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Doad J, Gupta N, Leavitt L, Hart A, Nguyen A, Kaura S, DeStefano F, McCray E, Lucke-Wold B. Economic Trends in Commonly Used Drugs for Spinal Fusion and Brain Tumor Resection: An Analysis of the Medicare Part D Database. Biomedicines 2023; 11:2185. [PMID: 37626682 PMCID: PMC10452193 DOI: 10.3390/biomedicines11082185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/22/2023] [Accepted: 08/01/2023] [Indexed: 08/27/2023] Open
Abstract
With the incidence of central and peripheral nervous system disorders on the rise, neurosurgical procedures paired with the careful administration of select medications have become necessary to optimize patient outcomes. Despite efforts to decrease the over-prescription of common addictive drugs, such as opioids, prescription costs continue to rise. This study analyzed temporal trends in medication use and cost for spinal fusion and brain tumor resection procedures. The Medicare Part B Database was queried from 2016 to 2020 for data regarding spinal fusion and brain tumor resection procedures, while the Part D Database was used to extract data for two commonly prescribed medications for each procedure. Pearson's correlation coefficient and linear regression were completed for the analyzed variables. The results showed a significant negative correlation between the number of spinal procedure beneficiaries and the cost of methocarbamol, as well as between the annual percent change in spinal beneficiaries and the annual percent change in oxycodone cost. Linear regression revealed that oxycodone cost was the only parameter with a statistically significant model. Moving forward, it is imperative to combat rising drug costs, regardless of trends seen in their usage. Further studies should focus on the utilization of primary data in a multi-center study.
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Affiliation(s)
- Jagroop Doad
- Leon Levine Hall of Medical Sciences, School of Osteopathic Medicine, Campbell University, 4350 US Hwy 421 S, Lillington, NC 27546, USA
| | - Nithin Gupta
- Leon Levine Hall of Medical Sciences, School of Osteopathic Medicine, Campbell University, 4350 US Hwy 421 S, Lillington, NC 27546, USA
| | - Lydia Leavitt
- College of Medicine, University of Illinois, 1601 Parkview Ave., Rockford, IL 61107, USA
| | - Alexandra Hart
- Lake Erie College of Osteopathic Medicine at Seton Hill, Lynch Hall, 20 Seton Hill Dr, Greensburg, PA 15601, USA
| | - Andrew Nguyen
- College of Medicine, University of Florida, 1600 SW Archer Rd., Gainesville, FL 32610, USA
| | - Shawn Kaura
- Lake Erie College of Osteopathic Medicine at Seton Hill, Lynch Hall, 20 Seton Hill Dr, Greensburg, PA 15601, USA
| | - Frank DeStefano
- Department of Neurological Surgery, University of Kansas Medical Center, 2060 W 39th Ave., Kansas City, KS 66160, USA
| | - Edwin McCray
- Department of Orthopedic Surgery, College of Medicine, University of Arizona, 1501 N Campbell Ave., Tucson, AZ 85724, USA
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, 1600 SW Archer Rd., Gainesville, FL 32610, USA
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Muacevic A, Adler JR, Doad J, Watts R. Postpartum Idiopathic Pancreatitis Complicated by Acute Necrotizing Pancreatitis. Cureus 2023; 15:e34002. [PMID: 36811051 PMCID: PMC9939027 DOI: 10.7759/cureus.34002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2023] [Indexed: 01/22/2023] Open
Abstract
Acute pancreatitis (AP) is a common medical condition with a wide variety of etiologies. One of the common but frequently undetected causes of acute pancreatitis is microlithiasis, which can appear as biliary "sludge" in the gallbladder on imaging. While a broad workup should be initiated, endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard for the diagnosis of microlithiasis. In this case, we present a severe presentation of acute pancreatitis in a teenager within the postpartum period. A 19-year-old woman presented with severe 10 out of 10 right upper quadrant (RUQ) pain with episodes of nausea that radiated to her back. She had no history of chronic alcoholism, illicit drug use, or over-the-counter supplement use, and no familial history of autoimmune disease, or pancreatitis. The patient was diagnosed with necrotizing acute pancreatitis with gallbladder "sludge" using contrast-enhanced computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP). She followed up with gastroenterology and had a great clinical recovery. Therefore, it is important to consider acute pancreatitis in patients with idiopathic pancreatitis in their postpartum period as they are prone to forming gallbladder "sludge" which can precipitate and cause a variation in gallbladder pancreatitis which can be difficult to detect on imaging.
