scholarly journals Home Treatment for Children with Hemophilia

1977 ◽  
Author(s):  
N.B. McWilliams ◽  
R. Ownby ◽  
L.C. Anderson
Keyword(s):  
Hepatitis B ◽  
Severe Disease ◽  
Symptomatic Improvement ◽  
Home Treatment ◽  
Factor Ix ◽  
Chronic Synovitis ◽  
Hepatitis B Antigen ◽  
The Mean ◽  
Mean Cost ◽  
Disease Family

Twenty-four hemophilic boys between the ages of 2 and 21, 4 with factor IX and 20 with factor VIII deficiency, have been on a home transfusion program for 2 to 22 months. Criteria for participation include: moderate or severe disease, family cooperation, accessible veins and attendance at Comprehensive Hemophilia Clinic. Strict guidelines are given to families for treating hemorrhages without physician consultation at home, versus those that must be seen by a physician.Only 1 child has required hospitalization for bleeding. One child has had clinical hepatitis on 2 occasions. No patient has developed an inhibitor. No complications related to nonprofessional I.V. administration have occurred. Of 18 boys tested for hepatitis B antibodies, 17 were positive. None has been positive for hepatitis B antigen. Of 12 boys with established severe arthropathy, 8 have had symptomatic improvement and 4 are stable. Of 12 boys with minimal or no arthropathy, all are stable except 1 who has developed chronic synovitis.Psycho-social benefits include a new found independence, improved living routine for family units and opportunities to participate in more activities. The mean cost/boy/month was $397.We conclude that home treatment for hemophilic children is both safe and effective and should be available to all children meeting the above criteria.

scholarly journals AB0277 PREVALENCE OF HEPATITIS MARKERS IN PATIENTS TREATED WITH BIOLOGICAL DISEASE-MODIFYING ANTIRHEUMATIC DRUGS: RESULTS OF THE TUNISIAN REGISTRY BINAR

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1437.1-1438
Author(s):  
A. Fazaa ◽  
H. Boussaa ◽  
S. Miladi ◽  
K. Ouenniche ◽  
L. Souabni ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Liver Function ◽  
Disease Activity ◽  
Liver Function Tests ◽  
Hbv Dna ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
The Mean ◽  
Disease Modifying ◽  
Hbs Ag

Background:In the recent decades, biological disease-modifying antirheumatic drugs (bDMARDs) have significantly improved management and quality of life in patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA).However, bDMARDs have also a strong influence on the immune system, leading to a risk of serious infection. Reactivation of hepatitis B (HBV) and C (HCV) virus is one of the most redoubtable complications of these immunosuppressive agents.Objectives:The aims of this study were to determine the screening rate for hepatitis B and C before starting a biological treatment and to examine the prevalence of their markers in patients with RA or SpA.Methods:Our study evaluated all patients included in the Tunisian registry BINAR (Biologic National Registry) since 2018 who had RA (ACR/EULAR 2010) or SpA (ASAS criteria) aged with more than eighteen years old and receiving their first bDMARDs during the two past years.The following information were retrieved from the registry: demographic data on the patients, disease parameters, medication, HBV surface antigen (HBs Ag), antibody to HBs Ag (Anti HBs), antibody to HBV core antigen (Anti HBc), HBV-DNA, antibody to HCV (anti HCV) status and liver function tests (AST: aspartate aminotransferase; ALT:alanine aminotransferase).Results:A total of 298 patients was included, 111 men and 178 women, with a mean age of 49.2 ± 14.1 years old [18-79]. Among them, 58.7% were diagnosed with RA and 41.3% were diagnosed with SpA. The mean disease duration was 6.7±3.5 years [1-12] in patients with RA and 6.5±3 [1-12] in patients with SpA. The mean Disease Activity Score (DAS28) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were respectively of 4.9±1.5 [1-8] and 4.1±1.8 [0-9].Therapeutically, 167 patients (56%) were on Prednisone at a mean daily posology of 8.2±5.4 mg [4-60] and 70.3% on conventional synthetic disease modifying antirheumatic drug (csDMARD) in association with bDMARDs. It was about Tumor Necrosis Factor alpha antibodies (anti TNF a) in 87.9% of cases, Tocilizumab in 10.4% of cases and Rituximab in 5% of cases.A screening of HBV was performed in 286 patients (96%). Ag HBs was positive in two cases (0.7%), and anti-HBc was positive in 16 cases (6.4%) which indicate a prior HBV infection. Fifteen patients (6%) were immunized with positive anti HBs. HBV-DNA was measured in 177 cases (66.8%) and was positive in 15 patients (6%).HCV infection was searched in 282 patients (94.6%) and anti-HCV was negative in all cases.AST and ALT mean rates were respectively of 18.3 [2-108] and 17.9 UI/l [2-74]. A perturbation of these liver function tests was observed in 13 patients (4.4%).Conclusion:Screening for hepatitis B and C were performed respectively in 96% and 94% of our Tunisian patients before receiving any bDMARDs. This should be systematic to avoid HBV reactivation which can lead to fulminant hepatic failure with a severe prognosis.Disclosure of Interests:None declared

