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https://www.readbyqxmd.com/read/29457585/training-nurses-in-a-competency-framework-to-support-adults-with-epilepsy-and-intellectual-disability-the-epaid-cluster-rct
#1
Howard Ring, James Howlett, Mark Pennington, Christopher Smith, Marcus Redley, Caroline Murphy, Roxanne Hook, Adam Platt, Nakita Gilbert, Elizabeth Jones, Joanna Kelly, Angela Pullen, Adrian Mander, Cam Donaldson, Simon Rowe, James Wason, Fiona Irvine
BACKGROUND: People with an intellectual (learning) disability (ID) and epilepsy have an increased seizure frequency, higher frequencies of multiple antiepileptic drug (AED) use and side effects, higher treatment costs, higher mortality rates and more behavioural problems than the rest of the population with epilepsy. The introduction of nurse-led care may lead to improvements in outcome for those with an ID and epilepsy; however, this has not been tested in a definitive clinical trial...
February 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29457543/greener-chemicals-for-the-future-qsar-modelling-of-the-pbt-index-using-eta-descriptors
#2
P De, K Roy
Persistent, bioaccumulative and toxic (PBT) chemicals symbolize a group of substances that are not easily degraded; instead, they accumulate in different organisms and exhibit an acute or chronic toxicity. The limited empirical data on PBT chemicals, the high cost of testing together with the regulatory constraints and the international push for reduced animal testing motivate a greater reliance on predictive computational methods like quantitative structure-activity relationship (QSAR) models in PBT assessment...
April 2018: SAR and QSAR in Environmental Research
https://www.readbyqxmd.com/read/29457201/validity-of-oral-fluid-test-for-delta-9-tetrahydrocannabinol-in-drivers-using-the-2013-national-roadside-survey-data
#3
Huiyan Jin, Sharifa Z Williams, Stanford T Chihuri, Guohua Li, Qixuan Chen
BACKGROUND: Driving under the influence of marijuana is a serious traffic safety concern in the United States. Delta 9-tetrahydrocannabinol (THC) is the main active compound in marijuana. Although blood THC testing is a more accurate measure of THC-induced impairment, measuring THC in oral fluid is a less intrusive and less costly method of testing. METHODS: We examined whether the oral fluid THC test can be used as a valid alternative to the blood THC test using a sensitivity and specificity analysis and a logistic regression, and estimate the quantitative relationship between oral fluid THC concentration and blood THC concentration using a correlation analysis and a linear regression on the log-transformed THC concentrations...
February 19, 2018: Injury Epidemiology
https://www.readbyqxmd.com/read/29456880/cost-effectiveness-of-nivolumab-in-patients-with-advanced-renal-cell-carcinoma-treated-in-the-united-states
#4
Charles McCrea, Sukhvinder Johal, Shuo Yang, Justin Doan
Background: We evaluated the cost-effectiveness of nivolumab versus everolimus in patients with advanced renal cell carcinoma (RCC) from a US payer perspective. Methods: A partitioned survival model consisting of three health states, progression-free survival (PFS), progressive disease, and death, was developed to evaluate the cost-effectiveness of intravenous nivolumab versus oral everolimus over a lifetime. The proportion of patients in each state was calculated based on parametric distributions fitted to PFS and overall survival (OS) data from CheckMate 025 (N = 821), a large randomized phase 3 trial of nivolumab versus everolimus for advanced RCC...
2018: Experimental Hematology & Oncology
https://www.readbyqxmd.com/read/29456815/crispr-cas9-a-new-approach-to-successful-knockdown-of-abcb1-p-glycoprotein-and-reversal-of-chemosensitivity-in-human-epithelial-ovarian-cancer-cell-line
#5
Leyla Norouzi-Barough, Mohammadreza Sarookhani, Rasoul Salehi, Mohammadreza Sharifi, Sahar Moghbelinejad
Objectives: Multidrug resistance (MDR) is a major obstacle in the successful chemotherapy of ovarian cancer. Inhibition of P-glycoprotein (P-gp), a member of ATP-binding cassette (ABC) transporters, is a well-known strategy to overcome MDR in cancer. The aim of this study was to investigate the efficiency and ability of CRISPR/Cas9 genome editing technology to knockdown ABCB1 gene expression in adriamycin resistant (A2780/ADR) ovarian cancer cell line and evaluate the sensitivity changes to doxorubicin...
