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A Cost Analysis of Systematic Vitamin D Supplementation in the Elderly Versus Supplementation Based on Assessed Requirements

Abstract:

Hypovitaminosis D is common among older people and treatment with vitamin D is associated with reduced risk of falls and fractures. This paper provides a cost analysis of assessing the vitamin D status of and providing the pharmaceuticals for elderly citizens in Kalmar County, Sweden (population approximately 230,000). Four hypothetical interventions were analyzed: (a) systematic vitamin D/calcium supplementation to all elderly (≥75 years), (b) assessment of vitamin D status in elderly and supplementation to those with insufficient levels, (c) systematic vitamin D/calcium supplementation to all nursing-home residents, and (d) assessment of vitamin D status in nursing-home residents and supplementation to those with insufficient levels. The calculations were based on an estimated reduction in overall costs due to the assessed number of hip fractures after vitamin D/calcium supplementation. The annual net economic benefit of vitamin D/calcium supplementation was e...

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Influence of Long-Term Space Flight on Mechanical Properties of the Human Triceps Surae Muscle: Electro Mechanical Delay and Musculo-Tendinous Stiffness

Abstract:

The effects of long-term space flight on human triceps surae (TS) muscle function and electromechanical delay (EMD) have been investigated. Voluntary and electrically evoked contractions of the TS were obtained from 7 male cosmonauts 30 days before and 3 days after landing. For all cosmonauts the isometric maximal voluntary contraction was reduced by 41.7 % (p < 0.01), whereas the electrically evoked maximal tetanic contraction force (Po) was found to decrease by 25.6 % (p < 0.05). Force deficit increased by 50 % (p < 0.001). This suggests that most of the force loss is due to a reduction in motor drive (motor control). The decrease in Po was associated with a significant increase of the corresponding maximal rates of tension development (43.7 %). The twitch tension (Pt) was not significantly changed and the Pt/ Read Article

Development of a Chronic Obstructive Pulmonary Disease Severity Classification System Using A Japanese Health Insurance Claims Database

Abstract:

Background:

Healthcare services provided to patients should vary depending on disease severity. However, disease severity bias, a type of selection bias, is a commonly encountered problem in administrative database studies. Herein, we selected chronic obstructive pulmonary disease (COPD), which commonly affects elderly Japanese citizens, for the development and validation of a severity classification system based on a health insurance claims database.

Methods:

Patients who received COPD-related diagnostic codes in 2011 were selected from a commercially based health insurance claims database. COPD patients were randomly divided into two groups to develop and validate severity scores. A principal component analysis was used to estimate factor loadings used to weight calculations of COPD severity scores. Score validit...

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Tissue trauma induced by lens fragmentation patterns in femtosecond laser assisted cataract surgery

Abstract:

Background:

To evaluate cumulative dissipated energy (CDE), laser time, central corneal thickness and endothelial cell loss after two different fragmentation pattern by means of femtosecond laser-assisted cataract surgery (FLACS).

Methods:

Eighty eyes of 80 patients that underwent FLACS were randomized in two groups: mixed chop and dice lens fragmentation pattern (group 1 with 40 eyes) and mixed chop and cylindrical lens fragmentation pattern (group 2 with 40 eyes).

Results:

Cumulative dissipated energy was significantly lower in group 1 compared to group 2 (p<0.001). Postoperatively there was a decrement of endothelial cells count at the centre of the cornea in both groups compared with preoperative values with greater d...

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Investigation on Phytochemical and Antioxidant Activity of the Plant Murraya koenigii Linn (Curry leaf) in Rajshahi, Bangladesh

Abstract:

The use of herbal medicine is becoming popular day by day due to toxicity and side effects of allopathic medicines. Considering the medicinal importance of the plant Murraya koenigii Linn (Curry leaf), the antioxidant activity (AC), total phenolic content (TPC), total flavonoid content (TFC), of different fractions of methanolic extract (DIA-ion resin adsorbed fraction, chloroform, Ethyl acetate and petroleum ether) of M. koenigii were investigated. Among the fractions, DIA-ion resin-adsorbed fraction showed the highest total antioxidant activity with absorbance 2.320±06 and petroleum ether fraction showed the lowest total antioxidant activity with absorbance 1.944 at 100 mg/ml concentration. The TPC were found range between 13.285 to 17.52 mg GAE/g while the highest amount of TFC recorded among the extracts was 16.65 mg CatE/g. DPPH free radical scavenging activity of different extracts of leaves was also measured where DIA-ion resin-adsorbed fraction had the hi...