scholarly journals Hepatic steatosis: a risk factor for increased COVID-19 prevalence and severity—a computed tomography study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Asmaa Ali ◽  
Mona Hasan ◽  
Shaimaa Hamed ◽  
Amir Elhamy
Keyword(s):  
Hepatic Steatosis ◽  
Severe Disease ◽  
Severe Pneumonia ◽  
Liver Disorder ◽  
Control Group ◽  
Case Group ◽  
World Population ◽  
Positive Class ◽  
The Mean ◽  
And Control

Abstract Background Around 25% of the world population was affected by the metabolic-related fatty liver disorder. Hepatic steatosis is frequently observed in conjunction with hypertension, obesity comorbidities, and diabetes. We evaluate the hepatic steatosis frequency found in chest CT exams of COVID-19-positive cases compared to non-infected controls and evaluate the related increased prevalence and severity of COVID. Results Our research includes 355 subjects, 158 with positive PCR for COVID-19 (case group) and 197 with negative PCR and negative CT chest (control group). The mean age in the positive group was 50.6 ± 16 years, and in the control, it was 41.3 ± 16 years (p < 0.001). Our study consists of 321 men (90.5%) and 34 women (9.5%). The number of males in both cases and control groups was greater. In the case group, 93% men vs. 6.9% women, while in controls, 88.3% men vs.11.6% women, p < 0.001. CT revealed normal results in 55.5% of individuals (i.e., CORADs 1) and abnormal findings in 45.5% of participants (i.e., CORADs 2–5). In abnormal scan, CO-RADs 2 was 13.92%, while CO-RADs 3–4 were 20.89% of cases. CO-RADs 5 comprised 65.19% of all cases. Approximately 42.6% of cases had severe disease (CT score ≥ 20), all of them were CO-RADs 5. The PCR-positive class had a greater prevalence of hepatic steatosis than controls (28.5% vs.12.2%, p < 0.001). CO-RADs 2 represented 11.1%, CO-RADs 3–4 represented 15.6%, and CO-RADs 5 represented 73.3% in the hepatic steatosis cases. The mean hepatic attenuation value in the case group was 46.79 ± 12.68 and in the control group 53.34 ± 10.28 (p < 0.001). When comparing patients with a higher severity score (CT score ≥ 20) to those with non-severe pneumonia, it was discovered that hepatic steatosis is more prevalent (73.2% vs. 26.8%). Conclusions Steatosis was shown to be substantially more prevalent in COVID-19-positive individuals. There is a relation among metabolic syndrome, steatosis of the liver, and obesity, as well as the COVID-19 severity.

