Comparison of Time to Next Treatment,Health Care Resource Utilization,and Costs in Patients with Chronic Lymphocytic Leukemia Initiated on Front-line Ibrutinib or Chemoimmunotherapy

BackgroundStudies assessing ibrutinib’s economic burden versus chemoimmunotherapy (CIT) focused on pharmacy costs but not medical costs. This study compared time to next treatment (TTNT), health care resource utilization (HRU), and total direct costs among patients with chronic lymphocytic leukemia (CLL) initiating front-line ibrutinib single agent (Ibr) or CIT.Materials and MethodsOptum Clinformatics Extended DataMart De-Identified Databases were used to identify adults with ≥ 2 claims with a CLL diagnosis initiating front-line Ibr or CIT from February 12, 2014 to June 30, 2017. Inverse probability of treatment weighting was used to control for potential differences in baseline characteristics between the Ibr and CIT cohorts. Two periods were considered: entire front-line therapy (until initiation of second-line therapy) and first 6 months of front-line therapy. Comparisons with a subgroup of CIT patients initiating bendamustine/rituximab (BR) were also conducted.ResultsTTNT was significantly longer for Ibr (N = 322) relative to CIT (N = 839; hazard ratio, 0.54; P = .0163; Kaplan-Meier rates [24 months]: Ibr = 88.6%, CIT = 75.9%) and the subset of CIT patients treated with BR (N = 455; hazard ratio, 0.54; P = .0208; Kaplan-Meier rates [24 months]: Ibr = 89.0%, BR = 79.0%). During the entire front-line therapy, Ibr patients had significantly fewer monthly days with outpatient visits (rate ratio = 0.75; P = .0200). Ibrutinib’s higher pharmacy costs (mean monthly cost difference [MMCD] = $6,849; P < .0001) were offset by lower medical costs (MMCD = ?$10,615; P < .0001), yielding net savings (MMCD = ?$3,766; P < .0001) versus CIT. Ibr was associated with net savings (MMCD = ?$5,569; P < .0001) versus BR. Cost savings and reductions in HRU were more pronounced during the first 6 months of front-line therapy.ConclusionDuring front-line CLL treatment, Ibr was associated with longer TTNT, fewer monthly days with outpatient visits, and net monthly total cost reduction versus CIT and BR.     

Social factors relating to depression among older people in Japan: analysis of longitudinal panel data from the AGES project

Abstract

Objectives: Preventing the onset of depression among older people in Japan requires clarifying the social determinants of depression by using longitudinal data, while also taking biological and psychological factors into account. Identification of such determinants may enable more active intervention through social policy. We aimed to reveal the social factors related to depression in Japan’s older people and consider associated policy implications.

Method: Panel data obtained from a longitudinal survey (Wave 1 to Wave 2) of 3464 elderly subjects, aged 65 years or more, as part of the Aichi Gerontological Evaluation Study (AGES) project was employed. The outcome variable was depression, as evaluated by the Geriatric Depression Scale. Frequency of meeting with friends, social support, hobbies, participation in organizations, life events, illness, self-rated health, instrumental activities of daily living, and sense of coherence were entered as explanatory variables within a logit model for each gender.

Results: Of the subjects without mental illness or depression at Wave 1, 14% had become depressed by Wave 2. In both men and women, life events predicted increased odds of depression, while sense of coherence predicted reduced odds. The frequency of meeting with friends, hobbies, and self-rated health predicted reduced odds of depression in men, while age predicted increased odds in women.

Conclusion: Overall, social interaction is important for preventing depression in Japan, and that the establishment of a system capable of promoting social interaction and providing care to the elderly during life events may be a useful social policy approach to preventing depression.     

数据挖掘法探讨周珉教授治疗原发性肝癌用药规律及经验总结

[目的]数据挖掘法分析周珉教授治疗原发性肝癌的中医用药规律,探讨相关病机并进行经验总结。[方法]收集2016年2月—2018年5月周珉教授门诊期间治疗原发性肝癌的方剂,运用"中医传承辅助系统(V2.50)"进行数据挖掘,并结合周珉教授临床经验,进行原发性肝癌病机探讨及用药规律分析。[结果]共收集治疗原发性肝癌方剂176首,涉及中药235种,列出方剂中的高频药物及组合规律。[结论]总结原发性肝癌以"湿热痰毒、气阴两伤"为基础病机,"清热化湿、健脾养阴"治则贯穿原发性肝癌治疗始末,同时,根据疾病不同发展阶段及治疗措施,权衡"扶正"与"祛邪"的主次分配,斟酌应用"攻毒散结""行气化瘀"等治法,以达到改善患者生活质量、延缓疾病进展的目的。     

