Shopping Detail Information and Home Freezer Sampling Confirmed the Role of Commercial, Modified-Atmosphere Packaged Meatballs as a Vehicle for Listeriosis in Finland.

In November 2016, an elderly patient was diagnosed with Listeria monocytogenes bacteremia in Finland. Grocery store loyalty card records and microbiological investigation of foods found in the home fridge and freezer of the patient revealed commercial, modified-atmosphere packaged meatballs as the source of the infection. Investigation of the meatball production plant revealed that the floor drain samples were contaminated with the same L. monocytogenes strain as those isolated from the patient and meatballs. Ready-to-eat meatballs were likely contaminated after heat treatment from the production environment before packaging. Long-term cold storage, modified-atmosphere conditions, and the absence of competing bacteria presumably enhanced the growth of L. monocytogenes. We recommend that collection of shopping details and home fridge and freezer sampling should be part of surveillance of all cases of L. monocytogenes infections to complement information obtained from in-depth interviews.

Costs and health-related quality of life effects of hysterectomy in patients with benign uterine disorders.

OBJECTIVE: To gain knowledge about the utility of hysterectomy in a real-world setting and to relate the utility of the intervention to its costs. DESIGN: Prospective observational study. SETTING: University referral hospital in Helsinki. POPULATION: A total of 337 women entering for routine hysterectomy due to a benign disease (210 benign uterine or ovarian cause, 20 endometriosis, 51 uterovaginal prolapse, 56 menorrhagia). METHODS: Patients filled in the 15D health-related quality of life (HRQoL) questionnaire before and six months after the operation. Costs were examined from the perspective of secondary care provider. Benefits of surgery were extrapolated till the end of remaining statistical life expectancy of each woman in the prolapse group and until menopause in the other groups. MAIN OUTCOME MEASURES: HRQoL and cost per quality-adjusted life year (QALY) gained. RESULTS: Mean [standard deviation (SD)] HRQoL score (on a 0-1 scale) in the whole group improved from the preoperative of 0.905 (0.073) to 0.925 (0.077) six months after the operation (p < 0.001). The largest mean (SD) improvement was seen in patients with endometriosis [0.048 (0.067)] followed by those with menorrhagia [0.024 (0.054)], benign uterine or ovarian cause [0.018 (0.071)], and prolapse [0.017 (0.055)]. In the whole group, the intervention produced a mean (SD) of 0.222 (1.270) QALYs at mean (SD) direct hospital cost of euro3,138 (2,098). Consequently, the cost per QALY gained in the whole group was euro14,135 varying from euro3,720 to 31,570 in the disease groups. CONCLUSIONS: The cost per QALY gained for hysterectomy for benign uterine disorders is strongly dependent on the indication for surgery.

Cost analysis and health-related quality of life of home and self-care satellite haemodialysis.

BACKGROUND: Home haemodialysis (HHD) and self-care satellite dialyses (SHD) have been suggested to offer significant benefits over conventional in-centre haemodialysis. However, little is known about differences between these two modalities. The purpose of the study was to analyse costs and health-related quality of life (HRQoL) of HHD and SHD. METHODS: On 15 October 2004, a total of 65 patients attended self-care haemodialysis in the area. Of those patients, 33 were on HHD and 32 on SHD. Cost data were collected from those study patients who were on dialysis the whole calendar year 2004 (23/33 HHD and 28/32 SHD patients). HRQoL was measured by the generic 15D instrument. The questionnaire was administered to all the study patients. A total of 23/33 of HHD and 24/32 of SHD patients returned the questionnaire. RESULTS: Direct medical costs of dialysis and hospital treatment were higher in HHD (31 834 +/- 6046 EUR/year, mean +/- SD) than in SHD (27 528 +/- 4325), P < 0.005. By contrast, travel costs were lower in HHD (426 +/- 743 EUR/year) than in SHD (5228 +/- 4236), P < 0.001. Costs of pharmaceuticals did not differ significantly. There was no significant difference in the total costs between HHD and SHD (38 477 +/- 7685 and 39 781 +/- 10 226 EUR/year), P = not significant. There were no significant differences in the total 15D score or in the 15 dimensions of the 15D instrument between home and satellite patients. CONCLUSIONS: HHD and SHD are, from the patient's perspective, equally effective in providing health. Although there were significant differences in the distribution of costs (which needs to be taken into account when evaluating different treatment strategies), total costs were similar. However, in the HHD setting, patients had on average more and longer sessions. Patient preference should be the main decisive factor when choosing between home or satellite haemodialysis.