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At least 19 recordsLinked to original sources
PubMed1979

Treatment costs for patients with head and neck cancer.

A national health program is inevitable if medical care costs continue to soar as they have in recent years. Those of us treating patients with cancer of the head and neck are aware that the costs are high, but many are not aware of the actual figures involved. In this study, five typical head and neck cancer patients were selected, and the costs incurred by these patients were calcualted. Both direct and indirect medical expenses were considered and are presented. In addition, we report the representative costs of various treatment modalities. An awareness of medical care costs plus appropriate consideration of them in the planning and administration of treatment may help to reduce health care expenses. If we do not control these costs, the government undoubtedly will.

Costs and Cost Analysis↗
PubMed1978

Predicting treatment costs and life expectancy for end-stage renal disease.

To estimate the cumulative 10-year direct medical costs and life expectancy associated with different methods of treatment for end-stage renal disease, we assessed predictively three treatment transition options. It is predicted that if 1000 patients shift from facility to home dialysis for each of 10 years, life expectancy of the cohort will not be reduced, but there will be a reduction of $241 million in total costs. The same number shifting from facility dialysis to cadaveric transplantation are predicted to have a $279 to $330 million reduction in total costs but a reduction of 7 to 17 per cent in life expectancy. Shifting from home dialysis to transplantation is predicted to reduce total costs by +103 to $142 million, and life expectancy by 10 to 20 per cent. As new program policies for treatment of end-stage renal disease are developed, their effect on both costs and life expectancy needs to be considered.

Cadaver↗
PubMed2026

Clinical performance of the urine-based TERT promoter AbsoluteQ Digital PCR for non-invasive detection of bladder cancer.

Bladder cancer (BC) is the ninth most common cancer worldwide, with urothelial carcinoma accounting for approximately 90% of all cases and presenting predominantly as non-muscle-invasive disease. Due to its high recurrence rate and the need for long-term surveillance, BC is associated with the highest lifetime treatment costs per patient among all cancers, making its effective management a significant clinical and economic challenge. The most frequently identified variants in the TERT gene promoter are c.-124C>T (C228T) and c.-146C>T (C250T), located within a region characterized by high guanine-cytosine (GC) content, which makes amplification challenging. We aimed to validate the AbsoluteQ Digital PCR assay for the detection of urine-based TERT promoter variants for the diagnosis of urothelial bladder cancer and to assess its diagnostic performance in comparison with standard methods. Urine samples were collected from patients with histopathologically confirmed bladder cancer (n = 58) and compared with a control group (n = 55). The C228T and C250T variants were tested using the AbsoluteQ Digital PCR assay. Sensitivity, specificity, and predictive values were calculated to evaluate the performance of the assessed method. The AbsoluteQ Digital PCR demonstrated superior diagnostic performance compared to conventional Sanger sequencing for detecting TERT promoter variants, achieving a sensitivity of 89.65% (95% CI: 78.16-95.72) and a specificity of 100% (95% CI: 91.87-100), with no false positives observed. Given its robustness and clinical relevance, AbsoluteQ Digital PCR is emerging as a promising tool for non-invasive molecular diagnostics targeting TERT promoter variants.

Humans↗
PubMed1978

Economic losses resulting from bovine cysticercosis with special reference to Botswana and Kenya.

Economic losses from cysticercosis are determined by disease prevalence, grade of animals infested, potential markets, prices of cattle and treatment costs for detained carcasses. The main features of the livestock economics of Botswana and Kenya are discussed. Botswana is more dependent on meat exports than Kenya and its cattle prices are much higher. The incidence of cysticercosis at export abattoirs in Botswana and Kenya is about 8 and 20% respectively. Annual losses in Botswana now approach 0-5 million pounds, while in Kenya they are about 1 million pounds. The loss per animal slaughtered is 2-25 pounds in Botswana and 1-50 pounds in Kenya. Some implications for veterinary research in this area are examined. Blanket treatment with a drug or vaccine would only be economical where prevalence was very high. An in vivo diagnostic test would be of use mainly with high value cattle.

