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https://www.readbyqxmd.com/read/28531883/conventional-versus-ultrasound-guided-transbronchial-needle-aspiration-for-the-diagnosis-of-hilar-mediastinal-lymph-adenopathies-a-randomized-controlled-trial
#1
Martina Bonifazi, Irene Tramacere, Lina Zuccatosta, Federico Mei, Michele Sediari, Maria Cristina Paonessa, Stefano Gasparini
BACKGROUND: Conventional transbronchial needle aspiration (c-TBNA) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) are both valuable diagnostic techniques for the diagnosis of hilar/mediastinal lesions. Although a superiority of EBUS-TBNA over c-TBNA may be expected, evidence-based data on a direct comparison between these 2 procedures are still lacking. OBJECTIVES: We aimed to test the superiority of EBUS-TBNA over c-TBNA in a randomized trial and to evaluate the cost-effectiveness profile of a staged strategy, including c-TBNA as initial test followed by EBUS-TBNA, in case of inconclusive results at rapid on-site evaluation...
May 23, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28531837/possible-developments-for-ex-situ-phytoremediation-of-contaminated-sediments-in-tropical-and-subtropical-regions-review
#2
REVIEW
Marco Pittarello, Jader Galba Busato, Paolo Carletti, Leonardo Barros Dobbss
The growing problem of remediation of contaminated sediments dredged from harbor channels needs to be resolved by a cost effective and sustainable technology. Phytoremediation, by ex situ remediation plants, seems to have the potential to replace traditional methods in case of moderately contaminated sediments. On the other side, the need to mix sediments with soil and/or sand to allow an easier establishment of most employed species causes an increase of the volume of the processed substrate up to 30%. Moreover the majority of phytoremediating species are natives of temperate climate belt...
April 22, 2017: Chemosphere
https://www.readbyqxmd.com/read/28531565/efficiency-cost-effectiveness-and-need-of-inversion-in-nutritional-therapy-importance-of-detecting-and-documenting-undernutrition
#3
Jesús Manuel Morán López, María Piedra León, Belén Beneítez Moralejo, Fidel Jesús Enciso Izquierdo, Luis Miguel Luengo Pérez, José Antonio Amado Señaris
Disease Related Malnutrition (DRM) is highly prevalent in Spanish hospitals. WHO estimates that 20-40% of health-associated expenses are lost due to inefficiency. Demonstration that DRM is a component of inefficiency and hiring a specialist physician for its detection and treatment is cost-effective. MATERIAL AND METHODS: Comparison between nutritional diagnosis and procedures detected and encoded at discharge using McNemar test. Recoding of 162 discharge reports including nutritional diagnoses and procedures...
June 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28531129/rapid-and-cost-effective-quantification-of-glucosinolates-and-total-phenolic-content-in-rocket-leaves-by-visible-near-infrared-spectroscopy
#4
Eva María Toledo-Martín, Rafael Font, Sara Obregón-Cano, Antonio De Haro-Bailón, Myriam Villatoro-Pulido, Mercedes Del Río-Celestino
The potential of visible-near infrared spectroscopy to predict glucosinolates and total phenolic content in rocket (Eruca vesicaria) leaves has been evaluated. Accessions of the E. vesicaria species were scanned by NIRS as ground leaf, and their reference values regressed against different spectral transformations by modified partial least squares (MPLS) regression. The coefficients of determination in the external validation (R²VAL) for the different quality components analyzed in rocket ranged from 0.59 to 0...
