scholarly journals Cost-effectiveness of using stone cone, balloon dilator, stone basket, and entrapment device in ureteroscopic laser lithotripsy for ureteric stones

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110610
Author(s):  
Kürşat Çeçen
Keyword(s):  
Laser Lithotripsy ◽  
Secondary Treatment ◽  
Auxiliary Equipment ◽  
Total Cost ◽  
End Of Treatment ◽  
Significant Difference ◽  
Total Treatment ◽  
The Mean ◽  
Mean Cost ◽  
First Time

Objective To evaluate the costs and stone-free rates of ureteroscopic laser lithotripsy (ULL) performed with and without auxiliary equipment and to compare first-time ULL with total treatment. Methods One hundred patients who underwent first-time ULL without the use of auxiliary equipment because its unavailability comprised the no-device ULL (ndULL) group. Additionally, 100 patients who underwent first-time ULL with the use of auxiliary equipment when necessary comprised the device ULL (dULL) group. Results In the ndULL and dULL groups, the stone-free rates after first-time ULL were 72% and 94% and the mean cost was US $1037 ± 15.10 and US $1452 ± 19.80 per case, respectively, with a statistically significant difference. The stone-free rates at the end of treatment were 98% and 99%, respectively, without a statistically significant difference. When secondary treatment costs were added to the first ULL costs after failed treatment, the mean total cost was US $1625 ± 12.60 in the ndULL group and US $1566 ± 11.01 in the dULL group without a statistically significant difference. Conclusions The stone-free rates and costs after first-time ULL were significantly different between the groups. However, after total treatment, there was no statistically significant difference between the two groups.

scholarly journals Potato Late Blight in the Columbia Basin: An Economic Analysis of the 1995 Epidemic

Plant Disease ◽  
1997 ◽  
Vol 81 (1) ◽  
pp. 103-106 ◽  
Author(s):  
D. A. Johnson ◽  
T. F. Cummings ◽  
P. B. Hamm ◽  
R. C. Rowe ◽  
J. S. Miller ◽  
...  
Keyword(s):  
Late Blight ◽  
Management Practice ◽  
Columbia Basin ◽  
Copper Hydroxide ◽  
Total Cost ◽  
Late Season ◽  
The Mean ◽  
The Cost ◽  
Mean Cost ◽  
First Time

The cost of managing late blight in potatoes during a severe epidemic caused by new, aggressive strains of Phytophthora infestans in the Columbia Basin of Washington and Oregon in 1995 was documented. The mean number of fungicide applications per field varied from 5.1 to 6.3 for early- and midseason potatoes, and from 8.2 to 12.3 for late-season potatoes in the northern and southern Columbia Basin, respectively. In 1994, a year when late blight was not severe, the mean number of fungicide applications per field made to early- and midseason potatoes was 2.0; whereas late-season potatoes received a mean of 2.5 applications. The mean per acre cost of individual fungicides applied varied from $4.90 for copper hydroxide to $36.00 for propamocarb + chlorothalonil. Total per acre expenses (application costs plus fungicide material) for protecting the crop from late blight during 1995 ranged from $106.77 to $110.08 for early and midseason potatoes in different regions of the Columbia Basin and from $149.30 to $226.75 for lateseason potatoes in the northern and southern Columbia Basin, respectively. Approximately 28% of the crop was chemically desiccated before harvest as a disease management practice for the first time in 1995, resulting in an additional mean cost of $34.48/acre or $1.3 million for the region. Harvested yields were 4 to 6% less than in 1994. The total cost of managing late blight in the Columbia Basin in 1995 is estimated to have approached $30 million.

scholarly journals Cost Effectiveness Analysis of Crystalloid and Crystaloid-Colloid Combination on Dengue Fever without Shok in Bhakti Asih General Hospital Tangerang

2018 ◽  
Vol 8 (2) ◽  
pp. 70
Author(s):  
Suratni Suratni ◽  
Yusi Anggriani ◽  
Agusdini Banun
Keyword(s):  
Dengue Fever ◽  
Study Groups ◽  
Medical Patients ◽  
Cost Of Treatment ◽  
Total Cost ◽  
Effectiveness Analysis ◽  
Significant Difference ◽  
High Incidence ◽  
The Mean ◽  
Mean Cost

