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Biomedical subjects

L Amir

Publications and source records attributed to L Amir.

17 recordsLinked to original sources
PubMed2006

[Vertical distraction osteogenesis of the extremely resorbed edentulous mandible. A retrospective description of 16 patients].

This study's objective is to assess long-term results of vertical distraction osteogenesis for the extremely resorbed edentulous mandible by clinically measuring and taking x-rays from the beginning of the treatment of 16 subsequent patients to its final moment in the follow up period (ranging from 2-62 months). Bone height, nerve sensitivity, complications and loss of implant were registered. Average bone resorption after 3 years was 11.2%. Out of 16 patients 5 experienced sensory nerve disturbance; 3 suffered complications. The implant success rate was 89.2%. Distraction osteogenesis appears to be a reliable technique, with which stable bone tissue is developed. Risk of sensory nerve disturbance and complications however, must be taken into consideration.

Aged↗
PubMed2000

Rates of breastfeeding in Australia by State and socio-economic status: evidence from the 1995 National Health Survey.

OBJECTIVE: To estimate rates of breastfeeding in the first year of life in Australia, according to state and socio-economic status. METHODOLOGY: Analysis of data from the 1995 Australian National Health Survey. RESULTS: Estimated breastfeeding rates are 81.8% on discharge from hospital, 57.1% fully breastfed at 3 months and 62.6% fully or partially breastfed at 3 months. At 6 months, it is estimated that 18.6% of babies are fully breastfed and 46.2% fully or partially breastfed. At 1 year, 21.2% of infants are receiving some breast milk. Comparison between states demonstrates that there is considerable variation in breastfeeding practice within Australia. Rates of breastfeeding also vary according to the socio-economic status of the geographic area in which the child is living, with a strong inverse relationship between rates of breastfeeding and socio-economic status. CONCLUSION: : Australia's target for breastfeeding in the year 2000 is to have 80% of babies at least partially breastfed for the first 6 months of life. Although Australia has good rates of initiation of breastfeeding, these levels are not maintained over time, and it seems unlikely that we will reach the year 2000 targets.

Australia↗
PubMed2000

Economics of the antithymocyte globulins Thymoglobulin and Atgam in the treatment of acute renal transplant rejection.

OBJECTIVE: To evaluate the economic implications for transplant centres, Medicare and society of treatment of corticosteroid-resistant Banff Grades I, II and III acute kidney transplant rejection with the antithymocyte globulins Thymoglobulin or Atgam. DESIGN AND SETTING: This was a cost analysis of a randomised double-blind multicentre clinical trial comparing the safety and efficacy of Thymoglobulin and Atgam that was performed at 25 centres in the US in 1994 to 1996. PATIENTS AND PARTICIPANTS: The study enrolled 163 patients, 82 in the Thymoglobulin arm and 81 in the Atgam arm. METHODS: Estimates of the cost of care from the initiation of rejection therapy to 90 days post-therapy were derived from various publicly available sources and applied to patient-specific clinical events documented in the clinical trial. Patients received either intravenous Thymoglobulin (1.5 mg/kg/day) for an average of 10 days or intravenous Atgam (15 mg/kg/day) for an average of 9.7 days. RESULTS: On average, Thymoglobulin provided significant cost savings compared with Atgam from the perspective of society [$US5977 (1996 values); 95% confidence interval (CI) $US3719 to $US8254], Medicare ($US4967; 95% CI $US3256 to $US6678) and the transplant centre ($US3087; 95% CI $US1512 to $US4667). The overall advantage attributable to Thymoglobulin was primarily due to savings from fewer recurrent rejection treatments and less frequent return to dialysis. CONCLUSIONS: Treatment of acute renal transplant rejection with Thymoglobulin is a cost saving strategy when compared with treatment with Atgam.

Acute Disease↗
PubMed1999

Women's knowledge and attitudes about emergency contraception: a survey in a Melbourne women's health clinic.

