50 research outputs found
Economic evaluation of screening programs for hepatitis C virus infection: evidence from literature
No full textSilvia Coretti,1 Federica Romano,1 Valentina Orlando,2 Paola Codella,1 Sabrina Prete,1 Eugenio Di Brino,1 Matteo Ruggeri1 1Post-Graduate School of Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, Rome, Italy; 2Center of Pharmacoeconomics (CIRFF), Department of Pharmacy, Federico II University, Naples, Italy Background: Hepatitis C is a liver infection caused by hepatitis C virus. Its main complications are cirrhosis and liver cancer. According to the World Health Organization (WHO), more than 185 million people worldwide are infected with hepatitis C virus and, of these, 350,000 die every year. Due to the high disease prevalence and the existence of effective (and expensive) medical treatments able to dramatically change the prognosis, early detection programs can potentially prevent the development of serious chronic conditions, improve health, and save resources. Objective: To summarize the available evidence on the cost-effectiveness of screening programs for hepatitis C. Methods: A literature search was performed on PubMed and Scopus search engines. Trip database was queried to identify reports produced by the major Health Technology Assessment (HTA) agencies. Three reviewers dealt with study selection and data extraction blindly. Results: Ten papers eventually met the inclusion criteria. In studies focusing on asymptomatic cohorts of individuals at general risk the cost/quality adjusted life year of screening programs ranged between US 50,000/quality adjusted life year gained, while in those focusing on specific risk factors the incremental cost-effectiveness ratio ranged between 128,424/quality adjusted life year gained. Age of the target population and disease prevalence were the main cost-effectiveness drivers. Conclusion: Our results suggest that, especially in the long run, screening programs represent a cost-effective strategy for the management of hepatitis C. Keywords: hepatitis C, screening, early detection, cost-effectivenes
Correction: Six minute walk distance and reference values in healthy Italian children: A cross-sectional study (PLoS ONE (2018) 13, 10 (e0205792) DOI:10.1371/journal.pone.0205792)
No full textThe affiliation for the fifth author is incorrect. Roberto Codella is not affiliated with #4–8 but with #4 and #8: School of Exercise Sciences, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy and Metabolism Research Center, IRCCS Policlinico San Donato, San Donato Milanese, Italy
Investigating the generalizability of Economic Evaluations conducted in Italy: a critical review
No full textbstract: Aim. To assess the methodological quality of Italian HEEs and their generalizability or
transferability to different settings.
Methods. A literature search was performed on Pubmed search engine to identify trial-based, non-
experimental prospective studies or model-based full economic evaluations, carried out in Italy from
1995 to 2013. The studies were randomly assigned to four reviewers who applied a detailed checklist
to assess the generalizability and the quality of reporting. The review process followed a three-step
blinded procedure. The reviewers who carried out the data extraction were blind as to the name of the
author(s) of each study. Second, after the first review, articles were re-assigned through a second blind
randomization to a second reviewer. Finally, any disagreement between the first two reviews was
solved by a senior researcher.
Results. One-hundred fifty-one economic evaluations eventually met the inclusion criteria. Over time,
we observed an increasing transparency of methods and a greater generalizability of results, along
with a wider and more representative sample in trials and a larger adoption of transition-Markov
models. On the other hand, often context-specific economic evaluations are carried out and not enough
effort is done to assure the transferability of their results to other contexts. In recent studies, Cost-
Effectiveness Analyses and the use of the Incremental Cost-Effectiveness Ratio were preferred.
Conclusion. Despite a quite positive temporal trend, generalizability of results still appears as an
unsolved question, even if some indication of improvement within Italian studies has been observe
Economic evaluation of screening programs for hepatitis C virus infection: evidence from literature
No full textHepatitis C is a liver infection caused by hepatitis C virus. Its main complications are cirrhosis and liver cancer. According to the World Health Organization (WHO), more than 185 million people worldwide are infected with hepatitis C virus and, of these, 350,000 die every year. Due to the high disease prevalence and the existence of effective (and expensive) medical treatments able to dramatically change the prognosis, early detection programs can potentially prevent the development of serious chronic conditions, improve health, and save resources
Cost effectiveness studies in HIV treatment with Lopinavir/Ritonavir: a Review.
