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Syed AZ. Soft Tissue Calcifications in the Head and Neck Region. Dent Clin North Am 2024; 68:375-391. [PMID: 38417996 DOI: 10.1016/j.cden.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
This article provides an overview of the soft tissue calcifications in the head and neck region as noted on dental imaging, with particular focus on the radiographic appearance of these entities..
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Affiliation(s)
- Ali Z Syed
- Oral and Maxillofacial Medicine and Diagnostic Sciences, School of Dental Medicine - Case Western Reserve University, 9601 Chester Avenue, Cleveland, OH 44106, USA.
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2
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Lucas-Noll J, Clua-Espuny JL, Lleixà-Fortuño M, Gavaldà-Espelta E, Queralt-Tomas L, Panisello-Tafalla A, Carles-Lavila M. The costs associated with stroke care continuum: a systematic review. HEALTH ECONOMICS REVIEW 2023; 13:32. [PMID: 37193926 DOI: 10.1186/s13561-023-00439-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 04/18/2023] [Indexed: 05/18/2023]
Abstract
Stroke, a leading cause of death and long-term disability, has a considerable social and economic impact. It is imperative to investigate stroke-related costs. The main goal was to conduct a systematic literature review on the described costs associated with stroke care continuum to better understand the evolution of the economic burden and logistic challenges. This research used a systematic review method. We performed a search in PubMed/MEDLINE, ClinicalTrial.gov, Cochrane Reviews, and Google Scholar confined to publications from January 2012 to December 2021. Prices were adjusted using consumer price indices of the countries in the studies in the years the costs were incurred to 2021 Euros using the World Bank and purchasing power parity exchange rate in 2020 from the Organization for Economic Co-operation and Development with the XE Currency Data API. The inclusion criteria were all types of publications, including prospective cost studies, retrospective cost studies, database analyses, mathematical models, surveys, and cost-of-illness (COI) studies. Were excluded studies that (a) were not about stroke, (b) were editorials and commentaries, (c) were irrelevant after screening the title and abstract,(d) grey literature and non-academic studies, (e) reported cost indicators outside the scope of the review, (f) economic evaluations (i.e., cost-effectiveness or cost-benefit analyses); and (g) studies not meeting the population inclusion criteria. There may be risk of bias because the effects are dependent on the persons delivering the intervention. The results were synthetized by PRISMA method. A total of 724 potential abstracts were identified of which 25 articles were pulled for further investigation. The articles were classified into the following categories: 1)stroke primary prevention, 2) expenditures related to acute stroke care, 3) expenditures for post-acute strokes, and 4) global average stroke cost. The measured expenditures varied considerably among these studies with a global average cost from €610-€220,822.45. Given the great variability in the costs in different studies, we can conclude that we need to define a common system for assessing the costs of strokes. Possible limitations are related to clinical choices exposed to decision rules that trigger decisions alerts within stroke events in a clinical setting. This flowchart is based on the guidelines for acute ischemic stroke treatment but may not be applicable to all institutions.
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Affiliation(s)
- Jorgina Lucas-Noll
- Department of Primary Care, Institut Català de La Salut, Av. de Cristòfol Colom, 20, Tortosa, Tarragona, 43500, Spain.
- University Institute for Primary Health Care Research Jordi Gol I Gurina (IDIAPJGol), Barcelona, Spain.
