scholarly journals Blood Conservation in Neurosurgery: Erythropoietin and Autologous Donation

2014 ◽  
Vol 41 (5) ◽  
pp. 583-589 ◽  
Author(s):  
Alexander McGirr ◽  
Katerina Pavenski ◽  
Bhanu Sharma ◽  
Michael D. Cusimano
Keyword(s):  
Significant Proportion ◽  
International Classification Of Diseases ◽  
Recombinant Erythropoietin ◽  
Blood Conservation ◽  
Retrospective Case ◽  
Transfusion Requirements ◽  
Classification Of Diseases ◽  
Matching Criteria ◽  
The Cost ◽  
Rbc Transfusion

AbstractBackgroundNeurosurgery may involve significant blood loss and frequently requires allogeneic red blood cell (RBC) transfusion. Preoperative recombinant erythropoietin (EPO) may be used to improve erythroid status and recovery, and used either alone or in combination with preoperative autologous donation (PAD) it may reduce exposure to allogeneic RBC. We wished to study the use of EPO with and without PAD and the risk of RBC transfusion in neurosurgery.MethodsUsing a retrospective case-control design, 57 patients who received EPO preoperatively were matched 2:1 for age, sex, year of surgery, and International Classification of Diseases code most responsible for surgery (three were excluded because of stringent matching criteria, leaving 54 cases and 108 comparison subjects). Thirty-two cases participated in PAD. Medical and anesthetic records as well as laboratory investigations were reviewed and extracted.ResultsAllogeneic RBC exposure was identical for EPO cases and comparison subjects (18.5%). Concomitant PAD and EPO did not reduce allogeneic RBC exposure (21.9%), and resulted in a greater number of RBC units transfused. Last recorded hemoglobin levels suggested that autologous RBCs were not more liberally used. Patients who engaged in PAD and EPO suffered from iatrogenic anemia. A significant proportion (58.6%) of the autologous RBCs was ultimately not used and discarded.ConclusionFurther research is needed to determine the efficacy of EPO in neurological surgery. PAD does not appear to reduce the risk of allogeneic RBC transfusion, despite concomitant EPO. Indeed, PAD resulted in iatrogenic anemia and increased transfusion requirements. The cost-effectiveness of blood conservation efforts in neurosurgery deserves additional research.

Prevalence and risk factors for chalazion in an older veteran population

2021 ◽  
pp. bjophthalmol-2020-318420
Author(s):  
Sneh Patel ◽  
Natalia Tohme ◽  
Emmanuel Gorrin ◽  
Naresh Kumar ◽  
Brian Goldhagen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tear Film ◽  
International Classification Of Diseases ◽  
Retrospective Case ◽  
Eyelid Margin ◽  
Factors Associated ◽  
Classification Of Diseases ◽  
Health Database ◽  
Irritable Bowel ◽  
The Impact

BackgroundChalazia are common inflammatory eyelid lesions, but their epidemiology remains understudied. This retrospective case–control study examined the prevalence, risk factors and geographic distribution of chalazia in a large veteran population.MethodsData on all individuals seen at a Veterans Affairs (VA) clinic between October 2010 and October 2015 were extracted from the VA health database. Subjects were grouped based on International Classification of Diseases, Ninth Revision (ICD-9) code for chalazion. Univariable logistic regression modelling was used to identify clinical and demographic factors associated with chalazion presence, followed by multivariable modelling to examine which factors predicted risk concomitantly. All cases were mapped across the continental US using geographic information systems modelling to examine how prevalence rates varied geographically.ResultsOverall, 208 720 of 3 453 944 (6.04%) subjects were diagnosed with chalazion during the study period. Prevalence was highest in coastal regions. The mean age of the population was 69.32±13.9 years and most patients were male (93.47%), white (77.13%) and non-Hispanic (93.72%). Factors associated with chalazion risk included smoking (OR=1.12, p<0.0005), conditions of the tear film (blepharitis (OR=4.84, p<0.0005), conjunctivitis (OR=2.78, p<0.0005), dry eye (OR=3.0, p<0.0005)), conditions affecting periocular skin (eyelid dermatitis (OR=2.95, p<0.0005), rosacea (OR=2.50, p<0.0005)), allergic conditions (history of allergies (OR=1.56, p<0.0005)) and systemic disorders (gastritis (OR=1.54, p<0.0005), irritable bowel syndrome (OR=1.45, p<0.0005), depression (OR=1.35, p<0.0005), anxiety (OR=1.31, p<0.0005)). These factors remained associated with chalazion risk when examined concomitantly.ConclusionPeriocular skin, eyelid margin and tear film abnormalities were most strongly associated with risk for chalazion. The impact of environmental conditions on risk for chalazion represents an area in need of further study.