Dengue fever is an infectious disease caused by virus transmitted through Aedes aegypty. The high incidence dengue fever can lead to increased healthcare costs. This study was conducted to analyze the effectiveness and direct cost of medical patients dengue fever without shock use fluid therapy by comparing crystalloid and crystalloid colloid combination. The subjects were 171 patients divided into two groups: 106 patients with crystalloid and 65 patients with crystalloid colloid combination. Assessed of effectiveness treatment and the mean medical costs. The results showed reviewed from hematocrit value no difference (p>0.05) in both study groups. The mean total cost of treatment for crystalloid Rp 4.005.223, the crystalloid colloid combination Rp 5.525.407. The highest cost of drug costs was 31.75% of the total cost crystalloid, 40.9% of the total cost crystalloid colloid combination. There was a significant difference between mean cost and two study groups (p0.05) with effectiveness treatment. Conclusion crystalloid have the same effectiveness as crystalloid colloid combination fluids at lower costs.

Comparison of stapler and handsewn anastomosis techniques in creating an ileal conduit following radical cystectomy

2021 ◽  
pp. 1
Keyword(s):  
Postoperative Complications ◽  
Ileal Conduit ◽  
Perioperative Complications ◽  
Movement Time ◽  
Oral Intake ◽  
Total Cost ◽  
Handsewn Anastomosis ◽  
Significant Difference ◽  
The Mean ◽  
Mean Time

Background and objective: Ileal conduit for urinary diversion can be completed using either end-to-end handsewn or stapled anastomosis. This study aimed to compare stepled and handsewn anastomosis methods in terms of complications, hospitalization and cost. Materials and methods: Forty-three patients were included in the hand-sewn and 44 patients in the stapler group. After creating an ileal conduit, continuity of the loop was achieved either with handsewn or stapler method. Patients' demographic data, time to onset of bowel movement, time to transit to oral intake, time to removal of the drain, perioperative and postoperative complications, mortality and total costs were retrospectively recorded and compared between the two groups. Results: There was no statistically significant difference between the groups in terms of the mean to the onset of bowel movements (p = 0.51) and the mean time to transit to oral intake (p = 0.23). The mean time to removal of the drain was significantly lower in the stapler group (p = 0.023). Perioperative complications were seen in eight patients in the handsewn group, while none of the patients in the stapler group developed perioperative complication (p = 0.003). Postoperative complications were similar between both groups (p = 0.75). The duration of hospitalization was statistically significantly lower in the stapler group (p = 0.004) and the mean total cost was statistically significantly more advantageous (p < 0.001). Conclusion: No significant difference was found between stapler and handsewn anastomosis techniques in terms of postoperative complications. On the other hand, hospitalization and total cost were in favour of stapler technique, showing that this technique can be used safely.

scholarly journals First evaluation of coral recruitment in Madagascar

2021 ◽  
Vol 20 (1) ◽  
pp. 47-62
Author(s):  
Gildas G.B. Todinanahary ◽  
Nomeniarivelo Hasintantely ◽  
Igor Eeckhaut ◽  
Thierry Lavitra
Keyword(s):  
Larval Density ◽  
Average Density ◽  
Recruitment Rate ◽  
Seasonal Distribution ◽  
Coral Recruitment ◽  
Significant Difference ◽  
Southwest Region ◽  
The Mean ◽  
First Time ◽  
Very High

The distribution of larvae and recruitment of scleractinians in the southwest region of Madagascar were evaluated for the first time between October 2013 and September 2014 at 3 sites. The presence of coral larvae (planulae) was monitored through weekly sampling using a plankton net and the recruitment rate evaluated by monthly sampling of the newly settled corals (<1 year stage) on recruitment tiles and by a monitoring of the recruitment of juveniles (1< Juveniles < 2 years) using the quadrat method. Planulae were present in the plankton for 9 months during the survey. The recorded mean annual density of planula varied from 0.43 ± 0.41 larvae m-3 to 3.23 ± 5.72 larvae m-3 depending on site, with a peak in larval density towards the end of November and the beginning of December. The variability in the occurrence of planula is very high and implied that the density observed in the year does not present a significant difference between the sites (pKW=0.33). The average density of total recruits was 620.13 ± 621.30 recruits m-2, 40.28 ± 50.97 recruits m-2 and 36.34 ± 33.82 recruits m-2, respectively at the sites of Nosy Tafara, Grande Vasque and Rose Garden. Seasonal distribution of coral recruitment was different between the sites. The mean annual density of newly settled recruits (< 1 month stage) was significantly higher at Nosy Tafara with 94.91±101.08 recruits m-2 compared to Grande Vasque and Rose Garden with 18.75±34.32 recruits m-2 and 11.57±18.47 recruits m-2 (pKW<0.001), respectively. The highest density of newly settled recruits was observed between October to December. Higher density of recruits was also observed in March at Nosy Tafara and in May at all three sites. Results of juvenile monitoring showed high rates (> 10 juveniles m-2) compared to other regions and the threshold, but it revealed high mortality among recruits. Coral recruitment in the southwest region of Madagascar was found to be high and could result in increased resilience of the coral reef assemblages.

