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1.
Artículo en Inglés | MEDLINE | ID: mdl-38710664

RESUMEN

Purpose of this article is to study the possible direct antiviral effect of "Armenikum" on SARS-CoV-2, conduct an in vitro study on the SARS-CoV-2 encephalomocarditis virus, and an in vivo study on the Syrian hamster model. Human coronavirus SARS-CoV-2 (delta strain) was used as the virus. Two groups of four-specimen hamsters were used to study the therapeutic activity of the drug during 48 h after infecting. One group of hamsters served as positive control and was infected with the virus at a similar dose as experimental one and was used as a control of pathology induced by the viral infection till the end of the experiment. Another group of hamsters (four of them) was injected physiological solution and was used as a control. The Syrian hamsters underwent a clinical blood test and computed tomography. "Armenikum" in the form of an injection has a significant antiviral effect on the human coronavirus SARS-CoV-2, credibly reducing the titers of the virus and the time of its elimination from the Syrian hamsters, significantly mitigating the viral infection. "Armenikum" in the form of an injection drug almost completely removes the pathological effect of the virus in the lungs of the hamsters.

2.
Clin Gastroenterol Hepatol ; 8(6): 498-503, 2010 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-20304102

RESUMEN

BACKGROUND & AIMS: Functional dyspepsia (FD) is a common morbid condition but data are limited on the direct and indirect costs for employees with FD or on its impact on productivity. Few data on absenteeism and no objective information are available. This study aimed to assess the impact of FD on costs and effects on absenteeism and work output (productivity). METHODS: We performed a retrospective analysis of payroll data and adjudicated health insurance medical and prescription claims collected over a 4-year study period (January 1, 2001 to December 31, 2004) from more than 300,000 employees. Data from employees with and without (controls) FD were compared using 2-part regression techniques. Outcome measures included medical (total and by place of service) and prescription costs, absenteeism, and objectively measured productivity output. RESULTS: Employees with FD (N = 1669) had greater average annual medical and prescription drug costs and indirect costs (owing to sick leave and short- and long-term disability absences) than controls (N = 274,206). Compared with controls, the FD employees incurred costs that were $5138 greater and had greater costs for each place of service (all P < .0001). The employees with FD had an additional 0.83 absence days per year and produced 12% fewer units per hour than controls (both P < .05). CONCLUSIONS: Employees with FD have greater costs at all places of service and lower productivity than employees without FD.


Asunto(s)
Absentismo , Costo de Enfermedad , Dispepsia/economía , Adulto , Eficiencia , Femenino , Humanos , Masculino , Estudios Retrospectivos , Ausencia por Enfermedad/economía
3.
Curr Med Res Opin ; 22(7): 1381-9, 2006 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-16834837

RESUMEN

OBJECTIVE: To examine the economic burden of illness of gout in an employed population, quantifying the impact on employers annual health benefit costs for medical and prescription claims, sick leave, short- and long-term disability, and workers' compensation. METHODS: Adjudicated claims data from 300000 employees from 2001 through 2004 were utilized. T-tests were used to compare demographic data and medical costs and services by Agency for Healthcare Research and Quality (AHRQ) diagnostic categories. Two-part models were used to determine average annual health benefit costs overall and medical costs by place of delivery. A risk stratification quintile analysis was also performed utilizing gout-specific medical and pharmaceutical costs. RESULTS: There were 1171 employees with gout identified (total n = 249 038). All demographic variables between the two groups were statistically different (p

Asunto(s)
Empleo , Gota/economía , Costos y Análisis de Costo , Prescripciones de Medicamentos/economía , Femenino , Gota/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Modelos Económicos , Ausencia por Enfermedad/economía , Estados Unidos , Indemnización para Trabajadores/economía
4.
Curr Med Res Opin ; 25(6): 1469-76, 2009 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-19422277

