[Show abstract][Hide abstract]ABSTRACT: To determine whether an increased number and duration of non-acid reflux events as measured using the multichannel intraluminal impedance pH (MII-pH) is linked to gastroparesis (GP).
A case control study was conducted in which 42 patients undergoing clinical evaluation for continued symptoms of gastroesophageal reflux disease (both typical and atypical symptoms) despite acid suppression therapy. MII-pH technology was used over 24 h to detect reflux episodes and record patients' symptoms. Parameters evaluated in patients with documented GP and controls without GP by scintigraphy included total, upright, and supine number of acid and non-acid reflux episodes (pH < 4 and pH > 4, respectively), the duration of acid and non-acid reflux in a 24-h period, and the number of reflux episodes lasting longer than 5 min.
No statistical difference was seen between the patients with GP and controls with respect to the total number or duration of acid reflux events, total number and duration of non-acid reflux events or the duration of longest reflux episodes. The number of non-acid reflux episodes with a pH > 7 was higher in subjects with GP than in controls. In addition, acid reflux episodes were more prolonged (lasting longer than 5 min) in the GP patients than in controls; however, these values did not reach statistical significance. Thirty-five patients had recorded symptoms during the 24 h study and of the 35 subjects, only 9% (n = 3) had a positive symptom association probability (SAP) for acid/non-acid reflux and 91% had a negative SAP.
The evaluation of patients with a documented history of GP did not show an association between GP and more frequent episodes of non-acid reflux based on MII-pH testing.
Article · Oct 2013 · World Journal of Gastroenterology
[Show abstract][Hide abstract]ABSTRACT: Public and private stakeholders of substance abuse treatment services require economic cost data to guide program evaluations and funding decisions.
Rigorous cost assessments have been conducted for several treatment programs across the United States, but a systematic and comprehensive evaluation of programs in a particular state has never been attempted.
The present study recruited all publicly funded treatment programs in the State of Florida and administered the Brief Drug Abuse Treatment Cost Analysis Program.
A total of 175 programs participated in the study, representing a 71% response rate.
Annual, weekly, and episode costs are estimated by modality.
The study procedures and empirical findings from this research can be used by program evaluators and government officials in Florida and other states as they develop service reimbursement algorithms and initiate more extensive evaluations of publicly funded substance abuse treatment programs.