scholarly journals Anxiety and Depression in Patients With Retinitis Pigmentosa

2020 ◽  
pp. 247412642093645
Author(s):  
Patrick Le ◽  
Michelle Nguyen ◽  
Thoai Vu ◽  
Diem-Phuong Dao ◽  
Daniel Olson ◽  
...  
Keyword(s):  
Retinitis Pigmentosa ◽  
Medical Records ◽  
International Classification Of Diseases ◽  
Anxiety And Depression ◽  
Retrospective Case ◽  
Comorbid Anxiety ◽  
Potential Association ◽  
Chronic Progressive Disease ◽  
Classification Of Diseases ◽  
The University

Purpose: Retinitis pigmentosa (RP) is a chronic progressive disease with no curative treatments. Understanding the variables involved with improving patients’ quality of life is important in managing this population. The literature investigating the relationship of anxiety and depression with RP relies on the analysis of smaller subset populations of patients with RP, and no study has quantified the effect size of the potential association. This study aims to elucidate and quantify the association between RP, anxiety, and depression. Methods: A retrospective case-control study was conducted of 6 093 833 medical records within the University of North Carolina Hospital and outpatient clinic system from July 1, 2004, to August 30, 2019. Patients with a diagnosis of RP, anxiety, and depression were identified within the Carolina Data Warehouse for Health by International Classification of Diseases, Ninth and Tenth Revision codes. Results: From the base population of 6 093 833 patients' medical records, 690 patients were diagnosed with RP, 253 065 with anxiety, and 232 541 with depression. Patients with RP have an odds ratio, adjusted for sex and age, of 4.915 (95% CI, 4.035-5.987) for having comorbid anxiety, 5.609 (95% CI, 4.622-6.807) for comorbid depression, and 4.130 (95% CI, 3.187-5.353) for comorbid anxiety and depression. Conclusions: Patients with RP have a higher prevalence of anxiety and depression, with increased odds of approximately 5 to 6 times for also carrying a diagnosis of anxiety or depression and about 4 times for carrying diagnoses of anxiety and depression compared with the general population.

What Should HIV/AIDS be Called in Malawi?

2005 ◽  
Vol 12 (2) ◽  
pp. 187-192 ◽  
Author(s):  
Adamson S Muula
Keyword(s):  
Health Professionals ◽  
Case Study Research ◽  
International Classification Of Diseases ◽  
Hiv And Aids ◽  
Retrospective Case ◽  
Hiv Test ◽  
Classification Of Diseases ◽  
Medical Wards ◽  
Retrospective Case Study ◽  
Hiv Aids

HIV/AIDS is the leading cause of morbidity and mortality in the southern African country of Malawi. At the largest referral health facility in Blantyre, the Queen Elizabeth Central Hospital, the majority of patients hospitalized in medical wards and up to a third of those in the maternity unit are infected with HIV. Many patients in the surgical wards also have HIV/AIDS. Health professionals in Blantyre, however, often choose not to write down the diagnosis of HIV or AIDS; rather, they prefer to use ‘SGOT’, ‘ELISA’ and ‘spot test’ to represent the HIV test, while ‘immunosuppression’, ‘↓ CD4 disease’ and ‘ARC’ are preferred instead of ‘AIDS’. It is possible that health professionals’ belief that mentioning HIV and/or AIDS will harm patients is encouraging them to use these euphemisms. The use of less than exact terms to label HIV and AIDS may not be without cost. For instance, future attempts to conduct retrospective case study research may be hampered by this practice, which is not in accordance with the international classification of diseases. It is suggested that, although stigmatization and discrimination could be important driving factors in the use of cryptic language, it may be more worthy to fight discrimination and stigmatization head-on, rather than create avenues where these reactions may be perpetuated.

scholarly journals The cost of health care in Serbia according to the international classification of diseases for the period from 2004 to 2009

2011 ◽  
Vol 58 (3) ◽  
pp. 127-138 ◽  
Author(s):  
Milena Gajic-Stevanovic ◽  
Snezana Dimitrijevic ◽  
Slavoljub Zivkovic ◽  
Nevenka Teodorovic ◽  
Darinka Perisic-Rajnicke
Keyword(s):  
Health Care ◽  
Comparative Analysis ◽  
International Classification Of Diseases ◽  
Financial Information ◽  
Cost Of Health Care ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
The Cost ◽  
Circulatory Diseases

