scholarly journals Physical health examination in outpatients with schizophrenia: the cost effectiveness of laboratory screening tests

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Saana Eskelinen ◽  
Janne V. J. Suvisaari ◽  
Jaana M. Suvisaari
Keyword(s):  
Cost Effectiveness ◽  
Laboratory Test ◽  
Reference Range ◽  
Health Examination ◽  
Abnormal Result ◽  
Gamma Glutamyltransferase ◽  
Hydroxyvitamin D ◽  
Laboratory Screening ◽  
25 Hydroxyvitamin D ◽  
The Cost

Abstract Background Guidelines on laboratory screening in schizophrenia recommend annual monitoring of fasting lipids and glucose. The utility and the cost effectiveness of more extensive laboratory screening have not been studied. Methods The Living Conditions and the Physical Health of Outpatients with Schizophrenia Study provided a comprehensive health examination, including a laboratory test panel for 275 participants. We calculated the prevalence of the results outside the reference range for each laboratory test, and estimated the cost effectiveness to find an aberrant test result using the number needed to screen to find one abnormal result (NNSAR) and the direct cost spent to find one abnormal result (DCSAR, NNSAR x direct cost per test) formulas. In addition, we studied whether patients who were obese or used clozapine had more often abnormal results. Results A half of the sample had 25-hydroxyvitamin D below, and almost one-fourth cholesterol, triglycerides or glucose above the reference range. One-fifth had sodium below and gamma glutamyltransferase above the reference range. NNSAR was highest for potassium (137) and lowest for 25-hydroxyvitamin D (2). DCSAR was below 5€ for glucose, all lipids and sodium, and below 10€ for creatinine and gamma glutamyltransferase. Potassium (130€), pH-adjusted ionized calcium (33 €) and thyroid stimulating hormone (33€) had highest DCSARs. Several abnormal results were more common in obese and clozapine using patients. Conclusions An annual laboratory screening panel for an outpatient with schizophrenia should include fasting glucose, lipids, sodium, creatinine, a liver function test and complete blood count, and preferably 25-hydroxyvitamin D.

Concentration of 25-hydroxyvitamin D in 246 men’s blood serum population on Wroclaw

2020 ◽  
Vol 56 (1) ◽  
pp. 11-16
Author(s):  
Jolanta Stacherzak-Pawlik ◽  
Marlena Najmrocka
Keyword(s):  
Vitamin D ◽  
Reference Range ◽  
Medical Center ◽  
Average Concentration ◽  
The Body ◽  
Microsoft Excel ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Roche Diagnostics ◽  
The Relationship

The aim of the study was to analyze vitamin D concentrations in the blood of 246 men aged 16–89 in the period from September 2017 to February 2018. As the material for research used the results of 25(OH)D concentration determinations from the Laboratory of the Lower Silesian Medical Center DOLMED S.A. The assays were performed using the Roche Diagnostics – Cobas e410 immunochemical analyzer. Vitamin D test was used. It is the competence assay, which is based on the phenomenon of ectrochemiluminescence (ECLI). The analysis showed that the average concentration of vitamin D in the body of the studied patients was 27.7 ng/ml. 6% of men tested had a deficit, 26% had a deficiency, and 27% had hypovitaminosis. The concentration of the housing in the reference range were observed in 41% of research. The relationship between age and 25 (OH) D concentration was demonstrated. With increasing age, the concentration of vitamin D increases. In the population studied, there were no concentrations higher than 80 ng/ml. The relationship between calcidiol concentration and the month in which the study was performed was also demonstrated. The statistical analysis of the obtained data was made using Statistica version 13 and Microsoft Excel 2016.

scholarly journals A Market Research Of Obesity And Bariatric Surgery In Turkey And Tunisia

2020 ◽  
Vol 1 (1) ◽  
pp. 37-47
Author(s):  
G. Kockaya ◽  
E. B. Karahan ◽  
S. Oztopcu ◽  
G. Oguzhan ◽  
A. M. Charaf
Keyword(s):  
Bariatric Surgery ◽  
Cost Effectiveness ◽  
Surgical Procedures ◽  
Health Technology ◽  
Public Hospitals ◽  
Tunisian Population ◽  
Health Examination ◽  
Patient Profile ◽  
Rate Of Increase ◽  
The Cost

