scholarly journals Evaluation of Human Chorionic Gonadotropin (HCG) Therapeutic Results in Patients With Unilateral cryptorchidism (Undescended Testis)

2020 ◽  
Vol 13 (1) ◽  
pp. 13-17
Author(s):  
Farzaneh Sharifiaghdas ◽  
Sepideh Sharifiaghdas ◽  
Esmaeil R. Maleki ◽  
Behzad Narouie ◽  
Abdolsamad Shikhzadeh ◽  
...  
Keyword(s):  
Undescended Testis ◽  
Inguinal Canal ◽  
Cost Effective ◽  
Therapeutic Effects ◽  
Therapeutic Results ◽  
Invasive Method ◽  
One Year ◽  
Retractile Testis ◽  
Hcg Therapy ◽  
Unilateral Cryptorchidism

Background: Cryptorchidism or undescended testis is an evolutionary defect where one or both testes fail to descend into the scrotum. HCG causes the testes to fail, possibly due to weight gain, an increase in testicular vasculature, and stimulating the testosterone and di-hydro-testosterone. The present study has been conducted to evaluate the therapeutic effects of HCG on patients with unilateral cryptorchidism. Methods: In a prospective descriptive study, 211 patients of 8 months to 7 years old with unilateral cryptorchidism whose parents refused surgery received HCG therapy. The patients were followed up 1 month, 3months, and 12 months after the first injection. They were examined in terms of the location of testes, possible relapses, sides of undescended testes, treatment complications, and HCG therapeutic results. Results: Four weeks after the first injection, 160 patients (75.12%) out of 211 cases had the descent of testes into the inguinal canal and the scrotum. 69.5% of non-palpable abdominal testes descended into the inguinal canal, 69.7% of patients with inguinal testes, 78% of patients with supra inguinal testes and 100% of patients with retractile testis experienced the descent of testes into the scrotum. Conclusion: The therapeutic response to HCG was successful in more than 50% of the cases in all the groups. Therefore, the need for performing surgical procedures on children with unilateral cryptorchidism would be decreased and they can be treated by a cost-effective and less invasive method. Moreover, at least one-year follow-up of the patients is required to ensure outcomes of the treatment.

Sonographically guided, transcatheter foam sclerotherapy of the great saphenous vein

Phlebologie ◽  
2007 ◽  
Vol 36 (06) ◽  
pp. 309-312 ◽  
Author(s):  
T. Schulz ◽  
M. Jünger ◽  
M. Hahn
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Clinical Stage ◽  
Clinical Signs ◽  
Cost Effective ◽  
Duplex Sonography ◽  
Foam Sclerotherapy ◽  
Average Loss ◽  
One Year ◽  
The Cost

Summary Objective: The goal of the study was to assess the effectiveness and patient tolerability of single-session, sonographically guided, transcatheter foam sclerotherapy and to evaluate its economic impact. Patients, methods: We treated 20 patients with a total of 22 varicoses of the great saphenous vein (GSV) in Hach stage III-IV, clinical stage C2-C5 and a mean GSV diameter of 9 mm (range: 7 to 13 mm). We used 10 ml 3% Aethoxysklerol®. Additional varicoses of the auxiliary veins of the GSV were sclerosed immediately afterwards. Results: The occlusion rate in the treated GSVs was 100% one week after therapy as demonstrated with duplex sonography. The cost of the procedure was 207.91 E including follow-up visit, with an average loss of working time of 0.6 days. After one year one patient showed clinical signs of recurrent varicosis in the GSV; duplex sonography showed reflux in the region of the saphenofemoral junction in a total of seven patients (32% of the treated GSVs). Conclusion: Transcatheter foam sclerotherapy of the GSV is a cost-effective, safe method of treating varicoses of GSV and broadens the spectrum of therapeutic options. Relapses can be re-treated inexpensively with sclerotherapy.