The cost of a general stochastic epidemic

1972 ◽  
Vol 9 (02) ◽  
pp. 257-269 ◽  
Author(s):  
J. Gani ◽  
D. Jerwood
Keyword(s):  
Recursive Equation ◽  
Stieltjes Transform ◽  
Stochastic Epidemic ◽  
The Mean ◽  
The Cost ◽  
Mean Cost ◽  
General Stochastic

This paper is concerned with the cost Cis = aWis + bTis (a, b &gt; 0) of a general stochastic epidemic starting with i infectives and s susceptibles; Tis denotes the duration of the epidemic, and Wis the area under the infective curve. The joint Laplace-Stieltjes transform of (Wis, Tis ) is studied, and a recursive equation derived for it. The duration Tis and its mean Nis are considered in some detail, as are also Wis and its mean Mis . Using the results obtained, bounds are found for the mean cost of the epidemic.

scholarly journals Comparison of the costs of HPV testing through community health campaigns versus home-based testing in rural Western Kenya: a microcosting study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e033979
Author(s):  
Easter Elizabeth Olwanda ◽  
James G Kahn ◽  
Yujung Choi ◽  
Jessica Yasmine Islam ◽  
Megan Huchko
Keyword(s):  
Community Health ◽  
Outcome Measures ◽  
Health Campaigns ◽  
Capital Goods ◽  
Western Kenya ◽  
Home Based ◽  
Registration Number ◽  
The Mean ◽  
The Cost ◽  
Mean Cost

ObjectivesTo estimate the cost of human papillomavirus (HPV)-based screening through community health campaigns (CHCs) and home-based testing.SettingCHCs and home-based testing in six communities in rural Western Kenya.ParticipantsCHCs and home-based screening reached 2297 and 1002 women aged 25–65 years, respectively.Outcome measuresOutcome measures were overall cost per woman screened achieved through the CHCs and home-based testing and the cost per woman for each activity comprising the screening intervention.ResultsThe mean cost per woman screened through CHCs and home-based testing were similar, at $37.7 (range $26.4–$52.0) and $37.1 (range $27.6–$54.0), respectively. For CHCs, personnel represented 49% of overall cost, supplies 25%, services 5% and capital goods 23%. For home-based testing, these were: personnel 73%, supplies 25%, services 1% and capital goods 2%. A greater number of participants was associated with a lower cost per participant.ConclusionsThe mean cost per woman screened is comparable for CHC and home-based testing, with differences in type of input. The CHCs generally reached more eligible women in the six communities, whereas home-based strategies more efficiently reached populations with low screening rates.Trial registration numberNCT02124252.

scholarly journals Assessment of costs and insurance policies for referral treatment of equine colic

2019 ◽  
Vol 185 (16) ◽  
pp. 508-508 ◽  
Author(s):  
Isobel Barker ◽  
Sarah L Freeman
Keyword(s):  
Surgical Treatment ◽  
Insurance Companies ◽  
Insurance Policies ◽  
Insurance Cover ◽  
Survey Costs ◽  
The Mean ◽  
High Degree ◽  
Mean Cost ◽  
Monthly Premium ◽  
Equine Colic

Colic is the most common emergency problem in horses. The aims of this study were to survey costs of different referral treatments and to review insurance policies relevant to horses with colic. Data were collected retrospectively from nine equine hospitals for case costs, categorised into four different outcomes: admitted and euthanased; euthanased during or immediately after surgery; medical treatment and survived more than 24 hours; and surgical treatment and survived more than 24 hours. Data from five UK equine insurance companies were extracted and analysed using a standardised case example. Costs were obtained for 108 cases. The mean cost for horses admitted and euthanased was £873.89 (range £459.72–£1471.51), and for surgical treatment and survival more than 24 hours was £6437.80 (range £3178.87–£9100.00). Insurance cover for veterinary fees ranged from £5000 to £7500, and monthly premium rates for a standardised case ranged from £27.06 to £47.06. The terms and conditions for the insurance policies ranged in length from 2098 to 17,701 words; Flesch Kincaid Reading Ease scores ranged from 21.6 to 57.7, indicating a high degree of complexity and low readability. This study highlights the complexity and challenges for decision-making in critical cases of colic.

