An economic evaluation of asthma in the United States

Article Abstract:

Hospitalization is the largest component of health care costs for asthma and the cost of hospitalization could be reduced by educating asthma patients about their disease, giving them regular check-ups and treating them in clinics. A projection was made of the amount of money spent on care and treatment of asthma patients in 1990 based on the estimated amount spent in 1985. The cost of treatment for asthma patients in 1990 was estimated at $6.2 billion. The largest estimated direct cost was inpatient hospital care at approximately $1.6 billion. The largest indirect cost was days missed from school at approximately $900 million. Hospitalization, emergency room use and death made up 43% of costs associated with care and treatment of asthma patients. Asthma patients who receive regular medical care are rarely hospitalized. But those who cannot afford regular care may be hospitalized more frequently, and are more likely to die from asthma complications. More effective drugs for asthma patients may increase the immediate cost of medical care, but decrease expenses associated with hospitalization and death.

Medical economics, Economic aspects, Statistics, Asthma

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Tetanus - forgotten but not gone

Article Abstract:

It may be wise to give tetanus booster shots to all adults who have not received one in 10 years or more. Tetanus is a serious disease that is very rare in developed countries, but only because of the success of childhood immunization programs. There are approximately one million reported cases of tetanus worldwide every year. The symptoms are caused by toxins produced by a bacterium that occurs naturally in soil. One of the toxins blocks nerves that use the neurotransmitter gamma-aminobutyric acid. Patients with tetanus experience muscle contraction that can lock their jaws, contract facial muscles and inhibit their breathing. Benzodiazepines are the treatment of choice because they can block the toxin. The effectiveness of tetanus immune globulin has not been adequately proven. The antibiotic metronidazole appears to be better than penicillin in killing the bacterium. The best treatment is to prevent the disease by giving all adults booster shots, a practice recommended by the Immunization Practices Advisory Committee.

Editorial, Standards, Immunization

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A population-based serologic survey of immunity to tetanus in the United States

Article Abstract:

Many adults and elderly people may not be adequately immunized against tetanus. Data from 10,618 people six years of age and older examined during the third National Health and Nutrition Examination Survey (NHANES) between 1988 and 1991 reveal that the percentage of people who are adequately immunized begins to drop substantially after the age of 40. Ninety-six percent of six-year-old children examined were adequately immunized, compared to 27.8% of those 70 years or older. Twenty percent of children aged 10 to 16 are not adequately immunized. A greater percentage of men were adequately protected longer, possibly because men have more accidents that require booster shots. The pattern of declining immunity was also present in blacks and Hispanics. A smaller percentage of the poor, uneducated and foreign-born had adequate protection against tetanus. Booster shots every 10 or 20 years may protect adults from tetanus.

Demographic aspects, Immunity, Immunity (Physiology)

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