A Clinical Study and Management of Inguino-scrotal Swellings In Children

2018 ◽  
Vol 2 (S1) ◽  
pp. e000125
Author(s):  
Khyati Vaja ◽  
Mukesh Suvera
Keyword(s):  
Inguinal Hernia ◽  
Pediatric Surgery ◽  
Pediatric Patients ◽  
Undescended Testis ◽  
Length Of Hospital Stay ◽  
Indirect Inguinal Hernia ◽  
Short Term ◽  
One Year ◽  
Groin Hernias ◽  
Inguinal Hernia In Children

Aims and Objectives: To know the most common surgical problems in pediatric patients presented with inguino-scrotal swellings and management done routinely. Methodology: This study was carried out in the department of general surgery, Sharadaben hospital and pediatric surgery of VS hospital, Ahmedabad. The cases were studied for a period of about one year (January, 2017 to Dec, 2017) and all children below 12 years of age, presenting to us with inguinoscrotal swellings were included in this study. The information was analysed in terms of age, diagnosis, procedure carried out and outcome. Results: Amongst the 150 children under the age of 12 years, 143 patients were males and 7 were females. Among these 150, 52 cases were of hydrocoele, 70 cases of hernia (of which 63 were males and 7 were females), 25 cases of undescended testis and 3 cases of epididymo orchitis were documented. All cases underwent simple herniotomy for hernia and hydrocoele, orchidopexy for undescended testis. The length of hospital stay ranged from 2-4 days with mean of 2.46 days. 11 children in the study were documented to have short term complications, all of which were recognised in the hospital and managed with good results. Conclusion: Hernia and Hydrocoele in children are often congenital and diagnosed clinically (history and examination). Indirect inguinal hernia are more common than other groin hernias. Open herniotomy is the operation of choice for inguinal hernia in children.

Cost Avoidance and Clinical Benefits Derived from a Pharmacy-Managed Anemia Program

2000 ◽  
Vol 35 (2) ◽  
pp. 169-175 ◽  
Author(s):  
Robert A. Quercia ◽  
Ronald Abrahams ◽  
C. Michael White ◽  
John D'Avella ◽  
Mary Campbell
Keyword(s):  
Cost Savings ◽  
Cost Effective ◽  
Hemodialysis Patients ◽  
Cost Avoidance ◽  
Number Of Patients ◽  
Epoetin Alpha ◽  
Clinical Benefits ◽  
Unit Dose ◽  
One Year ◽  
Alpha Therapy

A pharmacy-managed anemia program included distribution and clinical components, with the goal of making epoetin alpha therapy for hemodialysis patients more cost-effective. The Pharmacy Department prepared epoetin alpha doses for patients in unit-dose syringes, utilizing and documenting vial overfill. Pharmacists dosed epoetin alpha and iron (oral and intravenous) per protocol for new and established patients. Baseline data were obtained in 1994, one year prior to implementation of the program, and were re-evaluated in 1995 and 1998. Cost avoidance from utilization of epoetin alpha vial overfill in 1995 and 1998 was $83,560 and $91,148 respectively. In 1995 and 1998, cost avoidance from pharmacy management of anemia was $191,159 and $203,985 respectively. The total cost avoidance from 1995 through 1998 was estimated at $1,018,638. The number of patients with hematocrits under 31% decreased from 32% in 1994 to 21% and 14% in 1995 and 1998 respectively. We conclude that a pharmacy-managed anemia program for hemodialysis patients results in significant cost savings and better achievement of target hematocrits.

Magnetic properties of PM in indoor/outdoor domestic environments 

2021 ◽  
Author(s):  
Aruã Da Silva Leite ◽  
Melina Macouin ◽  
Sonia Rousse ◽  
Jean-François Leon ◽  
Loïc Drigo ◽  
...  
Keyword(s):  
Iron Oxides ◽  
Cost Effective ◽  
Tree Bark ◽  
Indoor Environments ◽  
Magnetic Mineralogy ◽  
Magnetic Methods ◽  
Tree Barks ◽  
Domestic Environments ◽  
One Year ◽  
The City