February 2018: Iranian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/29455026/an-approach-for-cell-viability-online-detection-based-on-the-characteristics-of-lensfree-cell-diffraction-fingerprint
#6
Guoxiao Li, Rongbiao Zhang, Ning Yang, Changsheng Yin, Mingji Wei, Yecheng Zhang, Jian Sun
To overcome the drawbacks such as low automation and high cost, an approach for cell viability online detection is proposed, based on the extracted lensfree cell diffraction fingerprint characteristics. The cell fingerprints are acquired by a constructed large field-of-view (FOV) diffraction imaging platform without any lenses. The approach realizes distinguishing live and dead cells online and calculating cell viability index based on the number of live cells. With theoretical analysis and simulation, diffraction fingerprints of cells with different morphology are simulated and two characteristics are discovered to be able to reflect cell viability status effectively...
February 7, 2018: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/29454592/effective-antimicrobial-stewardship-strategies-for-cost-effective-utilization-of-telavancin-for-the-treatment-of-patients-with-hospital-acquired-bacterial-pneumonia-caused-by-staphylococcus-aureus
#7
James A McKinnell, Shelby Corman, Dipen Patel, Grace H Leung, Lynne M Gordon, Thomas P Lodise
PURPOSE: Clinicians and stewardship programs are challenged with positioning of novel, higher priced antibiotic agents for the treatment of clinical infections. We developed a decision-analytic model to describe costs, including drug, total treatment costs, and health care outcomes, associated with telavancin (TLV) compared with vancomycin (VAN) for patients with Staphylococcus aureus (SA) hospital-acquired bacterial pneumonia (HABP). METHODS: This decision-analytic model assessed the treatment of SA-HABP with TLV versus VAN...
February 14, 2018: Clinical Therapeutics
https://www.readbyqxmd.com/read/29454590/understanding-how-prostate-cancer-patients-value-the-current-treatment-options-for-metastatic-castration-resistant-prostate-cancer
#8
Tarik Benidir, Karen Hersey, Antonio Finelli, Rob Hamilton, Anthony M Joshua, Girish Kulkarni, Alexandre Zlotta, Neil Fleshner
Several new compounds are now available for castration resistant prostate cancer (CRPC). Individual costs range between $40,000 and $93,000 with mean survival extensions from 2.4 to 4.8 months. Currently, it remains unclear how patients with prostate cancer (PCa) value the effect of these therapies in the setting of CRPC. OBJECTIVE: To assess patient understanding of core cancer concepts, opinions on the cost and overall benefit of CRPC drugs, whether out-of-pocket costs would change opinions and whether patients would ultimately opt out of CRPC drug treatment for an end-of-life (EOL) premium...
February 14, 2018: Urologic Oncology
https://www.readbyqxmd.com/read/29453848/postoperative-recurrence-of-crohn-s-disease-pathophysiology-diagnosis-and-treatment
#9
Antonio Di Sario, Paola Sassaroli, Luigi Daretti, Giulia Annulli, Laura Schiada, Giorgia Falcioni, Emanuele Bendia, Simone Antuono, Antonio Benedetti
BACKGROUND: Up to 80% of Crohn`s disease (CD) patients require at least one surgical intervention in their lifetime and up to 70% of these patients develop postoperative endoscopic recurrence within 1 year. The most important predictors of early postoperative recurrence are represented by smoking, prior intestinal surgery, penetrating disease and perianal location. Genetic factors, gut microbiota structure and immunological alterations may be involved in the pathogenesis of postoperative recurrence of CD, although their specific roles have to be determined yet...
February 16, 2018: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/29453841/beyond-cost-benefit-analysis-in-the-governance-of-synthetic-biology
#10
Wendell Wallach, Marc Saner, Gary Marchant
For many innovations, oversight fits nicely within existing governance mechanisms; nevertheless, others pose unique public health, environmental, and ethical challenges. Synthetic artemisinin, for example, has many precursors in laboratory-developed drugs that emulate natural forms of the same drug. The policy challenges posed by synthetic artemisinin do not differ significantly in kind from other laboratory-formulated drugs. Synthetic biofuels and gene drives, however, fit less clearly into existing governance structures...
