Two Decades of Stroke in the United States: A Healthcare Economic Perspective.

INTRODUCTION: Stroke is a leading cause of morbidity and mortality in the USA and has implications on the financial health of patients, families, and healthcare systems. The objective of this study aimed to determine the economic perspective of stroke on the national healthcare system for the past 2 decades. METHODS: This retrospective study of inpatient subjects from 2000 to 2020 with stroke was collected from the Healthcare Cost and Utilization Project (HCUP). We queried patients admitted primarily for ischemic or hemorrhagic stroke. Patients were evaluated for demographics, length of stay (LOS), mortality, and hospital charges. Statistical Z-testing with a significance of p < 0.05 was conducted for the analysis. RESULTS: During the study period, 12,158,747 stroke subjects were studied, with 51.9% female and a mean age of 70.08 (±0.16) years old. The mean rate of stroke discharges per 100,000 persons was 187.71 (±3.44), decreasing from 200 to 193 during the study (p = 0.16). The mean percentage of deaths was 8.78% (±0.17), which decreased from 10.96% to 6.81% (p = 0.00). The mean LOS was 6.28 days (±0.08), which increased from 6.70 to 7.15 (p = 0.00). During the study period, the aggregated national bill was USD 725 billion. The mean hospital charges per patient were USD 57,178 (±1,504), increasing from USD 19,647 to USD 121,765 per person during the study period (p = 0.00), while mean hospital costs per stay were USD 15,781 (±330). These data closely conform to an exponential growth pattern, and forecasting per patient charges for the next 10 years demonstrates a cost of USD 287,836 by 2030. CONCLUSIONS: Our data show that the rate and mortality of stroke have decreased, but its charges and costs are increasing. The improvement in outcomes could be multifactorial such as establishment of comprehensive stroke centers and evolving treatment modalities. Ironically, the charges per patient increased more than sixfold with a national bill almost equal to the annual Medicare budget. Thus, the significance of preventive medicine, such as controlling hypertension, diabetes, and smoking cessation, cannot be understated. With such a dramatically increasing financial burden, improvements in mitigating risk factors, educational programs, and access to care may be a more cost-effective option.

Linfomas no hodgkin: área metropolitana de Bucaramanga / Non-hodgkin lymphomas from Bucaramanga metropolitan area

Introducción: Ninguna neoplasia ha generado tanta confusión en sus sistemas de clasificación como los linfomas no Hodgkin (LNH). Una correcta tipificación es necesaria para el diagnóstico, pronóstico y tratamiento. El propósito de este estudio fue clasificar los LNH del registro poblacional de cáncer del área metropolitana de Bucaramanga. Pacientes y métodos: Se realizó un estudio observacional de corte transversal, utilizando como población los pacientes con LNH del área metropolitana de Bucaramanga de enero de 2000 a diciembre de 2006. La información se obtuvo de las historias clínicas y de inmunohistoquímica en bloques de parafina. Se utilizo la clasificación de linfomas de la OMS. Resultados: Se estudiaron 320 pacientes y se encontró predominio de la enfermedad en la 6ª y 7ª década. La distribución por género fue mayor en hombres con 61,26% y mujeres 45,6%. El sitio anatómico de compromiso más frecuente fue ganglios cervicales con 25,6%. La mayoría expresaron antígenos B, 86,8%, y T, 1,8%. El subtipo más frecuente fue difuso de célula grande en el 29,6%. Conclusiones: La mayoría los LNH del área metropolitana de Bucaramanga son de linajes B, nodales y de célula grande difuso. Fue evidente el uso limitado de otras técnicas para la clasificación de estas neoplasias en nuestra región.

Introduction: There is not a neoplasm that has generated such confusion on its classification system such as the Non- Hodgkin’s lymphoma. An adequate classification is necessary for diagnosis, prognostic and treatment. The purpose of this study was to classify the NHL from the Bucaramanga metropolitan area poblational cancer registry. Patients and methods: An observational cross-sectional study was made, using as population the patients with NHL from the Bucaramanga metropolitan area from January 2000 until December 2006. The information was obtained from the clinical records and inmunohistochemistry in paraffin blocks. The WHO lymphoma classification was used. Results: 320 patients were studied and a predominance of the disease was found on the 6th and 7th decade of life. Gender distribution was higher in men with 61.26% and women 45.6%. The anatomical site more frequently affected were the cervical lymph nodes with 25.6%. Most of them expressed B antigens, 86.8%, and T, 1.8%. The most frequent subtype was diffuse large B cell in 29.6%. Conclusions: Most of the NHL from the Bucaramanga metropolitan area are nodal, of B lineage, and diffuse large cell subtype. The limited use of other techniques for the classification of these neoplasms in our region was evident.

Ventajas de la coloración de giemsa para la determinación de eosinófilos en el tejido conectivo general

Se realiza un estudio cuanticualitativo de los eosinófilos en la mucosa duodenal de ratas, para valorar comparativamente la efectividad de la coloración de giemsa en la hemtoxilina y eosina.Para esto se tiñen 90 cortes histológicos por cada tipo de coloración,realizándose el conteo de 900 vellosidades, el cualarrojó mayores valores medios y diferencias significativas entre la cantidad de células encontradas en las preparaciones tratadas con giemsa en relación a las teñidas con hematoxilina y eosina.Se observan con mejor precisión y contraste los eosinófilos con la tinción de giemsa, por lo que se demuestra la utilidad de este colorante poco explotado