Introduction. As the part of research on costs in the health care system, there is a growing interest in the world for the estimating costs for the treatment of disease. This value represents the burden that a particular disease or group of diseases puts on the society. Until the year 2000, when the Organization for Economic Countries Development (OECD) established a System of Health Accounts (SHA), there was not even approximate methodological guide for calculating the cost of the disease. The aim of this study was to determine the costs of health care in the Republic of Serbia according to the major International Classification of Diseases (ICD-10) and to provide a comparative cost analysis for the treatment of diseases in the period from 2004 to 2009. Material and Methods. A retrospective and comparative analysis of health statistics from the database of the Institute of Public Health of Serbia and financial information provided by the Health Insurance Fund in the period 2004-2009 was performed. Financial information and data on hospital services, outpatient, home health care, ancillary health care services, drug consumption and consumer goods in healthcare were analyzed using SHA methodology. Results. Results showed that during the observation period, the maximum cost of health care in Serbia by main classification of ICD-10 was achieved in 2009 and it was RSD 144,150,456,906.00 (? 1,503,321,134; $ 2,160,253,219) and the minimal cost was achieved in 2004 - the amount being RSD 49,546,211,470.00 (? 628,086,723; $ 855,203,134). Results showed that in 2004 the highest costs were allocated to circulatory diseases (18.98%), followed by neoplasm (11.12%), and lowest for congenital anomalies (0.64%). In 2009, the highest costs were allocated to circulatory diseases (18.87%), infectious and parasitic diseases (11.20%), diseases of digestive system (9.26%) nervous system diseases (9.20%), and neoplasm (8.88%), whereas the minimal funds were allocated for congenital anomalies (0.33%). Conclusion. Comparative analysis showed that the value of overall spending in healthcare increased three times in 2009 as compared to 2004.

scholarly journals Symptom rating scales for schizophrenia and other primary psychotic disorders in ICD-11

2017 ◽  
Vol 27 (3) ◽  
pp. 219-224 ◽  
Author(s):  
J. W. Keeley ◽  
W. Gaebel
Keyword(s):  
Negative Symptoms ◽  
Rating Scales ◽  
Psychotic Disorders ◽  
Rating Scale ◽  
Field Testing ◽  
International Classification Of Diseases ◽  
Severity Rating ◽  
Classification Of Diseases ◽  
The Cost ◽  
Symptom Rating

The subtype system for categorising presentations of schizophrenia will be removed from International Classification of Diseases 11th Revision. In its place will be a system for rating six domains of psychotic disorder pathology: positive symptoms, negative symptoms, depressive symptoms, manic symptoms, psychomotor symptoms and cognitive symptoms. This paper outlines the rationale and description of the proposed symptom rating scale, including current controversies. In particular, the scale could adopt either a 4-point severity rating or a 2-point presence/absence rating. The 4-point scale has the advantage of gathering more information, but potentially at the cost of reliability. The paper concludes by describing the field testing process for evaluating the proposed scale.

Incremental Costs for Psoriasis and Psoriatic Arthritis in a Population-based Cohort in Southern Sweden: Is It All Psoriasis-attributable Morbidity?

2016 ◽  
Vol 43 (3) ◽  
pp. 640-647 ◽  
Author(s):  
Sofia Löfvendahl ◽  
Ingemar F. Petersson ◽  
Elke Theander ◽  
Åke Svensson ◽  
Caddie Zhou ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Productivity Loss ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Drug Costs ◽  
Productivity Losses ◽  
Classification Of Diseases ◽  
A Minor ◽  
The Cost

Objective.To estimate incremental costs for patients with psoriasis/psoriatic arthritis (PsO/PsA) compared to population-based referents free from PsO/PsA and estimate costs attributable specifically to PsO/PsA.Methods.Patients were identified by International Classification of Diseases, 10th ed., codes for PsO/PsA using information from 1998 to 2007 in the Skåne Healthcare Register, covering healthcare use for the population of the Skåne region of Sweden. For each patient, 3 population-based referents were selected. Data were retrieved from Swedish registers on healthcare, drugs, and productivity loss. The human capital method was used to value productivity losses. Mean annual costs for 2008 to 2011 were assessed from a societal perspective.Results.We identified 15,283 patients fulfilling the inclusion criteria for PsO [n = 12,562, 50% women, mean age (SD) 52 (21) yrs] or PsA [n = 2721, 56% women, mean age 54 (16) yrs] and included 45,849 referents. Mean annual cost per patient with PsO/PsA was 55% higher compared to referents: €10,500 vs €6700. The cost was 97% higher for PsA compared to PsO. Costs due to productivity losses represented the largest share of total costs, ranging from 52% for PsO to 60% for PsA. Biological drug costs represented 10% of the costs for PsA and 1.6% for PsO. The proportion of cost identified as attributable to PsO/PsA problems was greatest among the patients with PsA (drug costs 71% and healthcare costs 31%).Conclusion.Annual mean incremental societal cost per patient was highest for PsA, mainly because of productivity losses and biological treatment. A minor fraction of the costs were identified as attributable to PsO/PsA specifically, indicating an increased morbidity in these patients that needs to be further investigated.