<p>The finer fraction of the particulate matter (PM) is the most harmful health wise, as it has more capacity to reach deeper parts of the respiratory system. Among other constituents, PM also contains iron oxides, allowing for the use of magnetic methods in its investigation as proxies for the whole of PM. Those methods present advantages in comparison to traditional ones, being quick, cost effective and sensible to investigate iron oxides among PM. </p><p>To better understand the risks related to PM exposition in the domestic context, the assessment of magnetic parameters may be used in outdoor and indoor environments, giving us information on the concentration of iron oxides (and consequently, PM) and its dispersion from one environment to the other. </p><p>We developed a citizen sciences experiment in the city of Toulouse, France. Tree barks were used as bio-collectors. Garlands composed of tree bark pieces were distributed to the population in May-2019, and placed in both indoors and outdoors of flats and homes to capture PM. They were retrieved after one year. Measurement of magnetic susceptibility, ARM, SIRM, S -ratio and estimation of superparamagnetic concentration were performed. A total of 86 bio-collectors kits were successfully analyzed. The preliminary results indicate a higher concentration of iron oxides outdoors, with a mean difference between outdoor and indoor measurements of 6.58x10<sup>-9</sup>m<sup>3</sup>/kg and 1.38x10<sup>-5</sup>Am<sup>2</sup>/kg in susceptibility and SIRM respectively. The concentration of the SP fraction also follows this trend of higher outdoor values. The magnetic mineralogy is mostly dominated by low coercivity magnetite-like carriers.</p><div> <div> <div> </div> </div> <div> <div> </div> </div> </div>

The Treatment of Iron-deficiency Anemia—Palatable but Ineffective Iron Medication

PEDIATRICS ◽  
1963 ◽  
Vol 31 (6) ◽  
pp. 1041-1044
Author(s):  
LOUIS K DIAMOND ◽  
J. LAWRENCE NAIMAN ◽  
DONALD M. ALLEN ◽  
FRANK A. OSKI,
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Ferrous Sulfate ◽  
Oral Iron ◽  
Gastrointestinal Absorption ◽  
Deficiency Anemia ◽  
Therapeutic Effects ◽  
Rapid Rise ◽  
Carbohydrate Complex ◽  
Therapeutic Results

Experience with a new oral iron-carbohydrate complex (Jefron) in the treatment of iron-deficiency anemia shows that the therapeutic results are inferior to those obtainable with ferrous sulfate. Many children showed no response after months of treatment with this drug and when subsequently placed on ferrous sulfate therapy showed a rapid rise in hemoglobin to normal levels. Preliminary studies suggest that poor gastrointestinal absorption may be a factor in the inadequate therapeutic effects.

scholarly journals A one-year cost–utility analysis of REBOA versus RTACC for non-compressible torso haemorrhage

Trauma ◽  
2017 ◽  
Vol 21 (1) ◽  
pp. 45-54 ◽  
Author(s):  
Maxwell S Renna ◽  
Cristiano van Zeller ◽  
Farah Abu-Hijleh ◽  
Cherlyn Tong ◽  
Jasmine Gambini ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Cost Utility ◽  
Incremental Cost Effectiveness Ratio ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Cost Effectiveness Ratio ◽  
One Year ◽  
Quality Adjusted Life

Introduction Major trauma is a leading cause of death and disability in young adults, especially from massive non-compressible torso haemorrhage. The standard technique to control distal haemorrhage and maximise central perfusion is resuscitative thoracotomy with aortic cross-clamping (RTACC). More recently, the minimally invasive technique of resuscitative endovascular balloon occlusion of the aorta (REBOA) has been developed to similarly limit distal haemorrhage without the morbidity of thoracotomy; cost–utility studies on this intervention, however, are still lacking. The aim of this study was to perform a one-year cost–utility analysis of REBOA as an intervention for patients with major traumatic non-compressible abdominal haemorrhage, compared to RTACC within the U.K.’s National Health Service. Methods A retrospective analysis of the outcomes following REBOA and RTACC was conducted based on the published literature of survival and complication rates after intervention. Utility was obtained from studies that used the EQ-5D index and from self-conducted surveys. Costs were calculated using 2016/2017 National Health Service tariff data and supplemented from further literature. A cost–utility analysis was then conducted. Results A total of 12 studies for REBOA and 20 studies for RTACC were included. The mean injury severity scores for RTACC and REBOA were 34 and 39, and mean probability of death was 9.7 and 54%, respectively. The incremental cost-effectiveness ratio of REBOA when compared to RTACC was £44,617.44 per quality-adjusted life year. The incremental cost-effectiveness ratio, by exceeding the National Institute for Health and Clinical Effectiveness’s willingness-to-pay threshold of £30,000/quality-adjusted life year, suggests that this intervention is not cost-effective in comparison to RTACC. However, REBOA yielded a 157% improvement in utility with a comparatively small cost increase of 31.5%. Conclusion Although REBOA has not been found to be cost-effective when compared to RTACC, ultimately, clinical experience and expertise should be the main factor in driving the decision over which intervention to prioritise in the emergency context.