scholarly journals Implementation strategy and cost of Mozambique’s HPV vaccine demonstration project

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Caroline Soi ◽  
Joseph B. Babigumira ◽  
Baltazar Chilundo ◽  
Vasco Muchanga ◽  
Luisa Matsinhe ◽  
...  
Keyword(s):  
Hpv Vaccine ◽  
Annual Cost ◽  
Implementation Strategy ◽  
National Level ◽  
Vaccine Dose ◽  
Demonstration Project ◽  
Total Cost ◽  
School Based ◽  
The Mean ◽  
Mean Cost

Abstract Background Cost is an important determinant of health program implementation. In this study, we conducted a comprehensive evaluation of the implementation strategy of Mozambique’s school-based HPV vaccine demonstration project. We sought to estimate the total costs for the program, cost per fully immunized girl (FIG), and compute projections for the total cost of implementing a similar national level vaccination program. Methods We collected primary data through document review, participatory observation, and key informant interviews at all levels of the national health system and Ministry of Education. We used a combination of micro-costing methods—identification and measurement of resource quantities and valuation by application of unit costs, and gross costing—for consideration of resource bundles as they apply to the number of vaccinated girls. We extrapolated the cost per FIG to the HPV-vaccine-eligible population of Mozambique, to demonstrate the projected total annual cost for two scenarios of a similarly executed HPV vaccine program. Results The total cost of the Mozambique HPV vaccine demonstration project was $523,602. The mean cost per FIG was $72 (Credibility Intervals (CI): $62 - $83) in year one, $38 (CI: $37 - $40) in year two, and $54 CI: $49 - $61) for years one and two. The mean cost per FIG with the third HPV vaccine dose excluded from consideration was $60 (CI: $50 - $72) in year one, $38 (CI: $31 - $46) in year two, and $48 (CI: $42 - $55) for years one and two. The mean cost per FIG when only one HPV vaccine dose is considered was $30 (CI: $27 - $33)) in year one, $19 (CI: $15–$23) in year two, and $24 (CI: $22–$27) for both years. The projected annual cost of a two-and one-dose vaccine program targeting all 10-year-old girls in the country was $18.2 m (CI: $15.9 m - $20.7 m) and $9 m (CI: $8 m - $10 m) respectively. Conclusion National adaptation and scale-up of Mozambique’s school-based HPV vaccine strategy may result in substantial costs depending on dosing. For sustainability, stakeholders will need to negotiate vaccine price and achieve higher efficiency in startup activities and demand creation.

scholarly journals Expenditure survey on continued veno-venous hemodialysis procedure in the intensive care unit

2007 ◽  
Vol 15 (6) ◽  
pp. 1138-1143 ◽  
Author(s):  
Lígia Maria dal Secco ◽  
Valéria Castilho
Keyword(s):  
Total Expenditure ◽  
Procedure Time ◽  
Time Duration ◽  
Total Cost ◽  
Acute Renal Insufficiency ◽  
Male Patients ◽  
The Mean ◽  
Procedure Duration ◽  
Mean Cost ◽  
Dialytic Treatment

This study aimed to characterize patients submitted to dialytic treatment with CVVHD in ICUs; monitor procedure time duration; estimate nurses' labor wages and; estimate the direct procedures mean costs. The study was developed in a public teaching hospital located in São Paulo, Brazil. A total of 93 procedures performed in 50 patients composed the sample. The results showed the predominance of male patients (62%); mean age was 60.8 years old; ICU hospitalization time was 19.2 days; 86% of the patients died; 76% of the patients presented acute renal insufficiency and, mean procedure time per patient was 1.9. The mean procedure duration was 26.6 hours. The mean cost of nurses' wages were R$ 592.04 which represented 28.7% of the total cost. The mean total expenditure was R$ 2,065.36 ranging from R$ 733.65 to R$ 6,994.18.