A review on the alterations in the brain of persistent postural-perceptual dizziness patients and non-pharmacological interventions for its management

2020 ◽  
Vol 31 (6) ◽  
pp. 675-680
Author(s):  
Li Sun ◽  
Ke Xiang
Keyword(s):  
Sensory Processing ◽  
Structural Changes ◽  
Behavioral Therapy ◽  
Treatment Options ◽  
Significant Proportion ◽  
Treatment Strategies ◽  
International Classification Of Diseases ◽  
Standard Drug ◽  
Non Invasive ◽  
Classification Of Diseases

AbstractPersistent postural perceptual dizziness (PPPD) is a relatively newer term, and this term is included in the International Classification of Diseases in its 11th revision. The typical features of PPPD include the presence of persistent dizziness, non-spinning vertigo, and unsteadiness, and these symptoms are exacerbated during upright posture, movement, or visual stimuli. Moreover, the structural changes have also been identified in the brains of PPPD patients, particularly in visual, vestibular, and limbic areas. These include a decrease in the volume and gyration of gray matter, a decrease in the blood flow to the cortex region, and alterations in the structural and functional connectivity, particularly in the visual-vestibular networks. Moreover, the impairment in sensory processing is restricted not only to the vestibular and visual regions; instead, there is a generalized impairment in the sensory processing, and thus, there is a multisensory dimension of sensory impairment. Selective serotonin uptake inhibitors and serotonin-norepinephrine reuptake inhibitors are the mainstay drugs for the management of PPPD patients. However, a significant proportion of PPPD patients do not show improvement in response to standard drug therapy. The employment of alternative and complementary treatment strategies, including vestibular rehabilitation therapy, cognitive behavioral therapy, and non-invasive vagal nerve stimulation, is effective in the management of PPPD patients. The present review discusses the alterations in the brains of PPPD patients along with the possible non-pharmacological treatment options in these types of patients.

scholarly journals Direct healthcare costs of lip, oral cavity and oropharyngeal cancer in Brazil

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246475
Author(s):  
Vanessa Milani ◽  
Ana Laura de Sene Amâncio Zara ◽  
Everton Nunes da Silva ◽  
Larissa Barbosa Cardoso ◽  
Maria Paula Curado ◽  
...  
Keyword(s):  
Healthcare Costs ◽  
Health Sector ◽  
National Health System ◽  
Health Resources ◽  
Indirect Costs ◽  
International Classification Of Diseases ◽  
Outpatient Procedures ◽  
Classification Of Diseases ◽  
Direct Healthcare Costs ◽  
The Cost

The efficiency of public policies includes the measurement of the health resources used and their associated costs. There is a lack of studies evaluating the economic impact of oral cancer (OC). This study aims to estimate the healthcare costs of OC in Brazil from 2008 to 2016. This is a partial economic evaluation using the gross costing top-down method, considering the direct healthcare costs related to outpatients, inpatients, intensive care units, and the number of procedures, from the perspective of the public health sector. The data were extracted from the Outpatient and Inpatient Information System of the National Health System, by diagnosis according to the 10th Revision of the International Classification of Diseases, according to sites of interest: C00 to C06, C09 and C10. The values were adjusted for annual accumulated inflation and expressed in 2018 I$ (1 I$ = R$2,044). Expenditure on OC healthcare in Brazil was I$495.6 million, which was composed of 50.8% (I$251.6 million) outpatient and 49.2% (I$244.0 million) inpatient healthcare. About 177,317 admissions and 6,224,236 outpatient procedures were registered. Chemotherapy and radiotherapy comprised the largest number of procedures (88.8%) and costs (94.9%). Most of the costs were spent on people over 50 years old (72.9%) and on males (75.6%). Direct healthcare costs in Brazil for OC are substantial. Outpatient procedures were responsible for the highest total cost; however, inpatient procedures had a higher cost per procedure. Men over 50 years old consumed most of the cost and procedures for OC. The oropharynx and tongue were the sites with the highest expenditure. Further studies are needed to investigate the cost per individual, as well as direct non-medical and indirect costs of OC.