scholarly journals Telemedicine Strategy to Rescue CPAP Therapy in Sleep Apnea Patients with Low Treatment Adherence: A Pilot Study

2021 ◽  
Vol 10 (18) ◽  
pp. 4123
Author(s):  
Onintza Garmendia ◽  
Ramon Farré ◽  
Concepción Ruiz ◽  
Monique Suarez-Girón ◽  
Marta Torres ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Cost Effective ◽  
Smartphone Application ◽  
Poor Adherence ◽  
Therapeutic Effects ◽  
Cpap Adherence ◽  
Included Patient ◽  
Number Of Patients ◽  
Nasal Pressure ◽  
Voice Recorder

Patients with sleep apnea are usually treated with continuous positive airway pressure (CPAP). This therapy is very effective if the patient′s adherence is satisfactory. However, although CPAP adherence is usually acceptable during the first months of therapy, it progressively decreases, with a considerable number of patients accepting average treatment duration below the effectiveness threshold (4 h/night). Herein, our aim was to describe and evaluate a novel telemedicine strategy for rescuing CPAP treatment in patients with low adherence after several months/years of treatment. This two-week intervention includes (1) patient support using a smartphone application, phone and voice recorder messages to be answered by a nurse, and (2) daily transmission and analysis of signals from the CPAP device and potential variation of nasal pressure if required. On average, at the end of the intervention, median CPAP adherence considerably increased by 2.17 h/night (from 3.07 to 5.24 h/night). Interestingly, the procedure was able to markedly rescue CPAP adherence: the number of patients with poor adherence (<4 h/night) was considerably reduced from 38 to 7. After one month, adherence improvement was maintained (median 5.09 h/night), and only 13 patients had poor adherence (<4 h/night). This telemedicine intervention (103€ per included patient) is a cost-effective tool for substantially increasing the number of patients with CPAP adherence above the minimum threshold for achieving positive therapeutic effects.

scholarly journals Retos y análisis de un programa municipal de prescripción de ejercicio físico para la salud: El programa VIU-ACTIU (Challenges and analysis of a local program of exercise prescription for health: The VIU-ACTIU program)

Retos ◽  
2020 ◽  
Author(s):  
Pablo Monteagudo Chiner ◽  
José Luís Herreros ◽  
Jesús Beltrán ◽  
Ana Cordellat Marzal ◽  
Ainoa Roldán Aliaga ◽  
...  
Keyword(s):  
Physical Exercise ◽  
Interdisciplinary Collaboration ◽  
Cost Effective ◽  
Drop Out ◽  
Promotion Strategy ◽  
Calidad De Vida ◽  
Health Promotion Strategy ◽  
Local Program ◽  
Sufficient Intensity ◽  
One Year

