was a prospective cohort study of patients with Buruli ulcer who were identified from a community-based survey...
October 23, 2016: Transactions of the Royal Society of Tropical Medicine and Hygiene
Matthew J Grosso, Ari Berg, Samuel LaRussa, Taylor Murtaugh, David P Trofa, Jeffrey A Geller
BACKGROUND: Commercial silver-impregnated occlusive dressings (such as Aquacel Ag Surgical wound dressing) have been touted as antimicrobial dressings to be used following total joint arthroplasty. Given the increased cost of an Aquacel dressing over a standard dressing for total joint arthroplasty, the objective of this study was to determine whether Aquacel surgical dressing is effective in reducing the rates of acute periprosthetic joint infection (PJI) compared to standard sterile dressing...
September 28, 2016: Journal of Arthroplasty
Vanessa E C Pourier, Gert J de Borst
OBJECTIVE: This review summarizes the available evidence and analyzes the current trends on treatments for carotid in-stent restenosis (ISR) after carotid artery stenting (CAS). METHODS: An update of a 2010 review of the literature (which included 20 articles) was conducted using PubMed and Embase. All studies published from inception until January 2016 reporting original data on ISR treatments were included. Treatment trends before and after 2005 were compared...
November 2016: Journal of Vascular Surgery
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