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- Andersson, F, et al.
(författare)
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The costs of exacerbations in chronic obstructive pulmonary disease (COPD)
- 2002
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Ingår i: Respiratory Medicine. - : Elsevier BV. - 1532-3064 .- 0954-6111. ; 96:9, s. 700-708
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Tidskriftsartikel (refereegranskat)abstract
- Exacerbations are the key drivers in the costs of chronic obstructive pulmonary disease (COPD). The objective was to examine the costs of COPD exacerbations in relation to differing degrees of severity of exacerbations and of COPD. We identified 202 subjects with COPD, defined according to the BTS and ERS criteria. Exacerbations were divided into mild (self-managed), mild/moderate (telephone contact with a health-care centre and/or the use of anti biotics/systemic corticosteroids), moderate (health-care centre visits) and severe (emergency care visit or hospital admission). Exacerbations were identified by sending the subjects a letter inquiring whether they had any additional respiratory problems or influenza the previous winter. At least one exacerbation was reported by 61 subjects, who were then interviewed about resource use for these events. The average health-care costs per exacerbation were SEK 120(95% CI = 39-246), SEK 354 (252-475), SEK 2111 (1673-2612) and SEK 21852 (14436-29825) for mild, mild/moderate, moderate and severe exacerbations, respectively. Subjects with impaired lung function experienced more severe exacerbations, which was also reflected in the cost of exacerbations per severity of the disease during the 41 month study period (ranging from SEK 224 for mild to SEK 13708 for severe cases, median SEK 940). Exacerbations account for 35-45% of the total per capita health-care costs for COPD. In conclusion, costs varied considerably with the severity of the exacerbation as well as with the severity of COPD. The prevention of moderate-to-severe exacerbations could be very cost-effective and improve the quality of life.
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- Ericsson, Ann-marie, et al.
(författare)
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Operator Patterns for Analysis of Composite Events in Timed Automata
- 2003
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Ingår i: WIP Proceedings. ; , s. 1555-1558
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Konferensbidrag (refereegranskat)abstract
- Abstract—Event-triggered real-time systems interact with the environment by executing actions in response to monitored events. Such systems may be implemented using event condition action (ECA) rules, which execute an action if the associated event occurs and a specified condition is true. However, the ECA rule paradigm is known to be hard to analyze with respect to correctness and timeliness, which is not conducive to the high predictability requirements typically associated with real-time systems. To still take advantage of the ECA rule paradigm when event-triggered real-time systems are developed, we propose an approach where systems are specified and analyzed in a high-level formal language (timed automata) and later transformed into the ECA rule paradigm. We especially focus on a high-level approach for specifying and analyzing composite event occurrences in timed automata.
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- Lindgren, BF, et al.
(författare)
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Insulin-like growth factor I correlates with protein intake estimated from the normalized protein catabolic rate in hemodialysis patients
- 2000
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Ingår i: American journal of nephrology. - : S. Karger AG. - 0250-8095 .- 1421-9670. ; 20:4, s. 255-262
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background/Aim:</i> Malnutrition and catabolism are predominant problems in patients undergoing hemodialysis. The aim of this study was to clarify the relationship between insulin-like growth factor I (IGF-I), the serum levels of which are influenced by nutrition and which by itself promotes amino acid uptake, and insulin-like growth factor binding protein 1 (IGFBP-1), known to regulate serum (s) IGF-I and protein intake, in end-stage renal disease patients. <i>Methods:</i> Thirty hemodialysis patients were studied, and s-IGF-I and s-IGFBP-1 levels were measured by radioimmunoassay. The s-IGF-I method used was validated according to a reference method. The s-IGF-I standard deviation (SD) score was calculated, giving the individual deviation from the mean of a reference population. The protein intake was estimated both directly by 3-day food recall by a dietician and indirectly by normalized protein catabolic rate (PCRn). <i>Results:</i> The mean serum IGF-I level was 166 ± 10 μg/l, corresponding to a normal s-IGF-I SD score (0.5 ± 0.3). S-IGFBP-1 was elevated threefold to 101 ± 11 μg/l as compared with normal subjects. The s-albumin was 39.9 ± 0.5 g/l and the s-bicarbonate 24 ± 0.4 mmol/l. There were significant correlations between s-IGF-I SD score or s-IGF-I (log-transformed) and PCRn (r = 0.37, p < 0.004, and r = 0.41, p < 0.001, respectively). The s-IGF-I/s-IGFBP-1 ratio was also positively correlated with PCRn (r<sub>s</sub> = 0.36, p < 0.007, by Spearman’s rank correlation). The s-albumin was inversely correlated with log s-IGFBP-1 (r = –0.38, p < 0.01) and positively with the s-IGF-I/s-IGFBP-1 ratio (r = 0.36, p < 0.007) but not with s-IGF-I (p < 0.13). Serum total cholesterol, triglycerides, and total body fat as percentage of body weight correlated with s-IGF-I (r = 0.47, p < 0.004, r = 0.45, p < 0.01, and r = 0.42, p < 0.004, respectively) as well as with the s-IGF-I SD score. No correlations were seen between s-IGF-I and protein or caloric intake by direct estimates from dietary food recalls. <i>Conclusions:</i> The s-IGF-I and the s-IGF-I/s-IGFBP-1 ratio were correlated with estimates of protein intake of the patients calculated from urea kinetics (PCRn) but not with direct estimates by the dietitian. The s-IGF-I SD score and the ratio s-IGF-I/s-IGFBP-1 might be a tool to monitor anabolic status and to select hemodialysis patients for therapeutic intervention with recombinant human IGF-I and/or recombinant human growth hormone to counteract catabolism.
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