Objective To determine whether total hip arthroplasty is associated with lower reoperation rates, mortality, and complications, and better function and quality of life than hemiarthroplasty for displaced fractures of the femoral neck in older patients. Design Systematic review and meta-analysis of randomised trials, quasirandomised trials, and cohort studies. Data sources Medline, Embase, Cochrane register of controlled trials, publishers' databases, and manual search of bibliographies. Study selection Randomised controlled trials, quasirandomised trials, and cohort studies (retrospective and prospective) comparing hemiarthroplasty with total hip arthroplasty for treating displaced femoral neck fractures in patients aged more than 60 years. Data extraction Relative risks, risk differences, and mean differences from each trial, aggregated using random effects models. Analyses were stratified for experimental and non-experimental designs, and two way sensitivity analyses and tests for interaction were done to assess the influence of various criteria of methodological quality on pooled estimates. Data synthesis 3821 references were identified. Of the 202 full papers inspected, 15 were included (four randomised controlled trials, three quasirandomised trials, and eight retrospective cohort studies, totalling 1890 patients). Meta-analysis of 14 studies showed a lower risk of reoperation after total hip arthroplasty compared with hemiarthroplasty (relative risk 0.57, 95% confidence interval 0.34 to 0.96, risk difference 4.4%, 95% confidence interval 0.2% to 8.5%), although this effect was mainly driven by investigations without concealed treatment allocation. Total hip arthroplasty consistently showed better ratings in the Harris hip score (three studies, 246 patients, weighted mean difference 5.4, 95% confidence interval 2.7 to 8.2) after follow-up periods of 12 to 48 months. The standardised mean difference of different scores from five studies was 0.42 (95% confidence interval 0.24 to 0.

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Background: Although current human papillomavirus (HPV) genotype screening tests identify genotypes 16 and 18 and do not specifically identify other high-risk types, a new extended genotyping test identifies additional individual (31, 45, 51, and 52) and groups (33/58, 35/39/68, and 56/59/66) of high-risk genotypes. Methods:We developed a Markov model of the HPV disease course and evaluated the clinical and economic value of HPV primary screening with Onclarity (BD Diagnostics, Franklin Lakes, NJ) capable of extended genotyping in a cohort of women 30 years or older. Women with certain genotypes were later rescreened instead of undergoing immediate colposcopy and varied which genotypes were rescreened, disease progression rate, and test cost.

A 1 -A 2 9 8 A225 available on the Mexican Formulary Catalog (naproxen/esomeprazole, NSAIDs group and celecoxib). Incremental cost-effectiveness ratio (ICER) was performed with two measures: Life Years without AE (LY) and Quality Adjusted Life Years (QALYs). The analysis was done from public perspective, only considered direct costs, and is reported in US dollars. RESULTS: Treatment with naproxen/esomeprazole versus NSAIDs represents an ICER of $318.85 for one year without AE; celecoxib had an ICER of $1,226.59, less effective than naproxen/esomeprazole. The ICER per QALY gain was $1,363.26 for naproxen/esomeprazole and $4,562.90 for celecoxib. Sensitivity analysis confirms the consistency of the results. CONCLUSIONS: Naproxen/esomeprazole FDC dominated celecoxib and NSAIDs. The use of naproxen/esomeprazole in the treatment of patients with OA at risk of developing GI AE is cost-effective and could be considered as the first option in an institutional setting.