RESUMEN

OBJECTIVE: The purpose of this analysis was to assess the differences in lost time and health-benefit costs (HBCs) among employees treated with disease modifying treatments (DMTs) for multiple sclerosis (MS). STUDY DESIGN: Employees with an MS diagnostic code (ICD-9 340.xx) and a DMT prescription claim (1/1/2001-6/30/2007) were identified from the HCMS Research Reference Database and assigned to DMT cohorts. The first prescription for the DMT was used as each person's index date. One-year outcomes included HBCs and absenteeism (lost time, comprising sick leave [SL], short- and long-term disability [STD/LTD], and workers' compensation). METHODS: Demographics were compared using t-tests for continuous variables and chi-square tests for discrete variables. Two-part multivariate regression modeling (logistic regression combined with generalized linear regression) was used to determine annual HBCs and absenteeism for each cohort controlling for age, gender, job-related variables, and Charlson Comorbidity Score. All cost variables were inflated to US$2007. RESULTS: Annual ranges among the DMTs were: HBCs $17,953-26,970 and absenteeism 7.33-20.67 days. Compared with glatiramer acetate ('C'), IFN-beta1a IM ('A') users had lower SL ($445, p = 0.0469) and STD ($969, p = 0.0164) costs; and IFN-beta1b ('B') users had lower medical costs ($2143, p = 0.0091). In addition, those treated with 'A' had 4.2 fewer SL days (p = 0.0101) compared with those treated with 'C'. CONCLUSIONS: Patients treated with 'A' reported significantly lower SL costs, SL days, and STD costs than patients treated with 'C', suggestive of greater real world benefits with 'A'. Despite small sample sizes and the retrospective nature, the study provides interesting insights into the use of DMTs in MS. The study also revealed important areas of future research, specifically the need for development of methods to determine which MS patient groups respond best to which DMT treatments.


Asunto(s)
Absentismo , Planes de Asistencia Médica para Empleados/economía , Costos de la Atención en Salud , Beneficios del Seguro/economía , Esclerosis Múltiple/economía , Esclerosis Múltiple/terapia , Adulto , Empleo , Femenino , Humanos , Masculino , Medicamentos bajo Prescripción/economía , Estudios Retrospectivos , Ausencia por Enfermedad/economía , Estados Unidos
5.
Am J Manag Care ; 15(12): 871-80, 2009 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-20001168

RESUMEN

OBJECTIVES: To determine if antihypertensive medication adherence is associated with decreased medical and drug costs, medical service utilization, and work absence days. STUDY DESIGN: Retrospective database study using medical, pharmacy, sick leave, short-term and long-term disability, and workers' compensation claims data from multiple large US employers from 2001 to 2008. METHODS: We used medical and pharmacy claims to identify employees with hypertension. The index date was the date of the first hypertension-related pharmacy claim. Eligible employees had health plan enrollment 6 months before the index date and at least 12 months after the index date. Employees younger than 45 years were excluded from the study. Regression models estimated the effect of the proportion of days covered (PDC) by hypertension medication on outcomes after the index date, including health benefit costs, medical service utilization, and work absence days, as well as some clinical outcomes calculated separately for high-prior-cost and low-prior-cost employees. High-prior-cost employees were those who accounted for the top 60.0% of total medical costs during the 6 months before the index date. The regression models controlled for demographics, job-related variables, and comorbidities. RESULTS: Among low-prior-cost employees, high PDC was associated with increased medical and drug costs and work absence days. Among high-prior-cost employees, high PDC was associated with decreased medical and drug costs, fewer work absence days and inpatient hospital days, and increased hypertension-specific medical costs. CONCLUSION: Antihypertensive medication adherence was associated with improvement in some short-term utilization measures among high-prior-cost employees, but significant short-term improvement was not seen among low-prior-cost employees.


Asunto(s)
Antihipertensivos , Hipertensión/tratamiento farmacológico , Cooperación del Paciente , Adulto , Femenino , Planes de Asistencia Médica para Empleados , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Estados Unidos
6.
J Clin Psychiatry ; 70(8): 1098-104, 2009 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-19758521

