1
|
Runheim H, Kjellstrom B, Beaudet A, Ivarsson B, Husberg M, Pillai N, Levin LÅ, Bernfort L. Health care utilization and productivity loss associated with pulmonary arterial hypertension: a Swedish nationwide register study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Pulmonary arterial hypertension (PAH) is a rare and serious disease with a significant impact on the quality of life and life expectancy.
Purpose
To estimate the health care resource utilization (HCRU) and productivity loss associated with PAH five years before and five years after diagnosis in a nationwide setting, compared to a matched control group.
Methods
This retrospective observational case-control study included adult patients diagnosed with PAH and registered in the Swedish PAH registry between January 1, 2008, through June 30, 2019. The control group consisted of five individuals per PAH patient matched on sex, birth year and municipality of residence at the time of PAH patients' diagnosis. The study was based on a dataset of individual level data compiled from several interlinked Swedish national registries. Mean (SD) HCRU (inpatient, outpatient, and drug utilization) and productivity loss (sick leave and disability benefits) were summarized for patients versus controls. Patients and controls with up to five years of follow-up data, i.e. alive and uncensored, were analyzed.
Results
In total 749 PAH patients were included in this study of which, 307 were censored and 234 died during the five-year follow-up period post diagnosis. The mean (SD) age of patients and controls were 61.8 (16.2) years and 64% were female. For the PAH group, the mean number of inpatient admissions and outpatient visits followed a similar trend, with an increase starting three years prior to diagnosis that peaked at the time of diagnosis (Figure 1). After diagnosis, mean inpatient admissions and outpatient visits decreased gradually. For the PAH group, drug utilization began to increase three years before diagnosis (Figure 1) and continued to increase after diagnosis. Controls showed much lower healthcare utilization compared to the PAH group.
In a subgroup of the PAH group (work force participants only, n=449, Figure 1), the mean sick leave days per patient per year (PPPY) was three times higher for the PAH group compared to controls five years before diagnosis. On average, over the full ten-year period mean sick leave days was five times higher for PAH patients compared to controls. Mean disability pension days PPPY for the PAH group followed a similar trend as in- and outpatient utilization. This peaked around time of diagnosis and was eight times higher for the PAH group than controls. An estimation of the societal cost burden (Table 1) showed that the top cost drivers for the PAH group were drug use, disability pension and sick leave.
Conclusions
PAH is associated with a heavy economic burden on both the health care system and society, starting several years before time of diagnosis.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Actelion Pharmaceuticals, a Janssen Pharmaceutical Company of Johnson & Johnson, Allschwil, Switzerland.
Collapse
Affiliation(s)
- H Runheim
- Linkoping University, Department of Health, Medicine and Caring Sciences , Linkoping , Sweden
| | - B Kjellstrom
- Lund University, Department of Clinical Sciences Lund and Skåne University Hospital , Lund , Sweden
| | - A Beaudet
- Actelion Pharmaceuticals Ltd , Allschwil , Switzerland
| | - B Ivarsson
- Lund University, Department of Clinical Sciences Lund and Region Skåne , Lund , Sweden
| | - M Husberg
- Linkoping University, Department of Health, Medicine and Caring Sciences , Linkoping , Sweden
| | - N Pillai
- Actelion Pharmaceuticals Ltd , Allschwil , Switzerland
| | - L Å Levin
- Linkoping University, Department of Health, Medicine and Caring Sciences , Linkoping , Sweden
| | - L Bernfort
- Linkoping University, Department of Health, Medicine and Caring Sciences , Linkoping , Sweden
| |
Collapse
|
2
|
Smitha SG, Pillai N, Nayak B, Raveendran J. Correction to: A Study on Otorhinolaryngological Presentations in Covid 19 Patients in a Tertiary Health Care Center. Indian J Otolaryngol Head Neck Surg 2021; 74:3158. [PMID: 34604022 PMCID: PMC8476066 DOI: 10.1007/s12070-021-02705-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
[This corrects the article DOI: 10.1007/s12070-021-02564-2.].