| | - José L Clua-Espuny
- Department of Primary Care, Institut Català de La Salut, Av. de Cristòfol Colom, 20, Tortosa, Tarragona, 43500, Spain
- University Institute for Primary Health Care Research Jordi Gol I Gurina (IDIAPJGol), Barcelona, Spain
| | - Mar Lleixà-Fortuño
- Department of Nursing, Universitat Rovira I Virgili, Tarragona, Tarragona, Spain
| | - Ester Gavaldà-Espelta
- Department of Primary Care, Institut Català de La Salut, Av. de Cristòfol Colom, 20, Tortosa, Tarragona, 43500, Spain
- Department of Nursing, Universitat Rovira I Virgili, Tarragona, Tarragona, Spain
| | - Lluïsa Queralt-Tomas
- Department of Primary Care, Institut Català de La Salut, Av. de Cristòfol Colom, 20, Tortosa, Tarragona, 43500, Spain
- University Institute for Primary Health Care Research Jordi Gol I Gurina (IDIAPJGol), Barcelona, Spain
| | - Anna Panisello-Tafalla
- Department of Primary Care, Institut Català de La Salut, Av. de Cristòfol Colom, 20, Tortosa, Tarragona, 43500, Spain
- University Institute for Primary Health Care Research Jordi Gol I Gurina (IDIAPJGol), Barcelona, Spain
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Nau T, Bauman A, Smith BJ, Bellew W. A scoping review of systems approaches for increasing physical activity in populations. Health Res Policy Syst 2022; 20:104. [PMID: 36175916 PMCID: PMC9524093 DOI: 10.1186/s12961-022-00906-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/02/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction The past decade has increasingly seen systems approaches as a featured theme in public health studies and policy documents. This trend is evident in the area of physical activity, which is a significant global health risk factor that is addressed in WHO’s Global Action Plan on Physical Activity. We undertook a comprehensive scoping review to characterize the application of systems approaches to physical activity, to develop a typology of the objectives, themes and methods of research papers that purported to apply systems thinking to this issue. Methods We searched electronic databases (PubMed, Web of Science, Scopus and PsycINFO) for studies published during the period 2010–2021 that explicitly applied systems approaches or methods to investigate and/or address population physical activity. A framework using systems-based methodological approaches was adapted to classify physical activity studies according to their predominant approach, covering basic descriptive, complex analytical and advanced forms of practice. We selected case studies from retained studies to depict the current “state of the art”. Results We included 155 articles in our narrative account. Literature reporting the application of systems approaches to physical activity is skewed towards basic methods and frameworks, with most attention devoted to conceptual framing and predictive modelling. There are few well-described examples of physical activity interventions which have been planned, implemented and evaluated using a systems perspective. There is some evidence of “retrofitted” complex system framing to describe programmes and interventions which were not designed as such. Discussion We propose a classification of systems-based approaches to physical activity promotion together with an explanation of the strategies encompassed. The classification is designed to stimulate debate amongst policy-makers, practitioners and researchers to inform the further implementation and evaluation of systems approaches to physical activity. Conclusion The use of systems approaches within the field of physical activity is at an early stage of development, with a preponderance of descriptive approaches and a dearth of more complex analyses. We need to see movement towards a more sophisticated research agenda spanning the development, implementation and evaluation of systems-level interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s12961-022-00906-2.
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Affiliation(s)
- Tracy Nau
- Prevention Research Collaboration, Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. .,The Australian Prevention Partnership Centre, Sydney, NSW, Australia.
| | - Adrian Bauman
- Prevention Research Collaboration, Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,The Australian Prevention Partnership Centre, Sydney, NSW, Australia
| | - Ben J Smith
- Prevention Research Collaboration, Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,The Australian Prevention Partnership Centre, Sydney, NSW, Australia
| | - William Bellew
- Prevention Research Collaboration, Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,The Australian Prevention Partnership Centre, Sydney, NSW, Australia
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Rodrigues MDS, Santana LFE, Fernandes Castro AP, Almeida Coelho KK, Guimarães MP, Gomes OV, Schwingel PA, de Cerqueira RB, Guimarães MD, de Moura JC. Awareness towards stroke among high school students in Brazil: a cross-sectional study. SAO PAULO MED J 2022; 140:525-530. [PMID: 35508010 PMCID: PMC9491467 DOI: 10.1590/1516-3180.2021.0659.r2.13102021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/13/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Stroke is one of the main causes of death worldwide. Educational interventions on stroke are potentially effective in reducing the period between the onset of symptoms and the initial emergency medical assistance. OBJECTIVES To assess high school students' knowledge of stroke. DESIGN AND SETTING Cross-sectional study conducted in high schools in northeastern Brazil. METHODS A self-structured questionnaire survey regarding stroke awareness was applied among high school students in northeastern Brazil. Data were collected between 2018 and 2019. The chi-square test and other descriptive statistics were used. Univariate and multivariate analyses were performed using logistic regression. RESULTS A total of 1,788 students were analyzed. Eighty percent (n = 1430) of them did not have the minimum knowledge on how to act in a stroke situation. Only 10% (n = 179) presented the ideal knowledge on how to act. Males presented lower levels of knowledge on risk factors (odds ratio, OR: 0.62%; 95% confidence interval, CI: 0.49-0.79) and signs and symptoms of stroke (OR: 0.63%; 95% CI: 0.52-0.77). Students with ≥ 10 years of schooling (OR: 1.64%; 95% CI: 1.30-2.07) demonstrated greater knowledge of signs and symptoms of stroke. Students aged 18 years (OR: 1.70%; 95% CI: 1.14-2.52) demonstrated greater knowledge than other ages regarding the telephone number of the emergency medical services. CONCLUSIONS There was a knowledge deficit with regard to recognizing stroke and activating the emergency medical services. The findings apply to the sample investigated and suggest that there is a need for stroke educational interventions, starting in high school.