2010年-2018年甲状腺结节相关SCI论文知识图谱及数据可视化分析

目的:分析2010年至2018年甲状腺结节相关SCI论文，并建模进行定性与定量分析。方法:利用文献计量学中的引文分析、共被引分析、数据可视化、聚类分析等方法，使用CiteSpace分析工具，分析来源于Web of ScienceTM核心合集数据库中有关论文的出版情况、国家、机构、作者、知识基础与研究热点。结果:到2018年10月31日截止，研究了4 618篇论文。发表论文数:美国在国家/地区中排名第一，延世大学在研究机构中排名第一，Kwak JY在所有作者中排名第一。从2010年开始，每年发表的论文数量都在稳步增长，有相当多的论文发表在如《新英格兰杂志》、《THYROID》、《JAMA》、《CELL》等高影响因子的期刊上。甲状腺结节的SCI论文参考文献聚类为6类，分别是papillary-like nuclear feature、current statu、radiofrequency ablation、ultrasound elastography、goiter area、data system。代表研究前沿的关键词是meta-analysis、recommendation、thyroid carcinoma、shear wave elastography与bethesda system。结论:本文通过对国际上甲状腺结节的研究基础、研究热点的分析，阐述了甲状腺结节的研究趋势，为我国医学工作者的研究提供参考。     

观察切开引流术治疗肛周脓肿的护理方法和效果

目的评价切开引流术治疗肛周脓肿的护理方法和效果。方法研究时段:2017年6月—2018年7月,抽取以上时段内医院收治的70例行切开引流术治疗肛周脓肿的患者作为研究对象,回顾70例患者临床资料,以不同的护理措施作为分组依据,将70例患者分为对照组、实验组,每组35例。对照组用常规护理,实验组用综合护理,对比伤口愈合时间、住院时间、并发症发生率、护理满意度。结果伤口愈合时间、住院时间与对照组相比,实验组较短(P<0.05);并发症发生率与对照组相比,实验组较低(P<0.05);护理满意度与对照组相比,实验组较高(P<0.05)。结论切开引流术治疗肛周脓肿时应用综合护理,既可缩短伤口愈合时间、住院时间,又能减少并发症发生率、提高护理满意度。     

Efficacy and tolerability of alirocumab in Austrian clinical practice – results of the non-interventional PEARL-AT study

Abstract

Objective

Proprotein convertase subtilisin/kexin type 9 inhibition can be an effective treatment in patients with primary hypercholesterolemia, particularly in cases with concomitant coronary heart disease, peripheral artery occlusive disease or cerebrovascular occlusive disease for secondary prevention after an acute atherosclerotic ischemic event. The primary objective of the PEARL-AT study was to assess effectiveness and safety of alirocumab in a real-world setting in Austria.     

Research hotspots and effectiveness of repetitive transcranial magnetic stimulation in stroke rehabilitation

Repetitive transcranial magnetic stimulation, as a relatively new type of rehabilitation treatment, is a painless and non-invasive method for altering brain excitability. Repetitive transcranial magnetic stimulation has been widely used in the neurorehabilitation of stroke patients. Here, we used CiteSpace software to visually analyze 315 studies concerning repetitive transcranial magnetic stimulation for stroke rehabilitation from 1999 to 2019, indexed by Web of Science, to clarify the research hotspots in different periods and characterize the gradual process of discovery in this field. We found that four main points were generally accepted:(1) repetitive transcranial magnetic stimulation has a positive effect on motor function recovery in patients with subcortical stroke;(2) it may be more advantageous for stroke patients to receive low-frequency repetitive transcranial magnetic stimulation in the unaffected hemispheres than to receive high-frequency repetitive transcranial magnetic stimulation in affected hemisphere;(3) low-frequency repetitive transcranial magnetic stimulation has become a potential therapeutic tool for patients with non-fluent aphasia after chronic stroke for neurological rehabilitation and language recovery; and(4) there are some limitations to these classic clinical studies, such as small sample size and low test efficiency. Our assessment indicates that prospective, multi-center, large-sample, randomized controlled clinical trials are still needed to further verify the effectiveness of various repetitive transcranial magnetic stimulation programs for the rehabilitation of stroke patients.     

心理护理在ICU重症护理中的效果观察

目的探讨心理护理在ICU重症护理中的效果。方法选定本科于2017年6月-2019年8月收诊的ICU重症患者86例,等距抽样法分为对照组(43例,传统式护理)与观察组(43例,心理护理联合传统式护理)2组,比较2组ICU重症患者的护理满意率、情绪评分(SAS/SDS)指标。结果观察组ICU重症患者干预结束后的满意率高于对照组(P<0.05);观察组ICU重症患者干预结束后的SAS评分(32.52±3.26)分、SDS评分(30.09±3.45)分均低于对照组(P<0.05)。结论心理护理应用于ICU重症患者,可对其满意度、安全性进行保证。