Frysiegel9795

The purpose of this study was to estimate the cost of syphilis in the United States, in terms of the average lifetime direct medical cost per infection.

We used a decision tree model of the natural history of syphilis. The model allowed for numerous possible outcomes of infection, including treatment for syphilis at various stages, inadvertent treatment, and late syphilis outcomes in those who are alive and still infected 30 years after acquisition. Future costs were discounted at 3% annually. Model inputs, such as the cost and probability of each outcome, were based on published sources. The probabilities we applied yielded outcomes consistent with reported cases of syphilis by stage from national surveillance data and number of deaths due to late syphilis from national mortality data.

The estimated, discounted lifetime cost per infection was $1190 under base case assumptions (2019 dollars). Treatment costs associated with late syphilis outcomes, such as cardiovascular syphilis, accounted for only $26 of the average lifetime cost per infection. Results were most sensitive to assumptions regarding the treatment cost per case of unknown duration or late syphilis. In the probabilistic sensitivity analyses, the 2.5th and 97.5th percentiles of the 10,000 simulations of the lifetime cost per infection were $729 and $1884, respectively.

Our estimate of the lifetime cost per infection is about 50% higher than in a previous study, a difference due in large part to our higher cost assumptions for benzathine penicillin G.

Our estimate of the lifetime cost per infection is about 50% higher than in a previous study, a difference due in large part to our higher cost assumptions for benzathine penicillin G.

Cross-sectional study conducted between December 2017 and October 2019.

To determine the prevalence and risk factors associated with pregnancy-related pelvic girdle pain (PPGP) in Australia.

Pregnancy-related pelvic girdle pain (PPGP) is a common condition worldwide yet the prevalence and associated risk factors are not known in Australia.

A random sample of pregnant women (N = 780) of (mean (SD)) 31 (5) years of age between 14 and 38 weeks gestation attending ante-natal care in a tertiary referral hospital in Sydney, Australia was conducted. The main outcome measure was point-prevalence of PPGP as classified by recommended guidelines including a physical examination. A number of potential risk factors, including socio-demographic characteristics, country of birth, ethnicity, history of low back pain (LBP) and PPGP, family history of PPGP, occupational factors and physical activity were investigated with logistic regression.

The point-prevalence of PPGP in a random sample of 780 Australian women wasante-natal care to screen women and identify those at risk of this common and disabling condition.Level of Evidence 1.

Retrospective review at a single institution of all adult patients who underwent elective lumbar fusion surgery for degenerative spinal disease from 2013-2018. Reoperation rates and change in clinical management due to routine imaging findings were the primary outcomes.

To investigate what effects immediate routine postoperative imaging has on the clinical management of patients following lumbar fusion surgery.

The clinical utility of routine postoperative imaging following lumbar fusion surgery remains uncertain. Existing studies on the clinical utility of postoperative imaging in lumbar fusion patients have largely focused on imaging obtained post-discharge. We present a retrospective analysis that to our knowledge is the first study reporting on the clinical utility of routine imaging in lumbar fusion patients during the immediate postoperative period.

The medical records of patients who had undergone elective lumbar instrumented fusion for degenerative disease from 2013-2018 by neurosurgeons acrosutine imaging prior to discharge following elective lumbar fusion surgery appears to provide little utility to clinical management.Level of Evidence 3.

New neurologic deficit was the only significant predictor of reoperation. Routine imaging, whether normal or abnormal, was not found to be associated with reoperation. Futibatinib in vivo The practice of routine imaging prior to discharge following elective lumbar fusion surgery appears to provide little utility to clinical management.Level of Evidence 3.

Prospective cross-sectional blinded-assessor cohort study.

To determine the inter-rater reliability of the modified Japanese Orthopaedic Association (mJOA) in a large cohort of degenerative cervical myelopathy (DCM) patients.

The mJOA score is widely accepted as the primary outcome measure in DCM; it has been utilized in clinical practice guidelines and directly influences treatment recommendations, but its reliability has not been established.

A refined version of the mJOA was administered to DCM patients by 2 or more blinded clinicians. Inter-rater reliability was measured using intra-class correlation (ICC), agreement, and mean difference for mJOA total score and subscores. Data were also analyzed with ANOVA for differences by mJOA severity (mild 15-17, moderate 12-14, severe < 12), assessor, assessment order, previous surgery, age, and sex.

154 DCM patients underwent 322 mJOA assessments (183 paired assessments). ICC was 0.88 for total mJOA, 0.79 for upper extremity (UE) motor, 0.84 for lower-rater reliability of total mJOA and its subscores is good, except for UE sensory function (moderate). However, the vast majority of assessments differed between observers, indicating that this measure should be interpreted carefully, particularly when near the threshold between severity categories, or when a patient is reassessed for deterioration. Further efforts to educate clinicians on administration and refine UE sensory subscore may enhance the reliability of this tool.Level of Evidence 1.

Retrospective cohort study.

To investigate whether a preoperative difference in lumbar lordosis (D-LL) between the standing and supine positions is associated with clinical outcomes after transforaminal lumbar interbody fusion (TLIF).

Several factors have been reported to be associated with surgical outcomes after TLIF. However, the association between preoperative D-LL and clinical outcomes after TLIF is unknown.

We enrolled 45 lumbar degenerative disease patients (mean age 65.7 ± 11.3 years old; 24 male) treated with single-level TLIF. Surgical outcomes were assessed using Oswestry disability index, visual analog scale (VAS; low back pain (LBP), lower-extremity pain, numbness, LBP in motion, in standing, and in sitting), Japanese Orthopaedic Association Back Pain Evaluation Questionnaire, Japanese Orthopaedic Association score for intermittent claudication (JOA score), and Nakai's scoring system. The preoperative D-LL between the standing radiograph and computed tomography (CT) in the supine position was defined as LL in supine CT-standing radiograph.