Identification of Resource Use and Associated Costs for Viral Meningitis

ABSTRACT Purpose: This study involved identifying resource use and assigning monetary value to the diagnostic work-up and management of viral meningitis. Methodology: Using a previously established decision analytic framework, various resources were identified as part of routine management of viral meningitis. Secondary database analyses were used to quantify resources and assign a monetary value as a part of routine management of viral meningitis requiring use of the resource units identified in the decision analytic framework. Discharge data sources from the states of California, Florida, and Illinois, and Medicaid data sources from the state of Pennsylvania, were used for the purpose of analysis. Principal Findings: Physician visits, emergency room visits, hospital admissions, procedures, and medications were identified as the major resources used. Lumbar punctures, CT scans, and antibiotics were identified as the major procedures and medications utilized. No significant difference was found in the major resources used between the states' discharge data and the Medicaid data sources. The mean total charges for patient admissions with CT scans were significantly higher than for patient admissions without CT scans ($11,531.80 vs.$7,841.30, P<0.05). The mean lengths of stay for patients with CT scan were significantly higher than for patient admissions without CT scans (4.71 days vs. 3.88 days, P<0.05). The patient readmission rate was 10.7 percent, while the readmission rate for episodes with more than one hospitalization was 11.1 percent. The mean charge associated with readmission was $12,200

Contribution of plasma cells and B cells to hidradenitis suppurativa pathogenesis

Hidradenitis suppurativa (HS) is a debilitating chronic inflammatory skin disease characterized by chronic abscess formation and development of multiple draining sinus tracts in the groin, axillae, and perineum. Using proteomic and transcriptomic approaches, we characterized the inflammatory responses in HS in depth, revealing immune responses centered on IFN-γ, IL-36, and TNF, with lesser contribution from IL-17A. We further identified B cells and plasma cells, with associated increases in immunoglobulin production and complement activation, as pivotal players in HS pathogenesis, with Bruton’s tyrosine kinase (BTK) and spleen tyrosine kinase (SYK) pathway activation as a central signal transduction network in HS. These data provide preclinical evidence to accelerate the path toward clinical trials targeting BTK and SYK signaling in moderate-to-severe HS

Contribution of plasma cells and B cells to hidradenitis suppurativa pathogenesis

Hidradenitis suppurativa (HS) is a debilitating chronic inflammatory skin disease characterized by chronic abscess formation and development of multiple draining sinus tracts in the groin, axillae, and perineum. Using proteomic and transcriptomic approaches, we characterized the inflammatory responses in HS in depth, revealing immune responses centered on IFN-γ, IL-36, and TNF, with lesser contribution from IL-17A. We further identified B cells and plasma cells, with associated increases in immunoglobulin production and complement activation, as pivotal players in HS pathogenesis, with Bruton’s tyrosine kinase (BTK) and spleen tyrosine kinase (SYK) pathway activation as a central signal transduction network in HS. These data provide preclinical evidence to accelerate the path toward clinical trials targeting BTK and SYK signaling in moderate-to-severe HS