Lefko Charalambous

Prevalence, healthcare resource utilization and overall burden of fungal meningitis in the United States

Purpose. Previous epidemiological and cost studies of fungal meningitis have largely focused on single pathogens, leading to a poor understanding of the disease in general. We studied the largest and most diverse group of fungal meningitis patients to date, over the longest follow‐up period, to examine the broad impact on resource utilization within the United States. Methodology. The Truven Health Analytics MarketScan database was used to identify patients with a fungal meningitis diagnosis in the United States between 2000 and 2012. Patients with a primary diagnosis of cryptococcal, Coccidioides, Histoplasma, or Candida meningitis were included in the analysis. Data concerning healthcare resource utilization, prevalence and length of stay were collected for up to 5 years following the original diagnosis. Results. Cryptococcal meningitis was the most prevalent type of fungal meningitis (70.1 % of cases over the duration of the study), followed by coccidioidomycosis (16.4 %), histoplasmosis (6.0 %) and candidiasis (7.6 %). Cryptococcal meningitis and candidiasis patients accrued the largest average charges (

Novel Treatment of Cryptococcal Meningitis via Neurapheresis Therapy

103 236 and

Prevalence and Cost Analysis of Complex Regional Pain Syndrome (CRPS): A Role for Neuromodulation

103 803, respectively) and spent the most time in the hospital on average (70.6 and 79 days). Coccidioidomycosis and histoplasmosis patients also accrued substantial charges and time in the hospital (

Prevalence and Cost Analysis of Chronic Pain After Hernia Repair: A Potential Alternative Approach With Neurostimulation: PAIN AFTER HERNIA REPAIR: A POTENTIAL WITH NEUROSTIMULATION

82 439, 48.1 days;

TOMM40 OVEREXPRESSION AND PPAR-GAMMA AGONISTS PROTECT CELLS FROM PATHOPHYSIOLOGICAL STRESS ASSOCIATED WITH LATE ONSET ALZHEIMER'S DISEASE

78 609, 49.8 days, respectively). Conclusion. Our study characterizes the largest longitudinal cohort of fungal meningitis in the United States. Importantly, the health economic impact and long‐term morbidity from these infections are quantified and reviewed. The healthcare resource utilization of fungal meningitis patients in the United States is substantial.

In Vitro Characterization of the Neurapheresis™ System for the Treatment of Cryptococcal Meningitis

Cryptococcal meningitis (CM) has emerged as the most common life-threatening fungal meningitis worldwide. Current management involves a sequential, longitudinal regimen of antifungals; despite a significant improvement in survival compared with uniform mortality without treatment, this drug paradigm has not led to a consistent cure. Neurapheresis therapy, extracorporeal filtration of yeasts from cerebrospinal fluid (CSF) in infected hosts, is presented here as a novel, one-time therapy for CM. In vitro filtration of CSF through this platform yielded a 5-log reduction in concentration of the yeast and a 1-log reduction in its polysaccharide antigen over 24 hours. Additionally, an analogous closed-loop system achieved 97% clearance of yeasts from the subarachnoid space in a rabbit model over 4-6 hours. This is the first publication demonstrating the direct ability to rapidly clear, both in vitro and in vivo, the otherwise slowly removed fungal pathogen that directly contributes to the morbidity and mortality seen in CM.

Impact of Chronic Obstructive Pulmonary Disease on Postoperative Complication Rates, Ambulation, and Length of Hospital Stay After Elective Spinal Fusion (≥3 Levels) in Elderly Spine Deformity Patients

The diagnosis and treatment of complex regional pain syndrome (CRPS) is challenging and there is a paucity of data describing its overall cost burden and quantifying its impact on the US healthcare system. The aim of this study was to assess the prevalence and healthcare utilization costs associated with CRPS.

156 Independent Associations With 30- and 90-Day Unplanned Readmissions After Elective Lumbar Spine Surgery: A National Trend Analysis of 144 123 Patients

Chronic pain (CP) affects a significant number of patients following hernia repair, ranging from 11 to 54% in the literature. The aim of this study was to assess the prevalence, overall costs, and health care utilization associated with CP after hernia repair.

161 Association Between Preoperative Narcotic Use With Surgical Outcomes, Patient Reported Pain Scores and Ambulatory Status After Complex Spinal Fusion (≥5 Levels) for Adult Deformity Correction

AGONISTS PROTECT CELLS FROM PATHOPHYSIOLOGICAL STRESS ASSOCIATED WITH LATE ONSETALZHEIMER’S DISEASE Lefko T. Charalambous, Isaac Ng, Mirta Mihovilovic, Ann M. Saunders, Allen D. Roses, William Kirby Gottschalk, 1 Duke University Medical Center, Durham, NC, USA; 2 Duke University School of Medicine, Durham, NC, USA; Duke University Bryan ADRC, Durham, NC, USA; Zinfandel Pharmaceuticals, Inc., Durham, NC, USA; 5 Duke University, Durham, NC, USA; 6 Zinfandel Pharmaceuticals, Inc., Chapel Hill, NC, USA; 7 Cabernet Pharmaceuticals, Chapel Hill, NC, USA; Duke University ADRC, Durham, NC, USA. Contact e-mail: Ltc7@duke. edu