Valuing health using EQ‐5D: The impact of chronic diseases on the stock of health

Chronic diseases strongly affect individuals' health status. In aggregate terms, this impact is reflected by the stock of health, which measures the amount of health of a population in a given period of time. The objectives of this study were to measure the relative burden of chronic illnesses by assessing health‐related quality of life using the EQ‐5D‐5L instrument, to rank diseases according to their associations with the stock of health, and to calculate the stock of health of the Spanish population and the amount of health loss attributable to each chronic disease from a social perspective. Data were gathered from the Spanish Health Survey (ENSE 2011–2012, N = 20,587). A population weighted least squares model was used. Chronic diseases represent 19.19% of the stock of health losses in Spain compared with a country free from those diseases. In Spain, the stock of health in 2011 was 31.86 million units on the visual analog scale. The diseases with the strongest impact in terms of loss of stock of health at the individual level were mental illness and embolism, stroke, or cerebral hemorrhage. Collectively, the diseases with the largest impact included osteoarthritis, arthritis, or rheumatism; chronic back pain; and high blood pressure.     

Household Social Characteristics of the Demand for Alcoholic Beverages Among Spanish Students

This paper studies how household social capital affects adolescents’ demand for alcoholic drinks. To that end, we focus on a theoretical framework that combines elements from the Model of Rational Addiction and the Model of Social Economics. For the empirical framework, we use a simultaneous Type II Tobit model, with data drawn from the Spanish National Survey on Drug Use in the School Population (2000, 2002, and 2004). The sample is comprised of 12,627 students aged 17 years old. Our results confirm that parents’ decisions about drinking are even more decisive in their children's behavior than socioeconomic variables, such as parents’ educative levels or working status. Parental responsibilities go beyond the endowment of health and educational goods and services; so, these results suggest the importance of designing family-drug use prevention programs. The study's limitations are noted.     

An assessment of the ability of tree guards to prevent browsing damage using captive swamp wallabies (Wallabia bicolor)

Tree guards made of wire, plastic mesh, plastic film and rigid plastic tubing were examined for their ability to prevent browsing by captive swamp wallabies. All plastic mesh guards guards were ineffective as were all guards less than 1.0 m high other than rigid plastic tubes. Wire mesh guards reduced browsing but installation was difficult and laborious.     

Multilocus tetrasomic linkage analysis using hidden Markov chain model

The availability of reliable genetic linkage maps is crucial for functional and evolutionary genomic analyses. Established theory and methods of genetic linkage analysis have made map construction a routine exercise in diploids. However, many evolutionarily, ecologically, and/or agronomically important species are autopolyploids, with autotetraploidy being a typical example. These species undergo much more complicated chromosomal segregation and recombination at meiosis than diploids. In addition, there is evidence of polyploidy-induced and highly dynamic changes in the structure of the genome. These polysomic characteristics indicate the inappropriateness of the theory and methods of linkage analysis in diploids for use in these species and a gap in the theory and methodology of tetraploid map construction. This paper presents a theoretical model and statistical framework for multilocus linkage analysis in autotetraploids for use with dominant and/or codominant DNA molecular markers. The theory and methods incorporate the essential features of allele segregation and recombination under tetrasomic inheritance and the major challenges in statistical modeling and marker data analysis. We validated the method and explored its statistical properties by intensive simulation study and demonstrated its utility by analysis of AFLP and SSR marker data from an outbred autotetraploid potato population.     

