The Value of Laboratory Information Augmenting a Managed Care Organization’s Comprehensive Diabetes Care Efforts in New Mexico

2020 ◽  
Vol 5 (5) ◽  
pp. 978-986
Author(s):  
Richard VanNess ◽  
Kathleen Swanson ◽  
Virginia Robertson ◽  
Mark Koenig ◽  
Michael Crossey
Keyword(s):  
New Mexico ◽  
Managed Care ◽  
Diabetes Care ◽  
Care Management ◽  
Control Group ◽  
Study Group ◽  
Prescription Data ◽  
Hb A1c ◽  
Clinical Laboratories ◽  
Group Members

Abstract Background The National Committee on Quality Assurance’s Healthcare Effectiveness Data and Information Set on Comprehensive Diabetes Care requires patients with diabetes obtain a hemoglobin A1c (Hb A1c) and urine albumin-to-creatinine ratio (ACR) test every year. To improve these measures, managed care organizations (MCOs) rely on claim and prescription data to identify members for care management. TriCore Reference Laboratories collaborated with Blue Cross Blue Shield of New Mexico (BCBSNM) to determine if laboratory information would augment BCBSNM’s diabetes care management services. Method In January 2018, BCBSNM provided its Medicaid enrollment file to TriCore for identifying members and determining their diabetes status by evaluating their recent Hb A1c results. Of the 6,138 members with diabetes, a random sample of 600 was extracted, and half were provided to BCBSNM to perform care management from January 18 to May 1, 2018. Completion of Hb A1c and ACR were measured. Results Significantly more (P = 0.03) study group members (25%) than control group members (18%) received an Hb A1c test. The study group (14%) also received more ACR tests than the control group (9%; P = 0.07). We then calculated the monetary penalty to which New Mexico Medicaid MCOs are subject, leading to the identification of additional value ($3,693,000) that clinical laboratories provide beyond the cost per test. Conclusion Clinical laboratories play a critical role in healthcare, and this article demonstrates an approach for laboratories to collaborate with MCOs in their care management efforts. In addition, we calculate the value of this novel collaboration, which may play an integral role in laboratories’ pursuit of value-based care.

Mūzikas terapija pēcdzemdību depresijas mazināšanai

2021 ◽  
pp. 80-96
Author(s):  
Maija Roga ◽  
◽  
Mirdza Paipare ◽  
Keyword(s):  
Postpartum Depression ◽  
Music Therapy ◽  
Family Doctor ◽  
Control Group ◽  
Study Group ◽  
Group Members ◽  
Therapy Sessions

In recent years, the topic of postpartum depression has become more and more relevant, but despite this, research on the effectiveness of music therapy and its possibilities in reducing postpartum depression is limited, but in Latvia this type of research in music therapy has not been conducted, so this study could be useful to other students of music therapy and other fields. The results of the study could be useful to GPs (family doctor) and gynecologists to prescribe the most appropriate method of treatment for the patient. The aim of the article is to reflect the progress and results of a study that explored and reviewed the possibilities of music therapy for the reduction of postpartum depression. The study included 40 women with postpartum depression - 20 in the study and 20 in the control group. The study group members participated in twelve music therapy sessions.

Pretreatment with Methylprednisolone Improves Myocardial Protection during On-Pump Coronary Artery Bypass Surgery

2015 ◽  
Vol 18 (4) ◽  
pp. 171 ◽  
Author(s):  
Tolga Demir ◽  
Mehmet Umit Ergenoglu ◽  
Hale Bolgi Demir ◽  
Nursen Tanrikulu ◽  
Mazlum Sahin ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Myocardial Protection ◽  
Troponin T ◽  
Artery Bypass ◽  
Control Group ◽  
Study Group ◽  
Cabg Surgery ◽  
Anti Inflammatory ◽  
Pump Coronary Artery Bypass