This article aims to discuss four topics according to the recent scientific data a) to overview the frequency of obese and overweight individuals among Tunisia and Turkey populations; b) to examine health technology assessment of bariatric surgery (BS) report (HTA) in Tunisia and Turkey; c) to evaluate the cost and cost reimbursements by social health systems for bariatric surgery in Turkey and Tunisia; d) to examine the total number of bariatric surgical procedures and their costs in state and private health organizations in Tunisia and Turkey. The OECD (2011-2017) Turkey report was included for the data for the frequency of obese and over-weighted people among the general population Turkey, while the WHO report of «Diabetes Prevalence and Diabetes Risk Factors» of 2016 was included for Tunisia. Also supporting data on the overweight and obese population in Tunisia was provided from the news site named Middle East Monitor and the «Tunisian Health Examination Survey» conducted in 2016. Surgery cost and reimbursement of cost, analyses of bariatric surgery in Turkey published in 2014 was included as well. The data about the patient profile to whom bariatric surgery can be applied, the indications for bariatric surgery, and centers where it can be applied in Turkey are obtained from the Cost-Effectiveness of Obesity Surgery in Turkey and Economic Value Study (CEVOS-T) and Turkey Bariatric Surgery HTA Report. The Turkey Health Management Center website has been used for the total bariatric surgery performed. The authors analyzed the general status of bariatric operations in Turkey and Tunisia. The overweighted and obese individuals constitute 64.4% of Turkey’s population while this frequency is obtained as 62.8% of the Tunisian population. The rate of increase in obesity was obtained by 10.8% between 2014 to 2017 in Turkey. According to the results of CEVOS-T study the total economic burden attributable to an obesity rate of 1.16% of GDP in 2004, the proportion of the GDP in 2012 was seen as 1.73%. A total of 15,800 bariatric surgical procedures were performed in Turkey in 2018. The operational cost of a tube stomach surgery in the health unit of the Turkish Union of Public Hospitals (TKHK) was found to be 8930 TL. The cost of bariatric surgery in Tunisia including hospitalization is £ 3950. As the majority of the population is overweighted and obese in both Turkey and Tunisia, it can be interpreted as the occurrence of obesity-related health problems that can be increased. When the complications and advantages of bariatric surgery were examined it was decided that these two countries should give importance to bariatric surgery. Turkey’s interest in this subject is revealed with HTA and CEVOS-T report. Health economics analyses such as bariatric surgery HTA reports, number of bariatric surgery operations, the cost-effectiveness of BS in Tunisia could not be reached due to lack of statistics and resources. Turkey and Tunisia made with these investigations demonstrated a general situation in bariatric surgery. Keywords: bariatric surgery, health technology, market of bariatric surgery, obesity, overweight population.

The cost–effectiveness of point-of-care D-dimer tests compared with a laboratory test to rule out deep venous thrombosis in primary care

2014 ◽  
Vol 15 (1) ◽  
pp. 125-136 ◽  
Author(s):  
Janneke MT Hendriksen ◽  
Geert-Jan Geersing ◽  
Suzanne C van Voorthuizen ◽  
Ruud Oudega ◽  
Arina J ten Cate-Hoek ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Laboratory Test ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Point Of Care ◽  
The Cost ◽  
D Dimer ◽  
Rule Out

scholarly journals Vitamin and mineral nutrition in chronic alcoholocs including patients nwith Korsakoff's psychosis

1981 ◽  
Vol 45 (3) ◽  
pp. 469-473 ◽  
Author(s):  
M. S. Devgun ◽  
Anna Fiabane ◽  
C. R. Paterson ◽  
P. Zarembski ◽  
Anne Guthrie
Keyword(s):  
Reference Range ◽  
Chronic Alcoholism ◽  
Vitamin Deficiencies ◽  
Hydroxyvitamin D ◽  
Control Subjects ◽  
Calcium Magnesium ◽  
25 Hydroxyvitamin D ◽  
Subclinical Vitamin ◽  
Low Levels ◽  
Β Carotene