Collapse
Affiliation(s)
- S. G. Smitha
- Department of ENT, Kims Hospital, Bangalore, Karnataka India
| | - Nikitha Pillai
- Department of ENT, Kims Hospital, Bangalore, Karnataka India
| | - Bindya Nayak
- Department of ENT, Kims Hospital, Bangalore, Karnataka India
| | | |
Collapse
|
3
|
Smitha SG, Pillai N, Nayak B, Raveendran J. A Study on Otorhinolaryngological Presentations in Covid 19 Patients in a Tertiary Health Care Center. Indian J Otolaryngol Head Neck Surg 2021; 74:2935-2940. [PMID: 33937008 PMCID: PMC8076440 DOI: 10.1007/s12070-021-02564-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/12/2021] [Indexed: 12/26/2022] Open
Abstract
Corona virus also known as 2019 novel corona virus, a single stranded positive sense RNA virus is the causative agent of COVID 19 disease. It mainly spreads via the respiratory route by means of aerosols. The objectives of our study were. To know the prevalence of ENT presentations in COVID 19 patients and to know the relationship between the symptoms and category of the disease as well as to know the relation between the blood group and recovery from the disease. The first 500 patients who were tested positive for COVID 19 and getting treated in our hospital were included in the study after taking written informed consent from the patients who were willing to participate in the study. A detailed history was taken from all the patients and more stress was given on the ENT symptoms with respect to its onset, duration and time taken for the relief of symptoms. The ENT symptoms were compared with the category of the disease as well as the blood group of the patients. Statistical analysis was done using Chi square test and Statistical Package for Social Sciences [SPSS] for Windows Version 22.0 Released 2013. Armonk, NY: IBM Corp., was used to perform statistical analyses. In our study 310 (62.0%) were males and 190 (38.0%) patients were females (38%), of age group ranging from 2 years to 87 years. In our study 367 (73.3%) patients were symptomatic and the rest 133 (26.6%) were asymptomatic. There were 335 (67.0%) patients in category A, 140 (28.0%) in category B and 25 (5.0%) in category C. The most common ENT presentation was headache and its prevelance was more in category C and it was of statistical significance. On comparing the blood group and the ENT symptoms occurrence of sore throat was of statistical significance and its prevelance was more among the O blood group patients. In terms of recovery from the disease the patients with blood group O had good recovery rate. Covid 19 pandemic is still an on going problem and newer strains of the virus are arising as well hence. In our study we found out that isolated ENT symptoms such as aguesia and anosmia were the only presentation of the disease. Thus they can be considered as early marker of the disease and it will be helpful in early detection and isolation of the patient as well as prevention of further spread of the disease.
Collapse
Affiliation(s)
- S G Smitha
- Department of ENT, Kims Hospital, Bangalore, Karnataka India
| | - Nikitha Pillai
- Department of ENT, Kims Hospital, Bangalore, Karnataka India
| | - Bindya Nayak
- Department of ENT, Kims Hospital, Bangalore, Karnataka India
| | | |
Collapse
|
4
|
Anil HT, Lasya Raj N, Pillai N. A Study on Etiopathogenesis of Vocal Cord Paresis and Palsy in a Tertiary Centre. Indian J Otolaryngol Head Neck Surg 2019; 71:383-389. [DOI: 10.1007/s12070-018-1502-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 09/24/2018] [Indexed: 10/28/2022] Open
|
5
|
Yu N, Reyes-Rivera I, Hipp J, Zou M, Pillai N, Hammerschmidt S. Real world treatment patterns and outcomes for mNSCLC patients receiving second and third-line therapy in Germany. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx091.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
6
|
Mistry N, Pillai N, Cashwell A, Vaite S. Ending the neglect: The role of global policy advocacy in addressing Neglected Tropical Diseases (NTDs). Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
7
|
Panicker R, Pillai N, Nagarsekar U. Villar's Nodule: A Rare Presentation of External Endometriosis. Med J Armed Forces India 2010; 66:70-1. [DOI: 10.1016/s0377-1237(10)80101-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2009] [Accepted: 08/12/2009] [Indexed: 10/18/2022] Open
|
8
|
Rachko M, Safi AM, Yeshou D, Pillai N, Salciccioli L, Stein RA. Cryptogenic ischemic stroke and paradoxical embolism: should a patent foramen ovale be closed? Case report and literature review. Angiology 2001; 52:793-9. [PMID: 11716334 DOI: 10.1177/000331970105201111] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Paradoxical embolism is a well-recognized cause of stroke. While the diagnosis in the majority of the cases with a patent foramen ovale is presumptive, numerous treatment strategies have been described. However, there is no single approach that has been overwhelmingly recommended for these patients. A patient is described who presented with ischemic stroke. Transesophageal echocardiography revealed a thrombus that straddled a patent foramen ovale. Anticoagulation with intravenous heparin resulted in resolution of thrombus and neurologic deficit. The literature regarding diagnosis and treatment of paradoxical embolism in the presence of patent foramen ovale is reviewed.
