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Yini Wu, Jianping Wang, Xiaoyan Yu, Dongli Li, Xin Han, Lihua Fan
BACKGROUND: The effect of sevoflurane on the doxorubicin-induced myocardial injury was explored by investigating the phosphorylation states of proteins in phosphatidylinositol 3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) signaling pathway. METHODS: Myocardial injury rat models were induced by doxorubicin and evenly assigned into five groups according to different treatment: Doxorubicin group (DG, 200-µL saline solution), sevoflurane group (SevG, inhaled with 2...
February 15, 2017: Cardiology Journal
Benjamin Cadier, Julie Bulsei, Pierre Nahon, Olivier Seror, Alexis Laurent, Isabelle Rosa, Richard Layese, Charlotte Costentin, Carole Cagnot, Isabelle Durand-Zaleski, Karine Chevreul
: Hepatocellular carcinoma (HCC) is the leading cause of death in patients with cirrhosis. Patients outside clinical trials seldom benefit from evidence-based monitoring. The objective of this study was to estimate the cost-effectiveness of complying with HCC screening guidelines. The economic evaluation compared surveillance of patients with cirrhosis as recommended by the guidelines ("gold-standard monitoring") to "real-life monitoring" from the health care system perspective. A Markov model described the history of the disease and treatment course including current first-line curative treatment: liver resection, radiofrequency ablation (RFA), and liver transplantation...
February 8, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
J H Kappen, H C T van Zaanen, S M Snelder, A J P van Tilburg, A Rudolphus
We present a rare case of grade II lymphomatoid granulomatosis (LYG) with pulmonary and gastrointestinal involvement. LYG is considered an Epstein-Barr virus-driven lymphoproliferative disorder that often presents with multiple nodular lesions in the lungs and sometimes involvement of skin and the central nervous system. Although the aetiology is unknown, it is associated with the use of immunosuppressives. Involvement of other organ systems is very rare. We successfully treated our patients with 6 cycles of R-CHOP and autologous stem cell transplantation with a major response at 20 months follow-up...
February 6, 2017: BMJ Case Reports
Santiago Grau, Jose Ramon Azanza, Isabel Ruiz, Carlos Vallejo, Josep Mensa, Johan Maertens, Werner J Heinz, Jon Andoni Barrueta, Carmen Peral, Francisco Jesús Mesa, Miguel Barrado, Claudie Charbonneau, Darío Rubio-Rodríguez, Carlos Rubio-Terrés
OBJECTIVE: According to a recent randomized, double-blind clinical trial comparing the combination of voriconazole and anidulafungin (VOR+ANI) with VOR monotherapy for invasive aspergillosis (IA) in patients with hematologic disease or with hematopoietic stem cell transplant, mortality was lower after 6 weeks with VOR+ANI than with VOR monotherapy in a post hoc analysis of patients with galactomannan-based IA. The objective of this study was to compare the cost-effectiveness of VOR+ANI with VOR, from the perspective of hospitals in the Spanish National Health System...
2017: ClinicoEconomics and Outcomes Research: CEOR
Summer S Han, Kevin Ten Haaf, William D Hazelton, Vidit N Munshi, Jihyoun Jeon, Saadet A Erdogan, Colden Johanson, Pamela M McMahon, Rafael Meza, Chung Yin Kong, Eric J Feuer, Harry J de Koning, Sylvia K Plevritis
The U.S. Preventive Services Task Force (USPSTF) recently updated their national lung screening guidelines and recommended low-dose computed tomography (LDCT) for lung cancer (LC) screening through age 80. However, the risk of overdiagnosis among older populations is a concern. Using four comparative models from the Cancer Intervention and Surveillance Modeling Network, we evaluate the overdiagnosis of the screening program recommended by USPSTF in the U.S. 1950 birth cohort. We estimate the number of LC deaths averted by screening (D) per overdiagnosed case (O), yielding the ratio D/O, to quantify the trade-off between the harms and benefits of LDCT...
January 10, 2017: International Journal of Cancer. Journal International du Cancer
Khosro Keshavarz, Abbas Kebriaeezadeh, Seyed Moayed Alavian, Ali Akbari Sari, Mohsen Rezaei Hemami, Farhad Lotfi, Amir Hashemi Meshkini, Mehdi Javanbakht, Maryam Keshvari, Shekoufeh Nikfar
BACKGROUND: Although hepatitis B infection is the major cause of chronic liver disease in Iran, no studies have employed economic evaluations of the medications used to treat Iranian patients with chronic hepatitis B (CHB). Therefore, the cost-effectiveness of the different treatment options for this disease in Iran is unknown. OBJECTIVES: The aim of this study was to compare the cost utility and cost-effectiveness of medication strategies tailored to local conditions in patients with HB e antigen (HBeAg)-negative CHB infection in Iran...
