Zobrazení zdroje stránky Pikegeertsen2211

IMPORTANCE Patients with cancer are at risk for unplanned hospitalizations during treatment which can increase the cost of care. OBJECTIVES To determine demographic and clinical factors associated with healthcare utilization and costs among clinical trial participants. DESIGN, SETTING, AND PATIENTS We conducted a retrospective analysis among breast cancer patients over the age of 65 treated on SWOG clinical trials from 1999 to 2011 with trial data linked to Medicare claims. MAIN OUTCOMES AND MEASURES The outcomes were healthcare utilization (emergency room visits (ER), hospitalizations) and costs from Medicare Claims. Demographic, clinical, and prognostic factors were captured from clinical trial records. We identified cardiovascular comorbidities/risk factors (CVD-RFs) of diabetes, hypertension, hypercholesterolemia, and coronary artery disease (CAD) from Medicare claims. Multivariable logistic and linear regression were used to assess the association between CVD-RFs and outcomes. RESULTS Among the 708 patie, p = 0.02), and CAD ($37,781 vs $31,698, 19.2% increase, p = 0.04) had statistically significantly higher total healthcare costs. Additionally, those with ≥ 2 significant CVD-RFs ($35,353 vs. $28,899, 22.3% increase, p = 0.005) had statistically significantly higher total healthcare costs. CONCLUSIONS Among participants treated on clinical trials, black race and presence of multiple cardiovascular comorbidities was associated with a substantial increase in ER visits, hospitalizations and healthcare costs. Efforts to reduce unplanned hospitalizations should focus on this high-risk group.Organophosphate (OP) compounds are widely used as pesticides and herbicides and exposure to these compounds has been associated with both chronic and acute forms of neurological dysfunction including cognitive impairment, neurophysiological problems and cerebral ataxia with evidence of mitochondrial impairment being associated with this toxicity. In view of the potential mitochondrial impairment, the present study aimed to investigate the effect of exposure to commonly used OPs, dichlorvos, methyl-parathion (parathion) and chloropyrifos (CPF) on the cellular level of the mitochondrial electron transport chain (ETC) electron carrier, coenzyme Q10 (CoQ10) in human neuroblastoma SH-SY5Y cells. The effect of a perturbation in CoQ10 status was also evaluated on mitochondrial function and cell viability. A significant decreased (P  less then  0.0001) in neuronal cell viability was observed following treatment with all three OPs (100&nbsp;µM), with dichlorvos appearing to be the most toxic to cells and causing an 80% loso dichlorvos (50&nbsp;µM). However, post supplementation with CoQ10, complex II+III activity significantly increased by 33% (P  less then  0.0005), 25% (P  less then  0.005) and 35% (P  less then  0.0001) in dichlorvos, parathion and CPF (100&nbsp;µM) treated cells respectively compared to non-CoQ10 supplemented cells. In conclusion, the results of this study have indicated evidence of neuronal cell CoQ10 deficiency with associated mitochondrial dysfunction following OP exposure. Although CoQ10 supplementation was able to ameliorate OP induced deficiencies in CS activity, ETC complex II+III activity appeared partially refractory to this treatment. Accordingly, these results indicate the therapeutic potential of CoQ10 supplementation in the treatment of OP poisoning. However, higher doses may be required to engender therapeutic efficacy.This review based on the actual results of epidemic prevention management in radiology departments in epidemic areas, and using designated hospital management methods, to summarize the radiology protection system. With the cooperation of the whole hospital and radiology department, a number of effective evaluation methods have been carried out to ensure the optimization of clinical protection. These practical methods provide a&nbsp;basis for the further promotion of management strategies and reduction of nosocomial infection. To our knowledge, the establishment of standardized protection and clear process has opened up a new idea of epidemic prevention management, which can effectively provide timely, efficient, and accurate support for clinical research, and promote the transformation from clinical research type to scientific research management type.Maternal mortality and morbidity continue to rise in the United States. Despite these trends there are limited novel interventions to investigate and improve these metrics, partly due to research protocol limitations which restrict participation of pregnant women. Inclusion of pregnant women in research studies is integral to the process of obtaining important information regarding the safety and efficacy of therapeutics or interventions to improve maternal health and pregnancy outcomes. While significant changes in research practices have resulted in an increase of female participants, there remains a paucity of research trials directly targeting pregnant and lactating women. This article provides an overview of issues surrounding inclusion of pregnant or breastfeeding women in research studies, and includes historical perspectives, navigating concerns over safety profile, considerations for appropriate development, and future perspectives.PURPOSE The aim of this study was to determine the accuracy of orthopantomograms (OPGs) when assessing post-operative temporomandibular joint (TMJ) implant position, compared with cone beam computerized tomography (CBCT). METHODS A retrospective analysis was undertaken on six adult patients who were implanted with a custom TMJ prosthesis due to end-stage TMJ disease. Post-operative CBCT was compared with post-operative OPGs. Overall magnification of each OPG was calculated and used to linearly rescale each image. Implant position was assessed by measuring the gonion angle and the distance between each surgical screw and the mandibular gonion (SG length). RESULTS Mean magnification for OPGs was 24.2%. There were no significant differences (p &gt; 0.05) in the gonion angle on OPGs compared with CBCT images. There was a mean decrease in SG lengths of 0.02&nbsp;mm on OPGs, corresponding to error level of 5.31%. The 95% limits of agreement between OPGs and CBCT images for SG lengths were 1.65&nbsp;mm and - 1.73&nbsp;mm. [https://www.selleckchem.com/products/gsk3685032.html Selleck GSK3685032] CONCLUSION This study presents a clinically applicable and accurate first-line radiographic screening tool to assess TMJ implant position.