Outbreaks of Group A Streptococcal Abscesses Following Diphtheria-Tetanus Toxoid-Pertussis Vaccination

PEDIATRICS ◽  
1985 ◽  
Vol 75 (2) ◽  
pp. 299-303
Author(s):  
Harrison C. Stetler ◽  
Paul L. Garbe ◽  
Diane M. Dwyer ◽  
Richard R. Facklam ◽  
Walter A. Orenstein ◽  
...  
Keyword(s):  
Tetanus Toxoid ◽  
Bacterial Contamination ◽  
Preventive Measure ◽  
Cost Effective ◽  
Careful Attention ◽  
Short Term ◽  
Sterile Technique ◽  
Group A ◽  
Dtp Vaccine ◽  
Effective Preventive Measure

Two outbreaks of group A streptococcal abscesses following receipt of diphtheria-tetanus toxoid-pertussis (DTP) vaccine from different manufacturers were reported to the Centers for Disease Control (CDC) in 1982. The clustering of the immunization times of cases, the isolation of the same serotype of Streptococcus from all cases in each outbreak, and the absence of reported abscesses associated with receipt of the same lots of vaccine in other regions of the country, suggest that each outbreak was probably caused by contamination of a single 15-dose vial of vaccine. The preservative thimerosal was present within acceptable limits in unopened vials from the same lot of DTP vaccine in each outbreak. Challenge studies indicate that a strain of Streptococcus from one of the patients can survive up to 15 days in DTP vaccine at 4°C. Contamination of vials during manufacturing would have required survival of streptococci for a minimum of 8 months. Preservatives in multidose vaccine vials do not prevent short-term bacterial contamination. Options to prevent further clusters of streptococcal abscesses are discussed. The only feasible and cost-effective preventive measure now available is careful attention to sterile technique when administering vaccine from multidose vials.

scholarly journals A Comparative Study to Evaluate the Effect of Matra Basti with Shuddha Bala Taila and Ksheerabala Taila in the Management of Gridhrasi

AYUSHDHARA ◽  
2021 ◽  
pp. 3506-3510
Author(s):  
Ratnesh Kumar Dubey ◽  
Kulkarni Ashwini A ◽  
Raghvendra Y ◽  
Nitin Kumar
Keyword(s):  
Clinical Symptoms ◽  
Cost Effective ◽  
Treatment Result ◽  
Term Therapy ◽  
Inclusion Criteria ◽  
Short Term ◽  
Surgical Interventions ◽  
Operative Complications ◽  
Group A ◽  
Group B

In present scenario the most common cause of disability in patients under 45years of age is back pain. Gridhrasi can be correlated to Sciatica where pain radiates from buttock into thigh, calf, and occasionally the foot. In the surgical treatment of Sciatica may have serious post-operative complications. Basti being superior treatment in Vatavyadhis and keeping in view of lacunae in medical management and due to the complications caused by modern surgical interventions there is a need of a safe, potent, cost effective, simple and short-term therapy for this condition. So here is an attempt to compare the effect of Matra Basti with Shuddha Bala Taila (group A) and Ksheerabala Taila (group B) in the management of Gridhrasi. Where 40 patients who fulfilled the inclusion criteria randomly and distributed into 2 groups of 20 patients each. Clinical symptoms were given grading according their severity. After completion of the treatment result were assessed and statistically analyzed to know the significance. Considering the overall effect of the treatment, comparatively patients in group B showed better results in Parameters Pain (<0.05), Stambha (<0.05), and SLR (<0.05). Whereas patients in Group A showed better results in Spandana (<0.05) where as both group patients showed equal result in Toda. So, the Ksheerabala Taila is more effective than Shuddha Bala Taila in the management of Gridhrasi.

