Use of the burn intervention score to calculate the charges of the care of burns

Background

To our knowledge this is the first published estimate of the charges of the care of burns in Sweden. The Linköping Burn Interventional Score has been used to calculate the charges for each burned patient since 1993. The treatment of burns is versatile, and depends on the depth and extension of the burn. This requires a flexible system to detect the actual differences in the care provided. We aimed to describe the model of burn care that we used to calculate the charges incurred during the acute phase until discharge, so it could be reproduced and applied in other burn centres, which would facilitate a future objective comparison of the expenses in burn care.

Long-term incidence and risk factors of cardiovascular events in Asian populations: systematic review and meta-analysis of population-based cohort studies

Background: Scientific studies on cardiovascular disease (CVD) burden and risk factors are predominantly based on short-term risk in Westerner populations, and such information may not be applicable to Asian populations, especially over the longer term. This review aims to estimate the long-term (>10 years) CVD burden, including coronary heart disease (CHD) and stroke, as well as associated risk factors in Asian populations.

Methods: PubMed, Embase and Web of Science were systematically searched, and hits screened on: Asian adults, free of CVD at baseline; cohort study design (follow-up >10 years). Primary outcomes were fatal and non-fatal CVD events. Pooled estimates and between-study heterogeneity were calculated using random effects models, Q and I² statistics.

Results: Overall, 32 studies were eligible for inclusion (follow-up: 11–29 years). The average long-term rate of fatal CVD is 3.68 per 1000 person-years (95% CI 2.84–4.53), the long-term cumulative risk 6.35% (95% CI 4.69%–8.01%, mean 20.13 years) and the cumulative fatal stroke/CHD risk ratio 1.5:1. Important risk factors for long-term fatal CVD (RR, 95% CI) were male gender (1.49, 1.36–1.64), age over 60/65 years (7.55, 5.59–10.19) and current smoking (1.68, 1.26–2.24). High non-HDL-c, and β- and γ-tocopherol serum were associated only with CHD (HR 2.46 [95% CI 1.29–4.71] and 2.47 [1.10–5.61] respectively), while stage 1 and 2 hypertensions were associated only with fatal stroke (2.02 [1.19–3.44] and 2.89 [1.68–4.96] respectively).

Conclusions: Over a 10 year?+?follow-up period Asian subjects had a higher risk of stroke than CHD. Contrary to CVD prevention in Western countries, strategies should also consider stroke instead of CHD only.     

Comparison between superficial femoral artery stenting and bypass surgery in severe lower-limb ischaemia: a retrospective study

Symptomatic superficial femoral artery (SFA) disease presenting either with severe claudication or critical limb ischaemia is treated with bypass surgery and traditionally has been the ‘goldstandard’ procedure. Surgical bypass using autogenous vein or prosthetic grafts as a conduit is well accepted and there are comparable patencies and limb salvage rates with either conduit.1There have been considerable advances in the last two decades in percutaneous endovascular technology for the treatment of SFA disease. The techniques that have been developed include percutaneous balloon angioplasty and stenting, with variable results.2,3 Despite having three different options, namely surgical bypass, balloon angioplasty and stenting, none is superior to the other.Although the five-year primary patency rate of femoropopliteal above-the-knee bypass with autogenous saphenous vein is 70%, this method of treatment is invasive with long incisions in the lower extremities and a peri-operative complication rate of 12%.4 Vascular surgeons have become more experienced with catheter-based technology and due to the minimal invasiveness of the procedure, both patients and vascular surgeons are increasingly attracted to endovascular procedures. Mwipatayi et al.5 and Nguyen et al.6 found stenting resulted in equivalent outcomes when compared to balloon angioplasty alone, but Laird et al.7 found that self-expanding nitinol stents were associated with better angiographic results and improved patency compared with balloon angioplasty alone.Randomised, controlled trials comparing bypass surgery and balloon angioplasty alone generally showed similar outcomes in terms of amputation-free survival but in the short term, surgery was more expensive than angioplasty.8 Another study comparing surgical bypass with balloon angioplasty and stenting showed better primary patency for the stent group (67%) than the bypass group (49%) and there were higher re-intervention rates in the bypass group.9Since there are conflicting data in the literature regarding the success of different methods of treatment of SFA disease and there is a lack of consensus guidelines on the optimum management of SFA disease, the aim of this study was to compare the results of stenting and surgical bypass in the local environment with regard to limb salvage rates in patients with severe leg ischaemia.     

A comparative study of thyroid hormone levels in young diabetic and non-diabetic patients

Thyroid disorders can adversely affect diabetes control. The aim of the study was to compare thyroid hormone levels in type 1 diabetic patients with that of non-diabetic patients. Fifty two type 1 Diabetic patients were consecutively selected from among those attending the outpatient department of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorder (BIRDEM) hospital. Fifty three healthy non-diabetic volunteers were selected from the students of a university. Both groups were below 30 years of age. The patients with type 1 diabetes have significantly lower serum FT3 levels (P <0.001) when compared to the control groups. There was no significant difference between controls and study subjects in terms of serum FT4 (P?=?0.376) and TSH (P?=?0.821) concentration. We conclude that alteration of FT3 is a common feature in these subjects with type 1 diabetes mellitus.     

An Update on the Status of Potent Inhibitors of Metallo-β-Lactamases

The production of metallo-β-lactamases is the most important strategy by which pathogenic bacteria become resistant to currently known β-lactam antibiotics. The emergence of these enzymes is particularly concerning for the future treatment of bacterial infections. There are no clinically available drugs capable of inhibiting any of the metallo-β-lactamases, so there is an urgent need to find such inhibitors. In this review, an up-to-date status of the inhibitors investigated for the inhibition of metallo-β-lactamases has been given so that this rich source of structural information of presently known metallo-β-lactamases could be helpful in generating a broad-spectrum potent inhibitor of metallo-β-lactamases.     

Pork Consumption and Seroprevalence of Hepatitis E Virus,Thailand, 2007–2008

The nationwide seroprevalence of hepatitis E IgG was determined among young men in Thailand. Overall seroprevalence was 14% (95% CI 13%–15%); range by province was 3%–26%. Seroprevalence was lowest in the south, an area predominantly occupied by persons of the Islam religion, whose dietary laws proscribe pork.     

Natural and anthropogenic radioactivity levels and the associated radiation hazard in the soil of Oodalia Tea Estate in the hilly region of Fatickchari in Chittagong,Bangladesh

Radioactivity in the soil of a tea garden in the Fatickchari area in Chittagong, Bangladesh, was measured using a high-resolution HPGe detector. The soil samples were collected from depths of up to 20 cm beneath the soil surface. The activity concentrations of naturally occurring ²³⁸U and ²³²Th were observed to be in the range of 27 ± 7 to 53 ± 8 Bq kg⁻¹ and 36 ± 11 to 72 ± 11 Bq kg⁻¹, respectively. The activity concentration of ⁴⁰K ranged from 201 ± 78 to 672 ± 81 Bq kg⁻¹, and the highest activity of fallout ¹³⁷Cs observed was 10 ± 1 Bq kg⁻¹. The average activity concentration observed for ²³⁸U was 39 ± 8 Bq kg⁻¹, for ²³²Th was 57 ± 11 Bq kg⁻¹, for ⁴⁰K was 384 ± 79 Bq kg⁻¹ and for ¹³⁷Cs was 5 ± 0.5 Bq kg⁻¹. The radiological hazard parameters (representative level index, radium equivalent activity, outdoor and indoor dose rates, outdoor and indoor annual effective dose equivalents, and radiation hazard index) were calculated from the radioactivity in the soil.