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Alessandro Antônio Costa Pereira, Christian Barros Ferreira, João Adolfo Costa Hanemann, Livia Maris Ribeiro Paranaiba, Patricia Peres Iucif Pereira, Carla Isabelly Rodrigues-Fernandes, Celeste Sánchez-Romero, Oslei Paes de Almeida, Felipe Paiva Fonseca
Lymphomatoid granulomatosis (LYG) is a rare B-cell lymphoproliferative disorder driven by Esptein-Barr virus (EBV) that most commonly affects the lungs, although extra pulmonary sites like the central nervous system, skin, liver and kidney can also be involved. It is microscopically characterized by an angiocentric and angiodestructive growth pattern, predominantly composed by small T-cells, although a smaller population of atypical large B-cells is considered the true neoplastic component. Oral cavity involvement of LYG has rarely been described and the diagnosis of this neoplasm is very difficult...
March 14, 2018: Head and Neck Pathology
Michela Meregaglia, John Cairns, Lisa Licitra, Paolo Bossi
BACKGROUND: There is uncertainty around the optimal surveillance of head and neck cancer patients after the primary curative treatment. This study aims at assessing the cost-effectiveness of a post-treatment programme of frequent radiological assessments (maximal approach) compared with a symptom-driven surveillance (minimal approach). MATERIALS AND METHODS: A decision-analytic Markov model is developed to assess the cost utility of two alternative follow-up programmes with a lifetime horizon...
February 22, 2018: European Journal of Cancer
María D Ballesteros-Pomar, Diana Martínez Llinàs, Scott Goates, Rebeca Sanz Barriuso, Alejandro Sanz-Paris
Malnutrition has been related to prolonged hospital stays, and to increases in readmission and mortality rates. In the NOURISH (Nutrition effect On Unplanned Readmissions and Survival in Hospitalized patients) study, administering a high protein oral nutritional supplement (ONS) containing beta-hydroxy-beta-methylbutyrate (HP-HMB) to hospitalised older adult patients led to a significant improvement in survival compared with a placebo treatment. The aim of this study was to determine whether HP-HMB would be cost-effective in Spain...
February 22, 2018: Nutrients
Helmy M Guirgis
BACKGROUND: The impact of programmed death receptor-ligand1 (PD-L1) on costs and value of the immune check point inhibitors (ICPI) has received minimal attention. OBJECTIVES: 1- Design a sliding scale to grade survival in 2nd-line non-small-cell lung cancer (NSCLC). 2- Compare costs and value of Nivolumab (Nivo), Atezolizumab (Atezo) and Pembrolizumab (Pembro) vs. Docetaxel (Doc). METHODS: Previously reported median overall survival (OS) and prices posted by parent company were utilized...
February 20, 2018: Journal for Immunotherapy of Cancer
Zheng-Yi Zhou, Alex Mutebi, Simeng Han, Arielle G Bensimon, Marie Louise Ricculli, Jipan Xie, Anand Dalal, Ken Culver
AIMS: To assess the cost-effectiveness of first-line ceritinib vs crizotinib and platinum doublet chemotherapy for anaplastic lymphoma kinase (ALK)-positive metastatic non-small cell lung cancer (NSCLC) from a US third-party payer's perspective. MATERIALS AND METHODS: A partitioned survival model with three health states (stable disease, progressive disease, death) was developed over a 20-year time horizon. Ceritinib's efficacy inputs (progression-free and overall survival) were estimated from ASCEND-4; parametric survival models extrapolated data beyond the trial period...
March 12, 2018: Journal of Medical Economics
Blayne Welk, Wanrudee Isaranuwatchai, Andrei Krassioukov, Louise Husted Torp, Dean Elterman
STUDY DESIGN: A Markov model was used to analyze cost-effectiveness over a lifetime horizon. OBJECTIVE: To investigate the cost-effectiveness of hydrophilic-coated intermittent catheters (HCICs) compared with uncoated catheters (UCs) among individuals with neurogenic bladder dysfunction (NB) due to spinal cord injury (SCI). SETTING: A Canadian public payer perspective based on data from Ontario; including a scenario analysis from the societal perspective...
February 20, 2018: Journal of Medical Economics
Aleksandra Pelczarska, Michał Jakubczyk, Joanna Jakubiak-Lasocka, Maciej Banach, Małgorzata Myśliwiec, Marcin Gruchała, Maciej Niewada
BACKGROUND AND AIMS: Familial hypercholesterolaemia (FH) elevates the cholesterol level and increases the risk of coronary events and death. Early detection and treatment reduce this risk. We aimed to determine the cost-effectiveness of FH screening in Poland in children, first job takers, and after an acute coronary syndrome (ACS) event, each followed by a cascade screening in the relatives of the positively-diagnosed subjects. METHODS: A decision tree was constructed to model the diagnosis process...
