144 research outputs found
Cost-effectiveness of pertussis booster vaccination in the Netherlands
No full textThe aim of the current study is to estimate the epidemiological and economical consequences of several extended pertussis booster vaccination strategies and to explore the impact of parameters surrounded by large uncertainty on the cost-effectiveness. We developed an age structured transmission dynamic model to evaluate the impact of programs targeting (i) adolescents or adults using a single booster dose, (ii) a combination of adolescent and adult vaccination, and (iii) an every 10 years booster dose. The base case analysis, that is a single adolescent booster administered at the age of 12 years, resulted in a reduction of pertussis infections. However, due to an increase in the number of symptomatic infections in adults, the benefits in terms of QALYs gained and costs saved in children were partly offset. Despite these negative indirect effects in the adult population, administering an additional booster dose could still be considered cost effective with an ICER of euro4200 per QALY gained. Combining an adolescent booster dose at the age of 10 (most cost-effective age for a single adolescent booster dose) with an adult (18-30 years) booster dose always resulted in favorable ICERs (<euro10,000/QALY). Finally the every 10 year booster dose resulted in an ICER of euro16,900 per QALY. The impact of different assumptions regarding the disease epidemiology, disease-related parameters, and vaccination program-related issues was limited. To conclude, we show that extended pertussis booster vaccination strategies are likely to be considered as cost-effective
Ultra-Low Contrast Volume for Patients with Advanced Chronic Kidney Disease Undergoing Coronary Procedures
No full text<b><i>Background/Aims:</i></b> Contrast induced nephropathy (CIN) is associated with adverse clinical outcomes in patients undergoing coronary interventions, particularly in patients with advanced chronic kidney. The study was aimed to assess the real-life feasibility and safety of ultra-low volume coronary procedures in patients with advanced chronic kidney disease. <b><i>Methods:</i></b> A prospective study that included patients with an estimated glomerular filtration rate (eGFR) &#x3c;45 mL/min/1.73 m<sup>2</sup>) was conducted. Coronary procedures were performed using an ultra-low contrast volume technique. <b><i>Results:</i></b> The 30 patients had a mean eGFR of 31.8(±8) mL/min/1.73 m<sup>2</sup>. Indications for coronary angiography were non-ST elevation myocardial infarction (63.3%), unstable (20%), and stable angina pectoris (16.7%). Median contrast volume for diagnostic coronary angiography was 13 mL (interquartile ranges [IQR] 12–14.9), and an additional 13 mL (IQR 8.8–14.3) for percutaneous coronary intervention (PCI). In 3 patients (10%), a ≥25% increase was demonstrated in serum cystatin C levels 48 h following the procedure. None of the patients demonstrated a ≥25% increase in serum creatinine levels at 48 h. Following 6 months, no patient required renal replacement therapy or unplanned coronary intervention. <b><i>Conclusions:</i></b> In patients with advanced chronic kidney disease, the ultra-low contrast technique is feasible and effective and can be used safely without a significant deterioration in renal function. This technique may increase the utilization of PCI in high-risk coronary patients with chronic kidney disease.</jats:p
Orientational states, phase transitions, and spectra of vibrational excitations for two-dimensional systems with quadrupole interactions
No full text
- …
