Investigating nystagmus in patients with traumatic brain injury: A systematic review (1996 - 2016).

BACKGROUND: Traumatic brain injury (TBI) is a health and socioeconomic concern worldwide. In patients with TBI, post-traumatic balance problems are often the result of damage to the vestibular system. Nystagmus is common in these patients, and can provide insight into the damage that has resulted from the trauma. OBJECTIVE: To present a systematic overview of published literature regarding nystagmus in patients with TBI. METHODS: Nine databases and platforms were searched during October 2016 for articles published between 1996 and 2016. Studies of any research design and published in English that focused on nystagmus in patients with TBI were considered for inclusion. A total of 110 articles were screened once duplicates had been removed, and 29 full-text articles were assessed. Eleven articles were included in the quality appraisal phase (using the McMaster tool), after which 10 articles were included in this review. RESULTS: This review describes nystagmus in 713 patients, and all articles reviewed described the type of assessment method that was used. However, the results lacked comprehensive data regarding the assessment, measurement and description of nystagmus in TBI patients, or the possible link and relationship between nystagmus and TBI. CONCLUSIONS: This systematic review indicated that: (i) there is a growing body of evidence that benign paroxysmal positional vertigo should be considered during the medical examination of all patients suffering from head trauma; (ii) all patients with TBI should undergo visual (eye movement) and vestibular examination; and (iii) future studies should include quantitative measurements of eye movements and nystagmus.

Pricing and reimbursement of pharmaceuticals in Belgium.

The Belgian healthcare system has a tradition of access and equity at affordable prices. As in other countries, the system becomes pressured by increasing healthcare costs. This paper describes the actual situation in Belgium with special focus on pharmaceutical products and the potential role of pharmacoeconomics in decision making on price and reimbursement. Nearly all people in Belgium are covered by compulsory health insurance. The system is paid for by social security, the patients and the federal and regional authorities. The part of the consumption of pharmaceuticals that is charged to insurance was about 62.1 billion Belgian francs (BeF), i.e. about 50% of the pharmaceutical market in 1994. Price setting in Belgium has been rather low due to the positive reimbursement list, where the price of a new drug is compared to existing drugs in a comparable therapeutic class (so-called reimbursement criteria). The expenditure on pharmaceuticals is increasing faster than global funding for public health. In order to control drug budgets, different cost-containment measures have been or are being taken, i.e. a mix of price, reimbursement and volume controls. These cost-containment measures are not necessarily in accordance with a health economic approach. This paper suggests the scope for better implementation of pharmacoeconomic evaluation, which can lead to more flexible reimbursement systems in specific indications. Therefore, a formal recognition of the role of objective economic evaluations is needed for both hospital and ambulatory care. This process should be proceeded by improving the understanding and robustness of pharmacoeconomic evaluations.

Evaluation and optimal combination of TLC systems for qualitative identification I: sulfonamides.

A mathematical criterion for the evaluation of chromatographic analysis procedures is given by the information content as derived from Shannon's equation. This information content yields a numerical value representative of the merits of each chromatographic separation and thus allows selection of the optimal systems. In most cases, however, one analysis is not sufficient to allow the qualitative identification of the sample. Therefore, several chromatographic systems are combined. Two approaches allow the desired combination; one either calculates the information content of several procedures as one mathematical value or classifies the systems according to mutual resemblance by numerical taxonomy techniques. From the resulting groups of dissimilar systems, one optimal system can be chosen per group according to the information content. The results obtained by these mathematical procedures are illustrated with a practical example: the selection and evaluation of systems for the TLC analysis of sulfonamides.

Cost evaluation of infections in intensive care.

The study deals with one aspect of cost benefit analysis of infection control, namely the measurement of extra costs incured by patients who acquired nosocomial infections (NI) in intensive care units (ICU). The consequences of NI are expressed in terms of length of stay, extra drug and antibiotic costs, extra sterile supply used and mortality. Infected patients stayed at the ICU twice as long as non - infected patients, the mean cost of antibiotics prescribed was four times higher, the mean value of other drugs and infusion fluids was approximately 1 1/2 times higher. Three methods for measuring cost are compared: the physician's assessment method, comparison of infected patients with all non - infected patients and matched control analysis.

Computerized prescription of total parenteral nutrition in pediatrics.

Total parenteral nutrition is often administered in pediatrics, especially to newborn infants and (very)-low-birth-weight infants. The use of a personal computer virtually eliminates errors, and removes the problem of tedious mathematical and time-absorbing calculations. The authors describe and discuss the TPN-program they developed.

An integrated drug prescription and distribution system: challenges and opportunities.

Using the hospital's drug prescription and distribution system as a guide, benefits and drawbacks of a medical activity management system that is tightly integrated with the supply chain management of a hospital will be discussed from the point of view of various participating healthcare actors.

Evaluation and selection of optimal solvents and solvent combinations in thin-layer chromatography. Application of the method to basic drugs.

A series of simple mathematical techniques for the evaluation of solvents and solvent combinations in thin-layer chromatography have been investigated. A strategy for the rapid selection of the optimum combination is proposed. It uses classification procedures based on calculation of the similarity between systems. The classification is carried out using a simple graph-theoretical procedure (Kruskal's algorithm) or numerical taxonomy. The selection of optimal sets from the clusters which appear in the classification is based on the information content as derived from Shannon's equation. The method has been applied to an RF data set for basic drugs. It is concluded that these methods indeed allow the selection of optimal systems or combination of systems.

Solvated electrons in very small clusters of polar molecules: (HF)(3)(-).

Photoelectron spectra of (HF)(3)(-) reveal coexistence of two anionic isomers with vertical electron detachment energies (VDE) of 0.24 and 0.43 eV. The results of electronic-structure calculations, performed at the coupled cluster level of theory with single, double, and noniterative triple excitations, suggest that the two isomers observed experimentally are an open, zigzag, dipole-bound anion and an asymmetric solvated electron, in which the dipole-bound anion of (HF)(2) is solvated by one HF monomer at the side of the excess electron. The theoretical VDE of 0.21 and 0.44 eV, respectively, are in excellent agreement with the experimental data.