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Vikram K. Reddy K. Girish Pandit Lakshmi R. Vijendra Ajay Kumar R. Harsha 《Indian journal of pharmacology》2014,46(4):372-377
Objectives:
Benzodiazepines (BZDs) are the first-line drugs in alcohol-withdrawal syndrome (AWS). Baclofen, a gamma-aminobutyric acidB (GABAB) agonist, controls withdrawal symptoms without causing significant adverse effects. The objective of this study was to compare the cost-effectiveness of baclofen and chlordiazepoxide in the management of uncomplicated AWS.Materials and Methods:
This was a randomized, open label, standard controlled, parallel group study of cost-effectiveness analysis (CEA) of baclofen and chlordiazepoxide in 60 participants with uncomplicated AWS. Clinical efficacy was measured by the Clinical Institute Withdrawal Assessment for alcohol (CIWA-Ar) scores. Lorazepam was used as supplement medication if withdrawal symptoms could not be controlled effectively by the study drugs alone. Both direct and indirect medical costs were considered and the CEA was analyzed in both patient''s perspective and third-party perspective.Results:
The average cost-effectiveness ratio (ACER) in patient''s perspective of baclofen and chlordiazepoxide was Rs. 5,308.61 and Rs. 2,951.95 per symptom-free day, respectively. The ACER in third-party perspective of baclofen and chlordiazepoxide was Rs. 895.01 and Rs. 476.29 per symptom-free day, respectively. Participants on chlordiazepoxide had more number of symptom-free days when compared with the baclofen group on analysis by Mann-Whitney test (U = 253.50, P = 0.03).Conclusion:
Both study drugs provided relief of withdrawal symptoms. Chlordiazepoxide was more cost-effective than baclofen. Baclofen was relatively less effective and more expensive than chlordiazepoxide.KEY WORDS: Alcohol-withdrawal syndrome, baclofen, chlordiazepoxide, clinical institute withdrawal assessment for alcohol, cost-effectiveness analysis 相似文献124.
Kamath Amita Roudenko Alexandra Hecht Elizabeth Sirlin Claude Chernyak Victoria Fowler Kathryn Mitchell Donald G. 《Abdominal imaging》2019,44(4):1306-1322
Abdominal Radiology - Unique among solid organ tumors, hepatocellular carcinoma (HCC), may be diagnosed by imaging alone, without the need for biopsy. The Liver Imaging Reporting and Data System... 相似文献
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Mody GM Kalla AA 《Arthritis and rheumatism》2002,46(5):1407; author reply 1407-1407; author reply 1408
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MELD score as a predictor of pretransplant and posttransplant survival in OPTN/UNOS status 1 patients 总被引:12,自引:0,他引:12
Kremers WK van IJperen M Kim WR Freeman RB Harper AM Kamath PS Wiesner RH 《Hepatology (Baltimore, Md.)》2004,39(3):764-769
The Model for End-Stage Liver Disease (MELD) score is predictive of survival and is used to prioritize patients with chronic liver disease patients for orthotopic liver transplantation (OLT). The aims of this study are (1) to assess the ability of MELD score at listing to predict pretransplant and posttransplant survival for nonchronic liver disease patients listed with the Organ Procurement and Transplantation Network/ United Network for Organ Sharing (OPTN/UNOS) as Status 1; and (2) to compare survival associated with 4 diagnostic groups within the Status 1 designation. The study population consisted of adult patients listed for OLT at Status 1 in the UNOS national database between November 1, 1999 and March 14, 2002 (N = 720). Events within 30 days of listing were analyzed using Kaplan-Meier and Cox regression methodology. Patients meeting criteria for fulminant hepatic failure without acetaminophen toxicity (FHF-NA, n = 312) had the poorest survival probability while awaiting OLT; this was negatively correlated with MELD score (P =.0001). These patients experienced the greatest survival benefit associated with OLT, with an estimated improvement of survival from about 58% to 91% (P <.0001). Patients listed for primary nonfunction within 7 days of OLT (n = 268) did not show mortality to be related to MELD score (P =.41) and did not show a significant association between survival and OLT (P =.68). In conclusion, liver allocation within the Status 1 designation may need to be further stratified by diagnosis, and MELD score may be useful for prioritizing FHF-NA candidates. 相似文献
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Jason G. Andrade Atul Verma L. Brent Mitchell Ratika Parkash Kori Leblanc Clare Atzema Jeff S. Healey Alan Bell John Cairns Stuart Connolly Jafna Cox Paul Dorian David Gladstone M. Sean McMurtry Girish M. Nair Louise Pilote Jean-Francois Sarrazin Mike Sharma Laurent Macle 《The Canadian journal of cardiology》2018,34(11):1371-1392
The Canadian Cardiovascular Society (CCS) Atrial Fibrillation Guidelines Committee provides periodic reviews of new data to produce focused updates that address clinically important advances in atrial fibrillation (AF) management. This 2018 Focused Update addresses: (1) anticoagulation in the context of cardioversion of AF; (2) the management of antithrombotic therapy for patients with AF in the context of coronary artery disease; (3) investigation and management of subclinical AF; (4) the use of antidotes for the reversal of non-vitamin K antagonist oral anticoagulants; (5) acute pharmacological cardioversion of AF; (6) catheter ablation for AF, including patients with concomitant AF and heart failure; and (7) an integrated approach to the patient with AF and modifiable cardiovascular risk factors. The recommendations were developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) standards. Individual studies and literature were reviewed for quality and bias; the literature review process and evidence tables are included as Supplementary Material and are available on the CCS Web site. Details of the updated recommendations are presented, along with their background and rationale. This document is linked to an updated summary of all CCS AF guidelines recommendations, from 2010 to the present 2018 Focused Update, which is provided in the Supplementary Material. 相似文献