Biomedical subjects

Gene L Colice

Publications and source records attributed to Gene L Colice.

21 records · Page 2Linked to original sources

PubMed2002

Economic burden of respiratory infections in an employed population.

CONTEXT: While respiratory infections are a leading cause of morbidity, there is little information on the costs of medically treating these conditions, or on their workplace impact. OBJECTIVE: The purpose of this study was to estimate the economic burden of respiratory infections from the perspective of an employer. DESIGN, SETTING, AND PARTICIPANTS: A total of 63,890 patients with at least one diagnosis for a respiratory infection in 1997 were identified in a claims database of a national Fortune 100 company. Outcome measures were compared to those of a 10% random sample of beneficiaries in the overall beneficiary population. MAIN OUTCOME MEASURES: The annual per capita costs for each category of respiratory infections were determined for beneficiaries of this major employer by analyzing all medical, prescription drug, and disability claims in 1997. RESULTS: In 1997, the total cost to the employer per patient, as well as medical-service utilization, were higher among patients with respiratory infections than among beneficiaries in the overall beneficiary population. Significant variations exist in costs across the 11 selected respiratory infections. For example, annual per capita employer expenditures for patients with respiratory infections totaled $4,397, while expenditures for patients with pneumonia and patients with acute tonsillitis/pharyngitis were $11,544 and $2,180, respectively, as compared with costs for the average beneficiary, which was $2,368. CONCLUSIONS: Patients with respiratory infections present an important financial burden to employers. We estimate that the cost to employers of patients with respiratory infections in the United States in 1997 was $112 billion, including costs of medical treatment and time lost from work.

Employer Health Costs↗

PubMedDate not supplied

Influenza in the intensive care unit.

Influenza remains an important epidemic viral infection. Thousands of deaths occur and billions of dollars are spent each year with influenza-related illnesses. Morbidity and mortality are largely attributed to respiratory complications that may require intensive care unit (ICU) admission. Medical and neonatal ICUs, transplant units, chronic-care wards, and nursing homes are at increased risk for nosocomial outbreaks of influenza, which are characterized by abrupt onset and rapid spread. In this article, the authors review the current concepts, recent advances, and management strategies in influenza-associated pneumonia. Pertinent issues to the critical care practitioner are discussed in detail.

Antiviral Agents↗

PubMedDate not supplied

New developments in inhaled corticosteroids.

Inhaled corticosteroids (ICSs) are the foundation of pharmacotherapy in persistent asthma because they control airway inflammation. The anti-inflammatory effect of ICSs is primarily topical, at their site of deposition in the airways. Consequently, deposition characteristics of the ICS and its formulation and inhalation device, in addition to intrinsic properties of the corticosteroid, influence clinical efficacy. Small-particle formulations, especially those developed in a metered-dose inhaler with the new hydrofluoroalkane propellant, may have improved lung deposition characteristics along with possibly improved clinical efficacy. Lipid conjugation of ICSs within the lungs may allow prolonged duration of effect, enabling once-daily dosing. Safety concerns of ICSs are related to systemic absorption and oropharyngeal deposition. An ICS with a longer serum half-life, especially one with a higher affinity for the corticosteroid receptor, may be associated with greater systemic effects. Increased protein binding of an ICS within the systemic circulation and high systemic clearance of an ICS may reduce the risk for systemic effects. Reduced oropharyngeal deposition and administration of a prodrug may result in fewer oropharyngeal side effects. The ideal ICS will have increased lung deposition and reduced deposition in the upper airway, resulting in better clinical efficacy and less risk for upper airway adverse effects. An ICS with high plasma protein binding and rapid clearance might pose much less risk for systemic adverse effects than currently available drugs in this class.

Administration, Inhalation↗