Benefits of anti-coagulation for venous thromboembolism (VTE) prevention in total hip and knee arthroplasty (THA/TKA) may be offset by increased risk of bleeding. The aim was to assess in-hospital risk of VTE and bleeding after THA/TKA and quantify any increased costs.Healthcare claims from the Premier Perspective(TM) Comparative Hospital Database (January 2000-September 2008) were selected for subjects ≥ 18 years with ≥ 1 diagnosis code for THA/TKA. VTE was defined as ≥ 1 code for deep vein thrombosis or pulmonary embolism. Bleeding was classified as major/non-major. Incremental in-hospital costs associated with VTE and bleeding were calculated as cost differences between inpatients with VTE or bleeding matched 1:1 with inpatients without VTE or bleeding.A total of 820,197 inpatient stays were identified: 8042 had a VTE event and 7401 a bleeding event (2740 major bleeding). The risks of VTE, any bleeding, and major bleeding were 0.98, 0.90, and 0.33/100 inpatient stays, respectively. Mean incremental in-hospital costs per inpatient were $2663 for VTE, $2028 for bleeding, and $3198 for major bleeding.These included possible inaccuracies or omissions in procedures, diagnoses, or costs of claims data; no information on the amount of blood transfused or decreases in the hemoglobin level to evaluate bleeding event severity; and potential biases due to the observational design of the study.In-hospital risk and incremental all-cause costs with THA/TKA were higher for VTE than for bleeding. Despite higher costs, major bleeding occurred less frequently than VTE, suggesting a favorable benefit/risk profile for VTE prophylaxis in THA/TKA.
This study examined plaque psoriasis (PsO) patient characteristics across injectable biologics.Data were collected from 400 US dermatologists randomly selecting five charts each for patients with PsO (patient n = 2000): adalimumab (ADA; n = 447), etanercept (ETA; 539), ustekinumab (UST) 45 mg (511) and UST 90 mg (503). Physicians had to have been in practice 2-30 years, managing 10+ patients (5 + with biologics for PsO). Generalized estimating equation models, weighted according to inverse probability of patient selection and accounting for patient correlation within physicians, examined patient measures as a function of treatment (UST 90 mg = reference).Patients on UST 90 mg had higher odds of weighing >100 kg (adjusted mean = 34.4%) vs. ADA (10.9%), ETA (5.5%) or UST 45 mg (6.8%), greater body surface affected and higher odds of severe PsO prior to treatment and higher odds of prior biologics use. Mean prior biologics used was higher with UST 90 mg versus ADA or ETA. Number of comorbidities was higher with UST 90 mg versus ETA or UST 45 mg.Among biologics-treated patients with PsO, UST 90 mg appears to be used in patients with greater weight, baseline severity and prior biologics experience than ADA, ETA or UST 45 mg. UST 90 mg is used in patients with more comorbidities than other treatments except ADA.
Journal Article Codling Moth: Mass Production in Controlled-Environment Rearing Units Get access William C. Batiste, William C. Batiste Division of Entomology, University of California, Berkeley 94720 Search for other works by this author on: Oxford Academic PubMed Google Scholar William H. Olson William H. Olson Division of Entomology, University of California, Berkeley 94720 Search for other works by this author on: Oxford Academic PubMed Google Scholar Journal of Economic Entomology, Volume 66, Issue 2, 16 April 1973, Pages 383–388, https://doi.org/10.1093/jee/66.2.383 Published: 16 April 1973 Article history Received: 14 August 1972 Published: 16 April 1973
Even a slight deficiency can be costly. A single application of potash fertilizer can correct the deficiency for three to four years.Prune quality and value were highest in nondeficient trees, suggesting that potassium fertilization is profitable.
ABSTRACTObjective: Length of stay (LOS) and hospitalization costs were compared among patients admitted for community-acquired pneumonia (CAP) and initially treated with either levofloxacin 750 mg intravenous (IV) or with moxifloxacin 400 mg IV. Hospital-related complications and relationship of LOS and comorbidities were descriptively examined.Methods: A retrospective database study was conducted of adult patients admitted for CAP and given levofloxacin 750 mg IV or moxifloxacin 400 mg IV through the first 3 days of hospitalization, using the Premier Perspective comparative database. Cohorts were matched 1:1 by hospital geographic location, by coarse caliper propensity scores using all baseline covariates, and by Mahalanobis metric matching based on age and severity (All Patient Refined-Diagnosis-related Groups Severity of Illness (APR-DRG SOI) index). Comparisons between groups were further adjusted for characteristics that remained imbalanced after matching using generalized estimating equation methodology.Results: The initial sample of 3868 patients (levofloxacin = 827; moxifloxacin = 3041) was reduced to 1594 (797 patients per treatment group) after matching. Analyses of matched cohorts showed that the mean hospital LOS was significantly shorter for patients treated with levofloxacin 750 mg IV than for those patients treated with moxifloxacin 400 mg IV (5.8 vs. 6.4 days, respectively; least squares mean difference = 0.54 days; p = 0.020). Hospitalization costs were also lower for the levofloxacin 750 mg IV-treated patients (least squares mean difference = US$129; p = 0.753). There were no significant differences in the percentage of patients experiencing complications.Limitations: Although claims databases provide large sample sizes and reflect routine care, they do have several inherent limitations. Since randomization of subjects is not possible, adequate statistical techniques must be used to ensure treatment groups are balanced with respect to patient and clinical characteristics. In addition, data may be missing or miscoded.Conclusions: This retrospective study suggests that among patients hospitalized with CAP, initial treatment with levofloxacin 750 mg IV is associated with a significantly shorter mean hospital LOS compared with treatment with moxifloxacin 400 mg IV. The clinical implications of a shorter hospital LOS include improved patient and economic outcomes. Key words: : Community-acquired pneumoniaHospitalizationLength of stayLevofloxacinMoxifloxacin
A patient with retroperitoneal fibrosis was evaluated by Ga-67 citrate imaging. The radionuclide study accurately demonstrated the location and extent of the disease.
Botryosphaeria panicle and shoot blight of pistachio caused by the fungus Botryosphaeria dothidea is favored by high temperatures, 80° to 85° F, and wetness periods longer than 12 hours. Based on these requirements, the disease becomes severe in late spring and summer when temperatures increase and after sprinkler irrigations begin. The disease was substantially reduced by shortening sprinkler irrigations from 24 to 12 hours and from 48 to 24 hours in two commercial pistachio orchards in the Sacramento and San Joaquin valleys, respectively.