No full textCOST EFFECTIVENESS, HIV TREATMENT
Thermal responses induced by nitrogen and forced convection based partial-body cryostimulation
No full textPartial Body Cryostimulation (PBC) involves a very cold air flow directed to the body of subjects with minimal clothing. PBC is performed in a rapid timeframe, inside an on-purposed designed cryo-cabin. Recently, cryo-cabins have been built with different energy systems, however a validation study on relative thermal responses is missing. This study was aimed at comparing thermal responses following a PBC in an electrically powered cryo-cabin based on forced convection or into a standard nitrogen-fueled cryo-cabin. In a randomized crossover fashion, thirty-six subjects (F=20; M=16) underwent both cryo-exposures lasting 150 s each. Thermal responses were assessed before and immediately after completing each PBC session. Mixed model analysis of variance revealed a significantly colder temperature after electric PBC in all the body regions (except for the thighs) with respect to a standard nitrogen based PBC (F: 16.4 ± 1.4 vs 18 ± 5.8 °C; M: 16.4 ± 1.7 vs 20.9 ± 4 °C). Moreover, a significant lower thermal discomfort was perceived at the end of electric PBC as compared to that one felt following standard PBC. For the first time, the safety and thermo-effectiveness of an electric cryo-cabin based on forced convection was ensured. This methodology can be viable for practitioners of PBC and clinicians
Investigating the Generalizability of Economic Evaluations Conducted in Italy: A Critical Review
No full textObjectives To assess the methodological quality of Italian health economic evaluations and their generalizability or transferability to different settings. Methods A literature search was performed on the PubMed search engine to identify trial-based, nonexperimental prospective studies or model-based full economic evaluations carried out in Italy from 1995 to 2013. The studies were randomly assigned to four reviewers who applied a detailed checklist to assess the generalizability and quality of reporting. The review process followed a three-step blinded procedure. The reviewers who carried out the data extraction were blind as to the name of the author(s) of each study. Second, after the first review, articles were reassigned through a second blind randomization to a second reviewer. Finally, any disagreement between the first two reviewers was solved by a senior researcher. Results One hundred fifty-one economic evaluations eventually met the inclusion criteria. Over time, we observed an increasing transparency in methods and a greater generalizability of results, along with a wider and more representative sample in trials and a larger adoption of transition-Markov models. However, often context-specific economic evaluations are carried out and not enough effort is made to ensure the transferability of their results to other contexts. In recent studies, cost-effectiveness analyses and the use of incremental cost-effectiveness ratio were preferred. Conclusions Despite a quite positive temporal trend, generalizability of results still appears as an unsolved question, even if some indication of improvement within Italian studies has been observed
Insulin-mimetic effects of short-term rapamycin in type 1 diabetic patients prior to islet transplantation
No full textBACKGROUND:
The immunosuppressive drug rapamycin may influence insulin sensitivity in insulin-responsive tissues.
AIMS:
This study aimed at evaluating the effectiveness of rapamycin pre-treatment before pancreatic islet allotransplantation (ITx) in patients with type 1 diabetes mellitus (T1DM).
METHODS:
Forty-one T1DM patients were studied. Thirteen patients with poor glycemic control underwent a short-term rapamycin treatment before ITx (Group 1), and they were compared to 28 patients undergoing ITx without rapamycin pre-treatment (Group 2). Outcomes were daily insulin requirement (DIR), fasting blood glucose, HbA1c, C-peptide and the SUITO index of beta-cell function. A subgroup of patients pre-treated with rapamycin before ITx underwent euglycemic hyperinsulinemic clamp with [6,6-2H2] glucose before and after ITx to evaluate insulin sensitivity.
RESULTS:
We found a significant reduction in DIR after rapamycin pre-treatment (- 8 ± 6 U/day, mean ± SD, p < 0.001) and 1 year after ITx. DIR reduction 1 year after ITx was greater in Group 1 as compared to Group 2 (- 37 ± 15 vs. - 19 ± 13 U/day, p = 0.005) and remained significant after adjusting for gender, age, glucose and baseline HbA1c (beta = 18.2 ± 5.9, p = 0.006). Fasting glucose and HbA1c significantly decreased 1 year after ITx in Group 1 (HbA1c: - 2.1 ± 1.4%, p = 0.002), while fasting C-peptide (+0.5 ± 0.3 nmol/l, p = 0.002) and SUITO index increased (+57.4 ± 39.7, p = 0.016), without differences between the two groups. Hepatic glucose production decreased after rapamycin pre-treatment (- 1.1 ± 1.1 mg/kg/min, p = 0.04) and after ITx (- 1.6 ± 0.6 mg/kg/min, p = 0.015), while no changes in peripheral glucose disposal were observed.
CONCLUSIONS:
Rapamycin pre-treatment before ITx succeeds in reducing insulin requirement, enhancing hepatic insulin sensitivity. This treatment may improve short-term ITx outcomes, possibly in selected patients with T1DM complicated by insulin resistance
The Role of Erythrocyte Sedimentation Rate (ESR) in Myeloproliferative and Lymphoproliferative Diseases: Comparison between DIESSE CUBE 30 TOUCH and Alifax Test 1
No full text(1) background: the erythrocyte sedimentation rate (ESR) is widely diffused in hematology
laboratories to monitor inflammatory statuses, response to therapies (such as antibiotics), and
oncologic diseases. however, ESR is not a specific diagnostic marker but needs to be contextualized and compared with clinical and other laboratory findings. This study aimed to investigate the performance of two automated instruments, namely the DIESSE CUBE 30 TOUCH (DIESSE, siena, italy) and the alifax test 1 (alifax srl, polverara, italy), in comparison with the gold standard, the westergren method, in lymphoproliferative and myeloproliferative patients. (2) methods: 97 EDTA samples were selected from the hematology department of roma tor vergata hospital and analyzed. statistical analysis was applied. (3) A good correlation between CUBE 30 TOUCH and the gold standard was observed in the overall sample (R2 = 0.90), as well as in patients with lymphoproliferative diseases (R2 = 0.90) and myeloproliferative diseases (R2 = 0.90). the correlation between test 1 and the gold standard was observed in the overall sample (R2 = 0.68), as well as in patients with lymphoproliferative diseases (R2 = 0.79) and myeloproliferative diseases (R2 = 0.53). (4) conclusions: the CUBE 30 TOUCH appears to be a more trustworthy tool for evaluating ESR in these pathologies
Insulin-mimetic effects of short-term Rapamycin in type 1 diabetic patients prior islet transplantation
No full text
