Economic assessment of pressure sore prevention using a computerized mattress system in patients with spinal cord injury

Purpose. To assess the economic profitability of a new computerized mattress system in patients with spinal cord injuries (SCI) by comparison with two other alternatives, as an example of the use of a quantitative approach for decision-making in choosing between alternatives for sore prevention.

Method. The cost of achieving one day without signs of impending pressure sore was compared between the alternative options using cost minimization analysis. Savings in nursing costs for the three options were calculated for cost-benefit analysis.

Results. A foam mattress system is significantly cheaper than the other examined alternatives, and if the nursing manpower cost is constant and the nursing staff is capable of performing sufficient repositionings, this system would achieve the desired medical outcome at a minimal cost. However, if the nursing staff cannot perform sufficient repositionings, or if the use of nursing manpower can be adjusted to the actual need, then it is the computerized mattress system that achieves the desired outcome at the minimal cost. In this case, less than 20 New Israeli Shekels (NIS) per day spent on the equipment save NIS 45 per day in labor costs.

Conclusions. The economic evaluation indicates that the computerized mattress system is advisable for patients with SCI who require assistance for repositioning, but its profitability depends on the employment terms of the nursing manpower. In addition, other possible alternative pressure management systems should be examined, and additional research may be needed to determine the optimal combination of such systems for a spinal cord rehabilitation department.     

Corneal endothelial pumping in the presence of insulin and GABA

Glucose, in presence of GABA and insulin causes complete temperature reversal and survival for 7·5 hr of the corneal endothelial fluid pump.     

Gender, Primary Headache, and Psychological Distress

The study compared the psychological symptoms of 26 young men and 65 young women referred to a neurology clinic in northern Israel by their family physicians for medical advice regarding headache. The main findings indicated that the women had more severe psychological symptoms than the men in six subscales, although only in somatization, depression, and additional items did the differences reach statistical significance. The authors recommend, in addition to medical intervention, special psychological intervention for women, which would offer counseling in developing coping skills.     

Hemoglobin levels do not predict biochemical outcome for localized prostate cancer treated with neoadjuvant androgen-suppression therapy and external-beam radiotherapy

PURPOSE: To investigate whether hemoglobin (Hb) levels affect outcome in men with localized prostate adenocarcinoma (LPA) treated with neoadjuvant androgen-suppression therapy (NAST) and external-beam radiotherapy (EBRT). METHODS AND MATERIALS: A total of 563 men with LPA treated with NAST (median: 5.3 months) and EBRT who had Hb levels during treatment were retrospectively reviewed. Patient, tumor, and treatment variables, including the following Hb variables, were subjected to univariate and multivariable analyses to identify factors that predict biochemical control (bNED) and overall survival (OS): pre-EBRT Hb, Hb nadir during EBRT, and change in Hb from pre-EBRT to nadir during EBRT. RESULTS: Median PSA follow-up was 4.25 years. Forty-nine percent of men were anemic during EBRT, with a median Hb of 13.4 g/dL, and 68% experienced a decline in Hb from pre-EBRT to during EBRT of median 0.6 g/dL. Five-year Nadir+2 bNED and OS rates were similar for anemic and nonanemic patients during EBRT. High percent-positive biopsies, PSA and Gleason score, and use of AA monotherapy predicted worse bNED. High stage and age predicted worse OS. Hb variables were not predictive of bNED or OS. CONCLUSIONS: Anemia is a common side effect of NAST and is usually mild. Hb levels, however, do not predict biochemical control or survival.     

Using international emotional picture sets in countries suffering from violence

It is hypothesized that ratings of emotional stimuli are affected by a constant threat of traumatic events. Ratings of valence and arousal on the International Affective Picture System from young adults in the United States were compared to those of young Israeli adults. Israelis rated the pictures as less negative and less positive than did participants from the United States. Israeli women gave higher arousal ratings compared to the American women. These differences may be due to compulsory military service in Israel, during which exposure to traumatic events is more likely to occur, and to the timing of the study which followed a year of frequent suicide bomb attacks. The authors suggest that these findings may reflect mild symptoms of stress disorders.