26 research outputs found

    Tuberkuloosihaigestumus Eestis 2012-2013

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    Pulmonoloogia. Uued suunad ravimiresistentse tuberkuloosi ravis

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    Eesti Arst 2019; 98(4):233–23

    The State of Competitive Intelligence within New Zealand Private and Public Sector Organisations: a Comparison Study of Competitive Intelligence within New Zealand in 2009

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    Globalisation and rapid technology advancements are having a profound change on the competitiveness of local and global markets, and shaping the New Zealand marketplace. New Zealand companies are not just competing against other New Zealand companies, but are also competing against global companies. Competitive intelligence is critical for informing vital business decisions and potentially for the viability of a company. The purpose of this study was to research the state of competitive intelligence within the New Zealand private and public sectors and benchmark them against a similar study by Trengrove and Vryenhoek (1997). This research report further explores the relationship between knowledge management and competitive intelligence by examining the culture of competitive intelligence in an information (knowledge) economy through the analysis of competitive intelligence attitudes (Rouach and Santi 2001), 'Strategic Protection Factors' (Rothberg and Erickson, 2005), value and mindset of managing knowledge, and competitive intelligence within New Zealand companies

    Reumatoidartriidi patsientide haigestumus tuberkuloosi enne ja pärast bioloogilise ravi kasutuselevõttu Eestis: kahe perioodi võrdlus

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    Taust. Bioloogilise ravi (BR) kasutuselevõtt reumaatiliste haiguste korral on võimaldanud saavutada oluliselt paremaid ravitulemusi. BRi probleemiks on patsientide suurenenud vastuvõtlikkus infektsioonidele ja sagenenud haigestumine tuberkuloosi (TB). Eesmärgid. Võrrelda TB-haigestumust reumatoidartriidi (RA) haigetel enne ja pärast BRi kasutuselevõttu Eestis; kirjeldada TB esinemist BRi saavatel RA-patsientidel. Meetodid. Eesti Haigekassa andmete alusel koostati valim isikutest, kellel aastatel 2004–2017 oli diagnoositud RA koodidega M05 ja M06.0. RA-patsientidel registreeritud TB-juhud leiti linkimisel tuberkuloosiregistriga. Üldrahvastiku TB-haigestumuse hindamiseks kasutati tuberkuloosiregistrit ja Eesti Statistikaameti andmebaasi. Leiti RA-patsientide TB-haigestumus ajavahemikul 2000–2007 ja 2008–2016. Arvutati RA-patsientide vanuse ja soo järgi standarditud TB-haigestumusmäär võrreldavatel perioodidel. Bioloogilise ravi registrist saadi teave TBsse haigestunud RA-patsientide BRi kohta. Tulemused. RA-patsientide üldarv haigekassa andmebaasis oli 5040. Ühe aasta keskmine TB-haigestumus 100 000 RA-patsiendi kohta oli 24,8 perioodil 2000–2007 ja 30,9 perioodil 2008–2016. RA-patsientide standarditud haigestumusmäär (võrreldes üldrahvastikuga) oli 77% (95% usaldusvahemik 41–143) perioodil 2000–2007 ja 200% (95% usaldusvahemik 118–338) perioodil 2008–2016. Bioloogilist ravi sai kolm TBsse haigestunud RA-patsienti. Järeldused. Üldrahvastiku TB-haigestumuse vähenemise foonil on TB-haigestumus RA-patsientidel perioodide 2000–2007 ja 2008–2016 võrdluses suurenenud. Perioodil 2008–2016 oli RA-patsientide TB-haigestumus suurem üldrahvastiku TB-haigestumusest. RA-patsientide TB-haigestumuse suurenemine võib olla seotud BRi kasutuselevõtuga

    Modeling treatment effect modification in multidrug-resistant tuberculosis in an individual patient data meta-analysis

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    Effect modification occurs while the effect of the treatment is not homogeneous across the different strata of patient characteristics. When the effect of treatment may vary from individual to individual, precision medicine can be improved by identifying patient covariates to estimate the size and direction of the effect at the individual level. However, this task is statistically challenging and typically requires large amounts of data. Investigators may be interested in using the individual patient data (IPD) from multiple studies to estimate these treatment effect models. Our data arise from a systematic review of observational studies contrasting different treatments for multidrug-resistant tuberculosis (MDR-TB), where multiple antimicrobial agents are taken concurrently to cure the infection. We propose a marginal structural model (MSM) for effect modification by different patient characteristics and co-medications in a meta-analysis of observational IPD. We develop, evaluate, and apply a targeted maximum likelihood estimator (TMLE) for the doubly robust estimation of the parameters of the proposed MSM in this context. In particular, we allow for differential availability of treatments across studies, measured confounding within and across studies, and random effects by study

    Drug Susceptibility Patterns in MDR-TB Patients:Challenges for Future Regimen Design. A Cross-Sectional Study

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    Globally, there is substantial concern regarding the challenges of treating complex drug resistance patterns in multidrug resistant tuberculosis cases. Utilising data from three different settings (Estonia, Latvia, Romania) we sought to contrast drug susceptibility profiles for multidrug resistant tuberculosis cases, highlight the difficulties in designing universal regimen, and inform future regimen selection. Demographic and microbiological surveillance data for multidrug resistant tuberculosis cases from 2004-13 were analysed. High levels of additional resistance to currently recommended second line drugs were seen in all settings, with extensive variability between countries. Accurate drug susceptibility testing and drug susceptibility testing data are vital to inform the development of comprehensive, flexible, multidrug resistant tuberculosis guidance
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