New Determinants of Hepatitis B Antigen (Au or HB Antigen)

Vox Sanguinis ◽  
1973 ◽  
Vol 25 (3) ◽  
pp. 212-234 ◽  
Author(s):  
J.P. Soulier ◽  
A.M. Couroucé-Pauty
Keyword(s):  
Hepatitis B ◽  
Hepatitis B Antigen

Immuno-electron Microscopy of Hepatitis B Antigen in Liver

1972 ◽  
Vol 140 (4) ◽  
pp. 1334-1339 ◽  
Author(s):  
M. A. Gerber ◽  
F. Schaffner ◽  
F. Paronetto
Keyword(s):  
Electron Microscopy ◽  
Hepatitis B ◽  
Immuno Electron Microscopy ◽  
Hepatitis B Antigen

Outcomes and Cost of Outpatient or Inpatient Management of 712 Patients With Febrile Neutropenia

2008 ◽  
Vol 26 (4) ◽  
pp. 606-611 ◽  
Author(s):  
Linda S. Elting ◽  
Charles Lu ◽  
Carmelita P. Escalante ◽  
Sharon H. Giordano ◽  
Jonathan C. Trent ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Statistical Tests ◽  
Signs And Symptoms ◽  
Low Risk ◽  
Outpatient Management ◽  
Single Episode ◽  
Risk Patients ◽  
Inpatient Management ◽  
The Mean ◽  
Mean Cost

Purpose We retrospectively compared the outcomes and costs of outpatient and inpatient management of low-risk outpatients who presented to an emergency department with febrile neutropenia (FN). Patients and Methods A single episode of FN was randomly chosen from each of 712 consecutive, low-risk solid tumor outpatients who had been treated prospectively on a clinical pathway (1997-2003). Their medical records were reviewed retrospectively for overall success (resolution of all signs and symptoms of infection without modification of antibiotics, major medical complications, or intensive care unit admission) and nine secondary outcomes. Outcomes were assessed by physician investigators who were blinded to management strategy. Outcomes and costs (payer's perspective) in 529 low-risk outpatients were compared with 123 low-risk patients who were psychosocially ineligible for outpatient management (no access to caregiver, telephone, or transportation; residence > 30 minutes from treating center; poor compliance with previous outpatient therapy) using univariate statistical tests. Results Overall success was 80% among low-risk outpatients and 79% among low-risk inpatients. Response to initial antibiotics was 81% among outpatients and 80% among inpatients (P = .94); 21% of those initially treated as outpatients subsequently required hospitalization. All patients ultimately responded to antibiotics; there were no deaths. Serious complications were rare (1%) and equally frequent between the groups. The mean cost of therapy among inpatients was double that of outpatients ($15,231 v $7,772; P < .001). Conclusion Outpatient management of low-risk patients with FN is as safe and effective as inpatient management of low-risk patients and is significantly less costly.

scholarly journals High Dose of Lamivudine and Resistance in Patients with Chronic Hepatitis B

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Hamid Ullah Wani ◽  
Saad Al Kaabi ◽  
Manik Sharma ◽  
Rajvir Singh ◽  
Anil John ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Retrospective Study ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Standard Dose ◽  
High Dose ◽  
Lamivudine Therapy ◽  
Daily Dose ◽  
The Mean ◽  
Emergence Of Resistance

Background. Lamivudine is the most affordable drug used for chronic hepatitis B and has a high safety profile. With the daily dose of 100 mg there is progressive appearance of resistance to lamivudine therapy. In our study we used 150 mg of lamivudine daily as a standard dose which warrants further exploration for the efficacy of the drug. Aims of the Study. To assess the efficacy of lamivudine 150 mg daily on resistance in patients with chronic hepatitis B. Methods. This retrospective study consists of 53 patients with chronic hepatitis B treated with 150 mg of lamivudine daily. The biochemical and virological response to the treatment were recorded at a 1-year and 2-, 3-, 4-, and 5-year period and time of emergence of resistance to the treatment was noted. Results. The mean age of the patients was 54 years with 80% being males. The resistance to lamivudine 150 mg daily at 1 year and 2, 3, and 5 years was 12.5%, 22.5%, 37.5%, and 60%, respectively, which is much less compared to the standard dose of 100 mg of lamivudine. Conclusions. Lamivudine is safe and a higher dose of 150 mg daily delays the resistance in patients with chronic hepatitis B.

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