Effect of short-term use of oral contraceptive pills on intraocular pressure

2020 ◽  
Vol 35 (3) ◽  
Author(s):  
Tayyaba Gul Malik ◽  
Hina Nadeem ◽  
Eiman Ayesha ◽  
Rabail Alam
Keyword(s):  
Oral Contraceptive ◽  
Childbearing Age ◽  
Short Term ◽  
Oral Contraceptive Pills ◽  
Contraceptive Pills ◽  
Time Period ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Short Time

Objective: To study the effect of short-term use of oral contraceptive pills on intra-ocular pressures of women of childbearing age.   Methods: It was a comparative observational study, conducted at Arif memorial teaching hospital and Allied hospital Faisalabad for a period of six months. Hundred female subjects were divided into two groups of 50 each. Group A, included females, who had been taking oral contraceptive pills (OCP) for more than 6 months and less than 36 months. Group B, included 50 age-matched controls, who had never used OCP. Ophthalmic and systemic history was taken. Careful Slit lamp examination was performed and intraocular pressures (IOP) were measured using Goldman Applanation tonometer. Fundus examination was done to rule out any posterior segment disease. After collection of data, we analyzed and compared the intra ocular pressures between the two groups by using ANOVA in SPSS version 21.   Results: Average duration of using OCP was 14.9 months. There was no significant difference of Cup to Disc ratios between the two groups (p= 0.109). However, significant difference was noted between the IOP of OCP group and controls. (p=0.000). Conclusion: OCP significantly increase IOP even when used for short time period.

scholarly journals Cost-effectiveness of a hybrid emergency room system for severe trauma: a health technology assessment from the perspective of the third-party payer in Japan

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Takahiro Kinoshita ◽  
Kensuke Moriwaki ◽  
Nao Hanaki ◽  
Tetsuhisa Kitamura ◽  
Kazuma Yamakawa ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Emergency Room ◽  
Healthcare Costs ◽  
Cost Effective ◽  
Severe Trauma ◽  
Third Party ◽  
Trauma Patients ◽  
Short Term ◽  
The Third

Abstract Background Hybrid emergency room (ER) systems, consisting of an angiography-computed tomography (CT) machine in a trauma resuscitation room, are reported to be effective for reducing death from exsanguination in trauma patients. We aimed to investigate the cost-effectiveness of a hybrid ER system in severe trauma patients without severe traumatic brain injury (TBI). Methods We conducted a cost-utility analysis comparing the hybrid ER system to the conventional ER system from the perspective of the third-party healthcare payer in Japan. A short-term decision tree and a long-term Markov model using a lifetime time horizon were constructed to estimate quality-adjusted life years (QALYs) and associated lifetime healthcare costs. Short-term mortality and healthcare costs were derived from medical records and claims data in a tertiary care hospital with a hybrid ER. Long-term mortality and utilities were extrapolated from the literature. The willingness-to-pay threshold was set at $47,619 per QALY gained and the discount rate was 2%. Deterministic and probabilistic sensitivity analyses were conducted. Results The hybrid ER system was associated with a gain of 1.03 QALYs and an increment of $33,591 lifetime costs compared to the conventional ER system, resulting in an ICER of $32,522 per QALY gained. The ICER was lower than the willingness-to-pay threshold if the odds ratio of 28-day mortality was < 0.66. Probabilistic sensitivity analysis indicated that the hybrid ER system was cost-effective with a 79.3% probability. Conclusion The present study suggested that the hybrid ER system is a likely cost-effective strategy for treating severe trauma patients without severe TBI.

scholarly journals Effectiveness of Face Coverings in Mitigating the COVID-19 Pandemic in the United States

2021 ◽  
Vol 18 (7) ◽  
pp. 3666
Author(s):  
Olukayode James Ayodeji ◽  
Seshadri Ramkumar
Keyword(s):  
Public Health ◽  
United States ◽  
District Of Columbia ◽  
Preventive Measure ◽  
The United States ◽  
Protective Measure ◽  
Sharp Change ◽  
The Public ◽  
Public Health Challenges ◽  
Effective Preventive Measure

The COVID-19 pandemic has been one of the biggest public health challenges of the 21st century. Many prevalent measures have been taken to prevent its spread and protect the public. However, the use of face coverings as an effective preventive measure remains contentious. The goal of the current study is to evaluate the effectiveness of face coverings as a protective measure. We examined the effectiveness of face coverings between 1 April and 31 December 2020. This was accomplished by analyzing trends of daily new COVID-19 cases, cumulative confirmed cases, and cases per 100,000 people in different U.S. states, including the District of Columbia. The results indicated a sharp change in trends after face covering mandates. For the 32 states with face covering mandates, 63% and 66% exhibited a downward trend in confirmed cases within 21 and 28 days of implementation, respectively. We estimated that face covering mandates in the 32 states prevented approximately 78,571 and 109,703 cases within 21- and 28-day periods post face covering mandate, respectively. A statistically significant (p = 0.001) negative correlation (−0.54) was observed between the rate of cases and days since the adoption of a face covering mandate. We concluded that the use of face coverings can provide necessary protection if they are properly used.