Collapse
Affiliation(s)
- M Rachko
- Division of Cardiology, The Brooklyn Hospital Center, New York, 11201, USA
| | | | | | | | | | | |
Collapse
|
9
|
Safi AM, Pillai N, Rachko M, Chaudhry K, Stein RA. Dipyridamole-induced ST-segment elevation indicative of transmural myocardial ischemia--a case report. Angiology 2001; 52:553-7. [PMID: 11512695 DOI: 10.1177/000331970105200808] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dipyridamole nuclear myocardial perfusion test is a safe and effective alternative to exercise nuclear perfusion testing for detecting myocardial ischemia. It is the procedure of choice in selected patients who are unable to exercise adequately. Intravenous dipyridamole causes coronary vasodilation with resultant maldistribution and heterogeneity of coronary flow in the presence of significant coronary artery disease. True ischemia, causing symptoms or ST-segment depression, is uncommon, in part because there is no increase in myocardial oxygen demand. A patient in whom myocardial ischemia developed, manifested by ST-segment elevation, during dipyridamole stress testing is described. Scintigraphic images illustrated a myocardial perfusion defect, which was consistent with coronary angiographic findings. This case report addresses the importance of dipyridamole-induced ST-segment elevation, its correlation with angiographic findings, and the need for continued hemodynamic and electrocardiographic monitoring in patients following dipyridamole infusion.
Collapse
Affiliation(s)
- A M Safi
- Department of Medicine, The Brooklyn Hospital Center, NY 11201, USA
| | | | | | | | | |
Collapse
|
10
|
Gower WR, Salhab KF, Foulis WL, Pillai N, Bundy JR, Vesely DL, Fabri PJ, Dietz JR. Regulation of atrial natriuretic peptide gene expression in gastric antrum by fasting. Am J Physiol Regul Integr Comp Physiol 2000; 278:R770-80. [PMID: 10712300 DOI: 10.1152/ajpregu.2000.278.3.r770] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Atrial natriuretic peptide (ANP) gene expression was localized in the rat gastric antrum using immunohistochemistry and in situ hybridization to mucosal cells in the lower portion of the antropyloric glands. Colocalization of immunoreactive ANP, long-acting natriuretic peptide, i.e., proANP-(1-30), and serotonin in these cells identified them to be enterochromaffin cells. Fasting for 72 h in 8-mo-old (adult) rats produced a significant (P < 0.05) decrease in the levels of ANP prohormone mRNA, immunoreactive proANP-(1-30) and ANP to approximately 33% of that of fed rats. Fasting in 1-mo-old rats had no effect on these parameters. Transcripts for natriuretic peptide receptor subtypes NPR-A, NPR-B, and NPR-C were found in both mucosa and muscle tissues of the antrum. ANP, brain natriuretic peptide (BNP), and C-type natriuretic peptide (CNP) stimulated the production of cGMP in antral mucosa in vitro with a potency of ANP > BNP >> CNP, suggesting that these receptors were functional. We conclude that fasting decreases ANP prohormone mRNA and its gene products, long-acting natriuretic peptide, and ANP in the antrum of adult rats.
Collapse
Affiliation(s)
- W R Gower
- Laboratory, James A. Haley Veterans Hospital, Department of Biochemistry and Molecular Biology, University of South Florida, Tampa 33612, USA.
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Ramaswamy S, Pillai N, Gopalakrishnan V, Ghosh MN. Influence of clonidine on the acute tolerance pattern to morphine induced analgesia and sensitivity changes in mice. Life Sci 1981; 28:2237-41. [PMID: 7253819 DOI: 10.1016/0024-3205(81)90575-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|
12
|
Pillai N. Unique program in Antigua; stores distribute supplies. IPPF WHR News Serv 1973; 1:16. [PMID: 12258001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
|