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medical costs

E A Arkenbout, J C F de Winter, A Ali, J Dankelman, P Breedveld
Iterative prototyping is costly and time-consuming. Particularly when designing medical instruments, human factors related design choices significantly impact performance and safety. A tool is presented that allows for the evaluation of steerable instrument controls before the onset of the prototyping stage. The design tool couples gestural input to virtually simulated instrument motions using hand motion tracking. We performed a human-subject evaluation of two manual control strategies that differed in their degrees of freedom (DOF)...
2018: PloS One
Helena J Teede, Marie L Misso, Michael F Costello, Anuja Dokras, Joop Laven, Lisa Moran, Terhi Piltonen, Robert J Norman
STUDY QUESTION: What is the recommended assessment and management of women with polycystic ovary syndrome (PCOS), based on the best available evidence, clinical expertise, and consumer preference? SUMMARY ANSWER: International evidence-based guidelines including 166 recommendations and practice points, addressed prioritized questions to promote consistent, evidence-based care and improve the experience and health outcomes of women with PCOS. WHAT IS KNOWN ALREADY: Previous guidelines either lacked rigorous evidence-based processes, did not engage consumer and international multidisciplinary perspectives, or were outdated...
July 19, 2018: Clinical Endocrinology
Omolola Esther Fayemi, Anthony Chinonso Ekennia, Lebokang Katata-Seru, Azubuike Peter Ebokaiwe, Omamuyovwi Meashack Ijomone, Damian Chinedu Onwudiwe, Eno E Ebenso
A simple and cost-effective material composed of polyacrylonitrile nanofibers containing different concentrations of moringa (MR) leaf extracts was fabricated for antimicrobial properties and wound dressing. The fabricated materials were characterized by scanning electron microscopy, thermal gravimetric analysis, and Fourier transmission infrared spectroscopy. The antibacterial sensitivity of the developed polyacrylonitrile-moringa extract nanofibers was evaluated against Staphylococcus aureus and Escherichia coli by the agar diffusion method...
May 31, 2018: ACS Omega
Marzia Iarossi, Chiara Schiattarella, Ilaria Rea, Luca De Stefano, Rosalba Fittipaldi, Antonio Vecchione, Raffaele Velotta, Bartolomeo Della Ventura
A colorimetric immunosensor based on local surface plasmon resonance by gold nanoparticles is presented, and its application for the detection of human immunoglobulin G (IgG) is demonstrated. The color change of the colloidal solution is produced by nanoparticle aggregation, a process that can be tuned by the presence of the analyte once the nanoparticles are functionalized. In comparison to common functionalization techniques, the procedure described here is simpler, low-cost, and effective in binding antibodies upright on the gold surface...
April 30, 2018: ACS Omega
Donghee Seo
Objectives: Hand, Foot and Mouth disease (HFMD) is a highly contagious viral disease that affects young children and frequently causes epidemics. A vaccine is available in China (enterovirus 71) and, the Republic of Korea took the first step to develop a new vaccine. New vaccine development requires that disease burden is calculated in advance so the financial cost, morbidity and mortality can be measured. Methods: Data from National Sentinel Surveillance and health insurance systems of 1 million claimants were used...
June 2018: Osong Public Health and Research Perspectives
Angelina M Castillo, Jamie Natkowski, Georgina Rubal-Peace
Objective: To assess adherence to current national guidelines for appropriate albumin use at an academic medical center. Methods: This retrospective chart review of 150 randomly selected patients prescribed and administered at least one dose of albumin was conducted in an urban academic medical center to evaluate the adherence of albumin orders to current national guidelines. Inclusion criteria consisted of discharged patients at least 18-years-old admitted to the intensive care unit or medical/surgical unit from September 1, 2015 to August 31, 2016...
April 2018: Pharmacy Practice
Wei T Sze, Mei C Kong
Background: Early intravenous to oral (IV-PO) antibiotics switch, which is one of the important elements in antimicrobial stewardship (AMS) is not well implemented in Malaysian district hospitals. A systematic interventional strategy is required to facilitate IV-PO antibiotic switch. Objective: This study aimed to evaluate the impact of printed AMS recommendations on early IV-PO antibiotics switch practice in district hospitals. Methods: This study was an interventional study conducted in medical wards of eight Sarawak district hospitals from May to August 2015...
