Cost Analysis of Simple Non-Renewing Warranties – Group 1

Author(s):  
Ammar Y. Alqahtani ◽  
Surendra M. Gupta
Keyword(s):  
2016 ◽  
Vol 87 (4) ◽  
pp. 276
Author(s):  
Fatih Akbulut ◽  
Onur Kucuktopcu ◽  
Emre Kandemir ◽  
Erkan Sonmezay ◽  
Abdulmuttalip Simsek ◽  
...  

Objective: The aim of the study was to compare the efficacy of the laser lithotripter with the ultrasonic lithotripter in mini percutaneous nephrolithotomy (miniperc). Material and Methods: From June 2013 to January 2014; medical records of 77 consecutive patients who underwent miniperc operation were retrospectively evaluated. Ultrasonic lithotripter was used in 22 patients (Group 1), while laser was used in 55 patients. In the laser group, 22 patients were randomly selected who had same characteristics compared to group 1 (Group 2). Success rate, total operative time, complications according to modified Clavien classification, fluoroscopy time, haemoglobin drop, hospital stays and cost analysis were assessed. Success rates were evaluated on the second postoperative day and after the first month. Results: Total operative time (p = 0.635) and fluoroscopy time (p = 0.248) were not significantly different between the two groups. In the laser group, the success rate (81.8%) was notably more than in the ultrasonic lithotripter group (68.2%) but there was no statistically significance (p = 0.296). Ten reusable ultrasonic probe were used for 22 patients, due to thinness and sensitiveness of the probe. Conversely, one single laser fiber (550 micron) was used for 22 patients. When the cost analysis of lithotripsy was considered, the cost per case was 190 dollar in group 1 and 124 dollar in group 2. (p = 0.154) Complication rate, hospital stay and haemoglobin drop were similar in both groups. Conclusion: Laser lithotripsy seems to be more cost effective than ultrasonic lithotripsy for miniperc but larger number of patients are required to confirm this estimation.


2020 ◽  
Author(s):  
Chibuzo Manafa ◽  
Ahmed Barakat ◽  
Felicity Auld ◽  
Joideep Phadnis

Abstract Background Incidence of rotator cuff tears (RCT) following primary anterior glenohumeral dislocation in patients over 40 years is thought to be high. Current guidelines recommend specialist clinic review and advanced imaging for all patients. The aim of this study was to report the incidence of symptomatic RCT in a large cohort of patients and to assess the safety and efficacy of a physiotherapy led virtual protocol where patients were selectively investigated and treated based on symptoms. Methods 238 consecutive patients over 40 years of age with a primary anterior glenohumeral dislocation were identified between January 2015 and June 2018 (42 months). All patients were managed initially through a physiotherapy led virtual clinic with selective referral of patients with red flag symptoms to a specialist shoulder clinic. Advanced imaging (MRI or USS) was performed at the discretion of the shoulder specialist following patient assessment. The incidence of symptomatic RCT was assessed and compared between two groups (Group 1: 40-70 years, Group 2: >70 years). All surgical interventions were recorded. Patients were assessed at a mean of 22 months (range 10-54) using the Oxford shoulder score; patient satisfaction and return to pre-injury functional level. Cost analysis was performed to compare management using this protocol versus published guidelines.Results A total of 238 patients were identified with mean age of 65 years (range 40-96). 69% (n=164/238) were symptomatic and were referred to specialist clinic. The other 31% (n=74/238) were asymptomatic and were discharged to physiotherapy. Of those referred to a specialist clinic, only 46% (n=75/164) were sent for advanced imaging following clinical examination. The incidence of symptomatic RCTs was 31% (n=51/164) in this group and only 22% (n=11/51) of those underwent subsequent surgical repair of their rotator cuff. Of those patients discharged to physiotherapy, 62% (n=47/74) responded to the questionnaire with 89% fully satisfied, 85% returned to pre-injury level and mean Oxford score was 42 (33-38, SD 3.2) indicating excellent shoulder function. With all patients pooled excluding those lost to follow-up (n=27), the incidence of symptomatic RCTs was 24% (51/211). The incidence in group 1 was 16% (n=22/137) and was significantly lower than in group 2 which was 39% (n=29/74) (p<0.05). Cost analysis demonstrated 49% cost reduction using this protocol.Conclusion Incidence of symptomatic cuff tears following a primary glenohumeral dislocation in patients over 40 years was lower than previously reported. A protocol based on selective referral and investigation for symptomatic patients was cost effective and safe.


Author(s):  
Mai M. Said ◽  
Ramesh K. Nayak ◽  
Randall E. McCoy

Burgos and Wislocki described changes in the mucosa of the guinea pig uterus, cervix and vagina during the estrous cycle investigated by transmission electron microscopy. More recently, Moghissi and Reame reported the effects of progestational agents on the human female reproductive tract. They found drooping and shortening of cilia in norgestrel and norethindrone- treated endometria. To the best of our knowledge, no studies concerning the effects of mestranol and norethindrone given concurrently on the three-dimensional surface features on the uterine mucosa of the guinea pig have been reported. The purpose of this study was to determine the effect of mestranol and norethindrone on surface ultrastructure of guinea pig uterus by SEM.Seventy eight animals were used in this study. They were allocated into two groups. Group 1 (20 animals) was injected intramuscularly 0.1 ml vegetable oil and served as controls.


1989 ◽  
Vol 7 (1) ◽  
pp. 27-41 ◽  
Author(s):  
Norman Keith Womer
Keyword(s):  

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.


VASA ◽  
2015 ◽  
Vol 44 (5) ◽  
pp. 381-386 ◽  
Author(s):  
Christian Uhl ◽  
Thomas Betz ◽  
Andrea Rupp ◽  
Markus Steinbauer ◽  
Ingolf Töpel

Abstract. Summary: Background: This pilot study was set up to examine the effects of a continuous postoperative wound infusion system with a local anaesthetic on perioperative pain and the consumption of analgesics. Patients and methods: We included 42 patients in this prospective observational pilot study. Patients were divided into two groups. One group was treated in accordance with the WHO standard pain management protocol and in addition to that received a continuous local wound infusion treatment (Group 1). Group 2 was treated with analgesics in accordance with the WHO standard pain management protocol, exclusively. Results: The study demonstrated a significantly reduced postoperative VAS score for stump pain in Group 1 for the first 5 days. Furthermore, the intake of opiates was significantly reduced in Group 1 (day 1, Group 1: 42.1 vs. Group 2: 73.5, p = 0.010; day 2, Group 1: 27.7 vs. Group 2: 52.5, p = 0.012; day 3, Group 1: 23.9 vs. Group 2: 53.5, p = 0.002; day 4, Group 1: 15.7 vs. Group 2: 48.3, p = 0.003; day 5, Group 1 13.3 vs. Group 2: 49.9, p = 0.001). There were no significant differences between the two groups, neither in phantom pain intensity at discharge nor postoperative complications and death. Conclusions: Continuous postoperative wound infusion with a local anaesthetic in combination with a standard pain management protocol can reduce both stump pain and opiate intake in patients who have undergone transfemoral amputation. Phantom pain was not significantly affected.


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