Modelling the resource implications and budget impact of new reimbursement guidelines for the management of cow milk allergy in Finland.

Objective: To assess the impact of the decision by Kela (The Social Insurance Institution) to adopt guidelines for the management of food allergies in children, developed by the Finnish Medical Society Duodecim, as the basis for reimbursing clinical nutrition preparations for the treatment of cow milk allergy (CMA) in Finland.

Methods: A decision model was constructed using published clinical outcomes and clinician-derived resource utilisation estimates. The model was used to estimate the net resource implications and associated costs of Kela's new policy for the annual cohort of 1443 new CMA sufferers over the first 6 months following referral to a specialist.

The carbon footprint of laparoscopic surgery: should we offset?

The aim of this study was to estimate the effect that the expansion of laparoscopic surgery has had on global warming. Laparoscopic procedures performed in a hospital over a 10-year period were analysed. The number of CO(2) cylinders (size C) used over a 2.

The neuronal transfer function: contributions from voltage- and time-dependent mechanisms.

The discovery that an array of voltage- and time-dependent channels is present in both the dendrites and soma of neurons has led to a variety of models for single-neuron computation. Most of these models, however, are based on experimental techniques that use simplified inputs of either single synaptic events or brief current injections. In this study, we used a more complex time-varying input to mimic the continuous barrage of synaptic input that neurons are likely to receive in vivo.

Dendrite-to-soma input/output function of continuous time-varying signals in hippocampal CA1 pyramidal neurons.

We examined how hippocamal CA1 neurons process complex time-varying inputs that dendrites are likely to receive in vivo. We propose a functional model of the dendrite-to-soma input/output relationship that combines temporal integration and static-gain control mechanisms. Using simultaneous dual whole cell recordings, we injected 50 s of subthreshold and suprathreshold zero-mean white-noise current into the primary dendritic trunk along the proximal 2/3 of stratum radiatum and measured the membrane potential at the soma.

Acute central cord syndrome arising from a cervical epidural abscess: case report.

Objective: Acute central cord syndrome (ACCS) is a well-known sequela to spinal trauma but has rarely been associated with nontraumatic etiologies. Spinal epidural abscess (SEA) and spinal osteomyelitis/discitis are also well characterized clinical entities. Neither SEA nor osteomyelitis leading to ACCS has been previously reported.

Clinical and economic impact of using macrogol 3350 plus electrolytes in an outpatient setting compared to enemas and suppositories and manual evacuation to treat paediatric faecal impaction based on actual clinical practice in England and Wales.

Objective: To estimate the clinical and economic impact of using macrogol 3350 plus electrolytes (macrogol 3350; Movicol; Movicol Paediatric Plain) in an outpatient setting compared to enemas and suppositories and manual evacuation to treat paediatric faecal impaction.

Methods: A chart review was undertaken to extract clinical outcomes and resource use from the case notes of a cohort of children aged 2-11 years with faecal impaction who initially received either macrogol 3350 (in an outpatient setting) or enemas and suppositories or manual evacuation for initial disimpaction. Five centres across England and Wales participated in the study.

Hepatitis B virus and HIV coinfection: relationship of different serological patterns to survival and liver disease.

Objectives: Eighty per cent of HIV-positive patients show evidence of past or current infection with hepatitis B virus (HBV). The impact of chronic HBV infection or the presence of isolated HBV core antibody on survival in the era of highly active antiretroviral therapy (HAART) has not been well studied.

Methods: This retrospective analysis included patients from the HIV Atlanta Veterans Affairs Cohort Study (HAVACS).

Cost-utility of levonorgestrel intrauterine system compared with hysterectomy and second generation endometrial ablative techniques in managing patients with menorrhagia in the UK.

Objective: To estimate the cost-utility of levonorgestrel intrauterine system (LNG-IUS; Mirena) compared to second generation endometrial ablative techniques [i.e. microwave endometrial ablation (MEA) and thermal balloon endometrial ablation (TBEA)) and hysterectomy in the UK.

Pharmacoeconomic Impact of Low-Dose Macrogol 3350 plus Electrolytes Compared with Lactulose in the Management of Chronic Idiopathic Constipation among Ambulant Patients in Belgium.

