Economic evaluation of laparoscopic surgery for colorectal cancer

Objectives: To assess the cost-effectiveness of laparoscopic surgery compared with open surgery for the treatment of colorectal cancer. Methods: A Markov model was developed to model cost-effectiveness over 25 years. Data on the clinical effectiveness of laparoscopic and open surgery for colorectal cancer were obtained from a systematic review of the literature. Data on costs came from a systematic review of economic evaluations and from published sources. The outcomes of the model were presented as the incremental cost per life year gained and using cost-effectiveness acceptability curves (CEACs) to illustrate the likelihood that a treatment was cost-effective at various threshold values for society’s willingness to pay for an additional life year. Results: Laparoscopic surgery was on average £300 more costly and slightly less effective than open surgery and had a 30% chance of being cost-effective if society is willing to pay £30,000 for a life year. One interpretation of the available data suggests equal survival and disease-free survival. Making this assumption, laparoscopic surgery had a greater chance of being considered cost-effective. Presenting the results as incremental cost per quality adjusted life year (QALY) made no difference to the results, as utility data were poor. Evidence suggests short-term benefits following laparoscopic repair. This benefit would have to be at least 0.01 of a QALY for laparoscopic surgery to be considered cost-effective. Conclusions: Laparoscopic surgery is likely to be associated with short-term quality of life benefits, similar long-term outcomes and an additional £300 per patient. A judgement is required as to whether the short-term benefits are worth this extra cost.Peer reviewedAuthor versio

ANTITHROMBOTIC PROPHYLAXIS IN LAPAROSCOPIC CHOLECYSTECTOMY

Pulmonary thromboembolism is a common cause of in-hospital death. In moderate or high risk patients undergoing laparotomy, acute and long-term mortality can be effec-tively reduced with an appropriate prophylactic drug treatment, while in low-risk patients undergoing laparoscopy, the correlation between the thromboembolism risk and the pro-cedure itself, as well as potential benefits of thromboprophylaxis are, at present, unclear. Here we report the case of E., a 49-year-old woman with patent foramen ovale, consid-ered to be at low risk of thromboembolism, who experienced a sudden cardiopulmonary arrest following a laparoscopic cholecystectomy and died four days later. . The purpose of this case report is to highlight the necessity of continuing large sample studies on the correlation between laparoscopic surgery and thromboembolism in low-risk patients

Visual analytics for the interpretation of fluency tests during Alzheimer evaluation

International audienceA possible way to evaluate the progress of Alzheimer disease is to conduct the Isaac set test [13, 14]. In this activity, patients are asked to cite the largest possible number of city names within a minute. Since the city names are handwritten very quickly by a medical practitioner some cities are abbreviated or poorly written. In order to analyze such data, medical practitioners need to digitize the notes first and clean the dataset. Because these tasks are intricate and error prone we propose a novel set of tools, involving interactive visualization techniques, to help medical practitioners in the digitization and data-cleaning process. This system will be tested as part of an ongoing longitudinal study involving 9500 patients

A study on assessment of scholastic dropout and its determinants in adolescents residing in Raipur city of Chhattisgarh state

Background: In India, adolescents (10-19 years) constitute one fifth of the total population providing promising pillar for our nation’s future. Being a sensitive and key transitional period of life adolescents living environment (Family, school, Peers etc.) can present new challenges for these adolescents and symptoms of dysfunction may occur. Schooling constitutes major part of adolescent’s life, moulding them for bright future  but problem like scholastic dropout deprive them & can play as major factor determining their future perspective with regard to personal and social achievements. With  this  background,  the  present  study  was  conducted to  assess  the prevalence  of  Scholastic dropout   problems  in  adolescents, and its determinants in Raipur city (C.G.) IndiaMethods: Cross-sectional community based study was done, using multi stage simple random sampling 32 study (urban & slum) areas was selected. 643 adolescents were interviewed with prior consent by house to house survey.  Results: Problem of scholastic dropout was 10.89%. Major determinants contributing were socioeconomic status, mother’s education, family violence, poor academic performance, Substance abuse.Conclusions: Scholastic dropout seems to be small yet a prevalent problem in our society inspite of many government initiatives and as found in the study problem is multipronged indicating adoption of a holistic approach to alleviate whole environment in which adolescents live in.

“Putting the Arts in their Place”: A Case for Map-Making in Art History

The use of cartography in art history is less than common. Because of its link to the old artistic geography (Kunstgeographie) once used to defend nationalist issues in Nazi Germany, it fell into disfavor until the 1960s and 1970s, when maps regained some attention from a new generation of art historians. Mapping arts indeed proves to be very useful to visualize and organize large dataset and to formulate new hypotheses, both as a descriptive and a prospective tool. The challenge we proposed to the authors was to use maps for questioning the territorial logics, the centers and peripheries of the art worlds, the places of artistic activities and their specificities

Rancang Bangun Pembangkit Pulsa Tiga Sensor Ultrasonik Untuk Pendeteksi Kecacatan Beton Berbasis Mikrokontroler

NDT Research conducted to detect any defects on a solid materials. This method is done because not damage the object being tested. Various methods of NDT research also studied, one of which is a multi-transmitter. Multi-transmitter more efficient in scanning objects defective because a more extensive range of sensors. Prioritizing advantages compared with other pulse sources such as AFG, including portable, small radiation, the price relatively cheaper, variety of frequencies that can be generated, and smaller power supplies will be used microcontroller as signal generator.With this concept, generating ultrasonic waves 40kHz emitted by three transmitter input from serial PC to microcontroller and converted into analog signal AD9850 module. Amplitude of the frequency of AD9850 strengthened using LM386, and strengthened again using transfomator ferrite core. And choose sensor, used switches. From research conducted by a few conclusions. Maximum of output voltage AD9850 module is 1.04 V. Maximum output voltage of  LM386 is ± 14 V and maximum voltage output of  ferrite transformator is ± 170 V. The effective transmitter is  SRF04 and maximum input voltage is  ± 60 V. Amplitude of wave will be smaller if reflection distance farther, otherwise amplitude increases if the reflection distance is closer