Risultati per: Artrite psoriasica e altre comorbilità in pazienti con psoriasi nel setting della medicina generale

Marzi: “Definito un approccio inclusivo, nuovo e indispensabile”

Concerti organizzati dall’Irccs e dal Conservatorio di Potenza

Tra primi 5 al mondo in ricerca. Corso con Società oncologi Usa

Patologica la crescita delle università telematiche

Objectives
Racially minoritised communities (RMCs) were disproportionately affected by COVID-19, experiencing among the highest mortality rates of the UK’s pandemic. We sought to understand the priorities for action to address the impact of the COVID-19 pandemic on the health and well-being of RMCs in the ethnically diverse and socioeconomically unequal area of East London, located in the northeastern part of London, England.

Design
Prospective surveys and a consensus meeting following the established James Lind Alliance priority setting partnership (PSP) methodology, adapted for a specific geographic location and ethnic groups.

Setting
Conducted in East London between 2021 and 2023.

Participants
Participants were individuals aged ≥18 years living and/or working in East London. Communities represented included Black African, Black Caribbean, Somali, South Asian and Bangladeshi.

Outcome measure
People were asked to submit suggestions for the priorities for action to address the impact of the COVID-19 pandemic. Return responses were reviewed and prioritised in a final workshop.

Results
816 suggestions were gathered from 187 responses to the initial survey. These were summarised into a longlist of 40 for the second survey, from which 243 respondents identified a shortlist of 26 priorities for discussion in a consensus meeting. The final top 10 priorities cover community-based support and spaces spanning education, social support, mental health and housing.

Conclusion
A systematic methodology was used to identify the priorities of RMCs in East London in the context of recovery from the COVID-19 pandemic. The breadth of the top 10 reflects how profound the effects of the pandemic have been among these communities. It also demonstrates the capacity of a PSP to articulate diverse community-driven priorities for a topic that was wider than healthcare. The findings could have applications in other disease areas that disproportionately affect RMCs.

Minore diffusione al Sud per la qualità di una molecola

Disegni con messaggi, consigli e poesie per il Pontefice

Ingresso di giovani camici bianchi rafforza l’assistenza

Objective
Atezolizumab plus bevacizumab demonstrates a significant improvement in overall survival and progression-free survival compared with sorafenib in patients with unresectable hepatocellular carcinoma (HCC). The combined usage of these two medications could result in substantial consumption of resources, primarily due to their exceptionally high costs. The current study aims to evaluate the cost-effectiveness of atezolizumab plus bevacizumab as a first-line treatment for advanced HCC from the perspective of payers in developed and developing countries.

Design
A partitioned survival model was constructed to evaluate the cost-effectiveness of atezolizumab plus bevacizumab versus sorafenib as a first-line treatment for advanced HCC. The efficacy and safety data incorporated within the model were derived from the IMbrave150 trial. Costs and utilities were extracted from published sources.

Interventions
Atezolizumab plus bevacizumab versus sorafenib.

Outcome measures
Estimates were calculated for costs, life-years, quality-adjusted life-years (QALYs), incremental cost-effectiveness ratio (ICER) for both treatment strategies. One-way sensitivity, probabilistic sensitivity, expected value of perfect information (EVPI), subgroup and scenario analyses were conducted.

Results
The combination therapy of atezolizumab and bevacizumab results in an additional 0.72 life-years/0.57 QALYs in the USA and 0.64 life-years/0.47 QALYs in China compared with standard sorafenib treatment, although with a significant increase in costs, yielding an average ICER of US$253 247.07/QALY in the USA and US$181 552.71/QALY in China. The probability sensitivity analysis indicated that atezolizumab plus bevacizumab demonstrated a 13.60% likelihood of cost-effectiveness in the USA, whereas this likelihood is negligible (0%) in China. The expected value of uncertainty, as quantified by the EVPI, was estimated at approximately US$3658.41/patient in the USA and US$0/patient in China. The ICER was most sensitive to the cost of subsequent treatment in the USA, and most sensitive to the cost of atezolizumab in China. In scenario analyses, the atezolizumab plus bevacizumab treatment becomes favourable when the cost of atezolizumab decreases to 67.85% and 18.45% of its original price in the USA and China, respectively.

Conclusions
The atezolizumab plus bevacizumab is unlikely to be cost-effective compared with sorafenib for patients with unresectable HCC in the context of the USA and China. The implementation of significant reductions in drug prices may render the treatment economically viable.

Introduction
Benzodiazepine receptor agonists (BZRA) deprescribing interventions are needed to tackle high BZRA use in the older population. This study aims to assess the feasibility of the D-PRESCRIBE intervention, adapted from Canada to the Belgian community setting. This pharmacist-led intervention comprises a patient educational brochure and a pharmacist-to-prescriber communication tool.

Methods and analysis
We will conduct a feasibility study of a cluster randomised controlled trial involving 8–10 community pharmacies (clusters) and aiming to recruit 56–80 patients (≥65 years). Intervention pharmacies will deliver the adapted D-PRESCRIBE intervention and control pharmacies, usual care. Patients will be blinded to group allocation. Quantitative data will be collected at baseline, 3 months and 6 months through patients’ and pharmacists’ questionnaires, aiming: (1) to test the feasibility of the intervention, (2) to test the feasibility of the study design needed for its evaluation and (3) to perform an exploratory cost-effectiveness analysis. Hence, data about implementation outcomes, mechanisms of impact (ie, mechanisms through which the intervention is supposed to be effective) and contextual factors will be gathered. Patient-centred outcomes will also be collected as they would be in a full cost-effectiveness trial. The feasibility of the study design will be assessed through participation rate, completeness of the data and a satisfaction survey, sent to participants after the 6-month data collection. Data will be analysed using descriptive statistics. To gain a deeper understanding of pharmacists and patients’ experience with the intervention, interviews will be conducted after the 6-month data collection and the Theoretical Domains Framework will be used as a deductive framework for analysis.

Ethics and dissemination
This study was approved by the Ethics Committee of CHU UCL Namur (NUB: B0392023000036). Participants will receive a summary of the results. Results will also be disseminated through the organisation of a local symposium and a peer-reviewed publication.

Trial registration number
NCT05929417.

Obiettivo anno accademico 2025-2026.Correrò su decreti attuativi

Iniziativa all’Università Politecnica delle Marche

Iniziativa all’Università Politecnica delle Marche

This randomized clinical trial evaluates the effectiveness of smoking cessation interventions of varying intensities in the lung cancer screening setting.

Grinta, Continuerà nel solco tracciato dal dr. Zega