Classification of acetabular changes in osteoarthritis: a histological and radiological analysis of 122 consecutive drill biopsies routinely taken during THA

Background  Aseptic acetabular loosening cannot be explained with a single theory and lots of studies deal with the influence of implant design and surgical technique on implant survival. Implant registers show the effect of demographic and patient-related parameters on acetabular loosening. There is little information about the influence of the acetabular bone quality on cup loosening. Methods  In a prospective study, we investigated the first 122 consecutive routinely taken biopsies out of acetabular bone stock taken during primary total hip arthroplasty (THA) before reaming of the cup. Undecalcified bone samples should be classified in respect to architecture and vitality in different histological types. Four types were defined and the primary diagnosis and the severity of the preoperative radiological changes were correlated to this classification. Results  A total number of 110 (90%) out of 122 biopsies could be classified to one specific type of biopsy, nine were not classifiable and three showed special entities [rheumatoid arthritis (RA) and coxitis]. Double examination showed a high intraobserver agreement (kappa 0.972). There was a correlation between the four defined types of bone biopsies and the radiological severity of osteoarthritis (P < 0.0001) but not with the diagnosis (P = 0.104). Conclusion  Histological changes during the development of osteoarthritis of the hip occur regularly, can be classified in four groups and are predictable from radiological changes on preoperative radiographs.     

CTLA4Ig和西罗莫司短期联合使用延长异种胰岛移植物的存活

目的 观察细胞毒性T淋巴细胞相关抗原4融合蛋白(CTLA4Ig)与西罗莫司(SRL)联用阻断共刺激通路对异种胰岛移植物存活的影响.方法 取C57BL/6小鼠,腹腔注射链佐星,制成糖尿病模型.采用随机单位组设计分组法将糖尿病小鼠分为7组,各组均于小鼠左肾包膜下移植SD大鼠胰岛300胰岛当量.CTLA4Ig组分别于移植当天及移植后第2、4、6天腹腔注射CTLA4Ig 0.5 mg/d;SRL组分别于移植当天及移植后第1、2天给予SRL灌胃,0.2 mg·kg-1·d-1,其后隔天用药1次,共用2周;MRI组分别于移植当天及移植后第2、4天腹腔注射仓鼠抗小鼠CD154单克隆抗体(MR1)0.5 mg/d;CTLA4Ig和SRL联用组(SRL联用组)、CTLA4Ig和MRl联用组(MR1联用组)以及CTLA4Ig、MR1和SRL联用组(三药联用组)各药物的剂量与用法同上述各组;对照组仅行胰岛移植,不予以药物.观察至移植后200 d,通过监测受者血糖水平来判断排斥反应的发生情况.记录各组移植物的存活(即无排斥反应)时间.发生排斥反应者,或未发生排斥反应、移植物存活时间＞200 d者,取移植胰岛,行HE染色及免疫荧光染色,进行组织学观察.结果 对照组移植物存活时间中位数为17 d,该组最终均发生排斥反应.SRL组、MRl组和CTLA4Ig组移植物存活时间中位数分别为34 d、98 d和77 d.均明显长于对照组(P＜0.05),三组中分别有90%(9/10)、62.5%(5/8)和83.3%(5/6)的小鼠发生排斥反应.SRL联用组移植物存活时间中位数为130 d,明显长于上述4组(P＜0.01),有50%(3/6)的小鼠发生排斥反应.MR1联用组以及三药联用组移植物存活时间中位数均＞200 d,分别有42.9%(3/7)和25%(2/8)的小鼠发生排斥反应.组织学检查结果显示,对照组发生排斥反应时,其移植胰岛破坏严重,可见大量CD4+和CD8+淋巴细胞及巨噬细胞浸润,并可见IgG、IgM和补体C3沉积.其它组发生排斥反应者的组织学改变与对照组相似.SRL联用组存活200 d的小鼠,其移植胰岛组织中未见或仅有少量炎症细胞浸润,胰岛素和胰高血糖素染色阳性,未见IgG、IgM和补体C3沉积.结论 短期联合使用CTLA4Ig和SRL能显著延长小鼠体内大鼠来源的胰岛的存活时间.     

医院耗材管理浅析

分析了目前医院耗材管理的现状,针对管理中存在的不足,介绍了一种医院耗材管理的新模式,如多部门紧密合作、现代化管理系统软件的科学应用、管理流程的改进等,为医用耗材完善的科学化管理提出了可行性建议。