<strong>Background</strong>: This study was undertaken to determine whether methylprednisolone could improve myocardial protection by altering the cytokine profile toward an anti-inflammatory course in patients undergoing elective coronary artery bypass grafting (CABG) surgery with cardiopulmonary bypass (CPB).<br /><strong>Methods</strong>: Forty patients who were scheduled for elective CABG surgery were randomized into two groups: the study group (n = 20), who received 1 g of methylprednisolone intravenously before CPB, and the control group (n = 20), who underwent a standard CABG surgery without any additional medication. Blood samples were withdrawn prior to surgery (T1) and then 4 hours (T2), 24 hours (T3), and 36 hours (T4) after CPB. Plasma levels of interleukin (IL)-6, IL-10, creatine kinase isoenzyme MB (CK-MB), cardiac troponin-t (cTnT), and blood glucose as well as neutrophil counts were measured at each sampling time. <br /><strong>Results</strong>: A comparison of patients between both groups revealed significantly high levels of IL-6 in the control group at T2, T3, and T4 with respect to T1 (T2: P &lt; .001; T3: <br />P &lt; .001; T4: P &lt; .001). IL-10 levels were significantly higher in the study group at T2 compared with the control group <br />(P = .007). CK-MB levels were significantly lower in the study group than in the control group at T4 (P = .001). The increase of cTnT was higher in the control group at T3 and T4 compared with the study group (T3: P = .002; T4: P = .001).<br /><strong>Conclusions</strong>: This study demonstrates that methylprednisolone is effective for ensuring better myocardial protection during cardiac surgery by suppressing the inflammatory response via decreasing the levels of IL-6 and by increasing anti-inflammatory activity through IL-10.<br /><br />

CARDIOVASCULAR RISK FACTORS PECULIARITIES IN MEN UNDER 60 YEARS OLD WITH MYOCARDIAL INFARCTION AND CHRONIC INFLAMMATORY LUNG DISEASES

2020 ◽  
pp. 21-25
Author(s):  
Tupitsyn V.V. ◽  
Bataev Kh.M. ◽  
Men’shikova A.N. ◽  
Godina Z.N.
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Digestive System ◽  
Control Group ◽  
Study Group ◽  
Type I ◽  
Internal Organs ◽  
History Of

Relevance. Information about the cardiovascular diseases risk factors (CVD RF) for in men with chronic lung inflam-matory pathology (CLID) is contradictory and requires clarification. Aim. To evaluate the peculiarities of CVD RF in men under 60 years of age with CLID in myocardial infarction (MI) to improve prevention. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with CLID - 142 patients; II - control, without it - 424 patients. A comparative analysis of the frequency of observation of the main and additional cardiovascular risk fac-tors in groups was performed. Results. In patients of the study group, more often than in the control group we observed: hereditary burden of is-chemic heart disease (40.8 and 31.6%, respectively; p = 0.0461) and arterial hypertension (54.2 and 44.6%; p = 0.0461), frequent colds (24.6 and 12.0%; p = 0.0003), a history of extrasystoles (19.7 and 12.7%; p = 0.04); chronic foci of infections of internal organs (75.4 and 29.5%; p˂0.0001), non-ulcer lesions of the digestive system (26.1 and 14.6%; p = 0.007), smoking (95.1 and 66.3%; p˂0.0001), MI in winter (40.8 and 25.9%; p = 0.006). Less commonly were observed: oral cavity infections (9.2 and 23.6%; p˂0.0001); hypodynamia (74.5 and 82.5%; p = 0.0358), over-weight (44.4 and 55.2%; p = 0.0136), a subjective relationship between the worsening of the course of coronary heart disease and the season of the year (43.7 and 55.2%; p = 0.0173) and MI - in the autumn (14.1 and 21.9%; p = 0.006) period. Conclusions. The structure of CVD RF in men under 60 years of age with CLID with MI is characterized by the pre-dominance of smoking, non-ulcer pathology of the digestive system, frequent pro-student diseases, meteorological dependence, a history of cardiac arrhythmias and foci of internal organ infections. It is advisable to use the listed factors when planning preventive measures in such patients.