Effects of rising drug costs on efforts to control overall cost at a large academic cancer center.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 2-2
Author(s):  
Kerin B. Adelson ◽  
Maureen Canavan ◽  
Susanna N. Supalla ◽  
Tannaz Sedghi ◽  
Basit Chaudhry ◽  
...  
Keyword(s):  
Acute Care ◽  
Cost Of Care ◽  
Drug Costs ◽  
Cancer Center ◽  
Historical Period ◽  
Pharmaceutical Pricing ◽  
Total Cost ◽  
The Mean ◽  
Mean Cost ◽  
Post Acute Care

2 Background: Value-based payment programs like the Oncology Care Model (OCM) have focused efforts to reduce costly acute care use through improvements in access and coordination rather than targeting the exponential rise in pharmaceutical pricing. We assessed how participation in OCM affected total cost of cancer care at a large academic cancer center. Methods: Using Medicare claims for Yale-Smilow Cancer Hospital, an NCI-designated cancer center with an academic hub and 10 community practices, we identified episodes for chemotherapy initiated during a historical period (pre-OCM, 2012-2015) and performance period (post-OCM, 2016-2017) following OCM criteria to identify total cost of care. We reported frequency of utilization categories, the mean cost per episode, the proportion of total cost attributed to each utilization category and compared pre- and post-participation periods. Results: There were 8,843 episodes during the historical period and 6,679 episodes during the performance period. The mean total cost per episode increased from $28,645 to $32,666, but this was less than the Medicare-defined expected increase (target price). Between the two periods, the percentage of total episodes decreased for emergency department (ED) use from 36% to 33%, inpatient care from 33% to 29%, and post-acute care from 28% to 25% (p < 0.01). Mean costs of drugs per episode increased by 27% between periods, and from 52% to 58% of total cost of care (p < 0.01). While mean cost per episode for ED, inpatient, and post-acute care remained stable, the mean cost per episode for antineoplastics increased 39% from $10,676 to $14,843. Conclusions: After implementing OCM, we beat the Medicare target largely by decreasing acute care use and stabilizing the cost of hospitalizations and ED; however, actual cost increased largely due to pharmaceutical spending. Because drug costs were the largest proportion of overall cost of care, future value-based models must address the rising cost of pharmaceuticals. [Table: see text]

scholarly journals Evaluation of the effect of Teucrium polium ointment on the episiotomy wound healing in primiparous women

2021 ◽  
Vol 7 (2) ◽  
pp. e33-e33
Author(s):  
Atena Mohammady Rouzbahani ◽  
Mahrokh Dolatian ◽  
Tayebeh Jahedbozorgan ◽  
Faraz Mojab ◽  
Majid Tajik
Keyword(s):  
Clinical Trial ◽  
Wound Healing ◽  
Surgical Incision ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Significant Difference ◽  
Teucrium Polium ◽  
The Mean ◽  
First Time ◽  
Primiparous Women

Introduction: Episiotomy is a surgical incision at the vaginal opening performed in the second stage of labor during childbirth. The purpose of performing an episiotomy is to increase the size of the soft tissue of the pelvis floor and prevent damage to the perineum, facilitate delivery, and reduce the time during childbirth. Objectives: This study aimed to determine the effect of Teucriumpolium ointment on wound healing in primiparous women. Patients and Methods: This triple-blinded clinical trial was conducted on 84 primiparous women referred to Mahdieh hospital in Tehran. Participants randomly received 2% T. polium ointment and placebo. The first time the ointment was started 24 hours after delivery and continued twice a day for 10 days. Wound healing rate was measured by redness, edema, ecchymosis, discharge, and approximation (REEDA) scale on days 1, 5, and 10 postpartum. The data were analyzed using SPSS version 23. Results: The results were performed on 84 women, 43 people using T. polium ointment and 41 people using placebo ointment. There was no significant difference between the two groups regarding obstetrics and demographic characteristics at the beginning of the study. The mean scores of REEDA in the T. polium group in the first 12 hours, days 5 and 10 were significantly different from the placebo group (P<0.001). Conclusion: Wound healing following episiotomy can be accelerated due to antibacterial, anti-inflammatory, and antiseptic properties of T. polium ointment. Trial Registration: The trial protocol was approved by the Iranian registry of clinical trial (#IRCT20100130003226N18; https://en.irct.ir/trial/40004, ethical code# IR.SBMU.RETECH.1398.055).