September 2016: Hepatitis Monthly
Anne Goverde, Manon Cw Spaander, Helena C van Doorn, Hendrikus J Dubbink, Ans Mw van den Ouweland, Carli M Tops, Sjarlot G Kooi, Judith de Waard, Robert F Hoedemaeker, Marco J Bruno, Robert Mw Hofstra, Esther W de Bekker-Grob, Winand Nm Dinjens, Ewout W Steyerberg, Anja Wagner
PURPOSE: To assess cost-effectiveness of routine screening for Lynch Syndrome (LS) in endometrial cancer (EC) patients ≤70years of age. METHODS: Consecutive EC patients ≤70years of age were screened for LS by analysis of microsatellite instability, immunohistochemistry and MLH1 hypermethylation. Costs and health benefit in life years gained (LYG) included surveillance for LS carriers among EC patients and relatives. We calculated incremental cost-effectiveness ratios (ICERs) comparing LS screening among EC patients ≤70years with ≤50years and the revised Bethesda guidelines...
December 2016: Gynecologic Oncology
Andrew Keller, Christian Gericke, Jennifer A Whitty, John Yaxley, Boon Kua, Geoff Coughlin, Troy Gianduzzo
BACKGROUND AND OBJECTIVES: The Göteborg randomised population-based prostate cancer screening trial demonstrated that prostate-specific antigen (PSA)-based screening reduces prostate cancer deaths compared with an age-matched control group. Utilising the prostate cancer detection rates from this study, we investigated the clinical and cost effectiveness of a similar PSA-based screening strategy for an Australian population of men aged 50-69 years. METHODS: A decision model that incorporated Markov processes was developed from a health system perspective...
February 2017: Applied Health Economics and Health Policy
Shinichi Kan
Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) has been recently identified as an inflammatory central nervous system (CNS) disorder. Punctate and curvilinear gadolinium enhancement (peppering) the pons is a characteristic magnetic resonance imaging (MRI) feature of CLIPPERS. Pathogenesis of this disorder remains unknown. A specific serum or cerebrospinal fluid biomarker for this disorder is currently unknown. Whether CLIPPERS is an actual new disease or just represents overlapping symptoms from multiple diseases is still debated...
September 2016: Brain and Nerve, Shinkei Kenkyū No Shinpo
María Espinosa Bosch, Rocío Asensi Diez, Sara García Agudo, Ana Clopes Estela
Nintedanib is a triple angiokinase inhibitor that has been approved by the European Agency Medicines (EMA) in combination with docetaxel for the treatment of adult patients with locally advanced, metastatic or locally recurrent non small cell lung cancer (NSCLC) of adenocarcinoma tumour histology, after first-line chemotherapy. In LUME-Lung 1 clinical trial, the combination of nintedanib plus docetaxel vs. placebo plus docetaxel improved progression free survival (PFS) in NSCLC patients, and improved overall survival in the population of adenocarcinoma patients, particularly in those with progression within 9 months after first line treatment initiation, median 10...
June 1, 2016: Farmacia Hospitalaria
Ana Montalban-Arques, Philipp Wurm, Slave Trajanoski, Silvia Schauer, Sabine Kienesberger, Bettina Halwachs, Christoph Högenauer, Cord Langner, Gregor Gorkiewicz
Corpus-dominant lymphocytic gastritis (LyG) is characterized by CD8(+) T-cell infiltration of the stomach epithelium by a so far uncharacterized mechanism. Although Helicobacter pylori is typically undetectable in LyG, patients respond to H. pylori antibiotic eradication therapy, suggesting a non-H. pylori microbial trigger for the disease. Comparative microbiota analysis of specimens from LyG, H. pylori gastritis and healthy controls precluded involvement of H. pylori in LyG but identified Propionibacterium acnes as a possible disease trigger...
December 2016: Journal of Pathology
Julio C Chavez, Jose Sandoval-Sus, Pedro Horna, Samir Dalia, Celeste Bello, Paul Chevernick, Eduardo M Sotomayor, Lubomir Sokol, Bijal Shah
BACKGROUND: Lymphomatoid granulomatosis (LYG) is a rare B-cell lymphoproliferative disorder with frequent extranodal presentation and involvement of the respiratory system. The purpose of this study is to describe the clinical characteristics, pathologic findings, and treatment outcomes of LYG in a single tertiary institution. METHODS: This is a retrospective review of series of cases of LYG diagnosed at Moffitt Cancer Center (MCC) between 2000 and 2011. We describe clinical presentation, histopathologic findings, and treatment outcomes...
August 2016: Clinical Lymphoma, Myeloma & Leukemia
Cara Usher, Roisin Adams, Susanne Schmitz, Jennifer Kieran, Darina O'Flanagan, Joan O'Donnell, Kevin Connolly, Brenda Corcoran, Karina Butler, Michael Barry, Cathal Walsh
BACKGROUND: The aim of this study was to compare the cost effectiveness of the current Irish programme of universal BCG vaccination of infants versus a programme which considered selectively vaccinating high risk infants using decision analytical modelling. METHODS: The efficacy of the BCG vaccine was re-evaluated to inform a decision analytical model constructed to follow a birth cohort of vaccinated and unvaccinated infants over a 15 year time horizon. The number of life years gained (LYG) was the primary outcome measure and this was compared to the net cost of the vaccination strategies...