scholarly journals Comparison of the international terminologies SNOMED CT, LOINC and ICD-11: Applicability in a guideline-conform pathology vocabulary for urothelial carcinoma in Germany

2019 ◽  
Author(s):  
Franziska Van Wüllen ◽  
Teja Falk Radke ◽  
Elisabeth Pantazoglou ◽  
Gunter Haroske ◽  
Sylvia Thun
Keyword(s):  
Urothelial Carcinoma ◽  
Significant Proportion ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Snomed Ct ◽  
Urothelial Carcinomas ◽  
Classification Of Diseases ◽  
Systematic Nomenclature ◽  
Tumor Material

Abstract Objective With almost 30,000 new cases per year, urothelial carcinomas account for a significant proportion of cancer cases in Germany. Respective guidelines serve to help pathologists evaluate tumor material according to international classification standards, but to ensure interoperability, further regulations are required. Therefore, the study presented in this work aimed at improving the informational situation by evaluating the applicability of the international terminologies in the scope of urothelial carcinoma in Germany. Methods Based on the S1-guideline "Urothelkarzinom", a collection of terms recommended for a pathology vocabulary was compiled and mapped to SNOMED CT (Systematic Nomenclature of Medical Terms), LOINC (Logical Observation Identifiers Names and Codes) and ICD-11 (International Classification of Diseases 11th Revision), respectively. Results Of the 168 terms required, 163 (97.02%) could be mapped to SNOMED CT, 66 (39.29%) to LOINC and 70 (41.67%) to ICD-11. However, considering the equivalence of each coding and restricting the mapping accordingly resulted in significantly lower coverage. When aiming at absolute equivalence, even combining all three terminologies resulted in only 138 (82.14%) terms being mappable adequately. Discussion Results prove that currently even combining established terminologies does not cover the terms required for a standardized documentation of urothelial findings completely. They also highlight the importance of SNOMED CT, as within this study it provided the largest proportion of mappable terms. Results also clearly demonstrated that especially SNOMED CT and LOINC require extensive knowledge on the respective terminology itself as well as on the respective medical field to ensure reliable mappings.

The cost of prostate cancer care to society and to patients in the United States.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 116-116 ◽  
Author(s):  
Nicholas George Zaorsky ◽  
John Lin ◽  
Djibril Ba ◽  
Joel E Segel ◽  
Heath B. Mackley ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
Cancer Patient ◽  
Prostate Cancer Patient ◽  
Low Complexity ◽  
International Classification Of Diseases ◽  
The United States ◽  
Office Visits ◽  
Classification Of Diseases ◽  
The Cost

116 Background: Our objectives are to characterize prostate cancer patient resource consumption and cost (I) to society, in 1 calendar year; and (II) to the patient, 1 year after his diagnosis. Methods: The MarketScan database was used to summarize cost, including gross payment to provider for service, copayment, and deductibles. We identified the top 20 Current Procedural Terminology (CPT) codes to characterize which procedures drove costs for both objectives. For Objective I, diagnoses were identified in 1 calendar year (2014); codes and their costs for all patients were calculated. For Objective II, diagnoses were set at time = 0, and all CPT and International Classification of Diseases codes were characterized 1 year after diagnosis (2012-2013). Results: For objective I, there were 95,642 procedures totalling $38,696,423. The plurality of procedures were hospital consultations, level 2 (i.e. history + physical + straightforward decision-making; 17,103 performed, average $80 each, total $1,418,954) and level 3 (+ low complexity decision-making; 9,726 performed; average $127 each, total $1,232,928). The most costly procedure to society was a radical prostatectomy (8,883 performed, average $2,003 each, total $17,694,508) with accompanying anesthesia (7,960 performed, average $1262 each, total $10,048,653). For objective II (characterized in Table), the mean payment per month was $2,794, including mean gross cost $2,673, mean copayment $32, and mean deductible $46. Conclusions: The typical cost of therapy to a prostate cancer patient is $2,800/month after diagnosis, primarily from surgery (constituting the majority of cost to society) and subsequently from office visits (constituting the plurality of procedures). Societal measures to reduce cost should be aimed at the operating room and consultations.[Table: see text]

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