April 2018: Pharmacy Practice
Ayesha Jaleel, Kenneth G Saag, Maria I Danila
Similar to other chronic diseases such as diabetes and hypertension, osteoporosis has struggled with suboptimal medication adherence, resulting in an increased risk of fractures and all-cause mortality. The goal of this narrative review was to summarize interventions to improve medication adherence in osteoporosis. Because past reviews of this topic covered published literature through 2013, we conducted our literature search to include the period between January 2012 and November 2017. We identified 10 studies evaluating healthcare system and patient interventions aimed at improving osteoporosis treatment adherence, including three fracture liaison service (FLS) programs, one pharmacist-delivered counseling program, and six patient-directed interventions consisting of three coaching or counseling programs and three interventions using reminder prompts...
July 2018: Therapeutic Advances in Musculoskeletal Disease
Tadao Akizawa, Hiroyuki Okumura, Ana Filipa Alexandre, Ayako Fukushima, Grace Kiyabu, Julie Dorey
Anemia is a common complication for patients with chronic kidney disease (CKD) and is associated with cardiovascular comorbidities and reduced quality of life. The incidence of anemia increases as kidney function declines and affects approximately 32% of Japanese patients with stage 3-5 CKD. This review examined the current literature on anemia in CKD patients in Japan to provide an overview of the burden of anemia in CKD. Medline, Embase, and Igaku Chuo Zasshi databases were searched to identify relevant manuscripts and abstracts published from 2004 onward...
July 18, 2018: Therapeutic Apheresis and Dialysis
Bradley C Gill, James C Ulchaker
PURPOSE OF REVIEW: To review the costs associated with benign prostatic hyperplasia (BPH) management. Specifically, to compare the costs of medical therapy, office-based procedures, and surgical management from a payer perspective. RECENT FINDINGS: The American Urological Association released updated guidelines in 2018 for the surgical management of BPH. Over recent years, analyses investigating the cost-effectiveness of the modalities included in these guidelines have been completed...
July 19, 2018: Current Urology Reports
J Liu, H Guo, P Rai, L Pinto, R Barron
We examined the relationship between persistent osteoporosis medication use and fracture risk among female Medicare beneficiaries diagnosed with osteoporosis using Medicare claims, 2009-2012. Persistent use was associated with reduced risk of fracture and significantly lower total health care costs in the follow-up period. Results were consistent using different analytical methods. INTRODUCTION: This study aimed to examine the relationship between medication persistence and fracture risk among female Medicare beneficiaries diagnosed with osteoporosis...
July 18, 2018: Osteoporosis International
Ute Blassmann, Benedict Morath, Andreas Fischer, Holger Knoth, Torsten Hoppe-Tichy
Drug-related problems (DRPs) are a significant and often preventable cause for morbidity and mortality. Hospitalization is associated with a high risk for DRPs, especially due to a lack of information transfer at transitions of care. At the same time, interventions during inpatient treatment usually require a change in drug therapy and additionally increase the risk of DRPs. Thereby, DRPs can occur at all levels of the medication process and can be caused by different groups of professionals. One way to improve medication safety in hospitals is to integrate clinical pharmacists into the medication process...
July 18, 2018: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
Alexandra Mullen, Brendan Kim, Jose Puglisi, Nena Lundgreen Mason
BACKGROUND: A movement to include ultrasound training in undergraduate medical education is slowly taking place. However, many educational institutions are hesitant to include formal ultrasound training as a part of their curricula due to curricular time constraints, high cost of ultrasound equipment, and a lack of sufficient faculty skilled with ultrasound. We suggest that an economical ultrasound training strategy is needed to resolve these obstacles and enable hesitant medical programs to include ultrasound training...
July 18, 2018: BMC Medical Education
Imane Cherkaoui Jaouad, Abdelali Zrhidri, Wafaa Jdioui, Jaber Lyahyai, Laure Raymond, Grégory Egéa, Mohamed Taoudi, Said El Mouatassim, Abdelaziz Sefiani
BACKGROUND: Autosomal recessive primary microcephaly (MCPH) is a rare genetically heterogeneous disorder of neurogenic brain development characterized by a reduced head circumference at birth with no remarkable anomalies of brain architecture and variable degrees of intellectual impairment. Clinical and genetic heterogeneity in genetic disorders represent a major diagnostic challenge. CASE PRESENTATION: Two patients, 11 and 9 years old, born from consanguineous parents, were referred to the department of medical genetics at the National Institute of Health in Rabat...
