Biomedical subjects

J Brandeis

Publications and source records attributed to J Brandeis.

3 recordsLinked to original sources

PubMed2001

Racial differences in the cost of treating men with early-stage prostate cancer.

OBJECTIVE: To compare the cost and resource utilization in the evaluation, treatment, and 6-month follow-up of African-American and White men undergoing either external beam radiation therapy (XRT) or radical prostatectomy (RP) for early-stage prostate cancer. DESIGN: Retrospective analysis of cost and resource utilization data from encrypted patient-specific hospital inpatient, hospital outpatient, and physician/supplier data files. SETTING: National Medicare claims data from 1993 through 1996. PARTICIPANTS: A random 5% national sample of Medicare beneficiaries from the Health Care Financing Administration Public Use Files for 1993 through 1996. MEASUREMENTS: Inpatient, outpatient, and physician/supplier Medicare costs. RESULTS: African-American men undergoing RP for early-stage prostate cancer had significantly higher costs ($21,878 vs $18,786, P < .0001) than did White men. Most of the difference occurred in the inpatient setting. African-American men undergoing XRT had significantly greater costs ($18,131 vs $15,734, P < .0001) than did White men. Most of this difference was generated by longer duration of XRT treatments. CONCLUSIONS: In early-stage prostate cancer, charges for RP and XRT in African-American men are higher when compared with those for White men.

Adenocarcinoma↗

PubMed2000

A nationwide charge comparison of the principal treatments for early stage prostate carcinoma.

BACKGROUND: The diagnosis and treatment of men with early stage prostate carcinoma is expensive and controversial, yet the similarities in reported survival rates has underscored the importance of ascertaining the relative charges of different forms of therapy. METHODS: Patient specific data on demographic characteristics, hospital and physician resource use, and charges were obtained from the Health Care Financing Administration for 1993 through 1996. The inpatient, outpatient, and part B claims from men with a new diagnosis of prostate carcinoma were captured from the quarter of the year in which biopsy was performed through the two quarters after treatment. Charges are reported in inflation-unadjusted dollars. RESULTS: Of 10,107 men treated for early stage prostate carcinoma, 58% received external beam radiation therapy (XRT), 35% had radical prostatectomy, and 7% underwent brachytherapy. Over the 4 years, use of XRT decreased 19% whereas use of brachytherapy increased 21%. Men aged 65-69 years were more likely to have radical prostatectomy, but after age 70 years, XRT predominated. The most expensive treatments were radical prostatectomy with adjuvant XRT ($31,329) and brachytherapy with pretreatment XRT ($24,407). Cost of radical prostatectomy alone was more than XRT alone ($19,019 vs. 15,937; P < 0.05) or brachytherapy alone ($15,301; P < 0.05). Treatment utilization varied with age, race, and geographic region. CONCLUSIONS: The mean charges for the workup, treatment, and 6 month follow-up of patients treated for early stage prostate carcinoma ranged between $15,301 and $31,329, with significant treatment group differences. Without a clear survival advantage from one form of treatment, issues such as costs, quality of life, and patient preferences take on paramount importance.

Age Factors↗

PubMed1980

Ovarian hyperstimulation in rats.

Induction of a mild hyperstimulation syndrome in the female rat, and the possible effect of the induction on prolactin, were studied using light and electron microscopy as well as radioimmunoassay. Five days of human menopausal gonadotropin (HMG) treatment were followed by human chorionic gonadotropin (HCG) administration. Ovarian hyperstimulation was observed in all treated rats, as attested to by the weight increase and by histological studies. Ovaries were enlarged 3-4 times as compared with controls, and consisted mostly of corpora lutea follicular cysts and hemorrhagic cysts. Other visceral organs remained unaffected, except for slight edematous changes observed in the lungs of the treated rats. Electron microscopic examination of the hypophysis of the treated group tends to indicate increased synthesis and secretory activity of the prolactin cells. However, serum prolactin levels of treated and non-treated groups were not different. Augmented doses of the gonadotropins did not change the findings, and only mild grade 2 ovarian hyperstimulation, according to Schenker and Weinstein (1978), could be produced in the mature rat. Thus, the rat experimental model does not seem to be comparable with the situation in the human, and cannot be used to study the pathogenesis of the disorder in the human.

Animals↗