STUDY ON THE EFFECT OF THE CATGUT-EMBEDDING METHOD COMBINING WITH HERBAL MEDICINE ON THE TREATMENT OF SCIATICA BY WIND-COLD-DAMP ARTHRALGIA

2014 ◽  
pp. 206-215
Author(s):  
Huu Tham Nguyen ◽  
Thi Tan Nguyen
Keyword(s):  
Herbal Medicine ◽  
Traditional Medicine ◽  
Clinical Characteristics ◽  
Day Treatment ◽  
Patient Treatment ◽  
Control Group ◽  
Controlled Trials ◽  
Study Group ◽  
Moderate Pain ◽  
Embedding Method

Objectives: To investigate clinical characteristics of patients with sciatica in Traditional Medicine Hospital in Thua Thien Hue province; To evaluate the effectiveness of the catgut-embedding method combining with herbal medicine on the treatment of sciatica by wind-cold-damp arthralgia. Subjects and Methods: Patients diagnosed with sciatica by wind-cold-damp arthralgia in-patient treatment in Traditional Medicine Hospital in Thua Thien Hue province. Methods: Clinical and controlled trials, a survey of 72 patients, which were divided into 2 groups: The study group: 36 patients: receiving treatment by catgut-embedding and herbal medicine; The control group: 36 patients: only use herbal medicine. 28-day treatment period. Patients were assessed at admission (T0), after 14 days (T14), after 28 days of treatment (T28). Results: After 28 days of treatment: no severity both 2 groups. The study group fell to 8.3% moderate pain, mostly mild pain (91.7%); the control group was 44.4% moderate pain, mild 55.6%.The catgut-embedding method does not cause any side effects. Key words: catgut-embedding method, sciatica by wind-cold-damp arthralgia

Promoting Key Family Practices of Common Childhood Illnesses among Mothers with Under-Five Children in Selected Military Communities

2019 ◽  
Vol 31 (2) ◽  
pp. 153-158
Keyword(s):  
Health Promotion ◽  
Health Promotion Program ◽  
Control Group ◽  
Study Group ◽  
Post Intervention ◽  
Under Five ◽  
Under Five Children ◽  
Eta Squared ◽  
Family Practices ◽  
Knowledge And Practice

Mothers are fundamental caregivers for under-five children and thus, family participation in child health services is very important. Therefore, a quasi-experimental study for promoting key family practices of mothers with under-five children was conducted among 278 respondents from Oaktwin Cantonment and Inndaing Cantonment in 2014. Data were collected by face-to-face interview with pretested structured questionnaire. Health promotion program including health education and advocacy for unit supports was implemented in study group. Before intervention, baseline data of respondents and pre-intervention knowledge and practices levels were identified. In the three-month and six-month after interventions, post-intervention data collection was done in both groups and data were analyzed. Findings show that there was a statistically significant difference of knowledge and practice scores between study group and control group after three-month interventions (t=10.827, p<0.0001, eta squared=0.297 and t=8.2, p<0.0001, eta squared=0.195, respectively), and six-month post-intervention (t=10.035, p<0.0001, eta squared=0.267 and t=8.773, p<0.0001, eta squared=0.304, respectively). Moreover, knowledge and practice level within study groups have a significant effect for time (F=160.45, p<0.0001 and F=113.06, p<0.0001, respectively) and the magnitude of this effect was also large (eta squared=0.699 for knowledge and 0.621 for practice). At the same time, knowledge and practice of control group have a significant effect for time (F=3.648, p=0.029 and F=19.564, p<0.0001, respectively) but this effect was very small. It can be asserted that health promotion program can improve the knowledge and practice of mothers regarding key family practices. The findings of current study might be a cornerstone for improvement of maternal knowledge and practice on caring for children in the military community.