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Affiliation(s)
- Mateus de Sousa Rodrigues
- Undergraduate Medical Student, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina (PE), Brazil
| | | | | | | | - Manoel Pereira Guimarães
- Undergraduate Medical Student, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina (PE), Brazil
| | - Orlando Vieira Gomes
- MSc. Professor, School of Medicine, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina (PE), Brazil
| | - Paulo Adriano Schwingel
- PhD. Professor, Human Performance Research Laboratory, Universidade de Pernambuco (UPE), Pernambuco (PE), Brazil
| | - Renato Bispo de Cerqueira
- MD. Professor, School of Medicine, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina (PE), Brazil
| | - Marcos Duarte Guimarães
- PhD. Professor, School of Medicine, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina (PE), Brazil
| | - José Carlos de Moura
- PhD. Professor, School of Medicine, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina (PE), Brazil
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Ajmi SC, Kurz MW, Ersdal H, Lindner T, Goyal M, Issenberg SB, Vossius C. Cost-effectiveness of a quality improvement project, including simulation-based training, on reducing door-to-needle times in stroke thrombolysis. BMJ Qual Saf 2021; 31:569-578. [PMID: 34599087 DOI: 10.1136/bmjqs-2021-013398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 09/23/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Rapid revascularisation in acute ischaemic stroke is crucial to reduce its total burden including societal costs. A quality improvement (QI) project that included streamlining the stroke care pathway and simulation-based training was followed by a significant reduction in median door-to-needle time (27 to 13 min) and improved patient outcomes after stroke thrombolysis at our centre. Here, we present a retrospective cost-effectiveness analysis of the QI project. METHODS Costs for implementing and sustaining QI were assessed using recognised frameworks for economic evaluations. Effectiveness was calculated from previously published outcome measures. Cost-effectiveness was presented as incremental cost-effectiveness ratios including costs per minute door-to-needle time reduction per patient, and costs per averted death in the 13-month post-intervention period. We also estimated incremental cost-effectiveness ratios for a projected 5-year post-intervention period and for varying numbers of patients treated with thrombolysis. Furthermore, we performed a sensitivity analysis including and excluding costs of unpaid time. RESULTS All costs including fixed costs for implementing the QI project totalled US$44 802, while monthly costs were US$2141. We calculated a mean reduction in door-to-needle time of 13.1 min per patient and 6.36 annual averted deaths. Across different scenarios, the estimated costs per minute reduction in door-to-needle time per patient ranged from US$13 to US$29, and the estimated costs per averted death ranged from US$4679 to US$10 543. CONCLUSIONS We have shown that a QI project aiming to improve stroke thrombolysis treatment at our centre can be implemented and sustained at a relatively low cost with increasing cost-effectiveness over time. Our work builds on the emerging theory and practice for economic evaluations in QI projects and simulation-based training. The presented cost-effectiveness data might help guide healthcare leaders planning similar interventions.
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Affiliation(s)
- Soffien Chadli Ajmi
- Department of Neurology, Stavanger University Hospital, Stavanger, Norway .,Faculty of Health Sciences, Universitetet i Stavanger, Stavanger, Norway
| | - Martin W Kurz
- Department of Neurology, Stavanger University Hospital, Stavanger, Norway.,Institute of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Hege Ersdal
- Faculty of Health Sciences, Universitetet i Stavanger, Stavanger, Norway.,Department of Anaesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway
| | - Thomas Lindner
- Department of Anaesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway.,The Regional Centre for Emergency Medical Research and Development, Stavanger, Norway
| | - Mayank Goyal
- Department of Radiology and Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - S Barry Issenberg
- The Gordon Centre for Research in Medical Education, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Corinna Vossius
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
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Thomas S. Re: Defect-free care trends in the Paul Coverdell National Acute Stroke Program, program, 2008-2018. Am Heart J 2021; 236:110-111. [PMID: 33902824 DOI: 10.1016/j.ahj.2021.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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