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The Paradigm Shift From Patient to Health Consumer: 20 Years of Value Assessment in Health.
J Med Internet Res
January 2025
Virginia Commonwealth University, Richmond, VA, United States.
Health care is undergoing a "revolution," where patients are becoming consumers and armed with apps, consumer review scores, and, in some countries, high out-of-pocket costs. Although economic analyses and health technology assessment (HTA) have come a long way in their evaluation of the clinical, economic, ethical, legal, and societal perspectives that may be impacted by new technologies and procedures, these approaches do not reflect underlying patient preferences that may be important in the assessment of "value" in the current value-based health care transition. The major challenges that come with the transformation to a value-based health care system lead to questions such as "How are economic analyses, often the basis for policy and reimbursement decisions, going to switch from a societal to an individual perspective?" and "How do we then assess (economic) value, considering individual preference heterogeneity, as well as varying heuristics and decision rules?" These challenges, related to including the individual perspective in cost-effectiveness analysis (CEA), have been widely debated.
View Article and Find Full Text PDFEndoluminal Wound Vacuum Therapy: A Paradigm Shift in Managing Esophageal Bronchial Fistula.
Ann Thorac Surg Short Rep
December 2024
Division of Thoracic Surgery, Department of Surgery, Houston Methodist Hospital, Houston, Texas.
Esophageal bronchial fistula after Ivor Lewis esophagectomy is a challenging complication. Surgical treatment is definitive, but it carries high morbidity and mortality, whereas esophageal stents have been shown to be temporary measures. We highlight the case of a patient who was treated with endoluminal wound vacuum therapy.
View Article and Find Full Text PDFPsychedelic-assisted therapy - supposedly paradigm-shifting research with poor attempts at hypotheses falsifying and questionable ethics.
EXCLI J
December 2024
Department of Biochemistry, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore.
Implementation of a program to strengthen oral hygiene in patient with cleft deformities: a prospective randomized controlled clinical trial.
Trials
January 2025
INSERM, Regenerative Medicine and Skeleton, RMeS, CHU Nantes, Nantes Université, UMR 1229, Nantes, 44000, France.
Background: Cleft lip and/or palate is the most common congenital orofacial deformity, affecting 1/800 births. A thorough review of the literature has shown that children with cleft have poorer oral hygiene and dental health than other children, with higher levels of caries in both temporary and permanent teeth and poorer periodontal health. Cleft patients are treated by a multidisciplinary team that aims to provide comprehensive care from pre- or post-natal diagnosis to early adulthood and the end of growth.
View Article and Find Full Text PDFMitochondria and astrocyte reactivity: Key mechanism behind neuronal injury.
Neuroscience
January 2025
Biochemistry Department and Centro de Investigaciones Biomédicas (CEINBIO), Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
In this special issue to celebrate the 30th anniversary of the Uruguayan Society for Neuroscience (SNU), we find it pertinent to highlight that research on glial cells in Uruguay began almost alongside the history of SNU and contributed to the understanding of neuron-glia interactions within the international scientific community. Glial cells, particularly astrocytes, traditionally regarded as supportive components in the central nervous system (CNS), undergo notable morphological and functional alterations in response to neuronal damage, a phenomenon referred to as glial reactivity. Among the myriad functions of astrocytes, metabolic support holds significant relevance for neuronal function, given the high energy demand of the nervous system.
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