Comparison of Analgesic Effect of Levobupivacaine with Dexmedetomidine and Levobupivacaine for Scalp Block before Supratentorial Craniotomy: A Randomized Controlled Trial

2020 ◽  
Vol 103 (10) ◽  
pp. 1028-1035
Keyword(s):  
Postoperative Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Control Group ◽  
Study Group ◽  
Analgesic Requirement ◽  
Supratentorial Craniotomy ◽  
Numerical Rating ◽  
Fentanyl Consumption ◽  
Scalp Block

Background: Craniotomy causes acute and chronic pain. Uncontrolled postoperative pain may lead to adverse events. Perioperative scalp nerves block is not only effective in reducing intraoperative hemodynamic response, but it also reduces postoperative pain and postoperative analgesia requirement. Objective: To compare the benefits of adding dexmedetomidine to levobupivacaine in scalp nerves block before craniotomy for the duration of analgesia in supratentorial craniotomy. Materials and Methods: After approval by the Committee for Research, 50 supratentorial craniotomy patients were randomized into two groups. The control group received 30 mL scalp nerves block with 0.25% levobupivacaine with adrenaline 1:200,000, whereas the study group received 30 mL scalp nerves block with 0.25% levobupivacaine with adrenaline 1:200,000 plus dexmedetomidine 1 mcg/kg. The primary outcome was the time to first analgesic requirement postoperatively. The secondary outcomes included intraoperative fentanyl consumption, verbal numerical rating scale, tramadol consumption, and complications during the first 24 hours postoperatively. Results: Patients in the study group had significantly increase time to the first analgesic requirement in postoperative period and reduced intraoperative fentanyl consumption. The median time to first analgesic requirement was 555 (360 to 1,035) minutes in the study group versus 405 (300 to 520) minutes in the control group (p=0.023). Intraoperative fentanyl consumption 125 (75 to 175) mcg in the study group was significantly lower than 200 (150 to 250) mcg in the control group (p=0.02). The verbal numerical rating scale at 1, 4, 8, 12 and 24 hours postoperatively, tramadol consumption, and complications during the first 24 hours postoperatively were not statistically significant different. Conclusion: Preoperative scalp nerves block with 0.25% levobupivacaine with adrenaline (1:200,000) with dexmedetomidine 1 mcg/kg significantly increased the time to first analgesic requirement and reduced intraoperative fentanyl consumption compared to 0.25% levobupivacaine with adrenaline (1:200,000) without perioperative complications. Keywords: Scalp block, Dexmedetomidine, Post-craniotomy analgesia, Supratentorial tumor, Levobupivacaine

Psychosocial Impact of Covid-19 Pandemic on Frontline Healthcare Workers in Pakistan: A Cross-Sectional Study

2020 ◽  
Author(s):  
Quratul-Ain Zafar
Keyword(s):  
Data Collection ◽  
Emotional Distress ◽  
Healthcare Workers ◽  
Cross Sectional Study ◽  
Psychosocial Impact ◽  
Control Group ◽  
Study Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Frontline Healthcare Workers

Objective: The purpose of this study was to evaluate the impact of the COVID-19 pandemic on frontline healthcare workers in Pakistan in terms of psychological factors emotional distress, insomnia, and burnout. Study Design: Observational cross-sectional study. Place and Duration of Study: This study was conducted at different hospitals across Pakistan and data collection was carried out from 15th June 2020 till 15th August 2020. Material and Methods: This was a questionnaire-based study aiming to compare the levels of burnout and emotional distress between frontline COVID-19 and non-COVID-19 healthcare workers. Any physician, nurse, and other healthcare workers were recruited from emergency care units and Covid-19 care units (target group), and non-COVID-19 care units (control group). Participation was voluntary and participants had to complete self-reported questionnaires and scales. A mixed-mode data collection was carried out, either in paper or web-based form to ensure maximum participation. Results: The independent t-test showed a statistically significant difference between the two groups regarding depression, stress, and insomnia. The study group showed higher scores for these factors than the control group. Chi-square test of association revealed significant scores of burnout and professional fulfillment in both groups. There was a higher prevalence of burnout in the study group than in the control group. Conclusion: This study concludes that there was a significant psychosocial impact of the Covid-19 pandemic in the frontline healthcare workers measured in terms of emotional distress, insomnia, and burnout.