La política municipal debe atender a las necesidades de ejercicio físico de sus ciudadanos, con una oferta coste-efectiva y adecuada para todos. VIU-ACTIU es una estrategia integral de promoción de salud que se articula en torno a dos líneas de actuación municipal: a) asesoramiento y prescripción de ejercicio físico individualizado, supervisado por graduados en ciencias de la actividad física y el deporte en coordinación multidisciplinar con profesionales sanitarios; y b) coordinación con agentes del municipio en acciones de dinamización de salud comunitaria a través de “activos de salud” previamente mapeados. Objetivos: Evaluar cambios funcionales y psicosociales tras un año de programa, analizando dificultades encontradas durante su implantación; y proponer mejoras. Estudio longitudinal con evaluación pre-post donde 72 personas (63.49±10.92 años; 81.18±18.45 kg; 54 mujeres) fueron intencionalmente asignadas a dos propuestas de entrenamiento (paseos cardiosaludables; y paseos cardiosaludables + entrenamiento grupal supervisado). Los análisis estadísticos consideraron además las diferencias de cada entrenamiento en dos rangos de edad (<65, >65 años). Aptitud cardiovascular, agilidad y calidad de vida mejoraron significativamente (p<.05) en ambos tratamientos, con mayores beneficios en los >65. El preparador físico y el trabajo neuromuscular en los grupos supervisados aseguraron la intensidad necesaria para mejorar en los <65. Se requiere incluir una evaluación post obligatoria en el protocolo VIU-ACTIU, coordinada con el centro de salud, para cuantificar los beneficios de aquellos usuarios que, habiendo entrenado, abandonan antes de finalizar el programa. La colaboración interdisciplinar aporta valor añadido a los servicios municipales con asesoramiento, atención y supervisión profesional individualizada. Abstract. Municipal administration must address its citizens’ physical exercise needs, with a cost-effective and tailored offer. VIU-ACTIU is an overall health promotion strategy, developed around two lines of local intervention: a) advice and prescription of individualized physical exercise, supervised by individuals licensed in physical activity and sports sciences through multidisciplinary coordination with health professionals; and the coordination with local agents in policies of revitalization of community health through “health assets” previously mapped. The aim is to assess functional and psychosocial changes after one year of strategy, analyzing the difficulties encountered during its implementation; and to propose improvements. Longitudinal study with pre-post assessments in which 72 participants (63.49±10.92 years old; 81.18±18.45 kg; 54 women) were intentionally assigned to two training proposals (cardiovascular walks; and CV-walks + supervised group training). Statistical analysis also considered differences by age ranges (<65, >65 years old). Cardiorespiratory fitness, agility, and quality of life improved significantly (p<.05) in both groups, with greater benefits in >65 adults. The physical trainer and neuromuscular work in the supervised groups ensured sufficient intensity to improve in <65 elderly. A mandatory post-evaluation is required in the VIU-ACTIU protocol to quantify the benefits of those users who, despite having trained, drop out before the end of the program. Interdisciplinary collaboration adds value to municipal services with counseling, care, and individualized professional supervision.

SO056THE CLINICAL AND IMMUNOLOGICAL IMPACT OF LOW DOSE RITUXIMAB IN CLINICAL NEPHROLOGY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Sunu Alex
Keyword(s):  
B Cells ◽  
B Cell ◽  
Low Dose ◽  
Cost Effective ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cell Percentage ◽  
Steroid Dependent ◽  
One Year

Abstract Background and Aims Currently, the dose of rituximab used in nephrology practice is mostly extrapolated from the dose used in lymphoproliferative disorders. It is possible that a lesser dose may suffice when treating a non-neoplastic disorder. We conducted this study to study the clinical response and CD19 B cell suppression with a single dose of 100mg rituximab in nephrology practice Method This was a single center prospective study of role of 100mg rituximab as initial dose in steroid dependent (SDNS), frequently relapsing nephrotic syndrome (FRNS), idiopathic membranous nephropathy (MN) and high immunologic risk kidney transplantation with subsequent doses based on CD19 B cell reconstitution. Results Following 100mg rituximab in 42 patients, CD19 B cell percentage decreased from 16.3+7.6 to 0.3±0.3, 1.9±1.7 and 4.0±4.5 by 30, 90 and 180 days respectively. At 30th day, 40(95.2%) had CD19 B cell count &lt;1%. Of the 30 patients with SDNS and FRNS followed up for one year, 29(96.7%) went into remission at day 30. Remission was sustained in 23(76.6%) at day 180 and 21(70%) at 1 year. There was significant decrease [P &lt;0.001] in the dose of steroids needed to maintain remission at 180 days following rituximab (0.27±0.02mg/Kg to 0.02±0.00mg/Kg). Of the five patients with MN, four patients achieved remission by 6 months. Remission was sustained in three patients by 1 year. Of the 7 kidney transplant recipients, 2 had antibody mediated rejections though CD19 B cells were suppressed even at one year. Conclusion Low dose of 100 mg rituximab is sufficient to deplete CD19 B cells for up to 90days and is effective in inducing remission in SDNS and FRNS and MN. Targeting subsequent doses depending on CD19 B cell reconstitution may prevent relapses, limit toxicity and be cost effective.

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