Cost-effectiveness evaluation of a collaborative patient education hypertension intervention in Utah.

This study analyzed the cost-effectiveness of a patient hypertension education intervention that provided patient education through interactive voice response technology and distribution of automated blood pressure monitors to high-risk plan members with uncontrolled hypertension. A total of 17,318 members were identified with hypertension in an administrative database. The study sample consisted of all 534 high-risk hypertensive plan members who received blood pressure monitors. Using data on activity-based program costs and changes in hypertension control, this study modeled the intervention's cost-effectiveness relative to no intervention. The intervention was estimated to have brought hypertension under control in 151 patients during the study year. Across all 534 participants in 1 year, 0.3 events (acute myocardial infarction, stroke, congestive heart failure, and renal failure) were avoided and 2.77 life-years were gained (LYG). The incremental cost-effectiveness ratio (ICER) for the intervention compared with no intervention was $767 per person brought under control or $41,927 per LYG. If the gains in hypertension control from 1 year's investment were assumed to last 10 years, the 10-year ICER relative to no intervention was $1857 per LYG. The intervention is a cost-effective strategy to address hypertension and can serve as a model for future innovations.

[Acute leukemia frequency observed in a reference hospital]. / Frecuencia de leucemias agudas en un hospital de referencia.

OBJECTIVE: to compare the frequency of acute leukemia in two periods of study in a reference Hospital at Mexico City. METHODS: it was an observational study. There were registered 250 cases with the morphology diagnostic criterion of acute leukemia. RESULTS: 63 cases versus 92 of acute lymphoid leukemia (ALL) and 16 versus 79 acute myeloid leukemia (AML) of 1990-1992 versus 2008-2009 respectively was observed; corresponding to 62 % in total of ALL in both periods and 38 % of AML. The ALL was the most frequent variant (62 % versus 38 %). The median age was 26 years, male 52 %. It showed a significant increase in the number of admissions in the period of 2008-2009 and acute promyelocytic leukemia also showed an increase (p = 0.001). CONCLUSIONS: acute leukemia is the main cause of admission, mortality and morbidity. Our study differs slightly from the literature; the leukemia that diagnostic with major frequency was the acute lymphoid leukemia increasing his number in the period of 2008-2009. The significant rise due to an increase use of new diagnostic tools such as the flow cytometry and molecular biology.

Diagnostico del virus papiloma humano en cuello uterino de mujeres que acuden a su consulta anual citológica / Diagnosis of human papillomavirus in uterine cervix of women undergoin annual cytologic checkup

El presente estudio realizó la detección y tipificación del virus papiloma humano (VPH) mediante reacción en cadena polimerasa (PCR), en un grupo de 58 mujeres asintomáticas, las cuales acudieron a el Centro de Medicina Preventiva Brisas de Carabobo, de la ciudad de Valencia, entre febrero y marzo del año 2002. Se detectó através de la PCR 34,5 por ciento (20/58) de casos positivos, mientras que la citología identificó 18,2 por ciento (8/44) de infección por VPH. Predominaron los genotipos de riesgo intermedio con 42,9 por ciento (9/21), con respecto a los de bajo riesgo con 38,1 por ciento (8/21) y los de alto riesgo con 19 por ciento (4/21). Las cepas mas frecuentes fueron para el grupo intermedio la 45, mientras que para los grupos de bajo y alto riesgo fue la 6 y 16 respectivamente. Por otro lado, factores relacionados con la infección por VPH, como: edad, multiparidad, relaciones sexuales a temprana edad, hábito de fumar y promiscuidad no fueron estadísticamente significativas (p>0,05). En conclusión, la PCR detectó mayor número de mujeres con VPH que la citología, el diagnóstico de la infección por VPH en mujeres asintomáticas presentó una alta frecuencia de cepas de riesgos intermedio y alto (61,9 por ciento)