ABSTRACT
Abstract Background: Walking is an economic activity, the more efficient the mechanical contribution, the less metabolic energy is necessary to keep walking. Patients with chronic heart failure and heart transplant present peripheral musculoskeletal disorders, dyspnea, and fatigue in their activities. Objective: In this scenario, the present study sought to verify the correlations between metabolic and electromyographic variables in chronic heart failure, heart transplant patients, and healthy controls. Methods: Regression and correlation between cost of transport and electromyographic cost, as well as correlation between oxygen consumption and muscle coactivation in patients and controls at five different walking speeds have been performed, with alpha = 0.05. Results: Strong correlation values (r controls: 0.99; chronic heart failure: 0.92; heart transplant: 0.88) indicate a linear relationship between the cost of transport and electromyographic cost. Oxygen consumption was significantly correlated to muscle activation in all groups. Conclusion: These results suggested that dynamic muscle coactivation was an important factor, especially for CHF and HT. These data support the idea that peripheral muscle limitations play an important role in people with CHF and HT. These findings indicate a strong relation between metabolic and electromyographic variables. For chronic heart failure and heart transplant patients, it can help to explain some difficulties in daily activities and aid in physical rehabilitation.
ABSTRACT
The authors conducted a review of the literature of cost-effectiveness analyses regarding management of Barrett's esophagus, including screening, surveillance, and treatment strategies. Because of the presence of multiple systematic reviews on this topic, they chose to focus on more recent economic analyses, with an emphasis on comparative modeling because these analyses have been demonstrated to achieve greater validity and impact when there are multiple competing strategies that are clinically reasonable to pursue. The authors identified areas of consensus across studies regarding management strategies and also areas that require additional empirical data.
Subject(s)
Adenocarcinoma/economics , Barrett Esophagus/economics , Early Detection of Cancer/economics , Esophageal Neoplasms/economics , Esophagoscopy/economics , Precancerous Conditions/economics , Adenocarcinoma/diagnosis , Adenocarcinoma/therapy , Aged , Barrett Esophagus/diagnosis , Barrett Esophagus/therapy , Cost-Benefit Analysis , Early Detection of Cancer/methods , Esophageal Neoplasms/diagnosis , Esophageal Neoplasms/therapy , Esophagoscopy/methods , Female , Humans , Male , Middle Aged , Precancerous Conditions/diagnosis , Precancerous Conditions/therapy , Quality-Adjusted Life YearsABSTRACT
Introduction: Adolescence is the transition between childhood and adulthood. The beginning of reproductive sexual life in this phase means to 1 in 5 adolescents becoming pregnant. 64% of these pregnancies are not planned, which entails high costs in health institutions. Objective: Show by proportional analysis the costs of care for pregnant adolescents in a hospital in the Atlantic department in 2013 and 2017. Materials and methods: Cross-sectional descriptive study, by means of proportional analysis, estimated costs of vaginal delivery by caesarean section and ICU care in 2013 and 2017 periods. Results: It was found that the costs of patients attended in 2013 and 2017, the 2013 proportion is lower (chi-square: 2,287; P> 0.05). In the costs of patients attended by vaginal delivery in 2013 and 2017, the proportion of 2013 is lower (chi-square: 17,340; P <0.05). The costs of patients attended by Cesarean in 2013 and 2017, the proportion of 2013 is lower (chi-square: 5,771; P <0.05). The costs of patients cared for by Caesarean section and patients referred to the ICU for the year 2013, the proportion of patients referred to the ICU is lower. (chi-square: 5,771; P = 0.00 for Cesarean section in 2013 and a chi-square value: 2,276; P = 0.03 for ICU referral in 2013). Conclusions: adolescent pregnancy is a public health problem with an increasing trend that leads to obstetric complications that can occur during this period, plus the high rate of caesarean sections, which therefore increases costs in the provision of health services.
Introducción: La adolescencia marca la separación entre la infancia y la vida adulta, con el inicio de la vida sexual reproductiva conlleva a que 1 de cada 5 adolescentes quede embarazada. El 64% de estos embarazos no sean planeados, generando altos costos en las instituciones de salud. Objetivo: Determinar mediante análisis de proporciones los costos de la atención en embarazadas adolescentes en un hospital del Departamento del Atlántico en los periodos 2013 y 2017. Materiales y métodos: Estudio descriptivo transversal, mediante análisis de proporciones se estimaron costos de parto vaginal cesárea y atención en uci en periodos 2013 y 2017. Resultados: se encontró que los costos de pacientes atendidas en los años 2013 y 2017, la proporción 2013 es menor (chi cuadrado: 2,287; P > 0,05). Los costos de pacientes atendidas por parto vaginal en los años 2013 y 2017, la proporción del 2013 es menor (chi cuadrado: 17,340; P < 0,05). Los costos de pacientes atendidas por Cesárea en los años 2013 y 2017, la proporción del 2013 es menor (chi cuadrado: 5,771; P < 0,05). Los costos de pacientes atendidas por Cesárea y las pacientes remitidas a UCI para el año 2013, la proporción de pacientes remitidas a UCI es menor. (chi cuadrado: 5,771; P = 0,00 para Cesárea en 2013 y un valor de chi cuadrado: 2,276; P = 0,03 para remisión a UCI en 2013). Conclusiones: el embarazo adolescente es un problema de salud pública con tendencia al aumento que acarrea complicaciones obstétricas que pueden presentarse en el transcurso de este periodo más el índice elevado de cesáreas que por ende aumenta los costos en la prestación de los servicios de salud.
