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Biomedical subjects

H Holder

Publications and source records attributed to H Holder.

7 recordsLinked to original sources

The cost effectiveness of treatment for alcoholism: a first approximation.

This study undertakes an analysis of cost effectiveness of alcoholism treatment modalities based upon (1) findings from clinical trials, (2) costs for treatment in settings and/or by providers and (3) recommendations from treatment experts about appropriate settings, providers and treatment events. This analysis, which assumes a prototypic patient, suggests that modalities with the most evidence of effectiveness (based on three or more clinical trials) are not the most expensive. Within this study, total cost of care was negatively related to effectiveness. Modalities categorized as having insufficient evidence of effectiveness (i.e., lacking three or more clinical trials) are in the higher cost categories. The results of this first effort to establish initial cost/effectiveness considerations are intended to stimulate researchers to conduct the types of clinical studies where both cost and effectiveness are carefully measured to increase the scientific basis for future cost/effect policy considerations. The authors expect future clinical studies will revise the results of this initial effort.

Alcoholism

Familial lysosomal storage disease with generalized vacuolization and sialic aciduria. Sporadic Salla disease.

Two eight- and sixteen-year-old children with severe progressive neurologic disease revealed an ultrastructural finding of lysosomal vacuolization in mesenchymal or parenchymal cells of different organ biopsies (skin, muscle, nerve and liver), which may be very suggestive of mucolipidosis. However, in our patients biochemical tests available for these diseases yielded negative results, except for increased excretion of free sialic acid in urine and sialic acid storage in cultured fibroblasts. The clinical picture and the ultrastructural and biochemical findings were compatible with Salla disease, a rare lysosomal storage disease originally observed in Finland.

Adolescent