scholarly journals Subjects living in an onchocerciasis focus and treated 3-monthly with ivermectin develop fewer new onchocercal nodules than subjects treated annually

2020 ◽  
Author(s):  
Jérémy Campillo ◽  
Cédric B. CHESNAIS ◽  
Sébastien D. Pion ◽  
Jacques Gardon ◽  
Joseph Kamgno ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Poisson Regression ◽  
Prophylactic Effect ◽  
Poisson Regression Model ◽  
Initial Number ◽  
Treatment Groups ◽  
The Third ◽  
Significant Difference ◽  
The Mean ◽  
First Time

Abstract Background Little information is available on the effect of ivermectin on the third and fourth stage larvae of Onchocerca volvulus . To assess a possible prophylactic effect of ivermectin on this parasite, we compared the effects of different ivermectin regimens on the acquisition of onchocercal nodules. Methods We analyzed data from a controlled randomized clinical trial of ivermectin conducted in the Mbam valley (Cameroon) between 1994 and 1998 in a cohort of onchocerciasis infected individuals. The number of nodules that appeared between the start and the end of the clinical trial was analyzed, using ANOVA and multivariable Poisson regressions, between four treatment arms: 150 µg/kg annually, 800 µg/kg annually, 150 µg/kg 3-monthly, and 800 µg/kg annually. Results The mean number of nodules that appeared during the trial was reduced by 17.7% in subjects treated 3-monthly compared to those treated annually (regardless of the dose). Poisson regression model, adjusting on subject’s age and weight, initial number of nodules and intensity of O. volvulus infection in his village of residence, confirmed that the incidence of new nodules was reduced in 3-monthly treatment arms compared to annually treatment arms, and that the dosage of ivermectin does not seem to influence this effect. Besides, the number of newly acquired nodules was positively associated with the initial number of nodules. Analysis of disappearance of nodules did not show any significant difference between the treatment groups. Conclusions Our result suggest, for the first time in humans, that ivermectin has a prophylactic effect on O. volvulus . Three-monthly treatment seems more effective than annual treatment to prevent the appearance of nodules.

scholarly journals Assessment of Neopterin Serum Level for Monitoring Therapy of Patients with Mycobacterium Tuberculosis

2021 ◽  
Vol 13 (3) ◽  
Author(s):  
Shokrollah Salmanzadeh ◽  
Razieh Mombeini ◽  
Seyed Mohammad Alavi ◽  
Morteza Abdullatif Khafaie
Keyword(s):  
Serum Levels ◽  
Response To Treatment ◽  
Sputum Smear ◽  
Major Health Problem ◽  
Tb Treatment ◽  
Monitoring Therapy ◽  
Significant Difference ◽  
The Mean ◽  
First Time

Background: Tuberculosis (TB) is a major health problem worldwide. To date, the standard diagnostic method for TB is still the direct observation of Mycobacterium TB in a sputum smear or culture. Objectives: There is an urgent need for a method to detect the disease in a shorter time with acceptable sensitivity and specificity and help monitor the treatment. Methods: A panel of 34 adults newly diagnosed with smear-positive pulmonary TB was followed during their treatment period of five months. Neopterin (NPT) serum levels were measured three times (before treatment and two and five months after treatment) using the Brahms ELItest Neopterin kit, and the results were analyzed using descriptive and graphical methods. Results: The mean NPT for the first time before treatment was 27.47 ± 20.7 nmol/L. NPT was measured two months after the anti-TB treatment, and the associated mean was 16.97 ± 14.14 nmol/L. At the end of the fifth month, the mean NPT concentration reached 11.3 ± 10.5 nmol/L. The mean serum NPT before treatment had a statistically significant difference with the mean NPT at the end of the second and fifth months of the treatment (P = 0.001). Conclusions: According to the national protocol for treating TB, a sputum smear is still necessary for patients’ follow-up. It seems that the serum NPT level should be measured to monitor response to treatment in patients that, for any reason are not able to give sputum in TB treatment follow-up.

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