Animals↗
PubMed1976

Dynamic decision models for clinical diagnosis.

A unified approach to clinical decision-making is presented. This combines partially observable Markovian decision processes (Markov or semi-Markov) with cause-effect models as a probabilistic representation of the diagnostic process. Pattern recognition techniques are used in a first stage of system state identification. This new class of dynamic models has a direct application to medical diagnosis and treatment and specific physiological examples are emphasised. The methodology is given for combining the patient state of health, the clinician's state of knowledge of the cause-effect representation from the observation space (measurements), feature selection using pattern recognition techniques and, finally, the treatment decisions with which to restore the patient to a more desirable state of health. A cost functional for the decision process has then to be optimised according to some pre-assigned objective function (social return from the patient state of health or treatment cost for the patient), when the process has an infinite time horizon.

Computers↗
PubMed2026

K-wire versus screw fixation in Scarf-Akin osteotomy for hallux valgus: A retrospective cohort study.

BACKGROUND: Retention of metal implants after Scarf-Akin osteotomy (SAO) may cause irritation and psychological discomfort, often necessitating a hardware removal procedure. This study aimed to introduce K-wire fixation, allowing for outpatient removal, and to compare it with screw fixation. METHODS: This retrospective study included 64 patients with hallux valgus, comprising 32 in the K-wire fixation group and 32 in the screw fixation group. Clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS), and patient satisfaction. Radiographic parameters included hallux valgus angle(HVA), intermetatarsal angle(IMA), and distal metatarsal articular angle(DMAA). RESULTS: Both groups showed significant clinical and radiographic improvement (P&#x202f;<&#x202f;0.01). No significant between-group differences were observed in the other clinical or radiographic outcomes (P&#x202f;>&#x202f;0.05). Treatment costs were significantly lower in the K-wire group (P&#x202f;<&#x202f;0.001). CONCLUSIONS: K-wire fixation provides clinical and radiographic outcomes comparable to screw fixation, while avoiding the need for an additional procedure to remove the implant. LEVEL OF EVIDENCE: Level III.

Humans↗
PubMed1979

Benefit--cost methodology in the evaluation of therapeutic services for alcoholism.

Benefit--cost analysis as a form of "social profitability analysis" can be a powerful tool in the overall evaluation of alcoholism treatment efforts. Alcoholism treatment potentially leads to a multiplicity of benefits in addition to sobriety. Benefit--cost analysis provides a methodology for converting many of these diverse benefits into a common metric (dollars), thereby allowing the comparison of aggregate benefits and treatment costs. The analysis thus leads to the expression of treatment outcome in terms of the return on investment. A benefit--cost analysis conducted on 3034 clients from the Oklahoma data base indicated a return to society of $1.98 for every $1 invested in alcoholism treatment. Such data may represent a critical portion of the information required for responsible resource allocation decisions.

Alcoholism↗
PubMed1979

Techniques of economic analysis in psychiatric practice.

Since there is a limit to the amount of money that society can and will spend on health care, economic analysis is becoming increasingly important. This article attempts to review the use that has been made of economic analysis in psychiatric practice. It has been shown that treatment costs are a small part of the total cost of mental ill health, although 'expensive treatments' may reduce the cost of illness to society. In the USA the treatment of schizophrenia has been studied from the economic viewpoint. The economics of the alternatives of hospital and community care have been investigated. Cost-benefit analysis has been modified for application to the monitoring and assessment of psychiatric treatment. Economic analysis can and should be used, in conjunction with clinical analysis, to determine policies for better mental health care.

Community Mental Health Services↗
PubMed1978

Prolongation and enhancement of serum methotrexate concentrations by probenecid.

