Biomedical subjects

J Heras

Publications and source records attributed to J Heras.

5 recordsLinked to original sources

PubMed1991

[Cost-effectiveness analysis of home administration versus hospital administration of intravenous immunoglobulin].

A prospective analysis was carried out to evaluate the cost-effectiveness of two alternatives for the treatment of hypo-agammaglobulinemia with intravenous immunoglobulin: the current hospital administration and the administration in the patient's home. 38 patients or relatives were surveyed about their personal or family characteristics, current therapy and the possibility to be treated at home. Home therapy is feasible--43% of the patients would be able to have it and would prefer it--and less costly, as costs could be reduced in 18-20%. This alternative is felt as a greater patient's independence, with less feeling of illness and preventing the loss of school or work hours. 32% prefer the hospital because they feel more secure in it.

Adolescent↗

PubMed1988

Habitual dislocation of the hip.

We report the case of a girl, aged 2 years, who was able to dislocate her right hip voluntarily and in whom there was no other abnormality. She was given psychological treatment and the condition resolved after 2 years. Eight similar cases of habitual dislocation of the hip are reported in the world literature.

Child, Preschool↗

PubMedDate not supplied

A Markov random field model for bony tissue classification.

3D biomedical images are a valuable source of information for clinical diagnosis. In areas such as bone remodeling, fracture prediction and prosthesis design, the external geometry of the bones needs to be precisely defined and injuries identified. A system that automatically interprets and presents a 3D reconstruction of the bone can be very useful, although this task cannot be carried out without specific knowledge of the domain. This knowledge may be represented by a set of constraints over properties and relationships between regions. In this work we present a Markov random field model for identification of injuries in the proximal tibia.

Bone and Bones↗

PubMedDate not supplied

[Management costs of chest and CNS-related adverse events associated with the treatment of acute migraine attacks with oral triptans].

INTRODUCTION: Although adverse events of triptans are usually not important from a clinical point of view, they can worry patients and lead them to consume healthcare resources. METHODS: A decision analytic model was used to represent the behavior and management of patients who suffered adverse events after taking a triptan. Using data about the incidence of adverse events, the behavior and management of patients, and the unit cost of the healthcare resource consumed, the costs of treating adverse events were calculated, as was the iatrogenic cost factor of the triptans available in Spain. RESULTS: 10 % to 20 % of patients who suffer a chest or CNS-related adverse advent related to triptan use seek medical attention. The management cost of a chest-related event was estimated to be euros 66,43, euros 33,09, or euros 137,01, depending on whether the patient consulted a neurologist, a primary care physician, or a hospital emergency department. For CNS-related events the management cost was estimated to be euros 52,88, euros 16,89 or euros 102,17, respectively. Excluding the placebo effect, the resulting iatrogenic cost factor varied between 1 for almotriptan 12,5 mg and 1,21 for zolmitriptan 2,5 mg. In absolute values, the average cost per patient (above placebo) varied between 0 euros for almotriptan 12,5 mg and euros 1,17 for eletriptan 80 mg. CONCLUSIONS: The management of adverse events can add substantial costs to a treatment with triptans. These costs vary considerably between triptans due to differences in the incidence of adverse events. Lowest costs were found for almotriptan 12,5 mg.

Central Nervous System Diseases↗

PubMedDate not supplied

[Therapeutic strategies used by neurologists and primary care physicians in the symptomatic treatment of migraine. Findings from Strategia-I and Strategia-II opinion studies].

INTRODUCTION: Few studies have been carried out on the subject of stratification of medical care for migraines, and even fewer have been conducted with the aim of determining the attitudes adopted by physicians towards their patients when dealing with this issue. Strategia-I and II studies were designed for this purpose. SUBJECTS AND METHODS: The sample consisted of 162 neurologists and 3,168 Primary Care physicians (PCP). Participants in the studies filled out an opinion survey that was produced ad hoc and included the different possible strategies, namely a) Stepped care between attacks (the patient takes medication during several attacks and, if it is not effective, it is replaced by another in successive attacks); b) Stepped care within attacks (the patient treats his or her seizures with medication and, if it does not work, another is used as rescue medication); and c) Stratified care (the physician classifies the patient according to the degree of disability produced by the migraine and recommends the most appropriate drug at the start). RESULTS: Most participants in the study (90.7% of neurologists, 85.2% of PCP) reported using a single strategy. Stratified care was found to be the preferred choice by both collectives (67.6% of neurologists, 43.8% of PCP; p < 0.0001). Only 16% of the respondents admitted using some disability scale. Nonsteroidal antiinflammatory drugs are the medication chosen if disability is mild-moderate, while triptans are preferred if it is moderate-severe (92.9% of neurologists, 78.8% of PCP; p < 0.001). CONCLUSIONS: The strategy based on stratified care is the most widely used in visits to Neurology and Primary Care in Spain, although there are significant differences between the two collectives. Triptans are perceived as being the ideal medication in situations involving moderate-severe disability.

Clinical Protocols↗