Archive for the 'Health' Category

06 Aug

Navigating the stages of an academic career for paediatricians (part 8)

The success of any individual academic career depends on many factors, some individual, others interpersonal, yet others institutional and/or societal. Individual factors include resilience and sustainability, in other words, does the new recruit have the training, both in content and methodology, to provide the foundation on which their own innovations in research, education and/or clinical […]

02 Feb

An outbreak of cyclosporiasis in 1996 associated with consumption of fresh berries

PATIENTS AND METHODS The index Ontario cluster was investigated by the North York Public Health Department, Toronto, Ontario. Ini­tially, cases were ascertained and an environmental inspec­tion of the implicated venue was conducted. Thereafter, a retrospective cohort study examined food and water consump­tion by attendees. For this first cluster, a case was defined as having three […]

22 Jan

Test and treat strategies for Helicobacter: RESULTS part 2

The ICER of C-UBT versus serology ranged from $57/cure to over $32270/cure in sensitivity analysis and ex­ceeded $2000/cure only with variation in C-UBT cost and serology specificity (Table 5). In no case did C-UBT domi­nate serology. However, serology became dominant over 13C-UBT when the specificity of 13C-UBT fell below 81%. Two-way sensitivity analysis: Because the […]

21 Jan

Test and treat strategies for Helicobacter: RESULTS

RESULTS Base case scenario: The number of endoscopies per 1000 pa­tients was lowest with the C-UBT strategy, higher with serology and highest with empirical ranitidine therapy (Table 3). The number of H pylori eradica­tion regimens prescribed per 1000 patients was lowest with empirical ranitidine (200.1), highest with serology and intermediate with the 13C-UBT. In the […]

20 Jan

Test and treat strategies for Helicobacter: Cost inputs

Several sources were used to estimate locally relevant direct costs for the resources consumed in the model (Table 2). Wholesale drug costs were determined through a survey of local pharmacies including the Hamilton Health Sciences Corporation (McMaster Site) Outpatient Phar­macy, Hamilton, Ontario. A 10% pharmacy markup was added to the wholesale price, as well as […]

19 Jan

Test and treat strategies for Helicobacter: PATIENTS AND METHODS part 2

In each arm, the first-line regimen for H pylori eradication was omeprazole 20 mg, clarithromycin 500 mg and metroni­dazole 500 mg bid for seven days (OCM). The second-line regimen, used for OCM failures, was omeprazole 20 mg bid, clarithromycin 500 mg bid and amoxicillin 1000 mg bid for seven days. When a third attempt at […]

18 Jan

Test and treat strategies for Helicobacter: PATIENTS AND METHODS

Decision tree: The decision-analytic model was constructed using DATA software (TreeAge Software Inc, Williams- town, Massachusetts). A hypothetical cohort of 1000 pa­tients under the age of 50 years who had presented to their primary care practitioner with a new complaint of dyspepsia and did not use nonsteroidal anti-inflammatory drugs was used. Three initial management strategies […]

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