The disappearance of methotrexate (MTX) from the serum after an intravenous bolus injection and intravenous infusion was studied over 24 hours in eight and four patients respectively. Probenecid given at the same time as the bolus injection delayed the disappearance of MTX from the serum and resulted in enhanced concentrations throughout the 24 hours studied. At 24 hours the mean concentration was four times higher than in patients not given probenecid. Overall serum concentrations were even greater than those in patients who had received MTX by intravenous infusion. We suggest that smaller doses of MTX may be given and treatment costs thereby reduced if probenecid is given in addition.

Adult↗
PubMed1975

The cost of schizophrenia.

The cost of schizophrenia has been estimated at $11.6 to $19.5 billion annually. About two-thirds of this cost is due to lack of productivity by schizophrenic patients and about one-fifth to treatment costs. The estimate might be considerably higher if better figures were available on the cost of maintaining patients in the community. In the absence of more effective treatment, the savings from the current trend toward shorter hospitalization cannot be expected to decrease-and may actually increase-the overall costs of schizophrenia to society. The authors make recommendations aimed at reducing the cost by helping schizophrenic patients to be more productive through a system of community alternative-care facilities, increased rehabilitation services, aftercare, and research.

Aftercare↗
PubMed2026

Therapeutic Potential of Terpenes in Lung Cancer: Modulation of 4-Oxo- Retinoic Acid, TNF-&#x3b1;, NF-&#x3ba;B, and HDAC2 Pathways.

Non-small cell lung cancer (NSCLC) includes various epithelial malignancies, such as squamous cell carcinoma, large cell carcinoma, and adenocarcinoma. Despite advancements in surgical resection, chemoradiotherapy, and multimodal therapies, NSCLC prognosis remains challenging due to its complex molecular landscape, drug resistance, and high treatment costs. Recent research highlights the potential of natural compounds, particularly terpenes and terpenoids, derived from essential oils (EOs), to enhance NSCLC treatment. These compounds exhibit anticancer properties and modulate key pathways like the 4-oxo-retinoic acid pathway, TNF-&#x3b1; signaling, NF-&#x3ba;B activation, and histone deacetylases (HDACs). Retinoids, a subclass of terpenes, show both chemopreventive and therapeutic benefits, especially when combined with other agents, though challenges in dosing and delivery methods limit their clinical application. Terpenes may also synergize with emerging therapies, such as antiangiogenic treatments and immunotherapy, to improve outcomes. Biomarkers, including genomic, epigenomic, and proteomic markers, play a critical role in predicting responses to terpene-based treatments, supporting personalized medicine. The integration of terpenes into existing regimens, in combination with conventional therapies, holds promise in overcoming clinical challenges, improving patient outcomes, and advancing natural compound use in modern oncology. Future research should focus on optimizing terpene therapies and addressing clinical hurdles.

Humans↗
PubMed1979

Congenital hypothyroidism control programs. A cost-benefit analysis.

Comprehensive screening programs to control congenital hypothyroidism (CH), a preventable form of mental retardation, are being considered by some public health agencies. The proposed programs would test neonates' blood for thyroxine and, if warranted, provide follow-up testing and therapy. The estimated cost of detecting a single case of CH is $9,300, which includes specimen collection, laboratory analysis, and retesting of border-line cases. The present value of the treatment costs of CH adds $2,500 per case, a total cost of $11,800 per case detected and child treated. The economic benefits (averted costs of institutionalization and special education and increased productivity of the affected person) are estimated to have a present value of $105,000 per case, yielding a cost-benefit ratio of 1:8.9.

Adolescent↗
PubMed1977

[Intermittent positive pressure breathing (IPPB) with respirators in home nursing].

29 patients using a home respirator have been studied. Management of the respirator and inhalation were correct in 86%. Bacteriologic contamination in home treatment poses few problems. Blood gases and spirometric lung function tests do not demonstrate amelioration but show stabilization in long term treatment. Costs are high. Nevertheless, this treatment is indicated in certain carefully selected patients. Follow-up checks are essential.

Adrenergic beta-Agonists↗