The aim of the study was to determine the level of awareness of emergency contraception in women seeking pregnancy counselling and to investigate their attitudes towards emergency contraception. All women presenting for pregnancy counselling at a Melbourne women's health clinic in October 1997 were invited to complete a questionnaire detailing their contraceptive practices. One hundred and sixty-six questionnaires were distributed and 153 were completed (92% response rate). The majority of this sample population had heard of some form of emergency contraception and knew where to access it. However only 26% knew that emergency contraception should be taken within 72 hours of unprotected intercourse. Although 80% of the sample had heard of emergency contraception (or the morning after pill) only 9% used it in an attempt to prevent this pregnancy. The majority of the women surveyed support the increased availability of emergency contraception by rescheduling it to a non-prescription item and re-packaging as a single treatment.

Adolescent↗
PubMed1999

The validity of the uriscreen test for early detection of urinary tract infection in children.

OBJECTIVE: To determine the validity of the Uriscreen, a rapid diagnostic test based on the detection of urine catalase for the early detection of urinary tract infection (UTI) in children, compared with standard urinalysis and dipstick tests. STUDY DESIGN. Cross-sectional study. STUDY POPULATION: Children 1 month to 17 years of age who presented to the emergency department of a pediatric tertiary care center between March and November of 1996 with symptoms suggestive of UTI. METHODS: Urine specimens obtained from a random sample of 121 patients were evaluated simultaneously for possible UTI by Uriscreen (catalase test), urinalysis (microscopic pyuria), dipstick (leukocyte esterase and nitrite), and quantitative urine culture. All specimens were collected by one of three sterile techniques (midstream void technique, bladder catheterization, or suprapubic aspiration), as appropriate for age, and tested immediately. Using the quantitative urine culture as the gold standard (reference test), the sensitivity, specificity, and positive and negative predictive values of all the screening tests were determined and compared. Age, sex, temperature, presenting symptoms, and method of urine collection were recorded for each participant. RESULTS: Of the 121 patients, 35 (28.9%) had positive culture results: 30 girls (85.7%) and 5 boys (14.3%). Compared with urinalysis and dipstick tests, Uriscreen had the highest sensitivity (100% vs 88.6% and 97.1%, respectively) and the highest negative predictive value (100% vs 95% and 98.6%, respectively), but the poorest specificity (68.6% vs 88.4% and 82.5%, respectively) and positive predictive value (56.4% vs 75.6% and 69.4%, respectively). CONCLUSIONS: The clinical use of Uriscreen for the presumptive diagnosis of UTI in children is limited and not significantly superior to urinalysis or the dipstick test. However, because of its 100% sensitivity and negative predictive value and its ease of use, rapidity, and low cost, it is recommended highly for ruling out the diagnosis of UTI. In laboratories, a negative Uriscreen result may prevent the need for performing expensive urine cultures.

Bacteriuria↗
PubMed1998

A new product pricing model using intracorporate market perceptions to extract the value of additional information.

OBJECTIVE: This model introduces a unique and inexpensive technique to estimate profit increases that might be expected from: (i) an additional clinical trial to establish a drug's second clinical indication; and (ii) a survey of market demand. DESIGN: Microsoft Excel spreadsheets are used to solicit selected expert opinions about the new product's annual market share under scenarios reflecting different pricing points, promotional expenditures and clinical advantage. MAIN OUTCOME MEASURES AND RESULTS: The preprogrammed model returns profit-maximising price, promotional expenditure and market differentiation for each expert and the group as a whole. The extent of disagreement among the experts is used to estimate the additional profits which might be expected from a clinical trial and a market survey. Results from an illustrative application indicated greater incremental profits could be expected from the survey of market demand. The clinical trial generated smaller expected incremental profits because several experts felt that the trial's potential results would not affect the drug's profit-maximising price. CONCLUSIONS: With a 1-day meeting between 6 experts, the model provided a recommendation about the new product's profit-maximising market price and promotional expenditure. Furthermore, it estimated profit increases that might be expected from additional clinical trials and a survey of market demand.

Drug Costs↗
PubMed1995

Emergency medicine in Israel: state of the art.

Emergency medicine is in its infancy in Israel but is developing rapidly. Medical and government authorities such as the Israeli Medical Association and the Israeli Ministry of Health have already recognized the need for this field in Israel, although it remains for emergency medicine to be recognized as an independent medical specialty. Those involved in the intense process of obtaining formal recognition believe this will occur in the next year.

Emergency Medicine↗