RESUMEN

OBJECTIVE: To objectively assess the economic impact of insomnia on direct medical and prescription costs and indirect absence-related salary replacement costs and on absences and to compare the prevalence and costs of comorbidities in employees with and without insomnia. METHOD: A retrospective analysis was performed on employee data from the Human Capital Management Services Research Reference Database (January 2001-September 2007). Employees were identified as having insomnia (ICD-9 criteria) based on history of receiving medications used to treat insomnia or physician's diagnosis of insomnia. Control employees had no history of medications used to treat insomnia and no insomnia diagnosis. Annual costs and number of absences were compared using 2-part regression models, controlling for demographics, job information, geographic region, comorbid disorders, and the Charlson Comorbidity Index score. Comorbidity prevalence, costs, and services were compared. RESULTS: Data were collected for 299,188 employees (17,230 employees with insomnia and 281,958 control employees). Annual mean incremental costs were $2,053 greater (in total) for employees with insomnia compared with controls (specific increments: medical $751, drug $735, sick leave $208, short-term disability $179, long-term disability $10, and workers' compensation $170). Employees with insomnia missed a mean of 3.10 more workdays annually than those without insomnia. Nearly all comorbid conditions were more prevalent, were more costly, and resulted in a greater utilization of services in employees with insomnia compared to those without. All of the above comparisons were significant (P < .05). CONCLUSION: Insomnia was associated with increased costs, greater absenteeism, and an increased number of comorbid conditions in an employed population. Consistent with other analyses based on these data, the study estimated the annual cost of insomnia in the US civilian labor force to be approximately $15.0-17.7 billion (US dollars).


Asunto(s)
Absentismo , Costos de Salud para el Patrón/estadística & datos numéricos , Trastornos del Inicio y del Mantenimiento del Sueño/economía , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Estudios de Casos y Controles , Comorbilidad , Costo de Enfermedad , Bases de Datos como Asunto/estadística & datos numéricos , Costos de los Medicamentos , Empleo/economía , Empleo/estadística & datos numéricos , Planes de Asistencia Médica para Empleados/economía , Planes de Asistencia Médica para Empleados/estadística & datos numéricos , Humanos , Estudios Retrospectivos , Ausencia por Enfermedad/economía , Ausencia por Enfermedad/estadística & datos numéricos , Estados Unidos/epidemiología
7.
Curr Med Res Opin ; 23(3): 623-30, 2007 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-17355743

RESUMEN

OBJECTIVE: A cohort of employees with gout were compared to those without to evaluate the differences in prevalence of disorders associated with metabolic syndrome (both those considered underlying and those associated with end-stage morbidity and mortality) as well as the cost of annual medical services (AMS) required for treatment of these conditions. METHODS: Employees with gout were identified by International Classification of Diseases-9 (ICD-9) code during the calendar years of 2001-2004 and compared to propensity-score matched employees without gout using the Human Capital Management Services Research Reference Database. T-tests were then used to compare prevalence and average AMS of comorbid disorders defined from Agency for Healthcare and Research Quality (AHRQ) diagnostic categories. RESULTS: 'Hyperlipidemia', 'essential hypertension', and 'diabetes mellitus without complications' ranked in the top 10 categories of mean number of AMS for employees with gout using AHRQ specific categories; the values were higher than found for those without gout (all p < 0.0001). 'Essential hypertension', 'hyperlipidemia', 'diabetes mellitus without complications', and 'coronary atherosclerosis' showed an approximate 2:1 prevalence ratio for employees with gout over those without (p < or = 0.05). Main study limitations include the small number of subjects with gout, retrospective study design, and possible miscoding and/or non-coding of individuals with the studied disorders. CONCLUSION: These results support the continued need for patients with gout and their clinicians to be aware of the possibility of the increased risk of associated metabolic syndrome and related comorbidities in these individuals, emphasizing the need for prevention when possible and treatment when necessary.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Gota/epidemiología , Síndrome Metabólico/epidemiología , Adulto , Distribución por Edad , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/terapia , Estudios de Cohortes , Comorbilidad , Empleo/estadística & datos numéricos , Femenino , Gota/diagnóstico , Gota/tratamiento farmacológico , Encuestas Epidemiológicas , Humanos , Hiperlipidemias/diagnóstico , Hiperlipidemias/epidemiología , Hiperlipidemias/terapia , Hipertensión/diagnóstico , Hipertensión/epidemiología , Hipertensión/terapia , Clasificación Internacional de Enfermedades , Masculino , Síndrome Metabólico/diagnóstico , Síndrome Metabólico/terapia , Persona de Mediana Edad , Prevalencia , Pronóstico , Medición de Riesgo , Índice de Severidad de la Enfermedad , Distribución por Sexo , Ausencia por Enfermedad/economía , Estados Unidos/epidemiología
8.
Value Health ; 10(4): 231-7, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17645677