Objective: To estimate the economic impact of using low-dose macrogol 3350 plus electrolytes (macrogol 3350; Movicol((R))) compared with lactulose in the treatment of chronic idiopathic constipation among ambulant patients in Belgium, from the perspectives of the Sick Fund and patients. The analysis considered separately the economic impact of (a) a specialist and (b) a general practitioner (GP) initiating treatment.

Design And Setting: This was a modelling study performed from the perspective of Belgium's Sick Fund and patients.

Cost Effectiveness of Controlled-Release Oxybutynin Compared with Immediate-Release Oxybutynin and Tolterodine in the Treatment of Overactive Bladder in the UK, France and Austria.

Objective: To estimate the cost effectiveness of controlled-release (CR) oxybutynin compared with immediate-release (IR) oxybutynin and tolterodine in the treatment of overactive bladder (OAB) in Austria, France and the UK.

Design And Setting: This was a modelling study on the management of patients with OAB who were >/=18 years of age, and had urge or mixed incontinence with a primary-urge component. The study was performed from the perspective of payers (i.

Modelling the cost-utility of bio-electric stimulation therapy compared to standard care in the treatment of elderly patients with chronic non-healing wounds in the UK.

Objective: To estimate the cost-utility of bio-electric stimulation therapy (Posifect) compared to standard care in elderly patients with chronic, non-healing wounds of > 6 months duration, from the perspective of the National Health Service (NHS) in the UK.

Methods: Clinical and resource use data from a 16 week clinical evaluation of bio-electric stimulation therapy among patients who had recalcitrant wounds were combined with utility data obtained from a standard gamble analysis to construct a 16 week Markov model. The model considers the decision by a clinician to continue with a patient's previous care plan or treat with bio-electric stimulation therapy.

Laser trapping of 225Ra and 226Ra with repumping by room-temperature blackbody radiation.

We have demonstrated Zeeman slowing and capture of neutral 225Ra and 226Ra atoms in a magneto-optical trap. The intercombination transition 1S0-->3P1 is the only quasicycling transition in radium and was used for laser-cooling and trapping. Repumping along the 3D1-->1P1 transition extended the lifetime of the trap from milliseconds to seconds.

Randomised controlled trial comparing the efficacy of same-day administration of mifepristone and misoprostol for termination of pregnancy with the standard 36 to 48 hour protocol.

Objective: To determine the efficacy of oral mifepristone followed by vaginal misoprostol 6 hours later compared with the standard 36- to 48-hour regimen for medical termination of pregnancy.

Design: Single centre, two arm, parallel, open randomised controlled trial.

Setting: Medical termination service at a teaching hospital.

Guidelines for the conduct of clinical trials for spinal cord injury as developed by the ICCP panel: spontaneous recovery after spinal cord injury and statistical power needed for therapeutic clinical trials.

The International Campaign for Cures of Spinal Cord Injury Paralysis (ICCP) supported an international panel tasked with reviewing the methodology for clinical trials in spinal cord injury (SCI), and making recommendations on the conduct of future trials. This is the first of four papers. Here, we examine the spontaneous rate of recovery after SCI and resulting consequences for achieving statistically significant results in clinical trials.

Guidelines for the conduct of clinical trials for spinal cord injury (SCI) as developed by the ICCP panel: clinical trial outcome measures.

An international panel reviewed the methodology for clinical trials of spinal cord injury (SCI), and provided recommendations for the valid conduct of future trials. This is the second of four papers. It examines clinical trial end points that have been used previously, reviews alternative outcome tools and identifies unmet needs for demonstrating the efficacy of an experimental intervention after SCI.

Guidelines for the conduct of clinical trials for spinal cord injury as developed by the ICCP Panel: clinical trial inclusion/exclusion criteria and ethics.

The International Campaign for Cures of Spinal Cord Injury Paralysis established a panel tasked with reviewing the methodology for clinical trials for spinal cord injury (SCI), and making recommendations on the conduct of future trials. This is the third of four papers. It examines inclusion and exclusion criteria that can influence the design and analysis of clinical trials in SCI, together with confounding variables and ethical considerations.

Guidelines for the conduct of clinical trials for spinal cord injury as developed by the ICCP panel: clinical trial design.

