How does comorbidity affect cost of health care in patients with irritable bowel syndrome? A cohort study in general practice

<p>Abstract</p> <p>Background</p> <p>Irritable bowel syndrome (IBS) is associated with other disorders (comorbidity), reduced quality of life and increased use of health resources. We aimed to explore the impact of comorbidity on cost of health care in patients with IBS in general practice.</p> <p>Methods</p> <p>In this cohort study 208 consecutive patients with IBS (Rome II) were recruited. Sociodemographic data, IBS symptoms, and comorbidity (somatic symptoms, organic diseases and psychiatric disorders) were assessed at baseline. Based on a follow up interview after 6-9 months and use of medical records, IBS and non-IBS related health resource use were measured as consultations, hospitalisations, use of medications and alternative health care products and sick leave days. Costs were calculated by national tariffs and reported in Norwegian Kroner (NOK, 1 EURO equals 8 NOK). Multivariate analyses were performed to identify predictors of costs.</p> <p>Results</p> <p>A total of 164 patients (mean age 52 years, 69% female, median duration of IBS 17 years) were available at follow up, 143 patients (88%) had consulted their GP of whom 31 (19%) had consulted for IBS. Mean number of sick- leave days for IBS and comorbidity were 1.7 and 16.3 respectively (p < 0.01), costs related to IBS and comorbidity were 954 NOK and 14854 NOK respectively (p < 0.001). Age, organic diseases and somatic symptoms, but not IBS severity, were significant predictors for total costs.</p> <p>Conclusion</p> <p>Costs for health resource use among patients with IBS in general practice were largely explained by comorbidity, which generated ten times the costs for IBS.</p

Hypnosis as a treatment of chronic widespread pain in general practice: A randomized controlled pilot trial

<p>Abstract</p> <p>Background</p> <p>Hypnosis treatment in general practice is a rather new concept. This pilot study was performed to evaluate the effect of a standardized hypnosis treatment used in general practice for patients with chronic widespread pain (CWP).</p> <p>Methods</p> <p>The study was designed as a randomized control group-controlled study. Sixteen patients were randomized into a treatment group or a control group, each constituting eight patients. Seven patients in the treatment group completed the schedule. After the control period, five of the patients in the control group also received treatment, making a total of 12 patients having completed the treatment sessions. The intervention group went through a standardized hypnosis treatment with ten consecutive therapeutic sessions once a week, each lasting for about 30 minutes, focusing on ego-strengthening, relaxation, releasing muscular tension and increasing self-efficacy. A questionnaire was developed in order to calibrate the symptoms before and after the 10 weeks period, and the results were interpolated into a scale from 0 to 100, increasing numbers representing increasing suffering. Data were analyzed by means of T-tests.</p> <p>Results</p> <p>The treatment group improved from their symptoms, (change from 62.5 to 55.4), while the control group deteriorated, (change from 37.2 to 45.1), (p = 0,045). The 12 patients who completed the treatment showed a mean improvement from 51.5 to 41.6. (p = 0,046). One year later the corresponding result was 41.3, indicating a persisting improvement.</p> <p>Conclusion</p> <p>The study indicates that hypnosis treatment may have a positive effect on pain and quality of life for patients with chronic muscular pain. Considering the limited number of patients, more studies should be conducted to confirm the results.</p> <p>Trial Registration</p> <p>The study was registered in ClinicalTrials.gov and released 27.08.07 Reg nr NCT00521807 Approval Number: 05032001.</p

Plasma and Muscle Myostatin in Relation to Type 2 Diabetes

OBJECTIVE: Myostatin is a secreted growth factor expressed in skeletal muscle tissue, which negatively regulates skeletal muscle mass. Recent animal studies suggest a role for myostatin in insulin resistance. We evaluated the possible metabolic role of myostatin in patients with type 2 diabetes and healthy controls. DESIGN: 76 patients with type 2 diabetes and 92 control subjects were included in the study. They were matched for age, gender and BMI. Plasma samples and biopsies from the vastus lateralis muscle were obtained to assess plasma myostatin and expression of myostatin in skeletal muscle. RESULTS: Patients with type 2 diabetes had higher fasting glucose (8.9 versus 5.1 mmol/L, P<0.001), plasma insulin (68.2 versus 47.2 pmol/L, P<0.002) and HOMA2-IR (1.6 versus 0.9, P<0.0001) when compared to controls. Patients with type 2 diabetes had 1.4 (P<0.01) higher levels of muscle myostatin mRNA content than the control subjects. Plasma myostatin concentrations did not differ between patients with type 2 diabetes and controls. In healthy controls, muscle myostatin mRNA correlated with HOMA2-IR (r = 0.30, P<0.01), plasma IL-6 (r = 0.34, P<0.05) and VO2 max (r = -0.26, P<0.05), however, no correlations were observed in patients with type 2 diabetes. CONCLUSIONS: This study supports the idea that myostatin may have a negative effect on metabolism. However, the metabolic effect of myostatin appears to be overruled by other factors in patients with type 2 diabetes

Catalytic properties of oxide nanoparticles applied in gas sensors

A series of gas sensing layers based on indium oxide doped with gold were prepared by using the aerosol technology for deposition as the active contact layer in a metal oxide semiconductor capacitive device. The interaction between the measured species and the insulator surface was quantified as the voltage changes at a constant capacitance of the device. The sensor properties were investigated in the presence of H2, CO, NH3, NO, NO2 and C3H6 at temperatures between 100–400 °C. Significant differences in the morphology of the layer and its sensitivity were noted for different preparation methods and different gas environments

Nanoparticles for long-term stable, more selective MISiCFET gas sensors

Synthesis of metal-oxide nanoparticles and utilization of these particles as gate materials for field-effect sensor devices is reported. Improved selectivity to specific gases is expected by modulating the size of the oxide nanoparticles or impregnating them with catalytic metals. Another objective is to improve the long-term thermal stability of the sensors, since the metal loaded nanoparticles may prevent thermally induced restructuring of the gate layer, which is often a problematic issue for the catalytic metal layers. Because of its reasonably high electrical conductivity, which is especially important for the capacitive gas sensors, ruthenium dioxide has been identified to be one of the potential candidates as gate material for the field-effect sensor devices. Interestingly, this material has been found to change its resistivity in different gaseous ambients. When used as a gate material, sensitivity to reducing gases has been observed for the RuO2/SiO2/4H-SiC capacitors. Changes in the resistivity of the films due to various gas exposures have also been recorded. Morphological studies of nanoparticles (SiO2 and Al2O3), loaded or impregnated with catalytic metals (e.g. Pt), have been performed

Metal oxide nanoparticles as novel gate materials for field-effect gas sensors

Oxide nanoparticle layers have shown interesting behavior as gate materials for high temperature (typically at 300-400°C) metal-insulator-silicon carbide (MISiC) capacitive sensors. Distinct shifts in the depletion region of the C-V (capacitance-voltage) characteristics could be observed while switching between different oxidizing and reducing gas ambients (air, O2, H2, NH3, CO, NOx, C3H6). Shifts were also noticed in the accumulation region of the C-V curves, which can be attributed to the change in resistivity of the gate material. Sensor response patterns have been found to depend on operating temperature