May 20, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28530525/cost-effectiveness-of-nivolumab-ipilimumab-combination-therapy-compared-with-monotherapy-for-first-line-treatment-of-metastatic-melanoma-in-the-united-states
#5
Anna Oh, Dang M Tran, Leann C McDowell, Dor Keyvani, Jay Andrew Barcelon, Oscar Merino, Leslie Wilson
BACKGROUND: The approval of new immunotherapies has dramatically changed the treatment landscape of metastatic melanoma. These survival gains come with trade-offs in side effects and costs, as well as important considerations for third-party payer systems, physicians, and patients. OBJECTIVE: To develop a Markov model to determine the cost-effectiveness of nivolumab, ipilimumab, and nivolumab-ipilimumab combination as firstline therapy in metastatic melanoma, while accounting for differential effectiveness in programmed death-ligand 1 (PD-L1) positive and negative patients...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530519/does-a-one-size-fits-all-cost-sharing-approach-incentivize-appropriate-medication-use-a-roundtable-on-the-fairness-and-ethics-associated-with-variable-cost-sharing
#6
Jennifer S Graff, Chuck Shih, Thomas Barker, Gabriela Dieguez, Cheryl Larson, Helen Sherman, Robert W Dubois
BACKGROUND: Tiered formularies, in which patients pay copays or coinsurance out-of-pocket (OOP), are used to manage costs and encourage more efficient health care resource use. Formulary tiers are typically based on the cost of treatment rather than the medical appropriateness for the patient. Cost sharing may have unintended consequences on treatment adherence and health outcomes. Use of higher-cost, higher-tier medications can be due to a variety of factors, including unsuccessful treatment because of lack of efficacy or side effects, patient clinical or genetic characteristics, patient preferences to avoid potential side effects, or patient preferences based on the route of administration...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530122/low-pacemaker-incidence-with-continuous-sutured-valves-a-retrospective-analysis
#7
Lars Niclauss, Dominique Delay, Raymond Pfister, Sebastien Colombier, Matthias Kirsch, René Prêtre
Background Permanent pacemaker implantation after surgical aortic valve replacement depends on patient selection and risk factors for conduction disorders. We aimed to identify risk criteria and obtain a selected group comparable to patients assigned to transcatheter aortic valve implantation. Methods Isolated sutured aortic valve replacements in 994 patients treated from 2007 to 2015 were reviewed. Demographics, hospital stay, preexisting conduction disorders, surgical technique, and etiology in patients with and without permanent pacemaker implantation were compared...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28529347/variable-selection-for-case-cohort-studies-with-failure-time-outcome
#8
A I Ni, Jianwen Cai, Donglin Zeng
Case-cohort designs are widely used in large cohort studies to reduce the cost associated with covariate measurement. In many such studies the number of covariates is very large, so an efficient variable selection method is necessary. In this paper, we study the properties of a variable selection procedure using the smoothly clipped absolute deviation penalty in a case-cohort design with a diverging number of parameters. We establish the consistency and asymptotic normality of the maximum penalized pseudo-partial-likelihood estimator, and show that the proposed variable selection method is consistent and has an asymptotic oracle property...
September 2016: Biometrika
https://www.readbyqxmd.com/read/28529212/exploring-the-case-for-eminent-domain-of-hepatitis-c-virus-treatment-patents
#9
T Joseph Mattingly Ii, Emily L Heil, Kathleen S Hoke
Hepatitis C virus (HCV) is a silent epidemic affecting millions of patients and represents the leading indication for liver transplantation in the United States and worldwide. New direct-acting antiviral agents offer the potential to cure patients infected with HCV but it comes at a staggering cost. Given the recent attention to these high-priced HCV therapies and the impact treating individuals with HCV is having on drug expenditures in the United States, there may be a need to revisit drug patent laws and the options the federal government has to ensure patient access to care...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28529098/differences-in-the-economic-valuation-and-determining-factors-of-informal-care-over-time-the-case-of-blood-cancer
#10
Marta Ortega-Ortega, Roberto Montero-Granados, Juan de Dios Jiménez-Aguilera
OBJECTIVE: To estimate differences in the economic valuation and sociodemographic and clinical factors associated with informal care between phases of the treatment in the case of blood cancer patients. METHODS: 139 haematological cancer patients who underwent a stem cell transplantation completed a longitudinal questionnaire according to 3 phases of the treatment: short-term (pre-transplant), medium-term (1st year post-transplant) and long-term (2nd-6th year post-transplant)...
