An estimate of the potential budget impact of using prophylactic dressings to prevent hospital-acquired PUs in Australia.

OBJECTIVE: To estimate the potential cost saving to the Australian health-care system of introducing the use of prophylactic dressings to prevent hospital-acquired pressure ulcers (PUs) for patients with a high-risk developing a PU. METHOD: We estimated the costs of pressure ulceration based on conservative estimates of an incidence rate of 13% within 10% of the total admitted Australian patient population. RESULTS from a recent large randomised control trial of prophylactic dressing used to prevent PUs in high-risk patients were then extrapolated to this population to derive a potential national cost/benefit calculation. RESULTS: Our estimate revealed that within the high-risk population of acute hospitals, more than 71,000 patients could be expected to develop a PU annually costing AU$77,800,000 (£43,000,000). Whereas by implementing a national PU prevention initiative based on the use of prophylactic multilayer silicone foam dressings for high-risk patients, an annual saving of AU$34,800,000 (£19,700,000) could be achieved, which represents a cost benefit of 55% to the Australian health-care system. CONCLUSION: Our estimate of the potential cost benefit of implementing the use of prophylactic dressings to prevent hospital acquired PUs in high-risk patients uses conservative estimates of both the incidence rates of ulceration and of treatment costs. However, this is also based on one of the largest reported randomised control trials of this technique to prevent PUs. We believe that our modelling is robust yet requires replication in other countries with different health-care systems and costing structures.

Diseño de un dispositivo como herramienta diagnóstica en trastornos témporomandibulares / Design of a device as a diagnostic tool for temporomandibular joint disorder

En la práctica odontológica se puede evidenciar una insatisfacción, de los profesionales de la odontología, al solo contar con una imagen diagnóstica de una radiografía panorámica y lo inaccesible que resulta adquirir otros equipos que puedan aportar información para estudiar las afecciones en la Articulación Témporo Mandibular (ATM). Esta investigación orientada al diseño de un dispositivo receptor de imagen que asemeja un arco facial y un audífono, el cual, a su vez posee cámaras para la obtención de imágenes. A su vez, apoyado por un software (matlab) que interpreta los cambios de la imagen como una línea de desplazamiento, arrojando valores que son llevados a formar parte de un diagnóstico, en el estudio de desórdenes témporomandibulares. Este proyecto se enmarco en la modalidad de proyecto factible, con enfoque tecnicistas. Se utilizó una encuesta como técnica de recolección de datos y como instrumento se uso un cuestionario estructurado con preguntas dicotómicas. El estudio se aplico a docentes de la asignatura Oclusión y Rehabilitación Protésica, del Departamento de Prostodoncia y Oclusión de la Facultad de Odontología de la Universidad de Carabobo. Se evidencio que la mayoría de los docentes manifestaron poca confianza en los métodos diagnósticos existentes, ya que no ofrecen imágenes dinámicas y son poco accesibles a la población. Además, se encontró que el 100% está de acuerdo que el desarrollo del dispositivo antes mencionado. Se encuentra que este dispositivo seria innovador y cómodo, además de encontrarse una amplia motivación hacia su aplicación...

The purpose of this research is to develop a design of a receiver device supported by software that interprets the changes in an image as a displacement line of the TMJ. This research aims to present a device as a diagnostic tool for the témporomandibular joint disorder to the professors of the Faculty of dentistry in Carabobo University. This project was delimited as a workable project with a technicist approach where it is used a survey, as data collection technique and a structured questionnaire with dichotomous questions, as instrument. The study was applied to the professors of occlusion and prosthetic rehabilitation subject of the Faculty of dentistry in Carabobo University having 15 professors. It was found that most of the professors manifest a lack of confidence on the methods to study the TMJ disorders, due to it is unable to show the condylar dynamics and are also expensive for most of the population. Plus, it was evidenced that 100% were agree on develop of the device mentioned before, It´s described as comfortable, being motivated for the application..

Angiographic differentiation of types of ventricular septal defects.

A retrospective study of 40 patients with 41 surgically repaired ventricular septal defects was performed in order to correlate the anatomic findings with the angiographic features seen by axial angiography. In 39 patients there were 32 perimembranous, three muscular, and four subarterial defects. One patient had both perimembranous and inlet muscular ventricular septal defects. Perimembranous defects as seen on left ventriculograms on long axial view are in continuity with the aortic valve. The relation of the defect to the tricuspid valve allows distinction of the extension of the perimembranous defect toward the inlet, trabecular, or infundibular zones. This relation was determined angiographically, using the course of the contrast medium from the left ventricle through the ventricular septal defect opacifying the right ventricle. Muscular defects are separated from the semilunar and atrioventricular valves. Subarterial defects are related to both semilunar valves, and they are best demonstrated by the elongated right anterior oblique view of the left ventriculogram. This study demonstrated that with axial views an experienced angiographer can define the location, size, and relations of the ventricular septal defects with high accuracy. In only two of the 41 defects there were differences between the retrospective angiographic prediction and the previous surgical findings.

Identification of mimotopes of platelet autoantigens associated with autoimmune thrombocytopenic purpura.

GPIIb/IIIa, the human platelet glycoprotein complex, is the autoantigen most commonly recognized by autoantibodies in autoimmune thrombocytopenic purpura (AITP). Two murine monoclonal antibodies (mAbs), namely Y2/51 and 5B12, directed against gpIIIa and gpIIb/IIIa, respectively, and rabbit anti-human platelet polyclonal antibodies have been used to select AITP-related epitopes from a phage display peptide library expressing random dodecapeptides in the pIII coat protein of M13 phage. The selected phage clones were tested by ELISA for binding to rabbit anti-human platelet antibodies as well as to sera from AITP patients. Seven clones reacted strongly with rabbit anti-human platelet antibodies, and four clones reacted with sera from AITP patients. Some homology between peptide inserts sequences of selected clones and human platelet gpIIIa and gpIb were found.

Identification of peptide sequences specific for serum antibodies from human papillomavirus-infected patients using phage display libraries.

Three random phage display peptide libraries were screened with sera from human papillomavirus (HPV)-infected patients to characterize the specificities of antibodies present in patients' sera and to identify molecules that correspond to or mimic natural epitopes; 141 phage clones were randomly selected in three rounds of bioselection and their binding properties were analyzed in ELISA using sera from 36 patients with confirmed HPV 16 infection and 24 healthy control female blood donors. Sixteen of 36 (44%) patients' sera reacted with at least 1 phage clone, and only 2 of 24 female donors' sera showed positive reaction with 1 of the selected clones. We conclude that the combination of various disease-specific epitopes generated by screening of phage display peptide libraries may potentially lead to a multicomponent diagnostic assay for the early detection of HPV infection and precancerous cervical lesions, making possible the prevention of one of the most common cancers in women.

Íleo biliar resuelto por laparoscopia: reporte de un caso / Gallstone ileus corrected by laparoscopic enterolithotomy: report of one case

Se presenta el caso de un paciente de 65 años, con cuadro sospechoso de íleo biliar, que se resolvió en forma completa por laparoscopia. Se analiza aquí la técnica quirúrgica y los resultados postoperatorios.