1,720,962 research outputs found
PK-driven prophylaxis versus standard prophylaxis: When a tailored treatment may be a real and achievable cost-saving approach in children with severe hemophilia A
No full textBackground Prophylaxis is the gold standard for the treatment of children with severe hemophilia. In the last years a new approach to prophylaxis based on annual bleeding rate (ABR), pharmacokinetics (PK) and lifestyle of each patient has begun to be adopted in hemophilia treatment. Aim Aim of our observational retrospective study was to evaluate whether in a group of children with severe hemophilia A (HA) a tailored approach may be used to replace standard therapy, reducing costs. Methods PK evaluation was carried out in six hemophiliac children followed at our Hemophilia Center, and already receiving recombinant factor VIII (rFVIII) on prophylaxis, using a computing program (MyPKfit®). Bayesian curve was created for each child and tailored prophylaxis was estimated considering a trough level of 1%. Results The weekly frequency of infusions was reduced in one patient, while it was slightly increased in three children. As to the remaining children, only the dosage was changed. Scheduled follow-up revealed a complete adherence to treatment, a reduction of bleeds using PK-regimen and a general improvement in the quality of life. The comparison between the direct and indirect costs of treatment during standard and PK-driven prophylaxis showed a total saving of € 54,797.40 (− 10.67%) in case of tailored prophylaxis. Conclusion A therapeutic approach based on PK and clinical characteristics of each patient may change standard treatment. Based on our results, tailored prophylaxis could be an effective option for children with HA reducing costs
Iliopsoas bursitis and femoral vein thrombosis complicating total hip arthroplasty in an elderly patient
No full textPredominantly, cystic or solid extra-articular pelvic masses
have been increasingly recognized as a complication
of hip arthroplasty and have been described in association
with both metal-on-polyethylene and metal-on-metal
implants. These late and
uncommon complications cause a number of clinical
symptoms, including limb swelling and erythema, pain,
limp or restricted movement, palpable groin lump,
femoral nerve irritation or palsy. Here, we report a case of
a hemorrhagic cystic mass causing deep vein thrombosis
(DVT) in the femoral vein 9 years after the patient had
undergone a ceramic-on-ceramic cementless total hip
arthroplasty
Optimizing the treatment: the precision medicine using MyPKfit in a population of patients with moderate or severe haemophilia A
No full text
Gender-related differences in carotid atherosclerosis and flow-mediated dilation in patients with Cushing’s disease
No full textAim. Patients with Cushing's syndrome have a cardiovascular mortality rate four times higher than the general population. The purpose of this study was to establish any significant difference in cardiovascular morbidity evaluated by Intima-media Thickness (IMT) and endothelial dysfunction (FMD) among a group of patients with Cushing's syndrome and a control group matched for gender, age and classic risk factors for atherosclerosis. Methods. We retrospectively studied 63 patients (45 females and 18 males) with ACTH-dependent Cushing's syndrome. This group was matched and compared with a control group selected by their anthropometric and metabolic characteristics. All subjects underwent ultrasound of carotid arteries determining the related IMT and of brachial artery for FMD. Results. Cases presented greater IMT and lower FMD% compared with controls, particularly the women. When the two genders within the group of Cushing's patients were compared, we could find no significant differences in IMT or FMD between males and females. When these results were correlated with atherosclerotic risk factors, FMD was strongly reduced in female Cushing's patients by comparison with the female controls and it correlated closely with dyslipidemia and BMI. Among the males with Cushing's syndrome, the IMT and FMD findings correlated strongly with diabetes. Conclusion. Our retrospective case-control study indicates that Cushing's patients have a lower FMD and a higher carotid IMT, which correlate with their metabolic syndrome and are uninfluenced by gender. For this reason, it is important the control of their endothelial function to prevent atherosclerosis
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
- …