May 19, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/28528356/operating-room-fires-in-periocular-surgery
#11
Michael A Connor, Anne M Menke, Ivan Vrcek, John W Shore
AIM: A survey of ophthalmic plastic and reconstructive surgeons as well as seven-year data regarding claims made to the Ophthalmic Mutual Insurance Company (OMIC) is used to discuss operating room fires in periocular surgery. METHODS: A retrospective review of all closed claim operating room fires submitted to OMIC was performed. A survey soliciting personal experiences with operating room fires was distributed to all American Society of Oculoplastic and Reconstructive Surgeons...
May 20, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/28527978/enhanced-antimony-v-removal-using-synergistic-effects-of-fe-hydrolytic-flocs-and-ultrafiltration-membrane-with-sludge-discharge-evaluation
#12
Baiwen Ma, Xing Wang, Ruiping Liu, Zenglu Qi, William A Jefferson, Huachun Lan, Huijuan Liu, Jiuhui Qu
The integration of adsorbents with ultrafiltration (UF) membranes is a promising method for alleviating membrane fouling and reducing land use. However, a number of problems have become apparent concerning the granular adsorbents used currently, such as high running cost, high chance of causing membrane surface damage, low in situ chemical cleaning efficiency, etc. Herein, to overcome these disadvantages, loose in situ hydrolyzed flocs were directly injected into the membrane tank, providing strong adsorption ability at low cost...
May 13, 2017: Water Research
https://www.readbyqxmd.com/read/28527738/life-cycle-assessment-of-sustainable-raw-material-acquisition-for-functional-magnetite-bionanoparticle-production
#13
Jhuma Sadhukhan, Nimisha Joshi, Mobolaji Shemfe, Jonathan R Lloyd
Magnetite nanoparticles (MNPs) have several applications, including use in medical diagnostics, renewable energy production and waste remediation. However, the processes for MNP production from analytical-grade materials are resource intensive and can be environmentally damaging. This work for the first time examines the life cycle assessment (LCA) of four MNP production cases: (i) industrial MNP production system; (ii) a state-of-the-art MNP biosynthesis system; (iii) an optimal MNP biosynthesis system and (iv) an MNP biosynthesis system using raw materials sourced from wastewaters, in order to recommend a sustainable raw material acquisition pathway for MNP synthesis...
May 17, 2017: Journal of Environmental Management
https://www.readbyqxmd.com/read/28527687/cost-effectiveness-analysis-of-typhoid-conjugate-vaccines-in-five-endemic-low-and-middle-income-settings
#14
Marina Antillón, Joke Bilcke, A David Paltiel, Virginia E Pitzer
BACKGROUND: Typhoid fever remains endemic in low- and middle-income countries. Programmatic use of existing vaccines is limited, but upcoming typhoid conjugate vaccines (TCVs) could warrant wider use. We evaluated the cost-effectiveness of five TCV delivery strategies in three urban areas (Delhi and Kolkata, India and Nairobi, Kenya) and two rural settings (Lwak, Kenya and Dong Thap, Vietnam) with varying incidence. METHODS AND FINDINGS: We evaluated routine infant vaccination with and without catch-up campaigns among older individuals...
May 17, 2017: Vaccine
https://www.readbyqxmd.com/read/28527266/-risk-factors-associated-with-the-development-of-perinatal-asphyxia-in-neonates-at-the-hospital-universitario-del-valle-cali-colombia-2010-2011
#15
Javier Torres-Muñoz, Christian Rojas, Diana Mendoza-Urbano, Darly Marín-Cuero, Sandra Orobio, Carlos Echandía
INTRODUCTION: Perinatal asphyxia is one of the main causes of perinatal mortality and morbidity worldwide and it generates high costs for health systems; however, it has modifiable risk factors. OBJECTIVE: To identify the risk factors associated with the development of perinatal asphyxia in newborns at Hospital Universitario del Valle, Cali, Colombia. MATERIALS AND METHODS: Incident cases and concurrent controls were examined. Cases were defined as newborns with moderate to severe perinatal asphyxia who were older than or equal to 36 weeks of gestational age, needed advanced resuscitation and presented one of the following: early neurological disorders, multi-organ commitment or a sentinel event...
