Economic evaluation of computed tomography in a teaching hospital

Computed tomography is very important for accurate diagnosis of some health conditions. However, the procurement and maintenance of CT equipment is expensive and the operating cost per study is high. Against the backdrop, that financial resources are scarce, prudent management and appropriate price fixing of CT scanning procedures is necessary for continuity in business. Objectives: To evaluate the operations of a CT facility employing accounting, financial, and management principles to elucidate how to optimize economic gains in the operations of medical imaging facilities. Method: Record of CT scans done at the University of Port Harcourt Teaching Hospital (UPTH) from May, 2007 to December, 2008 and the revenues generated from the studies were obtained and used for economic performance evaluation of the CT facility. The evaluation was done by analyzing the average variable, fixed, and total costs, as well as the average revenue. Results: The operating cost per study for each of the studies was less than the billing per study thus, implying that profit was made per each study. Some studies contributed more to the profit per study than others e.g. sinuses, inner ear, and TMJ contributed 28,456.04 each to the profit/study while abdomen and chest contributed the least amounts of 17,792.01 and 17,818.24 respectively. Conclusion and recommendation: CT facility can generate enough profit to sustain itself if the products are adequately priced. It was therefore, recommended that part of the profit generated should be used to raise capital via a sinking fund for equipment replacement as demonstrated in the study

Holoprosencephaly In A Nigerian Female: A Case Report

Backround: Holoprosencephaly is a complex intracranial abnormality with 3 ranges of severity: Lobar, semi-lobar and alobar. The clinical presentation with typical facial anomalies is unique. Imaging with USS, CT and MRI are useful diagnostic tools. We here report the first case of holoprosencephaly in the University of Port Harcourt Teaching Hospital and highlight the clinical and radiological diagnosis of this condition.Methodology: The medical records of the patient who presented with Holoprosencephaly (HPE) and literature review of the subject using available journals and medline search were utilised. The reviewed radiologic investigation modality establishing the diagnosis was contrast enhanced computed Tomography in which axial noncontrast/postcontrast 10mm sections were taken and the axial images and reconstructions (coronal/ sagittal) were reviewed. The Computed Tomography machine used is a Helical 8 slices General Electric Machine and contrast medium administered was Iopamidol in standard dose for weightResult: A 1 day old female infant delivered in a peripheral hospital with absent nasal opening and neonatal asphyxia. Cranial computed tomography showed rudimentary nasal septum, hypotelorism and nasal apeture stenosis with absent interhemispheric fissure and falx cerebri, solitary widened monovertricle and fused thalami .Conclusion: Holoprosencephaly is a rare congenital structural anomaly of the prosencephalon that results in incomplete development of the brain. In its severe form it is incompatible with life. Its etiology is not fully establishedKeywords: holoprosencephaly; facial anomalies; Radiologic diagnosis; Nigeria

Analysis of high-identity segmental duplications in the grapevine genome

<p>Abstract</p> <p>Background</p> <p>Segmental duplications (SDs) are blocks of genomic sequence of 1-200 kb that map to different loci in a genome and share a sequence identity > 90%. SDs show at the sequence level the same characteristics as other regions of the human genome: they contain both high-copy repeats and gene sequences. SDs play an important role in genome plasticity by creating new genes and modeling genome structure. Although data is plentiful for mammals, not much was known about the representation of SDs in plant genomes. In this regard, we performed a genome-wide analysis of high-identity SDs on the sequenced grapevine (<it>Vitis vinifera</it>) genome (PN40024).</p> <p>Results</p> <p>We demonstrate that recent SDs (> 94% identity and >= 10 kb in size) are a relevant component of the grapevine genome (85 Mb, 17% of the genome sequence). We detected mitochondrial and plastid DNA and genes (10% of gene annotation) in segmentally duplicated regions of the nuclear genome. In particular, the nine highest copy number genes have a copy in either or both organelle genomes. Further we showed that several duplicated genes take part in the biosynthesis of compounds involved in plant response to environmental stress.</p> <p>Conclusions</p> <p>These data show the great influence of SDs and organelle DNA transfers in modeling the <it>Vitis vinifera </it>nuclear DNA structure as well as the impact of SDs in contributing to the adaptive capacity of grapevine and the nutritional content of grape products through genome variation. This study represents a step forward in the full characterization of duplicated genes important for grapevine cultural needs and human health.</p

Reconstructing the 2003/2004 H3N2 influenza epidemic in Switzerland with a spatially explicit, individual-based model

ABSTRACT: BACKGROUND: Simulation models of influenza spread play an important role for pandemic preparedness. However, as the world has not faced a severe pandemic for decades, except the rather mild H1N1 one in 2009, pandemic influenza models are inherently hypothetical and validation is, thus, difficult. We aim at reconstructing a recent seasonal influenza epidemic that occurred in Switzerland and deem this to be a promising validation strategy for models of influenza spread. METHODS: We present a spatially explicit, individual-based simulation model of influenza spread. The simulation model bases upon (i) simulated human travel data, (ii) data on human contact patterns and (iii) empirical knowledge on the epidemiology of influenza. For model validation we compare the simulation outcomes with empirical knowledge regarding (i) the shape of the epidemic curve, overall infection rate and reproduction number, (ii) age-dependent infection rates and time of infection, (iii) spatial patterns. RESULTS: The simulation model is capable of reproducing the shape of the 2003/2004 H3N2 epidemic curve of Switzerland and generates an overall infection rate (14.9 percent) and reproduction numbers (between 1.2 and 1.3), which are realistic for seasonal influenza epidemics. Age and spatial patterns observed in empirical data are also reflected by the model: Highest infection rates are in children between 5 and 14 and the disease spreads along the main transport axes from west to east. CONCLUSIONS: We show that finding evidence for the validity of simulation models of influenza spread by challenging them with seasonal influenza outbreak data is possible and promising. Simulation models for pandemic spread gain more credibility if they are able to reproduce seasonal influenza outbreaks. For more robust modelling of seasonal influenza, serological data complementing sentinel information would be beneficia

A review of 1000 cases presenting in a recently installed magnetic resonance imaging unit in Port Harcourt, Nigeria

No Abstract