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This paper evaluates the effect of COVID-19 vaccination on the individual propensity to delay or skip medical care. Our research design exploits the arguably exogenous variation in age-specific vaccine eligibility rollout across states and over time as an instrument for individual vaccination status. We find that receiving a COVID-19 vaccine reduces the likelihood of delaying care for any medical condition by 37%. Furthermore, our analysis reveals that children are significantly less likely to delay or skip healthcare as a result of their parents becoming vaccine eligible, indicating the presence of a positive health spillover within households that extends beyond protection against infection. Our analysis also shows that vaccination reduces concerns about contracting or spreading COVID-19, leading to increased mobility and potentially reducing delays or avoidance in seeking healthcare. Additionally, we find that vaccination notably increased access to elective care and surgeries, but had no significant impact on emergency department admissions, mental health cases or other medical conditions. Our results highlight the important role that vaccines play in, not only protecting against coronavirus, but also safeguarding against the worsening of health due to delayed or foregone medical care. The decline in delayed or foregone care caused by vaccination is particularly strong among minorities and those with a low socioeconomic background, revealing an important role that vaccination efforts can play in narrowing inequities in health and healthcare. In supplementary analysis, we use novel data on debit and credit card spending to demonstrate that increased vaccine uptake has a positive, albeit statistically insignificant, effect on consumer healthcare spending in the short run. Taken together, our findings imply that advancements in vaccine development coupled with a regulatory process that accelerates the availability of vaccines to the public in a safe manner can have the additional benefit of tackling unmet healthcare needs during a public health crisis. [ABSTRACT FROM AUTHOR]

Objective: Renal colic, predominantly due to ureteral stones, constitutes a significant portion of urinary system-related hospital admissions. Non-steroidal anti-inflammatory drugs, notably ibuprofen, are favored over opioids for pain management. However, the optimal intravenous (IV) ibuprofen dosage for renal colic remains unclear. This study aimed to compare the analgesic efficacy of IV ibuprofen at doses of 400 mg and 800 mg in moderate to severe renal colic patients. Methods: A multicenter, prospective, randomized, double-blind controlled clinical trial was conducted on patients with moderate to severe renal colic. Patients meeting inclusion criteria were randomly assigned to receive either 400 mg or 800 mg IV ibuprofen. Pain scores were assessed using numeric rating scale at baseline, 15, 30, 60, and 120 minutes. The need for rescue analgesics and occurrence of side effects were recorded. Results: Out of 150 initially enrolled patients, 126 completed the study. Pain reduction was more significant in the 800 mg group compared to the 400 mg group, especially at the 120-minute mark (p<0.05). The need for rescue analgesics and occurrence of side effects did not significantly differ between the two groups. Conclusion: This study suggests that IV ibuprofen at a dosage of 800 mg provides more effective analgesia for renal colic compared to 400 mg. Therefore, the higher dosage may be preferred in clinical practice due to its superior efficacy and safety profile. Further research could explore the long-term effects and optimal dosing regimens of IV ibuprofen in renal colic management. [ABSTRACT FROM AUTHOR]

Introduction: Chronic constipation is prevalent in the geriatric population. Undiagnosed and untreated constipation can lead to complications and decreased health-related quality of life. The aim of this study was to compare the therapeutic effectiveness of senna alone with a combination of bisacodyl and senna in patients diagnosed with chronic constipation. Materials and Method: This prospective, multicenter, double-blind, randomized controlled trial included patients aged 65 years and older who presented to the emergency department with chronic constipation, diagnosed according to the Rome IV criteria, between July and October 2023. Patients were randomly assigned to either the senna group (20 mg sennoside B) or the senna + bisacodyl group (3 mg sennoside B + 5 mg bisacodyl). Participants took the drugs twice daily for 28 days. The Constipation Scoring System and Patient Assessment of Constipation Quality of Life scores were calculated before and after treatment for each patient. Results: The study included 105 patients, with 54 in the senna group and 51 in the senna + bisacodyl group. There was a statistically higher need for dose reduction because of drug side effects in the senna + bisacodyl group compared with the senna group (p=0.026). Following treatment, the senna group had a higher score on the Constipation Scoring System and Patient Assessment of Constipation Quality of Life compared with the senna + bisacodyl group, and the difference was statistically significant (p<0.001, p=0.012). Conclusion: In geriatric patients, short-term treatment of chronic constipation with senna is more effective than senna+bisacodyl regarding constipation severity and quality of life. [ABSTRACT FROM AUTHOR]

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