Doing More With Less: Pragmatic Implementation of Vancomycin Area-Under-the-Curve (AUC) Monitoring

2021 ◽  
pp. 089719002110272
Author(s):  
Joanne Huang ◽  
Jeannie D. Chan ◽  
Thu Nguyen ◽  
Rupali Jain ◽  
Zahra Kassamali Escobar
Keyword(s):  
Quality Improvement ◽  
High Risk ◽  
Therapeutic Drug Monitoring ◽  
Paradigm Shift ◽  
Area Under The Curve ◽  
Cost Effective ◽  
Practical Method ◽  
Therapeutic Drug ◽  
Short Term ◽  
Quality Improvement Process

Universal area-under-the-curve (AUC) guided vancomycin therapeutic drug monitoring (TDM) is resource-intensive, cost-prohibitive, and presents a paradigm shift that leaves institutions with the quandary of defining the preferred and most practical method for TDM. We report a step-by-step quality improvement process using 4 plan-do-study-act (PDSA) cycles to provide a framework for development of a hybrid model of trough and AUC-based vancomycin monitoring. We found trough-based monitoring a pragmatic strategy as a first-tier approach when anticipated use is short-term. AUC-guided monitoring was most impactful and cost-effective when reserved for patients with high-risk for nephrotoxicity. We encourage others to consider quality improvement tools to locally adopt AUC-based monitoring.

In-line filtration reduced phlebitis associated with peripheral venous cannulation: Focus on cost-effectiveness and patients’ perspectives

2019 ◽  
Vol 21 (2) ◽  
pp. 154-160
Author(s):  
Gianluca Villa ◽  
Rosa Giua ◽  
Timothy Amass ◽  
Lorenzo Tofani ◽  
Cosimo Chelazzi ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Vascular Access ◽  
Cost Effective ◽  
Causative Factor ◽  
Control Group ◽  
Previous Trial ◽  
Venous Cannulation ◽  
Group A ◽  
The Cost ◽  
And Control

Background: In a previous trial, in-line filtration significantly prevented postoperative phlebitis associated with short peripheral venous cannulation. This study aims to describe the cost-effectiveness of in-line filtration in reducing phlebitis and examine patients’ perception of in-hospital vascular access management with and without in-line filtration. Methods: We analysed costs associated with in-line filtration: these data were prospectively recorded during the previous trial. Furthermore, we performed a follow-up for all the 268 patients enrolled in this trial. Among these, 213 patients responded and completed 6 months after hospital discharge questionnaires evaluating the perception of and satisfaction with the management of their vascular access. Results: In-line filtration group required 95.60€ more than the no-filtration group (a mean of € 0.71/patient). In terms of satisfaction with the perioperative management of their short peripheral venous cannulation, 110 (82%) and 103 (76.9%) patients, respectively, for in-line filtration and control group, completed this survey. Within in-line filtration group, 97.3% of patients were satisfied/strongly satisfied; if compared with previous experiences on short peripheral venous cannulation, 11% of them recognised in-line filtration as a relevant causative factor in determining their satisfaction. Among patients within the control group, 93.2% were satisfied/strongly satisfied, although up to 30% of them had experienced postoperative phlebitis. At the qualitative interview, they recognised no difference than previous experiences on short peripheral venous cannulation, and mentioned postoperative phlebitis as a common event that ‘normally occurs’ during a hospital stay. Conclusion: In-line filtration is cost-effective in preventing postoperative phlebitis, and it seems to contribute to increasing patient satisfaction and reducing short peripheral venous cannulation–related discomfort

Iodine deficiency diseases in Switzerland one hundred years after Theodor Kocher's survey: A historical review with some new goitre prevalence data

1990 ◽  
Vol 123 (6) ◽  
pp. 577-590 ◽  
Author(s):  
Hans Bürgi ◽  
Zeno Supersaxo ◽  
Beat Selz
Keyword(s):  
Military Service ◽  
Urinary Iodine ◽  
Historical Review ◽  
Mental Deficiency ◽  
Preventive Measure ◽  
Iodine Content ◽  
Cost Effective ◽  
Iodized Salt ◽  
Urinary Iodine Excretion ◽  
Human Consumption