July 18, 2018: BMC Medical Genetics
Donald P Rice, Michelle A Ordoveza, Ann M Palmer, George Y Wu, Lisa M Chirch
Direct-acting antiviral therapy is safe and cost-effective for the treatment of hepatitis C virus (HCV) infection. However, variability in drug payment rules represents a barrier to treatment that may disproportionately affect certain populations. We conducted a retrospective cohort study among HIV/HCV coinfected and HCV monoinfected patients using Kaplan-Meier and Fisher's exact test to analyze the time from the prescription of a direct-acting antiviral agent to delivery to the patient. Variables with significance p < ...
July 18, 2018: AIDS Care
Richard M Grimes, Deanna E Grimes
The START Study randomly assigned 4685 persons with CD4+ counts >500 to either immediate treatment (2326 persons) or a group (2359) that had treatment delayed until the CD4+ count was <350 or clinical judgment dictated treatment. The average time in the study was three years. The immediate group (IG) had 42 serious clinical events and the delayed group (DG) had 96. Policy considerations for adopting these results should consider the cost of medications for early treatment, which is the purpose of this article...
July 18, 2018: AIDS Care
Lindsay R Kosinski, Joseph A Gil, Wesley M Durand, Steven F DeFroda, Brett D Owens, Alan H Daniels
OBJECTIVES: The purpose of this study is to identify patient characteristics that increase risk for unplanned readmission within 30 days of an initial hospital stay after outpatient rotator cuff repair (RCR). METHODS: A retrospective cohort study was performed utilizing the National Surgical Quality Improvement Program (ACS NSQIP) datasets from 2012-2015. Patients were preliminarily included in the study based on the presence of a primary Common Procedural Terminology (CPT) code for rotator cuff repair (23410, 23412, 23420, and 29827)...
July 18, 2018: Physician and Sportsmedicine
Kuan-Chen Chen, Chu-Hua Wu, Chao-Hsiun Tang, Kuo-Cherh Huang
OBJECTIVES: This nationwide population-based study aimed at evaluating healthcare resource utilization and direct medical costs among rheumatoid arthritis (RA) patients receiving biologic therapies in Taiwan. DESIGN AND SETTING: A retrospective cohort of 2,425 RA patients who had received first-line tumor necrosis factor (TNF)-α antagonist treatment for at least 6 months (the baseline period) between 2007 and 2011 was identified from the National Health Insurance Research Database in Taiwan...
2018: PloS One
Jessica B McGillen, John Stover, Daniel J Klein, Sinokuthemba Xaba, Getrude Ncube, Mutsa Mhangara, Geraldine N Chipendo, Isaac Taramusi, Leo Beacroft, Timothy B Hallett, Patrick Odawo, Rumbidzai Manzou, Eline L Korenromp
BACKGROUND: Zimbabwe adopted voluntary medical male circumcision (VMMC) as a priority HIV prevention strategy in 2007 and began implementation in 2009. We evaluated the costs and impact of this VMMC program to date and in future. METHODS: Three mathematical models describing Zimbabwe's HIV epidemic and program evolution were calibrated to household survey data on prevalence and risk behaviors, with circumcision coverage calibrated to program-reported VMMCs. We compared trends in new infections and costs to a counterfactual without VMMC...
2018: PloS One
Daniel A Handel, Zemin Su, Nancy Hendry, Patrick Mauldin
OBJECTIVES: Tertiary referral centers have created inpatient units to meet the needs of specific patient populations but sometimes are forced to place patients on other units that, although having the basic necessary skillsets for treating the patient, are not focused on that diagnosis area. The objective of this study was to look at outcomes of patients admitted to these different inpatient settings. STUDY DESIGN: Retrospective review of patient data from a single tertiary academic medical center from August 1, 2014, to June 30, 2015, comparing patients admitted to primary versus secondary inpatient services...
July 1, 2018: American Journal of Managed Care
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