Reduced costs with bisoprolol treatment for heart failure - An economic analysis of the second Cardiac Insufficiency Bisoprolol Study (CIBIS-II)

Background Beta-blockers, used as an adjunctive to diuretics, digoxin and angiotensin converting enzyme inhibitors, improve survival in chronic heart failure. We report a prospectively planned economic analysis of the cost of adjunctive beta-blocker therapy in the second Cardiac Insufficiency BIsoprolol Study (CIBIS II). Methods Resource utilization data (drug therapy, number of hospital admissions, length of hospital stay, ward type) were collected prospectively in all patients in CIBIS . These data were used to determine the additional direct costs incurred, and savings made, with bisoprolol therapy. As well as the cost of the drug, additional costs related to bisoprolol therapy were added to cover the supervision of treatment initiation and titration (four outpatient clinic/office visits). Per them (hospital bed day) costings were carried out for France, Germany and the U.K. Diagnosis related group costings were performed for France and the U.K. Our analyses took the perspective of a third party payer in France and Germany and the National Health Service in the U.K. Results Overall, fewer patients were hospitalized in the bisoprolol group, there were fewer hospital admissions perpatient hospitalized, fewer hospital admissions overall, fewer days spent in hospital and fewer days spent in the most expensive type of ward. As a consequence the cost of care in the bisoprolol group was 5-10% less in all three countries, in the per them analysis, even taking into account the cost of bisoprolol and the extra initiation/up-titration visits. The cost per patient treated in the placebo and bisoprolol groups was FF35 009 vs FF31 762 in France, DM11 563 vs DM10 784 in Germany and pound 4987 vs pound 4722 in the U.K. The diagnosis related group analysis gave similar results. Interpretation Not only did bisoprolol increase survival and reduce hospital admissions in CIBIS II, it also cut the cost of care in so doing. This `win-win' situation of positive health benefits associated with cost savings is Favourable from the point of view of both the patient and health care systems. These findings add further support for the use of beta-blockers in chronic heart failure

The Elastic Surface Layer Model for Animated Character Construction

A model is described for creating three-dimensional animated characters. In this new type of layered construction technique, called the elastic surface layer model, a simulated elastically deformable skin surface is wrapped around a traditional kinematic articulated figure. Unlike previous layered models, the skin is free to slide along the underlying surface layers constrained by reaction forces which push the surface out and spring forces which pull the surface in to the underlying layers. By tuning the parameters of the physically-based model, a variety of surface shapes and behaviors can be obtained such as more realistic-looking skin deformation at the joints, skin sliding over muscles, and dynamic effects such as squash-and-stretch and followthrough. Since the elastic model derives all of its input forces from the underlying articulated figure, the animator may specify all of the physical properties of the character once, during the initial character design process, after which a complete animation sequence can be created using a traditional skeleton animation technique. A reasonably complex character at low surface resolution can be simulated at interactive speeds so than an animator can both design the character and animate it in a completely interactive, direct-manipulation environment. Once a motion sequence has been specified, the entire simulation can be recalculated at a higher surface resolution for better visual results. An implementation on a Silicon Graphics Iris workstation is described

Increased basal and alum-induced interleukin-6 levels in geriatric patients are associated with cardiovascular morbidity.

Low-grade systemic inflammation was suggested to participate to the decline of physiological functions and increased vulnerability encountered in older patients. Geriatric syndromes encompass various features such as functional dependence, polymorbidity, depression and malnutrition. There is a strong prevalence of cardiovascular diseases and related risk factors and chronic cytomegalovirus infections in the geriatric population. As these underlying conditions were proposed to influence the inflammatory state, the aim of this study was to assess their potential contribution to the association of geriatric syndromes with inflammatory parameters.Journal ArticleResearch Support, Non-U.S. Gov'tSCOPUS: ar.jinfo:eu-repo/semantics/publishe