The main purpose of this paper was to estimate the cost per quality-adjusted life year (QALY) saved by identifying Fusobacterium necrophorum in throat swabs followed by proper antibiotic treatment, to reduce the incidence of Lemierre's syndrome and peritonsillar abscesses (PTA) originating from a pharyngitis. The second purpose was to estimate the population size required to indicate that antibiotic treatment has an effect. Data from publications and our laboratory were collected. Monte Carlo simulation and one-way sensitivity analysis were used to analyse cost-effectiveness. The cost-effectiveness analysis shows that examining throat swabs from 15- to 24-year-olds for F. necrophorum followed by antibiotic treatment will probably be less costly than most other life-saving medical interventions, with a median cost of US$8,795 per QALY saved. To indicate a reduced incidence of Lemierre's syndrome and PTA in Denmark, the intervention probably has to be followed for up to 5 years. Identifying F. necrophorum in throat swabs from 15- to 24-year-olds followed by proper antibiotic treatment only requires a reduction of 20-25 % in the incidence of Lemierre's syndrome and PTA to be cost-effective. This study warrants further examination of the effect of antibiotic treatment on the outcome of F. necrophorum acute and recurrent pharyngitis, as well as the effect on Lemierre's syndrome and PTA.
Febrile seizure is a common childhood disorder that affects 2-5% of all children. It is defined as seizures associated with a body temperature above 38°C without serious underlying causes (ie head trauma, intracranial infection, or epilepsy) between 3 months and 5 years of age. [1][2][3][4][5] Febrile seizures are generally self-limiting and can be categorized as simple (generalized and brief seizures) or complex (focal symptoms and longer duration of seizures). 4,6 Long-term comorbidities include epilepsy 7 and neuropsychiatric disorders. 8 The development of childhood seizures likely involves a cascade of developmental molecular, cellular and neuronal network alterations
Eighteen patients undergoing alloplastic surgery of the hip were divided into three groups, each consisting of six patients. All operations were performed under endotracheal intubation using halothane N2O-O2 anaesthesia. After a steady state as to CO2-production had been obtained, suxamethonium 1 mg kg-1 was given intravenously to the patients in Group I. A maximum rise in CO2-production of 14.8% (range: 12.9-16.8) was observed after 5 min. In Group II, patients were pretreated with pancuronium 0.01 mg kg-1: no increase in CO2-production was observed. The third group received a continuous infusion of suxamethonium. In this group there was an increase in CO2-production of 17.6% (range: 6.7-22.0) 5 min after start of infusion. The CO2-production then fell to the preinfusion level over the next 10 min.
In a consecutive series of 62 patients with renal carcinoma transvascular embolization has been evaluated in regard to its limitations, complications, influence on the surgical procedure and success of treatment. Of 47 planned embolizations 36 could be accomplished. Total embolization was achieved in 29 of the 36 cases (81 per cent). One case was complicated due to displacement of the embolization material to the femoral artery. The subjective impression of the surgeon was that embolization facilitated nephrectomy, although this could not be proved by objective measurement of the duration of operation and perioperative blood loss. Survival after embolization and nephrectomy was no better than after nephrectomy alone.
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