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Expensive Alternative (expensive + alternative)

Distribution by Scientific Domains

Medical Sciences	75%

Selected Abstracts

Distributed loop-scheduling schemes for heterogeneous computer systems

CONCURRENCY AND COMPUTATION: PRACTICE & EXPERIENCE, Issue 7 2006
Anthony T. Chronopoulos
Abstract Distributed computing systems are a viable and less expensive alternative to parallel computers. However, a serious difficulty in concurrent programming of a distributed system is how to deal with scheduling and load balancing of such a system which may consist of heterogeneous computers. Some distributed scheduling schemes suitable for parallel loops with independent iterations on heterogeneous computer clusters have been designed in the past. In this work we study self-scheduling schemes for parallel loops with independent iterations which have been applied to multiprocessor systems in the past. We extend one important scheme of this type to a distributed version suitable for heterogeneous distributed systems. We implement our new scheme on a network of computers and make performance comparisons with other existing schemes. Copyright © 2005 John Wiley & Sons, Ltd. [source]

3315: Transconjunctival sutureless 20G

ACTA OPHTHALMOLOGICA, Issue 2010
CJ POURNARAS
Purpose To evaluate a trocar system that allows the use of the regular 20-gauge vitrectomy instruments for a transconjunctival sutureless surgery for the treatment of various surgically treated vitreo-retinal pathologies. Methods The 20-gauge trocar system uses a 10° self-sealing tunneled incision made with trocars introduced with a inserter blade of 0.9 mm diameter. Incisions are radially made at 3.5 mm from the limbus and tunnels are made limbus-parallel. Evaluation of the surgical procedure, sclerotomies closure by OCT, anatomical and visual outcomes in various vitreoretinal pathologies treated in current vitreoretinal practice. Results Postoperative patient comfort and less eye inflammation are provided by the sutureless technique, allthough small conjunctival hemorrhage caused by the grasping forceps used to hold the eye during the insertion of the trocars may occur. The 20-gauge trocar system using 10° self-sealing tunneled incision remains very stable in the eye even during peripheral vitrectomy with indentation and they also decrease the surgical induced trauma at the entry sites. The use of nonflexible instruments, the same as in 20-gauge conventional vitrectomy, provides easy access to the entire periphery.thus the system can be used in almost all vitreoretinal surgeries. It allows the use of phragmatome and is easy to work even with 5,000 centistokes silicone oil. Conclusion In the era of sutureless surgeries, the 20-gauge trocar system is a safe, comfortable, convinient with current instrumentation and less expensive alternative to 25- and 23-gauge vitrectomy. [source]

Blood Cultures Do Not Change Management in Hospitalized Patients with Community-acquired Pneumonia

ACADEMIC EMERGENCY MEDICINE, Issue 7 2006
Prasanthi Ramanujam MD
Objectives: To determine if blood cultures identify organisms that are not appropriately treated with initial empiric antibiotics in hospitalized patients with community-acquired pneumonia, and to calculate the costs of blood cultures and cost savings realized by changing to narrower-spectrum antibiotics based on the results. Methods: This was a retrospective observational study conducted in an urban academic emergency department (ED). Patients with an ED and final diagnosis of community-acquired pneumonia admitted between January 1, 2001, and August 30, 2003, were eligible when the results of at least one set of blood cultures obtained in the ED were available. Exclusion criteria included documented human immunodeficiency virus infection, immunosuppressive illness, chronic renal failure, chronic corticosteroid therapy, documented hospitalization within seven days before ED visit, transfer from another hospital, nursing home residency, and suspected aspiration pneumonia. The cost of blood cultures in all patients was calculated. The cost of the antibiotic regimens administered was compared with narrower-spectrum and less expensive alternatives based on the results. Results: A total of 480 patients were eligible, and 191 were excluded. Thirteen (4.5%) of the 289 enrolled patients had true bacteremia; the organisms isolated were sensitive to the empiric antibiotics initially administered in all 13 cases (100%; 95% confidence interval = 75% to 100%). Streptococcus pneumoniae and Haemophilus influenzae were isolated in 11 and two patients, respectively. The potential savings of changing the antibiotic regimens to narrower-spectrum alternatives was only 170. Conclusions: Appropriate empiric antibiotics were administered in all bacteremic patients. Antibiotic regimens were rarely changed based on blood culture results, and the potential savings from changes were minimal. [source]

Prescribing at the Primary Care Group level: census data and prescribing indicators

JOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 2 2001
D. C. E. F. Lloyd BAHons MSc
Objective: To examine the relationship between prescribing and morbidity, mortality and deprivation for the 481 Primary Care groups set up on 1 April 1999, by examining the prescribing of their constituent practices in the year 1998/99, i.e. the year before. Design: Cross-sectional study. Outcome measures: Set of 11 prescribing indicators taken from the Prescription Pricing Authority ,Toolkit' system; census measures of morbidity and deprivation and Standardized Mortality Ratio for those aged 75 and under. Setting: All practices in England belonging to a Primary Care Group. Results: Several of the indicators showed strong correlation with morbidity, mortality and, to a weaker extent, with deprivation. There was a negative correlation between the census-based measures and choice of more expensive alternatives or greater duration prescriptions for antibiotic prescribing and with the use of hormone replacement therapy (HRT). Conversely, there was a positive correlation with use of premium products and drugs of limited therapeutic value. Conclusion: Practices in areas of greater need (as measured by permanent sickness and Standardized Mortality Ratio) seem to be trying to hold down costs by the way they prescribe antibiotics. Conversely, their use of premium price products pushes up their costs in the absence of clear evidence concerning compliance. The use of HRT is low in areas of high overall need. [source]