January 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29453287/adoption-of-sacubitril-valsartan-for-the-management-of-patients-with-heart-failure
#11
Lindsey R Sangaralingham, S Jeson Sangaralingham, Nilay D Shah, Xiaoxi Yao, Shannon M Dunlay
BACKGROUND: The US Food and Drug Administration approved the use of sacubitril/valsartan in patients with heart failure with reduced ejection fraction in July 2015. We aimed to assess the adoption and prescription drug costs of sacubitril/valsartan in its first 18 months after Food and Drug Administration approval. METHODS AND RESULTS: Using a large US insurance database, we identified privately insured and Medicare Advantage beneficiaries who filled a first prescription for sacubitril/valsartan between July 1, 2015, and December 31, 2016...
February 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29452742/to-switch-from-botox-to-dysport-in-children-with-cp-a-real-world-dose-conversion-cost-effectiveness-study
#12
Kristina Tedroff, Gustaf Befrits, Carl Johan Tedroff, Stefan Gantelius
BACKGROUND AND OBJECTIVES: Children with cerebral palsy (CP) are routinely treated with botulinum toxin A (BoNT-A). Two non dose-equivalent and differently priced products, Botox and Dysport are used. Depending on the conversion one of the products is considerably cheaper. However, the dose conversion factors studied to date have varied widely and relevant studies have not included children. Our objective here was to compare the efficacy and health economics of the switch from Botox to Dysport in children with CP when conversion was set to 1:2...
February 3, 2018: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29452560/health-care-efficiencies-consolidation-and-alternative-models-vs-health-care-and-antitrust-regulation-irreconcilable-differences
#13
Michael W King
Despite the U.S. substantially outspending peer high income nations with almost 18% of GDP dedicated to health care, on any number of statistical measurements from life expectancy to birth rates to chronic disease, 1 the U.S. achieves inferior health outcomes. In short, Americans receive a very disappointing return on investment on their health care dollars, causing economic and social strain. 2 Accordingly, the debates rage on: what is the top driver of health care spending? Among the culprits: poor communication and coordination among disparate providers, paperwork required by payors and regulations, well-intentioned physicians overprescribing treatments, drugs and devices, outright fraud and abuse, and medical malpractice litigation...
November 2017: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29452450/-cost-comparison-of-licensed-intravitreal-therapies-for-insufficiently-anti-vegf-responding-fovea-involving-diabetic-macular-edema-in-germany
#14
Aljoscha S Neubauer, Christos Haritoglou, Michael W Ulbig
BACKGROUND: In the treatment of center-involving diabetic macular edema, despite initial therapy with an anti-VEGF compound, an insufficient response may occur. Further therapy options include a switch of anti-VEGF products or to corticosteroid implants, such as Fluocinolone acetonide or Dexamethasone. OBJECTIVES: Firstly, to investigate systematically which evidence-based study data are available describing the efficacy of in-label treatments after primary anti-VEGF treatment, secondly, to investigate which costs go along for the healthcare provider...
February 16, 2018: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/29451780/using-i-in-vitro-i-evolution-and-whole-genome-analysis-iviewga-to-discover-next-generation-targets-for-antimalarial-drug-discovery
#15
Madeline R Luth, Purva Gupta, Sabine Ottilie, Elizabeth A Winzeler
Although many new anti-infectives have been discovered and developed solely using phenotypic cellular screening and assay optimization, most researchers recognize that structure-guided drug design is more practical and less costly. In addition, a greater chemical space can be interrogated with structure-guided drug design. The practicality of structure-guided drug design has launched a search for the targets of compounds discovered in phenotypic screens. One method that has been used extensively in malaria parasites for target discovery and chemical validation is in vitro evolution and whole genome analysis (IVIEWGA)...