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Broberg DN, Wong D, Doad J, Umoh JU, Bellyou M, Norley CJD, Holdsworth D, Montero‐Odasso M, Beauchet O, Annweiler C, Bartha R. Effect of memantine and combination with vitamin D enrichment on body composition in APP/PS1 Alzheimer’s mice following vitamin D deprivation. Alzheimers Dement 2021. [DOI: 10.1002/alz.054580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Dana N Broberg
- Robarts Research Institute London ON Canada
- Western University London ON Canada
| | | | | | | | | | | | | | - Manuel Montero‐Odasso
- Parkwood Institute London ON Canada
- Schulich School of Medicine & Dentistry, Division of Geriatric Medicine, Western University London ON Canada
| | | | - Cedric Annweiler
- Research Center on Autonomy and Longevity, University Hospital Angers France
- University of Angers Angers France
| | - Robert Bartha
- Robarts Research Institute London ON Canada
- Western University London ON Canada
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Wong D, Broberg DN, Doad J, Umoh JU, Bellyou M, Norley CJD, Holdsworth DW, Montero-Odasso M, Beauchet O, Annweiler C, Bartha R. Effect of Memantine Treatment and Combination with Vitamin D Supplementation on Body Composition in the APP/PS1 Mouse Model of Alzheimer's Disease Following Chronic Vitamin D Deficiency. J Alzheimers Dis 2021; 81:375-388. [PMID: 33780366 DOI: 10.3233/jad-201137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Vitamin D deficiency and altered body composition are common in Alzheimer's disease (AD). Memantine with vitamin D supplementation can protect cortical axons against amyloid-β exposure and glutamate toxicity. OBJECTIVE To study the effects of vitamin D deprivation and subsequent treatment with memantine and vitamin D enrichment on whole-body composition using a mouse model of AD. METHODS Male APPswe/PS1dE9 mice were divided into four groups at 2.5 months of age: the control group (n = 14) was fed a standard diet throughout; the remaining mice were started on a vitamin D-deficient diet at month 6. The vitamin D-deficient group (n = 14) remained on the vitamin D-deficient diet for the rest of the study. Of the remaining two groups, one had memantine (n = 14), while the other had both memantine and 10 IU/g vitamin D (n = 14), added to their diet at month 9. Serum 25(OH)D levels measured at months 6, 9, 12, and 15 confirmed vitamin D levels were lower in mice on vitamin D-deficient diets and higher in the vitamin D-supplemented mice. Micro-computed tomography was performed at month 15 to determine whole-body composition. RESULTS In mice deprived of vitamin D, memantine increased bone mineral content (8.7% increase, p < 0.01) and absolute skeletal tissue mass (9.3% increase, p < 0.05) and volume (9.2% increase, p < 0.05) relative to controls. This was not observed when memantine treatment was combined with vitamin D enrichment. CONCLUSION Combination treatment of vitamin D and memantine had no negative effects on body composition. Future studies should clarify whether vitamin D status impacts the effects of memantine treatment on bone physiology in people with AD.
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Affiliation(s)
- Dickson Wong
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.,Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Dana N Broberg
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.,Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Jagroop Doad
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Joseph U Umoh
- Preclinical Imaging Research Centre, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Miranda Bellyou
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Chris J D Norley
- Preclinical Imaging Research Centre, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - David W Holdsworth
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.,Preclinical Imaging Research Centre, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Manuel Montero-Odasso
- Department of Medicine, Division of Geriatric Medicine, Parkwood Hospital, University of Western Ontario, London, ON, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada
| | - Olivier Beauchet
- Department of Medicine, University of Montreal and McGill University, Montreal, QC, Canada
| | - Cedric Annweiler
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France.,UPRES EA 4638, University of Angers, Angers, France
| | - Robert Bartha
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.,Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
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