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A New Spectrofluorimetric Approach for The Quantitation of Imipramine Hcl in Commercial Dosage Forms

Abstract:

A spectrofluorimetric method has been developed for the determination of imipramine HCl in bulk and commercial dosage forms. The method was based on measuring the fluorescence emission intensity of imipramine-eosin Y ion pair complex (λem = 558 and λex = 319) in dichloroethane at buffer solution (sodium acetate and acetic acid) of pH 4.8. The stoichiometric ratio between imipramine and eosin Y was studied by Job's method of continuous variations and found to be 2:1. Formation constant (Kf) and Gibb’s free energy change (ΔG) were calculated and pointed towards the spontaneous nature of the reaction. A series of variables were studied to optimize the reaction conditions. The proposed method was validated as per ICH guidelines and successfully applied for the determination of active imipramine HCl in commercial dosage forms with high degree of accuracy and precision.

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Atypical Patterns of Constrictive Pericarditis after Heart Transplantation: A Case Report

Abstract:

Constrictive pericarditis (CP) represents a rare complication after heart transplantation (HTx), resulting from various postoperative events such as mediastinitis, pericardial effusion, or allograft rejection. We describe our recent experience with managing an HTx recipient who developed atypical patterns of CP predominantly involving the right ventricle. A 52-year-old male who had received heart transplantation 2.5 years before was admitted to our institution because of progressive symptoms of heart failure. The patient had experienced acute rejection twice post-HTx, both with International Society for Heart and Lung Transplantation grade 1R, undergoing an additional endomyocardial biopsy other than those performed during regular check-ups. On admission, echocardiography revealed paradoxical septal motion and a large cystic-like mass with a thick capsule in front of the right ventricle. Right heart catheterization revealed elevation of right atrial pressure, with...

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Title - Case of Unilateral Congenital Aural Atresia &amp; Microtia with Cholesteatoma

Abstract:

We report a case of cholesteatoma associated with unilateral congenital aural atresia (CAA) and microtia, resulting in extracranial complication. A 13-year-old girl presented with right ear purulent discharge from pre and post auricular area with mastoid tenderness. On clinical examination, she had right grade II microtia with pre-auricular skin tag and healed scar tissue in periauricular region. On High Resolution Computerized Tomography (HRCT) scan of temporal bones, there was CAA of right ear with extensive cholesteatoma in middle ear cleft. The cholesteatoma was subsequently removed by radical mastoidectomy with uneventful post-operative period. Cholesteatoma associated with CAA may remain undiagnosed in early childhood resulting in life threatening temporal and intracranial complications.

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A Study on Contagious Bovine Pleuropneumonia in Khartoum State, Sudan

Abstract:

The study was carried out to investigate the occurrence of contagious bovine pleuropneumonia CBPP in Khartoum state. One-hundred twenty-two pneumonic lung tissue samples were collected from different slaughterhouses (116 samples most of which from local breed cattle) and from the field (six samples from cross breed cattle). Two-hundred and fifty-seven serum samples were collected randomly from cattle in different areas of the state. Tissue samples were cultivated using the standard mycoplasma procedures. Mmm was isolated from three pneumonic lungs collected from the field while no isolates were recovered from slaughterhouse samples. Histopathological sections from the positive samples revealed the typical picture of the CBPP which include fibrinonecrotic pneumonia within filtration of inflammatory cells and fibrin and distention of interlobular septae. One hundred and eight out of 257 serum samples were found positive for antibodies against Read Article

Recurrent branch retinal arterial occlusions associated with plasminogen activator inhibitor-1 mutation

Abstract:

A 57-year-old Hispanic female presented with 3 days of blurry vision in the left eye. Eight years prior, she had a branch retinal artery occlusion in the right eye and a hematologic work-up revealed a 4G/4G polymorphism in plasminogen activator inhibitor-1. With the current episode, she was found to have bilateral branch retinal artery occlusions and mild vitritis in the left eye, simulating a toxoplasma infection. An infectious and inflammatory work up, however, was negative and the vitritis resolved after a short course of steroids. Plasminogen activator inhibitor-1 mutations may be associated with an increased risk of retinal vascular occlusions.

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