Cost-effectiveness analysis of burning mouth syndrome therapy

Hens MJ, Alonso‐Ferreira V, Villaverde‐Hueso A, Abaitua I, Posada de la Paz M. Cost‐effectiveness analysis of burning mouth syndrome therapy. Community Dent Oral Epidemiol 2012; 40: 185–192. © 2011 John Wiley & Sons A/S Abstract – Objective: To study the cost‐effectiveness of four alternative treatments for burning mouth syndrome (BMS). Methods: A cost‐effectiveness analysis was conducted from a healthcare payer perspective of four therapy strategies (amisulpride, paroxetine, sertraline and topical clonazepam), using a decision‐tree model that incorporated direct healthcare costs and probabilities associated with the possible events and outcomes. Average cost‐effectiveness and incremental cost‐effectiveness ratios were calculated. Sensitivity analyses included the costs of brand name and generic drugs in five European countries (France, Italy, the Netherlands, Spain and UK), as well as two scenarios with different treatment length. Results: Of the drugs analysed, topical clonazepam proved to be the most cost‐effective therapy. Although generic proved more efficient than brand name drugs, they displayed no advantage over brand name topical clonazepam. The Netherlands was the country with the highest overall drug efficiency. Sensitivity analyses highlighted the robustness of the model, because topical clonazepam proved to be the most efficient therapy under all the different scenarios. Conclusions: Topical clonazepam, which previous analyses of clinical evidence have shown to be the drug of choice for BMS, also proved to be the most cost‐effective of the drugs analysed for this condition.     

Differences in medical treatment and clinical characteristics between men and women with heart failure – a single-centre multivariable analysis

European Journal of Clinical Pharmacology - The aims of this study were to examine sex differences in a heart failure population with regards to treatment and patient characteristics and to...     

Training Coaches in Community Agencies to Support Parents of Children with Suspected Autism: Outcomes,Facilitators, and Barriers

Journal of Autism and Developmental Disorders - This study evaluated the fidelity and effectiveness of a parent coach training program for toddlers at risk for autism spectrum disorder and...     

Persistent systemic monocyte and neutrophil activation in neonatal encephalopathy

Aim: Circulating immune cell activation is associated with worse outcome in adult and animal models of brain injury. Our aim was to profile the systemic inflammatory response over the first week of life in infants at risk of neonatal encephalopathy (NE) and correlate early neutrophil and monocyte endotoxin and activation responses with outcome.

Methods: Prospective observational study in a tertiary referral university hospital including 22 infants requiring resuscitation at birth who had serial (five time points) neutrophil and monocyte CD11b (marker of cell adhesion), intracellular reactive oxygen intermediates (ROI; cell activation) and Toll-like receptor (TLR; endotoxin recognition) before and after endotoxin stimulation ex vivo compared to neonatal controls.

Results: All neonates requiring resuscitation at delivery (n?=?122 samples) had higher neutrophil and monocyte CD11b and TLR-4 expression compared with adults and neonatal controls. Neonates with abnormal neuroimaging and/or severe NE had increased CD11b, ROI and TLR-4. Increased polymorphonuclear leukocytes TLR-4 expression was associated with increased mortality in infants with NE.

Conclusion: Innate immune dysregulation in the first week of life is associated with severity of outcome in neonatal brain injury in this cohort and may be amenable to immunomodulation.     

Expression sites of the collectin SP-D suggest its importance in first line host defence: power of combining in situ hybridisation, RT-PCR and immunohistochemistry

Surfactant proteins A and D are pattern recognition molecules that play a role in pulmonary host defence. In this paper, we describe for the first time the expression and localisation of both collectins in various porcine tissues using a combination of in situ hybridisation (ISH), RT-PCR and immunohistochemistry (IHC). SP-D was expressed in several tissues including lung, tongue, intestinal tract, thymus, skin, gall bladder and lacrimal gland. Focal SP-D expression was detected in oesophagus, stomach, kidney, liver, prostate and spleen with both histological techniques. These tissues tested negative with RT-PCR. In contrast, SP-A expression was limited to the lung as measured by ISH and IHC. Interestingly, analysis by RT-PCR showed that thymus, trachea, jejunum and duodenum are positive for the presence of SP-A mRNA. We conclude that the combination of different methods can be advantageous if tissue-specific expression is studied. The importance of SP-D in innate immune defence of the pig is underlined by its expression at the potential ports of entry of pathogens.