The International Campaign for Cures of Spinal Cord Injury Paralysis established a panel tasked with reviewing the methodology for clinical trials for spinal cord injury (SCI), and making recommendations on the conduct of future trials. This is the fourth of four papers. Here, we examine the phases of a clinical trial program, the elements, types, and protocols for valid clinical trial design.

Health economic impact of olopatadine compared to branded and generic sodium cromoglycate in the treatment of seasonal allergic conjunctivitis in the UK.

Objective: This study estimated the health economic impact of olopatadine (Opatanol) compared to branded cromoglycate (Opticrom) and generic sodium cromoglycate in the treatment of seasonal allergic conjunctivitis (SAC) in the UK.

Design And Setting: This was a modelling study performed from the perspective of the UK's National Health Service (NHS).

Methods: A decision model was constructed depicting the management of SAC sufferers who are 4 years of age or above over a typical allergy season of 4 months and considers the decision by a GP to initially treat a patient with olopatadine, branded or generic cromoglycate.

The annual cost of dry eye syndrome in France, Germany, Italy, Spain, Sweden and the United Kingdom among patients managed by ophthalmologists.

Objectives: To estimate the annual cost associated with the management of dry eye patients by ophthalmologists in France, Germany, Italy, Spain, Sweden, and the United Kingdom (UK) from the perspective of the healthcare systems in the respective countries.

Methods: Published epidemiological and healthcare resource use data attributable to dry eye syndrome was supplemented with information obtained from interviewing ophthalmologists in the six countries.

Results: The estimated prevalence of dry eye syndrome among patients reporting to ophthalmologists was less than 0.

Antiretroviral therapy in HIV-positive women is associated with increased apolipoproteins and total cholesterol.

Objectives: Dyslipidemia has become a common problem in HIV disease, especially in patients on combination antiretroviral (ARV) therapy. However, little data are available to evaluate lipid abnormalities in women on ARV therapy.

Methods: Using a cross-sectional design, the prevalence of abnormal plasma lipid and lipoprotein concentrations as well as other biomarkers for vascular disease was determined in 184 HIV-positive women from 2 HIV clinics in Atlanta during 2002.

Impact of the British Thoracic Society chronic obstructive pulmonary disease guidelines on patients' health status, healthcare resource use and health-related quality of life.

Background: British Thoracic Society (BTS) guidelines for chronic obstructive pulmonary disease (COPD) management are a consensus view and their impact on patients is unknown.

Aim: To determine the impact of the BTS COPD guidelines on patients' health status, healthcare resource use and health-related quality of life (HRQL).

Design And Setting: This was an observational, parallel group, cluster-controlled study comparing patients who were managed in general practices according to BTS guidelines (active practices) or usual care (control practices).

Switching asthma patients to a once-daily inhaled steroid improves compliance and reduces healthcare costs.

Objective: To determine the costs and consequences of switching asthma patients, managed in primary care, from a twice-daily inhaled corticosteroid (ICS), to either a once-daily or another twice-daily ICS.

Design: This was a case-control study based on an interrogation of the General Practice Research Database in the UK, for patients with a Read code of asthma who were managed between 1990 and 2001, and who had received at least two prescriptions for a twice-daily ICS within 12 months, before switching to a once-daily ICS (cases) or another twice-daily ICS (controls). Data on resource use was collected for one year before and after the switch.

Cellular transplants in China: observational study from the largest human experiment in chronic spinal cord injury.

Background: In China, fetal brain tissue has been transplanted into the lesions of more than 400 patients with spinal cord injury (SCI). Anecdotal reports have been the only basis for assuming that the procedure is safe and effective.

Objective: To compare available reports to the experiences and objective findings of patients who received pre-operative and postoperative assessments before and up to 1 year after receiving cellular implants.

Palliative care treatment patterns and associated costs of healthcare resource use for specific advanced cancer patients in the UK.

The purpose of this paper is to identify the treatment patterns and corresponding costs of healthcare resource use associated with palliative care for different types of advanced cancer patients, from the time they started strong opioid treatment until death. This was a modelling study performed from the perspective of the UK's National Health Service (NHS). A data set was created comprising 547 patients in the DIN-Link database who had a Read code for malignant neoplasms with a specific tumour-type diagnosis and who received their first strong opioid between 1 January 1998 and 30 September 2000 and died during that period.