April 1, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/28526943/a-global-reference-comparator-for-biosimilar-development
#16
Christopher J Webster, Gillian R Woollett
Major drug regulators have indicated in guidance their flexibility to accept some development data for biosimilars generated with reference product versions licensed outside their own jurisdictions, but most authorities require new bridging studies between these versions and the versions of them licensed locally. The costs of these studies are not trivial in absolute terms and, due to the multiplier effect of required repetition by each biosimilar sponsor, their collective costs are substantial. Yet versions of biologics licensed in different jurisdictions usually share the same development data, and any manufacturing changes between versions have been justified by a rigorous comparability process...
May 19, 2017: BioDrugs: Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
https://www.readbyqxmd.com/read/28526311/dramatic-effects-of-a-new-antimicrobial-stewardship-program-in-a-rural-community-hospital
#17
Claudia R Libertin, Stephanie H Watson, William L Tillett, Joy H Peterson
BACKGROUND: New Joint Commission antimicrobial stewardship requirements took effect on January 1, 2017, promoted as a central strategy for coping with the emerging problems of antimicrobial resistance and Clostridium difficile infection. Our objective was to measure the effects of a new antimicrobial stewardship program (ASP) in a rural community hospital with no prior ASP, in the context of having a new infectious disease specialist on staff. METHODS: An ASP team was formed to implement a prospective audit with health care provider feedback and targeting 12 antimicrobial agents in a rural hospital in Georgia...
May 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28525631/primary-leiomyosarcoma-of-inferior-vena-cava-adjacent-to-hepatic-veins-complete-off-pump-resection-and-inferior-vena-cava-graft-reconstruction-with-application-of-external-skin-surface-cooling
#18
Michael Malyshev, Sergey Zotov, Anton Malyshev, Andrey Rostovykh
OBJECTIVES: Resection of a leiomyosarcoma of the inferior vena cava (IVC) requires venovenous bypass, especially if IVC clamping above the hepatic veins is planned. This report describes the application of external skin surface cooling for off-pump resection of a primary IVC leiomyosarcoma adjacent to the hepatic veins with graft IVC reconstruction in conditions of suprahepatic caval clamping and uninterrupted Pringle's manoeuvre. METHODS: A 62-year-old woman presented with IVC leiomyosarcoma adjacent to the hepatic veins...
May 19, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28525473/is-total-disk-replacement-a-cost-effective-treatment-for-cervical-degenerative-disk-disease
#19
Bernd Wiedenhöfer, Joachim Nacke, Mike Stephan, Wiltrud Richter, Claus Carstens, Markus Eichler
STUDY DESIGN: A retrospective study. OBJECTIVE: The objective of this study was to assess the cost-effectiveness and clinical outcome of motion-preserving versus fusion procedures in cervical spine surgery. SUMMARY OF BACKGROUND DATA: During the last decade there has been a huge growth in spine surgery with a concurrent increase in the economic burden. Currently, there appear to be no differences in clinical outcome between cervical total disk replacement (TDR) and spinal fusion (SF)...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28525472/a-comparison-of-implants-used-in-open-door-laminoplasty-structural-rib-allografts-versus-metallic-miniplates
#20
Ehsan Tabaraee, Praveen Mummaneni, Amir Abdul-Jabbar, David Shearer, Esha Roy, Beejal Amin, Christopher Ames, Shane Burch, Vedat Deviren, Sigurd Berven, Serena Hu, Dean Chou, Bobby K Tay
STUDY DESIGN: A retrospective case-controlled study. SUMMARY OF BACKGROUND DATA: Open-door laminoplasty has been successfully used to address cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament. Two common implants include rib allograft struts and metallic miniplates. OBJECTIVE: The goals of this study were to compare outcomes, complications, and costs associated with these 2 implants. METHODS: A retrospective review was done on 51 patients with allograft struts and 55 patients with miniplates...
June 2017: Clinical Spine Surgery
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