January 31, 2018: Atherosclerosis
Kai Zhao, Yuyuan Yao, Xuwei Luo, Binyan Lin, Yujie Huang, Yuxin Zhou, Zhiyu Li, Qinglong Guo, Na Lu
Angiogenesis is critical for the growth and metastasis of triple-negative breast cancer (TNBC) and its inhibition reduces the risk of progression of metastatic TNBC. In this study, we investigated that LYG-202, a flavonoid with a piperazine substitution, inhibited angiogenesis induced by conditioned media (CM) from MDA-MB-231 cells under hypoxia and revealed its underlying mechanism. The results showed that LYG-202 decreased CXCL12 secretion and CXCR7 expression, leading to suppression of its downstream ERK/AKT/NF-κB signaling, which eventually decreased the expression of MMP-2, MMP-9, RhoA and increased VE-cadherin expression in EA...
January 30, 2018: Carcinogenesis
Andrea Aiello, Anna D'Ausilio, Roberta Lo Muto, Francesca Randon, Luca Laurenti
Background and Objective: Ibrutinib has recently been approved in Europe for Waldenström Macroglobulinemia (WM) in symptomatic patients who have received at least one prior therapy, or in first-line treatment for patients unsuitable for chemo-immunotherapy. The aim of the study is to estimate the incremental cost-effectiveness ratio (ICER) of ibrutinib in relapse/refractory WM, compared with the Italian current therapeutic pathways (CTP). Methods: A Markov model was adapted for Italy considering the National Health System perspective...
2017: Journal of Market Access & Health Policy
Raquel Sanchez-Santos, Esther Mariño Padin, Daniel Adam, Oleg Borisenko, Sergio Estevez Fernandez, Ester Carrera Dacosta, Sonia González Fernández, Juan Turnes Vazquez, Juan Carlos Ruiz de Adana, Felipe de la Cruz Vigo
BACKGROUND: We assessed the cost-effectiveness of bariatric surgery (BS) versus conservative management (CM) for treating morbid obesity in Spain. METHODS: We developed a probabilistic Markov model to estimate health outcomes, quality-adjusted life years (QALY), life years gained (LYG), and costs over lifetime and 10-year horizons. Combined common BS procedures were compared with CM. Clinical and utility inputs were obtained from the literature and resource use and costs from local sources (€2017)...
November 30, 2017: Expert Review of Pharmacoeconomics & Outcomes Research
Sujal Shah, Megan Smith, Randall Butler
Hodgkin lymphoma and lymphomatoid granulomatosis (LYG) are entities that contain a small number of large, variably Epstein-Barr virus (EBV)-positive neoplastic cells scattered within background non-neoplastic mixed inflammatory infiltrate. The 2 entities can typically be distinguished histologically by the angiocentric and angiodestructive pattern of lymphomatoid granulomatosis (LYG); also, they differ in overall prognosis. Herein, we report a case of Hodgkin lymphoma in a 64-year-old Caucasian woman, diagnosed at autopsy with unusual histologic features and aggressive clinical course that mimicked LYG...
November 20, 2017: Laboratory Medicine
Stephanie L Skala, Alexandra C Hristov, Johann E Gudjonsson, May P Chan
Clinical diagnosis of lymphomatoid granulomatosis (LYG) often is difficult, especially in patients with multiple comorbidities. We present a 60-year-old woman with worsening fatigue, night sweats, unintentional weight loss, and dyspnea of 2 weeks' duration. Her medical history was remarkable for recent radiation therapy for recurrent breast cancer and antisynthetase syndrome complicated by interstitial lung disease and controlled with azathioprine. Computed tomography showed ground-glass opacities and nodular infiltrates in all lung lobes, raising concern for radiation pneumonitis and drug toxicity...
October 2017: Cutis; Cutaneous Medicine for the Practitioner
Mostafa Ahmed Arafa, Karim Hamda Farhat
Colorectal cancer (CRC) is the third most common cancer worldwide and the fourth most common cause of death. Reduction in mortality rates in some countries worldwide are most likely ascribed to CRC screening and/or improved treatments. We reviewed the most relevant articles which discuss the cost-effectiveness of colorectal cancer screening procedures, in particular, the recent ones through the last eight years. The effectiveness of screening estimated by discounted life years gained (LYGs) compared to no screening, differed considerably between the studies...
September 2017: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
Irmgard Schiller-Fruehwirth, Beate Jahn, Patrick Einzinger, Günther Zauner, Christoph Urach, Uwe Siebert
BACKGROUND: In 2014, Austrian health authorities implemented an organized breast cancer screening program. Until then, there has been a long-standing tradition of opportunistic screening. OBJECTIVES: To evaluate the cost-effectiveness of organized screening compared with opportunistic screening, as well as to identify factors influencing the clinical and economic outcomes. METHODS: We developed and validated an individual-level state-transition model and assessed the health outcomes and costs of organized and opportunistic screening for 40-year-old asymptomatic women...