1. A group of 129 patients with chronic alcoholism were assessed for their nutritional status with respect to certain minerals and vitamins, and compared with control subjects.2. In all subjects the plasma values were normal for calcium, magnesium and zinc.3. As in other studies a seasonal variation was found in the plasma levels of 25-hydroxyvitamin D in the control subjects and the alcoholic subjects; in all seasons lower levels were found in the alcoholics than in the controls, but none of the alcoholic patients had results in the range found in osteomalacia.4. The alcoholic subjects had low levels of ascorbic acid both in the plasma and in the leucocytes.5. Although vitamin A and β-carotene levels were within the reference range, the results in alcoholics were found to be lower than in the control subjects.6. We suggest that subclinical vitamin deficiencies other than thiamine deficiency contribute to the cerebral impairment frequently found in alcoholism.

scholarly journals Genetic Association between Serum 25-Hydroxyvitamin D Levels and Lung Function in Korean Men and Women: Data from KNHANES 2011–2012

Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1362 ◽  
Author(s):  
Clara Park ◽  
So-Young Kwak ◽  
Garam Jo ◽  
Min-Jeong Shin
Keyword(s):  
Lung Function ◽  
Vital Capacity ◽  
Genetic Risk Score ◽  
Forced Expiratory Volume ◽  
Health Examination ◽  
Nucleotide Polymorphisms ◽  
Nutrition And Health ◽  
Single Nucleotide ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D

The association between single-nucleotide polymorphisms (SNPs) in the vitamin D metabolic pathway and lung function is unknown. We examined the association between five SNPs on DHCR7, GC, CYP2R1, and CYP24A1 along with serum 25-hydroxyvitamin D (25(OH)D) levels and lung function in older Korean men (n = 758) and women (n = 837). Lung function was determined by forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) from the data in the Korea Nutrition and Health Examination Survey 2011–2012. Genetic risk score (GRS) was calculated by the number of 25(OH)D-decreasing alleles of the five SNPs. Our results showed that increases in GRS were associated with reduced 25(OH)D levels (p < 0.05 for both sexes). In the entire population, FVC and FEV1 were associated with both GRS and 25(OH)D levels. In women, FVC and FEV1 were negatively associated with GRS (β-coefficient (95% CI): −0.022 (−0.039, −0.005) and −0.020 (−0.035, −0.005), respectively; both p < 0.05), but not with 25(OH)D. However, in men, FVC and FEV1 were positively associated with 25(OH)D (β-coefficient (95% CI): 0.008 (0.001, 0.016) and 0.008 (0.002, 0.015), respectively; both p < 0.05), but not with GRS. In conclusion, lung function was associated with genetic variation in Korean women and with 25(OH)D in Korean men.

scholarly journals Metastatic calcinosis cutis due to refractory hypercalcaemia responsive to denosumab in a patient with multiple sclerosis

2019 ◽  
Vol 12 (2) ◽  
pp. e223992 ◽  
Author(s):  
Ahmed Jorge ◽  
Robert Szulawski ◽  
Fnu Abhishek
Keyword(s):  
Multiple Sclerosis ◽  
Reference Range ◽  
Subcutaneous Tissue ◽  
Off Label Use ◽  
Calcinosis Cutis ◽  
Off Label ◽  
Hydroxyvitamin D ◽  
Ionised Calcium ◽  
25 Hydroxyvitamin D ◽  
Label Use

Metastatic calcinosis cutis results from abnormal calcium levels leading to the precipitation of insoluble calcium salts in the skin and subcutaneous tissue. Here, we present the case of a 67-year-old man with multiple sclerosis on chronic dexamethasone and concurrent supplementation of calcium and daily cholecalciferol presenting with painful calcified lesions. During initial presentation, corrected calcium was 13.8 mg/dL (reference range: 8.5–10.1 mg/dL), ionised calcium was 1.70 mg/dL (reference range: 1.13–1.32 mg/dL) and 25-hydroxyvitamin D was 41.6 ng/mL (reference range 30–100 ng/mL). Normocalcaemia was restored with the off-label use of denosumab, usually reserved for hypercalcaemia of malignancy and intractable osteoporosis. We discuss potential aetiologies of this patient’s hypercalcaemia, calcinosis cutis diagnosis and management and the off-label use of denosumab.

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