RESUMEN

OBJECTIVE: The goal of this analysis was to evaluate the impact of gout, a painful inflammatory arthritis condition, on an employed population's health-related work absence and objectively measured productivity output. METHODS: Payroll, demographic, medical, pharmaceutical, sick leave, short- and long-term disability, and workers' compensation data were collected from multiple large employers with employees widely dispersed across the United States. Data were collected during the time period of 2001 to 2004 from approximately 300,000 employees. Objective productivity output data were also available for a subset of employees (captured electronically in the form of units of work processed per person). T-tests and chi-square tests were used to compare demographic data. Two-stage multivariate regression models were used to compare annual work absence and at-work productivity between employees with and without gout, while controlling for group differences in demographics, salary, other work-related variables, and comorbidities (using the Charlson Comorbidity Index). RESULTS: The annual prevalence of gout was 4.7 per 1000 employees from 2001 to 2004. Employees with gout had 4.56 more annual absence days for all categories of health-related work absence than those without gout. Objective productivity (units of work processed) results were only available for a small subsample of employees (86 with gout and 27,472 without gout). Employees with gout processed 3.51% fewer units per hour worked and 2.38% fewer units per year than employees without gout (nonsignificant at P = 0.49 and P = 0.78, respectively). CONCLUSION: This study suggests that gout has a substantial impact on work absence and may also negatively impact productivity.


Asunto(s)
Absentismo , Eficiencia , Empleo/economía , Gota , Adulto , Estudios de Cohortes , Demografía , Femenino , Planes de Asistencia Médica para Empleados/economía , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
9.
J Urban Health ; 79(3): 373-82, 2002 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-12200506

RESUMEN

Most studies of psychopathology following disasters are concerned with posttraumatic stress disorder (PTSD). The present analyses sought to assess the rate and determinants of depression in adult survivors of the 1988 earthquake in Armenia. Unlike previous studies of earthquakes, the present analyses derive from a well-defined cohort of survivors who underwent diagnostic interviewing to characterize psychiatric morbidity. As part of a cohort study of 32,743 survivors of the 1988 earthquake in Armenia, a stratified population sample of 1,785 persons was interviewed about 2 years following the disaster using a special questionnaire based on the National Institute of Mental Health (NIMH) Disaster Interview Schedule/Disaster Supplement. 52% met the criteria for major depression. Of these, a total of 177 cases of depression with no other psychiatric diagnosis or comorbidity were compared with 583 controls from the same interviewed group who did not fulfill the criteria for any psychiatric disorder. Cases and controls were compared as to data obtained independently at the aftermath of the disaster on a number of exposures and characteristics related to the earthquake. More of the cases involved females (odds ratio [OR] for males 0.7 [95% confidence interval [CI] 0.5-0.9]) and from the city of Gumri, which had some of the worst destruction (OR for residents of Gumri 5.9 [95% CI 4.0-8.8]). Being with someone in the same building at the moment of the earthquake was protective for depression (OR for presence of other people 0.5 [95% CI 0.3-0.6]), and the risk of depression increased with the amount of loss that the family sustained as a result of the earthquake (OR for highest level of loss 2.5 [95% CI 1.3-4.8]). The use of alcohol was protective for depression (OR for those who drink 0.5 [95% CI 0.3-0.8]). In various models of multivariate adjustment and analysis, the increased risk of depression with loss, geographic location, and female gender was maintained. Also, being with someone during the disaster, receiving assistance and support after the earthquake, and alcohol use were protective for depression in these multivariate analyses. Depression is a common sequel to an earthquake. As with our previous study of PTSD, we were able to relate intensity of the disaster and loss to the risk of depression in a general population sample. The role of social support during and after the disaster as a protective mechanism against adverse psychological outcome was highlighted again. Whereas alcohol use in our previous study was not related to PTSD outcome, it is noteworthy that in the present analyses it emerged as a protective factor for depression.


Asunto(s)
Trastorno Depresivo/epidemiología , Desastres , Trastornos por Estrés Postraumático/epidemiología , Sobrevivientes/psicología , Adolescente , Adulto , Consumo de Bebidas Alcohólicas , Armenia/epidemiología , Aflicción , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Apoyo Social
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