Objective Arthritis is the most common health condition in midlife and late life, and heart disease is the leading cause of death. This article compares disability impacts of these 2 preeminent health problems. Methods Using data from the National Health Interview Survey Disability Supplement, we studied specific limitations and disabilities, accommodations used (buffers), and accommodations needed (barriers) for US population groups of adults with arthritis disability, heart disease disability, both arthritis and heart disease disability, and disability due to other conditions. Weights and complex SE adjusted for sample design. We hypothesized that arthritis disability is more extensive and troublesome than heart disease disability. Results People with arthritis disability had more numerous, longer, and more bothersome disabilities than people with heart disease disability. People with arthritis disability used more equipment and rehabilitation, whereas people with heart disease disability emphasized personal assistance, medications, and medical services. People with arthritis disability experienced more barriers and needs in activities and services. People with disabilities from both arthritis and heart disease were especially disadvantaged, with high levels of limitations and accommodations. People with disability from other conditions had the highest social participation, fewest disabilities, and most tailored accommodations of all groups. Conclusion Arthritis had higher and more extensive disability impact than heart disease. Both groups had more difficulty, buffers, and barriers in their lives than people disabled by other conditions. Therefore, arthritis and heart disease are premier conditions for disability attention and alleviation in the US population.
This study, the first to prospectively examine AHS incidence among uniformly treated patients in multiple institutions, established that as the intensity of AML therapy has increased, so has the rate of AHS. Young children, those with previous AHS bacteremias, and those receiving high-dose cytarabine are at particularly high risk of AHS bacteremia.
This report details a study whose purpose was to show the safety of and describe the clinical and financial outcomes of nasogastric (NG) and nasojejeunal (NJ) tube feedings for nutritional support during and after intensive treatment for cancer. During a 17-month period, NG or NJ tubes were inserted in 25 patients who experienced, or were anticipated to experience, suboptimal nutrition during or after their chemotherapy (n = 14), radiation therapy (n = 2), or chemotherapy plus radiation (n = 5), after bone marrow transplant (n = 2), and as a result of neurological impairment (n = 2). Patient ages ranged from 1 month to 14 years. NG/NJ tubes were used for a total of 1415 patient days (median 40 days). Of those, 756 days occurred in the hospital (median, 18 days) and 659 were outpatient days (median = 12 days). Total parenteral nutrition (TPN) was used during 104 patient days (range, 1 to 35 days), and combination NG/NJ feedings were given with TPN for a total of 101 days. A comparable number of days of TPN therapy for the NG-fed patients would have cost $177,390 (average $135/day), compared with $65,700 (average, $50/day) for enteral feedings, for a savings of $111,690. Ten patients experienced grade 2 to 3 diarrhea and/or vomiting during the study. No untoward outcomes were identified. Enteral feedings were found to be a safe and cost-effective method for providing nutrition to these children with cancer.
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