2016: Archives of Public Health, Archives Belges de Santé Publique
Ian Cromwell, Dean A Regier, Stuart J Peacock, Catherine F Poh
BACKGROUND: Management of low-grade oral dysplasias (LGDs) is complicated, as only a small percentage of lesions will progress to invasive disease. The current standard of care requires patients to undergo regular monitoring of their lesions, with intervention occurring as a response to meaningful clinical changes. Recent improvements in molecular technologies and understanding of the biology of LGDs may allow clinicians to manage lesions based on their genome-guided risk. METHODS: We used a decision-analytic Markov model to estimate the cost-effectiveness of risk-stratified care using a genomic assay...
September 2016: Oncologist
I Cromwell, M Gaudet, S J Peacock, C Aquino-Parsons
BACKGROUND: Precursors to anal squamous cell carcinoma may be detectable through screening; however, the literature suggests that population-level testing is not cost-effective. Given that high-grade cervical neoplasia (CIN) is associated with an increased risk of developing anal cancer, and in light of changing guidelines for the follow-up and management of cervical neoplasia, it is worthwhile to examine the costs and effectiveness of an anal cancer screening program delivered to women with previously-detected CIN...
2016: BMC Health Services Research
Amy B Knudsen, Ann G Zauber, Carolyn M Rutter, Steffie K Naber, V Paul Doria-Rose, Chester Pabiniak, Colden Johanson, Sara E Fischer, Iris Lansdorp-Vogelaar, Karen M Kuntz
IMPORTANCE: The US Preventive Services Task Force (USPSTF) is updating its 2008 colorectal cancer (CRC) screening recommendations. OBJECTIVE: To inform the USPSTF by modeling the benefits, burden, and harms of CRC screening strategies; estimating the optimal ages to begin and end screening; and identifying a set of model-recommendable strategies that provide similar life-years gained (LYG) and a comparable balance between LYG and screening burden. DESIGN, SETTING, AND PARTICIPANTS: Comparative modeling with 3 microsimulation models of a hypothetical cohort of previously unscreened US 40-year-olds with no prior CRC diagnosis...
June 21, 2016: JAMA: the Journal of the American Medical Association
Marjolein J E Greuter, Johannes Berkhof, Remond J A Fijneman, Erhan Demirel, Jie-Bin Lew, Gerrit A Meijer, Jaap Stoker, Veerle M H Coupé
OBJECTIVE: Imaging may be promising for colorectal cancer (CRC) screening, since it has test characteristics comparable with colonoscopy but is less invasive. We aimed to assess the potential of CT colonography (CTC) and MR colonography (MRC) in terms of (cost-effectiveness) using the Adenoma and Serrated pathway to Colorectal CAncer model. METHODS: We compared several CTC and MRC strategies with 5- or 10-yearly screening intervals with no screening, 10-yearly colonoscopy screening and biennial faecal immunochemical test (FIT) screening...
July 2016: British Journal of Radiology
Barry M Berger, Bernard Levin, Robert J Hilsden
Multitarget stool DNA (mt-sDNA) testing was approved for average risk colorectal cancer (CRC) screening by the United States Food and Drug Administration and thereafter reimbursed for use by the Medicare program (2014). The United States Preventive Services Task Force (USPSTF) October 2015 draft recommendation for CRC screening included mt-sDNA as an "alternative" screening test that "may be useful in select clinical circumstances", despite its very high sensitivity for early stage CRC. The evidence supporting mt-sDNA for routine screening use is robust...
May 15, 2016: World Journal of Gastrointestinal Oncology
F Bernard-Arnoux, M Lamure, F Ducray, G Aulagner, J Honnorat, X Armoiry
BACKGROUND: There is strong concern about the costs associated with adding tumor-treating fields (TTF) therapy to standard first-line treatment for glioblastoma (GBM). Hence, we aimed to determine the cost-effectiveness of TTF therapy for the treatment of newly diagnosed patients with GBM. METHODS: We developed a 3-health-state Markov model. The perspective was that of the French Health Insurance, and the horizon was lifetime. We calculated the transition probabilities from the survival parameters reported in the EF-14 trial...
August 2016: Neuro-oncology
Isabel Elías, Itziar Oyagüez, Luis Antonio Alvarez-Sala, Fernando García-Bragado, Andrés Navarro, Paloma González, Fernando De Andrés-Nogales, Javier Soto
OBJECTIVE: Cost-effectiveness analysis of a 6-month treatment of apixaban (10 mg/12h, first 7 days; 5 mg/12h afterwards) for the treatment of the first event of venous thromboembolism (VTE) and prevention of recurrences, versus low-molecular-weight heparins/vitamin K antagonists treatment (LMWH/VKA). MATERIAL AND METHODS: A lifetime Markov model with 13 health states was used for describing the course of the disease. Efficacy and safety data were obtained from AMPLIFY and AMPLIFY-EXT clinical trials; health outcomes were measured as life years gained (LYG) and quality-adjusted life years (QALY)...
1, 2016: Farmacia Hospitalaria
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