A study in BMCMedicine finds that the top five aggregate causes of Norwegian health spending in 2019 were mental and substance use disorders, neurological disorders, cardiovascular diseases, diabetes, kidney, and urinary diseases, and neoplasms.
]. Physicians are only required to submit one ICPC-2 code to be reimbursed. Though, they can choose to submit multiple codes, and in this case, the first listed diagnosis was considered the primary diagnosis. Private practicing specialist and psychologist submit International Statistical Classification of Diseases and Related Health Problems codes.The second part of NRPHC contains information about home-based services and nursing homes.
All pharmaceuticals consumed by inpatients, day patients, and outpatients were included in that spending and not in the spending for prescribed pharmaceuticals. Furthermore, the spending for the hospital-financed prescriptions were calculated separately, based on the Norwegian Prescription Database, but were included as hospital spending and not as pharmaceutical spending in accordance with the National Health Accounts.
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Bradykinin B2 receptor blockade and intradialytic hypotension - BMC NephrologyIntroduction Intradialytic hypotension (IDH) is a common clinical complication and is associated with increased morbidity and mortality in patients undergoing maintenance hemodialysis (MHD). The pathogenesis of IDH has been attributed to the rapid reduction of plasma volume during hemodialysis and the inadequate compensatory mechanisms in response to hypovolemia, such as the lack of vasoconstriction. This may be due to the increased production of vasodilators, such as bradykinin. In this study we test the hypothesis that bradykinin B2 receptor blockade prevents intradialytic hypotension. Methods We performed a post-hoc analysis of a double-blind, placebo-controlled, randomized, 2 × 2 crossover clinical trial comparing the continuous infusion of icatibant, a bradykinin B2 receptor blocker, and placebo during hemodialysis. Icatibant or placebo was infused for 30 min before and during hemodialysis in 11 patients on MHD. Results Seven of the patients had IDH, defined as a reduction of systolic blood pressure equal to or greater than 20 mmHg during hemodialysis. Stratified analysis, based on the presence of IDH, revealed that icatibant prevented the decrease in blood pressure compared to placebo in patients with IDH [blood pressure at average nadir (2.5 h after hemodialysis): Placebo,114.3 ± 8.9 vs. icatibant, 125.6 ± 9.1 mmHg, mean ± S.E.M]. Icatibant did not affect blood pressure in the group of patients without IDH. Conclusion Bradykinin B2 receptor blocker may prevent the occurrence of IDH. Further studies should evaluate the hemodynamic effects of icatibant during hemodialysis and the symptomatology associated with IDH.
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