September 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Toyohiko Watanabe, Shingo Yamamoto, Momokazu Gotoh, Tadanori Saitoh, Osamu Yokoyama, Tatsunori Murata, Masayuki Takeda
OBJECTIVES: To evaluate the cost effectiveness of disposable, hydrophilic-coated catheters in Japan. METHODS: A Markov decision model previously applied in a European study was used to evaluate the cost effectiveness of intermittent self-catheterization (ISC) with hydrophilic-coated catheters in Japanese spinal cord injury (SCI) patients suffering from chronic urinary retention from a lifetime perspective. To adjust the model to a Japanese setting, relevant Japanese data regarding the baseline risk of urinary tract infection (UTI), the average age at onset of SCI, costs, and general mortality were extracted from published literature, national statistics, or the opinions of Japanese experts...
September 2017: Lower Urinary Tract Symptoms
Ukamaka Nwakife Nwadibia, Kalyan Chakravarthy Potu, Eric A Larson, Galal Ahmed
In this report, we discuss an unusual case of pulmonary lymphomatoid granulomatosis (LYG), a rare form of angiocentric and angiodestructive lymphoproliferative disorder. This disease is thought to be caused by Epstein-Barr virus-induced lymphoproliferation. A 39-year-old male with no signi ficant past medical history presented with flu-like symptoms. Upon further evaluation, laboratory studies noted pancytopenia, and a chest X-ray showed bilateral nodular densities. A computerized tomography (CT) scan demonstrated bilateral pulmonary nodules and splenomegaly...
January 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
José Carlos Truzzi, Vanessa Teich, Camila Pepe
INTRODUCTION: Detrusor sphincter dyssynergia affects 70% to 80% of all spinal cord injury patients, resulting in increased risk of urinary tract infections (UTIs) and potential exposure to antimicrobial resistance. In Brazil, local guidelines recommend intermittent catheterization as the best method for bladder emptying, and two catheter types are available: the conventional uncoated PVC and the hydrophilic coated catheters. OBJECTIVE: To evaluate the cost-effectiveness of two types of catheters for intermittent catheterization from the perspective of the Brazilian public healthcare system...
August 8, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Usha Menon, Alistair J McGuire, Maria Raikou, Andy Ryan, Susan K Davies, Matthew Burnell, Aleksandra Gentry-Maharaj, Jatinderpal K Kalsi, Naveena Singh, Nazar N Amso, Derek Cruickshank, Stephen Dobbs, Keith Godfrey, Jonathan Herod, Simon Leeson, Tim Mould, John Murdoch, David Oram, Ian Scott, Mourad W Seif, Karin Williamson, Robert Woolas, Lesley Fallowfield, Stuart Campbell, Steven J Skates, Mahesh Parmar, Ian J Jacobs
BACKGROUND: To assess the within-trial cost-effectiveness of an NHS ovarian cancer screening (OCS) programme using data from UKCTOCS and extrapolate results based on average life expectancy. METHODS: Within-trial economic evaluation of no screening (C) vs either (1) an annual OCS programme using transvaginal ultrasound (USS) or (2) an annual ovarian cancer multimodal screening programme with serum CA125 interpreted using a risk algorithm (ROCA) and transvaginal ultrasound as a second-line test (MMS), plus comparison of lifetime extrapolation of the no screening arm and the MMS programme using both a predictive and a Markov model...
August 22, 2017: British Journal of Cancer
Iris Lansdorp-Vogelaar, S Lucas Goede, Linda J W Bosch, Veerle Melotte, Beatriz Carvalho, Manon van Engeland, Gerrit A Meijer, Harry J de Koning, Marjolein van Ballegooijen
BACKGROUND & AIMS: Biomarker assays could increase the accuracy of noninvasive detection of colorectal cancer (CRC); fecal immunochemical tests (FITs) are estimated to miss 27%-47% of CRCs and 70%-80% of advanced adenomas per round of screening. We investigated the conditions under which biomarker screens would be cost-effective compared with FIT screens of average-risk individuals. METHODS: We used the MISCAN-Colon microsimulation model to estimate the effects of various CRC screening test characteristics on life-years gained (LYG) and; age-specific all-cause mortality was based on the 2010 Dutch life tables...
April 2018: Clinical Gastroenterology and Hepatology
Hadi Bhurgri, Sami Samiullah
The month of March is dedicated to Colon Cancer Awareness. Worldwide, colorectal cancer (CRC) incidence has been on the rise. It is currently the third most common cancer in men (746,000 cases, 10.0% of the total) and the second in women (614,000 cases, 9.2% of the total).1 Arecent meta-analysis reported a 61% risk reduction in CRC incidence with colonoscopy.2 Unlike screening programs for breast and prostate cancers, not only has CRC screening reduced mortality from colon cancer and detected early CRC, it has also decreased the incidence of CRC through detection and removal of pre-cancerous lesions...
June 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
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