Methods This is a retrospective cohort study using administrative data of the largest Belgian sickness fund from January 1, 2000 through December 31, 2009. Cases included lumbar laminectomy, combined discectomy and fusion, posterior interarticular fusion, anterior lumbar interbody fusion (ALIF), posterior lumbar interbody fusion (PLIF) and standard discectomy. The main outcome measures were age- and sex-adjusted

rates of lumbar spine surgery, 1-year mortality, 1-year iterative surgery, no return to work (RTW) rate 1 year after surgery and length of hospital stay. Multivariate 17DMAG datasheet logistic regression analysis was used to determine the association between age, sex, geographic region, type of surgery, year of intervention and duration of pre-operative sick leave on outcome.

Results Spine surgery rates rose 44 % from 2001 through 2009 and data for 2009 showed twofold variations Mizoribine cost in spine surgery rates among 10 Belgian provinces. Reported 1-year mortality varied from 0.6 to 2.5 % among surgical procedures performed in 2008. The overall 5-year reoperation rate was 12 %. RTW rates 1 year after standard discectomy, ALIF, PLIF and combined discectomy and fusion for the follow-up sample of 2008 were 14.4, 22.7, 26.1 and 30.6 %, respectively. The

median length of hospital stay significantly decreased throughout the decade. Type of surgery and geographic region were significantly related to patient outcomes.

Conclusions Regional variations highlight professional find more uncertainty and controversy. The study results point to the need for peer comparisons and surgeon feedback.”
“Japan has a high BCG vaccination rate of 97.4%. In 2007, there were 25 311 newly notified patients and a notification rate of 19.8/100000. The objective of a first study was to look at the cost-effectiveness of the QFT (QuantiFERON(R)-TB

Gold) compared with the TST for tuberculosis contact screening in Japan. The target population was 20-year-old close contacts of patients with sputum smear-positive tuberculosis. The main outcome measure was the incremental cost per quality-adjusted life year (QALY) gained during the lifetime, with an annual discount rate of 3%. They looked at three strategies for screening the contacts: TST alone, TST followed by QFT, and OFT alone. They calculated the probability of having TB at a value of 0.2. Their conclusions for this study were that the QFT alone strategy is the most cost-effective for TB contact screening in Japan, and when the TST specificity is over 0.72, the TST followed by the QFT strategy is more cost-effective than the QFT-alone strategy at a level of US$25 000/QALY gained as a willingness to pay. They also concluded that the OFT-alone strategy would be more cost-effective in individuals at high risk of tuberculosis mortality, such as the elderly.