Statins for cardiovascular prevention according to different strategies: a cost analysis.

Background: Several studies have shown that treatment with HMG-CoA reductase inhibitors (statins) can reduce coronary heart disease (CHD) rates. However, the cost effectiveness of statin treatment in the primary prevention of CHD has not been fully established. Objective: To estimate the costs of CHD prevention using statins in Switzerland according to different guidelines, over a 10-year period. Methods: The overall 10-year costs, costs of one CHD death averted, and of 1 year without CHD were computed for the European Society of Cardiology (ESC), the International Atherosclerosis Society (IAS), and the US Adult Treatment Panel III (ATP-III) guidelines. Sensitivity analysis was performed by varying number of CHD events prevented and costs of treatment. Results: Using an inflation rate of medical costs of 3%, a single yearly consultation, a single total cholesterol measurement per year, and a generic statin, the overall 10-year costs of the ESC, IAS, and ATP-III strategies were 2.2, 3.4, and 4.1 billion Swiss francs (SwF [SwF1 = $US0.97]). In this scenario, the average cost for 1 year of life gained was SwF352, SwF421, and SwF485 thousand, respectively, and it was always higher in women than in men. In men, the average cost for 1 year of life without CHD was SwF30.7, SwF42.5, and SwF51.9 thousand for the ESC, IAS, and ATP-III strategies, respectively, and decreased with age. Statin drug costs represented between 45% and 68% of the overall preventive cost. Changing the cost of statins, inflation rates, or number of fatal and non-fatal cases of CHD averted showed ESC guidelines to be the most cost effective. Conclusion: The cost of CHD prevention using statins depends on the guidelines used. The ESC guidelines appear to yield the lowest costs per year of life gained free of CHD.

Dépistage et prévention chez les aînés: quelles interventions proposer, à qui, et jusqu'à quel âge [Screening and prevention in the elderly: which interventions should be proposed, to whom, and up to what age?].

Recommendations on preventive services rarely mention how to apply them to older people. Even though general criteria (prevalence of disease, quality of screening tests) that influence screening's efficacy remain important, appropriateness of screening in older persons depends much more on individual criteria, such as comorbidity, functional status, and life expectancy. More than with any other age group, patients preferences regarding future investigation and treatment guide the clinical decision. This article focuses on primary and secondary prevention, and discusses specific criteria to consider in each patient. A table summarizes the appropriate recommendations.

Prevention of Caval Collapse During Venous Drainage for CPB.

A new plastic self-expanding Smartcanula (Smartcanula LLC, Lausanne, Switzerland) is designed for central insertion and prevention of caval collapse. The objective of our work is to assess the influence of the new design on atrial chatter. Caval collapse over the entire caval axis, right atrial, hepatic, renal vein, and iliac vein is realized in drainage tubes with holes at 5 cm distance intervals. Smartcanulas with various lengths (26 cm [= right atrial], 34 cm [= hepatic], 43 cm [= renal], and 53 cm [= iliac]) versus two-stage cannulas are compared. Pressure drop (ΔP) is measured using Millar pressure-transducers. Flow rate (Q) is measured using an ultrasonic flow meter. Cannula resistance is defined as the ΔP/Q ratio. Data display and recording are controlled using LabView virtual instruments. At an 88 cm height differential, Q values are 8.69 and 6.8 l/min, and ΔP/Q ratios are 0.63 and 1.28 for the 26-cm Smartcanula and the reference cannula, respectively. The 34-cm Smartcanula showed 8.89 l/min and 0.6 ΔP/Q ratio vs. 7.59 l/min and 0.9 for the control cannula (P < 0.05). The 43-cm and 53-cm Smartcanulas showed Q values of 9.04 and 8.81 l/min, respectively, and ΔP/Q2 ratio of 0.6. The Smartcanula outperforms the two-stage cannula, and direct cannula insertion without guide wire is effective.

The Iowa African-American Journal, Spring/Fall 2001, Vol. 7, no. 1

Newsletter for the Iowa Commission on the Status of African-Americans

The Iowa African-American Journal, Spring/Fall 2002, Vol. 8, no. 1

Newsletter for the Iowa Commission on the Status of African-Americans

Iowa Juvenile Crime Prevention Community Grant Fund Outcomes Report and FY 2002 Juvenile Justice Youth Development Program Summary, 2002

This document contains two related, but separate reports. The Juvenile Crime Prevention Community Grant Fund Outcomes Report is a summary of outcomes from services and activities funded through the Juvenile Crime Prevention Community Grant Fund in FY2001. The Juvenile Justice Youth Development Program Summary describes Iowa communities current prevention and sanction programs supported with funding from the Division of Criminal and Juvenile Justice Planning (CJJP) during FY2002.

Juvenile Crime Prevention Community Grant Fund Outcomes Report and FY 2002 Juvenile Justice Youth Development Program Summary, 2002

This document contains two related, but separate reports. The Juvenile Crime Prevention Community Grant Fund Outcomes Report is a summary of outcomes from services and activities funded through the Juvenile Crime Prevention Community Grant Fund in FY 2001. The Juvenile Justice Youth Development Program Summary describes Iowa communities’ current prevention and sanction programs supported with funding from the Division of Criminal and Juvenile Justice Planning (CJJP) during FY 2002.

Iowa Juvenile Crime Prevention Community Grant Fund, 2000

The Division of Criminal & Juvenile Justice Planning, as a part of its duties to administer Iowa’s Juvenile Crime Prevention Community Grant Fund, compiled the information contained in this report. Persons involved in the preparation of this report include Eric Sage, Sonya Wendell, and Richard Moore. Much of the report’s descriptions of community projects was adapted from narrative information contained in the applications and progress reports of agencies and units of government throughout the state that are participating in the Juvenile Crime Prevention Community Grant Fund.

Iowa Juvenile Crime Prevention Community Grant Fund Outcomes Report, 2000

The following Outcome Reports are derived from the Iowa Juvenile Crime Prevention Community Grant Fund 1999-2000 Report compiled by the Division of Criminal and Juvenile Justice Planning, Department of Human Rights. The report includes background information on the Community Grant Fund and more detailed information on the individual community programs (community collaboration, program overview, contact information, and budget).

White Cane Update, Fall 1998

The White Cane Update newsletter includes information about the latest happenings at the Iowa Department for the Blind.

White Cane Update, Fall 2003

The White Cane Update newsletter includes information about the latest happenings at the Iowa Department for the Blind.

Iowa Civil Rights Commission Communicator, Fall 2000, Vol. 18, no. 2

Newsletter produced by the Iowa Civil Rights Commission

Personnel Matters, Fall 2001

Newsletter produced by Iowa Department of Management

Fresh News; The Farmers' Market Newsletter, Fall 2001

Newsletter produced by Iowa Department of Agriculture and Land Stewardship

Fresh News; The Farmers' Market Newsletter, Fall-Winter 2003

Newsletter produced by Iowa Department of Agriculture and Land Stewardship