Medicine
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Observational Study
Ambulatory blood pressure monitoring and diabetes complications: Targeting morning blood pressure surge and nocturnal dipping.
Ambulatory blood pressure monitoring (ABPM) correlates more closely to organ damages than clinic blood pressure (BP). In the current study we aimed to investigate the association between micro- and macrovascular complications of diabetes and both diurnal and nocturnal variability in BP. A total of 192 patients with type 2 diabetes (T2DM) who had complete data on ABPM were selected. ⋯ We demonstrated that diabetic neuropathy was associated with all the components of MBPS and abnormal dipping status. Our results indicated loss of nocturnal BP dipping but not MBPS as a risk factor for CVD and retinopathy in patients with T2DM. Our findings once again highlighted the importance of ambulatory BP monitoring and targeted antihypertensive therapy directed toward to restore normal circadian BP in patients with T2DM.
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Observational Study
Evaluation of willingness to pay per quality-adjusted life year for a cure: A contingent valuation method using a scenario-based survey.
Cost-effectiveness is 1 of the most important factors in medicine reimbursement, and social willingness to pay (WTP) can provide evidence for the threshold of cost-effectiveness analysis. Recently, the concept of curative medicines has been introduced, so it is necessary to study their cost-effectiveness. This study aimed to estimate WTP per quality-adjusted life year (QALY) for a cure in the Korean general population. ⋯ The results for the prolonged treatment effect scenarios were KRW 22 million/QALY and KRW 27 million/QALY, which are 1.4 and 1.8 times higher than the non-cure scenario, respectively. In all scenarios, the statistically significant factors affecting WTP per QALY were higher education, higher household income, and healthcare provider. This study revealed that WTP for a cure treatment was higher than that for non-cure; this higher WTP should be considered in future decision-making regarding curative treatments.
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Case Reports
Multiple myeloma with pathologically proven skull plasmacytoma after a mild head injury: Case report.
MM is a malignant tumor originating from the plasma cells of the bone marrow. Central nervous system myelomatosis is very rare and may be a complication of MM. ⋯ Despite a history of head injury, a differential diagnosis should be kept in mind during the diagnosis of solid intracranial-extracranial masses, especially in the presence of osteolytic skull at the lesioned site.
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Ulcerative colitis (UC) may severely limit patients' capacity to work. Recently, we validated a work disability questionnaire (WDQ) for Crohn disease. As UC shares clinical characteristics with Crohn disease, we hypothesized that the questionnaire might also be useful for UC. ⋯ Validation of the UC-WDQ included an assessment of its construct validity, including: discriminant validity, convergent validity, and reproducibility (test-retest). We also calculated the intraclass correlation and the Cronbach alpha. The UC-WDQ is a valid and reliable tool for measuring work disability in patients with UC.
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Warfarin is the most common oral anticoagulant. Because of a narrow therapeutic range, interindividual differences in drug responses, and the risk of bleeding, there are many challenges in using warfarin. We need to predict the warfarin maintenance dose. ⋯ Our model had a mean percentage error of 26.9%, the other 5 models have the mean percentage error of 27.7%, 27.2%, 52.3%, 45.7%, and 29.3%, respectively. Physicians can not adopt algorithm from other race directly to predict warfarin dose in patients with heart valve replacements, they should establish a new algorithm or adjust another algorithm to fit their patients. The algorithm established in this study has the potential to assist physicians in determining warfarin doses that are close to the appropriate doses.