Browsing by Subject "costs"
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Item Neuroprotective effects of peroxisome proliferator-activated receptor-gamma (PPAR-y) ligands against oxidative stress(2003-12-01) Aoun, Paul; Simpkins, James W.; Dillon, Glenn; Gracy, RobertAoun, Paul Neuroprotective effects of peroxisome proliferator-activated receptor-gamma (PPAR-y) ligands against oxidative stress. Doctor of Philosophy (Pharmacology and Neurosciences), December, 2003, 254 pp., 37 figures. Diabetes mellitus is a significant public health problem in the United States and the world resulting in substantial morbidity and mortality. Diabetes complications, i.e., neuropathy, are common and almost triple the annual cost of managing diabetes. In our studies, we investigated the role that insulin sensitizers currently used for the treatment of diabetes, the PPAR-y ligands, might play in protecting neurons against oxidative stresses. We showed that two PPAR-y ligands, 15 deoxy-PGJ2 and troglitazone, protected, in a dose-dependent manner, HT-22 mouse hippocampal and RGC-5 retinal ganglion cell lines against various oxidative insults. Further, we demonstrated that neuroprotection by 15deoxy-PGJ2 and troglitazone was independent of the PPAR-y receptor. Our findings brought to light an important role of PPAR-y ligands in preventing neuronal complications from diabetes. Moreover, the studies reported herein provide valuable insights into the development of novel therapeutic compounds that improve insulin sensitivity while preventing neurological, and possibly other complications of diabetes.Item Shorter length of hospital stay for hip fracture in those with dementia and without a known diagnosis of osteoporosis in the USA(BioMed Central Ltd., 2020-12-03) Rasu, Rafia S.; Zalmai, Rana; Karpes Matusevich, Aliza R.; Hunt, Suzanne L.; Phadnis, Milind A.; Rianon, NahidBACKGROUND: About 50% of all hospitalized fragility fracture cases in older Americans are hip fractures. Approximately 3/4 of fracture-related costs in the USA are attributable to hip fractures, and these are mostly covered by Medicare. Hip fracture patients with dementia, including Alzheimer's disease, have worse health outcomes including longer hospital length of stay (LOS) and charges. LOS and hospital charges for dementia patients are usually higher than for those without dementia. Research describing LOS and acute care charges for hip fractures has mostly focused on these outcomes in trauma patients without a known pre-admission diagnosis of osteoporosis (OP). Lack of documented diagnosis put patients at risk of not having an appropriate treatment plan for OP. Whether having a diagnosis of OP would have an effect on hospital outcomes in dementia patients has not been explored. We aim to investigate whether having a diagnosis of OP, dementia, or both has an effect on LOS and hospital charges. In addition, we also report prevalence of common comorbidities in the study population and their effects on hospital outcomes. METHODS: We conducted a cross-sectional analysis of claims data (2012-2013) for 2175 Medicare beneficiaries (>/=65 years) in the USA. RESULTS: Compared to those without OP or dementia, patients with demenia only had a shorter LOS (by 5%; P = .04). Median LOS was 6 days (interquartile range [IQR]: 5-7), and the median hospital charges were $45,100 (IQR: 31,500 - 65,600). In general, White patients had a shorter LOS (by 7%), and those with CHF and ischemic heart disease (IHD) had longer LOS (by 7 and 4%, respectively). Hospital charges were 6% lower for women, and 16% lower for White patients. CONCLUSION: This is the first study evaluating LOS in dementia in the context of hip fracture which also disagrees with previous reporting about longer LOS in dementia patients. Patients with CHF and IHD remains at high risk for longer LOS regardless of their diagnosis of dementia or OP.