February 16, 2018: ACS Infectious Diseases
https://www.readbyqxmd.com/read/29451470/use-of-integrated-clinical-trial-protocols-a-survey-in-early-medicines-development
#16
Katharina Erb-Zohar, Hildegard Sourgens, Kerstin Breithaupt-Groegler
PURPOSE: To collect information on the use of integrated protocols in early clinical medicines development. MATERIALS AND METHODS: The questionnaire was mailed in fall 2014 to members of human pharmacology societies in Europe for anonymous responses via the online tool SurveyMonkey®. RESULTS: 97 respondents reported on 164 integrated protocols overall. In general, integrated protocols comprised 2 or 3 trial elements. One third of integrated protocols involved patients...
February 16, 2018: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29451467/hemlibra-s-remarkable-efficacy-a-beacon-for-hemophilia-patients
#17
Thomas Morrow
Hemlibra demonstrates how far antibody science has progressed. Genentech's drug, approved late last year, connects two clotting factors to prevent the devastating bleeds in hemophilia patients with inhibitors. The high price may be offset by avoided costs in patients with factor VIII inhibitors.
February 2018: Managed Care
https://www.readbyqxmd.com/read/29451361/development-of-a-focused-library-of-triazole-linked-privileged-structure-based-conjugates-leading-to-the-discovery-of-novel-phenotypic-hits-against-protozoan-parasitic-infections
#18
Elisa Uliassi, Lorna Piazzi, Federica Belluti, Andrea Mazzanti, Marcel Kaiser, Reto Brun, Carolina B Moraes, Lucio H Freitas-Junior, Sheraz Gul, Maria Kuzikov, Bernhard Ellinger, Chiara Borsari, Maria Paola Costi, Maria Laura Bolognesi
Protozoan infections caused by Plasmodium, Leishmania, and Trypanosoma spp. contribute significantly to the burden of infectious diseases worldwide, causing severe morbidity and mortality. The inadequacy of available treatments calls for cost- and time-effective drug discovery endeavors. To this end, we envisaged the triazole linkage of privileged structures as an effective drug design strategy to generate a focused library of high-quality compounds. The versatility of this approach was combined with the feasibility of a phenotypic assay, integrated with early ADME-tox profiling...
February 16, 2018: ChemMedChem
https://www.readbyqxmd.com/read/29451142/cost-analysis-of-cervical-cancer-patients-with-different-medical-payment-modes-based-on-gamma-model-within-a-grade-a-tertiary-hospital
#19
Suo-Wei Wu, Tong Chen, Qi Pan, Liang-Yu Wei, Qin Wang, Jing-Chen Song, Chao Li, Ji Luo
Background: Cervical cancer shows a growing incidence and medical cost in recent years that has increased severe financial pressure on patients and medical insurance institutions. This study aimed to investigate the medical economic characteristics of cervical cancer patients with different payment modes within a Grade A tertiary hospital to provide evidence and suggestions for inpatient cost control and to verify the application of Gamma model in medical cost analysis. Methods: The basic and cost information of cervical cancer cases within a Grade A tertiary hospital in the year 2011-2016 were collected...
February 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29451116/population-tailored-care-for-homeless-veterans-and-acute-care-use-cost-and-satisfaction-a-prospective-quasi-experimental-trial
#20
Thomas P O'Toole, Erin E Johnson, Matthew Borgia, Amy Noack, Jean Yoon, Elizabeth Gehlert, Jeanie Lo
INTRODUCTION: Although traditional patient-centered medical homes (PCMHs) are effective for patients with complex needs, it is unclear whether homeless-tailored PCMHs work better for homeless veterans. We examined the impact of enrollment in a Veterans Health Administration (VHA) homeless-tailored PCMH on health services use, cost, and satisfaction compared with enrollment in a traditional, nontailored PCMH. METHODS: We conducted a prospective, multicenter, quasi-experimental, single-blinded study at 2 VHA medical centers to assess health services use, cost, and satisfaction during 12 months among 2 groups of homeless veterans: 1) veterans receiving VHA homeless-tailored primary care (Homeless-Patient Aligned Care Team [H-PACT]) and 2) veterans receiving traditional primary care services (PACT)...
February 15, 2018: Preventing Chronic Disease
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