Time to failure of arterial shunts in a pig hemorrhagic shock model.

Temporary vascular shunts (TVSs) are relied on frequently in the current military theater. Details of their physiology and outcome are of increasing interest and needed to further define their place in the management of trauma. This study was conducted using a porcine hemorrhagic shock model and aimed to 1) establish the time to failure of short, proximally placed vascular shunts; and 2) examine histological changes in the shunted artery.

Straight talk--new approaches in healthcare. Want better relationships with payors? Focus on medical management.

When it comes to managing medical care for their enrollees, payors are moving towards a broader focus for medical management that includes both costs and quality. In the twelfth installment of Straight Talk, we look at how health plans, such as CIGNA, are developing incentives to reward high-quality, low-cost providers of medical care and transitioning their utilization management operations to a new model. To ensure quality, they are beginning to compare providers' performance to national standards for medical outcomes.

Potential cost savings of erythropoietin administration in end-stage renal disease.

Background: In a Department of Veterans Affairs randomized controlled trial, a lower dose of recombinant human erythropoietin (epoetin) was shown to attain target hematocrit levels when administered subcutaneously compared with intravenously. Since epoetin is expensive, optimizing the therapeutic effect of epoetin using a strategy that includes subcutaneous administration could lead to substantial cost savings.

Methods: We used an economic cost projection model to estimate potential savings to the Medicare End-Stage Renal Disease Program that could occur during a transition from intravenous to subcutaneous administration of epoetin among hemodialysis patients.