Abstract. In certain regions of Switzerland, before prophylaxis, 0.5% of the inhabitants were cretins, almost 100% of schoolchildren had large goitres and up to 30% of young men were unfit for military service owing to a large goitre. Iodization of salt was introduced in 1922 at 3.75 mg I per kg and the iodine content was doubled twice, in 1962 and 1980, to the present 15 mg I per kg. In 1988, 92% of retail salt and 76% of all salt for human consumption (including food industry) was iodized, even though its use is voluntary. Urinary iodine excretion, previously between 18 and 64 μg per per day, has now risen to 150 μg per day. No new endemic cretins born after 1930 have been identified. Goitre disappeared rapidly in newborns and schoolchildren, more slowly in army recruits, and incompletely in elderly adults. In some Cantons (by constitution in charge of health matters and the salt monopoly) which allowed iodized salt only in 1952, disappearance of goitre lagged behind accordingly, proof that iodized salt was the cause of regression. The Swiss data provide evidence that isolated deafness, mental deficiency, and short stature, each without the other attributes of cretinism have also decreased. Adverse effects of iodized salt were minimal, possibly because the initial iodine content of salt was chosen very low. Iodization of salt has proved a highly cost-effective preventive measure in Switzerland.

CLINICAL OUTCOME AND COST COMPARISON OF CARPAL TUNNEL WOUND CLOSURE WITH MONOCRYL® AND ETHILON®: A PROSPECTIVE STUDY

Hand Surgery ◽  
2013 ◽  
Vol 18 (02) ◽  
pp. 189-192 ◽  
Author(s):  
Anis Dosani ◽  
Sameer K. Khan ◽  
Sheila Gray ◽  
Steve Joseph ◽  
Ian A. Whittaker
Keyword(s):  
Carpal Tunnel ◽  
Wound Closure ◽  
Unit Cost ◽  
Cost Effective ◽  
Cost Comparison ◽  
Absorbable Suture ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
A Prospective Study

This prospective non-randomised two-cohort study compares the use of an absorbable suture (Poliglecrapone [Monocryl]: Group A) and a non-absorbable suture (Polyamide [Ethilon]: Group B) in wound closure after elective carpal tunnel decompression. The primary outcome was scar cosmesis as assessed by the Stonybrook Scar Evaluation Scale (SBSES); the financial cost of wound closure was compared as a secondary outocome. All fifty patients completed follow-up. At six weeks, there was no significant difference in the two groups regarding scar tenderness (p = 0.5), although residual swelling was more evident in the absorbable group (p = 0.2). The mean SBSES score at six weeks was 4.72 in Group A, and 4.8 in Group B (p = 0.3). The unit cost per closed wound of Monocryl was three times than Ethilon (p < 0.05). Ethilon is thus cost-effective without compromising the cosmetic outcome, and we recommend using this as the preferred suture for closure of carpal tunnel wounds.

Short-term therapies (CBT and EMDR) for anxiety reactions and states in healthcare professionals

2021 ◽  
pp. 450-458
Author(s):  
Filipp Sergeevich Shturmin ◽  
Zhanna Robertovna Gardanova
Keyword(s):  
Behavioral Therapy ◽  
Medical Professionals ◽  
Control Group ◽  
Short Term ◽  
Anxiety States ◽  
Medical Institutions ◽  
Group Methods ◽  
Group A ◽  
Group B ◽  
People Group

The relevance of the topic under consideration lies in the need to analyze the effectiveness of short-term methods of psychotherapy to provide prompt psychotherapeutic assistance in dealing with anxiety states and reactions in employees of medical institutions, including during the period of increased stress associated with the spread of the coronavirus infection. The study was conducted on a sample of 60 medical professionals. The experimental group of 30 people was divided into two groups of 15 people (group A and group B) and a control group of 30 people. According to the results of the study, the positive effect of group methods of short-term psychotherapy on reducing the level of anxiety states and reactions in medical professionals was revealed. It was also found that the psychocorrective influence on medical professionals by means of techniques of eye movement desensitization and reprocessing was more effective than by the techniques of cognitive behavioral therapy.

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