Detection and Assessment of Interleukin 6 in Irreversible Pulp Inflamation

2017 ◽  
Vol 68 (2) ◽  
pp. 323-327
Author(s):  
Cristian Levente Giuroiu ◽  
Maria Vataman ◽  
Gabriel Melian ◽  
Dragos Bularda ◽  
Ludmila Lozneanu ◽  
...  
Keyword(s):  
Dental Caries ◽  
Interleukin 6 ◽  
Dental Pulp ◽  
The Other ◽  
Control Group ◽  
Study Group ◽  
Pulp Tissue ◽  
Immunohistochemical Technique ◽  
Systemic Distribution ◽  
Cell Zone

The study aimed to assess the number, localization and distribution of interleukin 6 (IL-6) positive cells in healthy pulp, acute and chronic pulpitis. The study group included 48 patients aged between 18-72, treated in University of Medicine and Pharmacy Grigore T. Popa Iasi, Romania. The pulpectomy was performed on 42 patients diagnosed with acute and chronic pulpitis. The other 6 patients, without signs of dental caries or periodontal disease, were submitted to extractions of teeth for orthodontic purposes, with pulpectomy performed before extraction. The pulp samples were examined with optic microscope. The detection and assessment of IL-6 were performed using immunohistochemical technique. Data were statistically analysed using non-parametric tests. According to morphopathological criteria, 42.85% were classified as acute pulpitis and 57.14% as chronic pulpitis. The pulp samples in control group were not associated with IL-6 positive cells. The analysis of all samples with acute and chronic pulpitis identified 73.80% samples with IL-6 and 26.20% associated with the absence of IL-6. The highest frequency of IL-6 positive cells was recorded in rich-cell zone of crown dental pulp. The systemic distribution of IL-6 positive cells was mostly diffused without well-defined orientation. IL-6 release in acute and chronic pulpitis is significantly higher comparing with healthy pulp tissue.

Application of the Measurement of Carotid Intima-Media Thickness for Prediction of the Essential Hypertension in Children

2018 ◽  
Vol 69 (6) ◽  
pp. 1550-1553
Author(s):  
Rosana Manea ◽  
Bianca Elena Popovici ◽  
Carmen Daniela Neculoiu ◽  
Dan Minea ◽  
Alina Calin
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Carotid Artery ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Diagnostic Methods ◽  
Control Group ◽  
Study Group ◽  
Media Thickness ◽  
Hypertension In Children

Hypertension is a major risk factor for progression of the atherosclerotic process and for developing of degenerative cardiovascular diseases in adulthood. The aim of this study is to evaluate how the measurement of carotid intima - media thickness for prediction of essential hypertension in children can be used.The study group included 81 children and the control group 61 children, all aged between 5 - 17 years and 11 months old, and admitted in Children Hospital Brasov in the period of 2009 � 2014. The study protocol included: BMI, blood pressure and Doppler echography of the common carotid artery for each group. Mean age of the patients from the study group was 13.67 years, 43.20 % girls and 56.80 % boys, while in the control group, the mean age was 14.07 years, 54.10% girls and 45.90 % boys. 70.37% of the children from the study group presented obesity, while in the control group 40.98% were obese. The IMTC study group ranged from 0.52 - 0.69 mm and the limits of the normotensive subjects were 0.32 -0.54 mm. In both groups the obese patients were found to have increased carotid artery intima-media, which means that IMTC was positively correlated with BMI (p=0.000001).It is necessary to identify diagnostic methods easily applicable for children, allowing involvement of the characteristics of the arterial wall in the degenerative pathological processes. Increased intima-media ratio is positively correlated with high values of blood pressure.

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