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Cost-effectiveness in Clostridium difficile treatment decision-making

World Journal of clinical Cases 2015年第11期3卷 935-941页

作者： Mark JC Nuijten Josbert J Keller Caroline E Visser Ken Redekop Eric Claassen Peter Speelman Marja H Pronk Ars Accessus Medica HAGA Teaching Hospital clinical microbiologist amc iMTA and BMG EUR EUR amc Europe-ExPro

AIM: To develop a framework for the clinical and health economic assessment for management of Clostridium difficile infection(CDI).METHODS: CDI has vast economic consequences emphasizing the need for innovative and cost effective solutions, which were aim of this study. A guidance model was developed for coverage decisions and guideline development in CDI. The model included pharmacotherapy with oral metronidazole or oral vancomycin, which is the mainstay for pharmacological treatment of CDI and is recommended by most treatment ***: A design for a patient-based cost-effectiveness model was developed, which can be used to estimate the cost-effectiveness of current and future treatment strategies in CDI. Patient-based outcomes were extrapolated to the population by including factors like, e.g., person-to-person transmission, isolation precautions and closing and cleaning wards of hospitals. CONCLUSION: The proposed framework for a population-based CDI model may be used for clinical and health economic assessments of CDI guidelines and coverage decisions for emerging treatments for CDI.

关键词： Clostridium difficile infection Guidance Cost-effectiveness Model Standardisation Decision making

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Paraben Content in Adjacent Normal-malignant Breast Tissues from Women with Breast Cancer

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Biomedical and Environmental Sciences 2019年第12期32卷 893-904页

作者： Mohammad Mehdi Amin Maryam Tabatabaeian Afsane Chavoshani Elham Amjadi Majid Hashemi Karim Ebrahimpour Roya Klishadi Sedigheh Khazaei Maijan Mansourian Environment Research Center Research Institute for Primordial Prevention of Non-Communicable DiseaseIsfahan University of Medical SciencesIsfahanIran Department of Environmental Health Engineering School of HealthIsfahan University of Medical SciencesIsfahanIran Breast Surgeon Board certificate in general surgery in Anahid ClinicIsfahanIran Student Research Committee Isfahan University of Medical SciencesIsfahanIran Anatomical clinical Pathologist Poursina Hakim Digestive Diseases Research CenterIsfahan University of Medical SciencesIsfahanIran Environmental Health Engineering School of Public HealthKerman University of Medical SciencesKermanIran Environmental Health Engineering Research Center Kerman University of Medical SciencesKermanIran Child Growth and Development Research Cen ter Research Institute for Primordial Prevention of Non-Communicable DiseaseIsfahan University of Medical SciencesIsfahanIran microbiologist Molecular Pathology Research CenterImam Reza HospitalKermanshah University of Medical SciencesKermanshahIran Department of Biostatistics and Epidemiology School of HealthIsfahan University of Medical SciencesIsfahanIran

Objective Accumulation of estrogenic compounds and other carcinogens in normal breast tissues contributes to unpredictable breast cancer incidence during adolescence and throughout *** assess the role of parabens in this phenomenon,the paraben content of adjacent normal-malignant breast tissues is measured in women with breast cancer living in Isfahan Province,*** Adjacent normal-malignant breast tissue samples were obtained from 53 *** parabens including methyl-paraben(Me PB),ethyl-paraben(Et PB),propyl-paraben(Pr PB),and butylparaben(Bu PB)were extracted from the sample supernatant and then subjected to gas chromatography *** Some risk factors for breast cancer were stimulated by parabens in adjacent malignant-normal breast tissues among young and middle-aged women with breast *** observed a significant association for dose-response pattern of Me PB[OR=98.34(11.43–185.2),P=0.027]for both ER+and PR+women and Me PB[OR=164.3(CI:112.3–216.3),P<0.001]for HER2+women than women with negative *** risk of 95-fold increase in Me PB dose and 164-fold increase in∑PBs dose were significant for women with hereditary breast cancer in first-degree *** These results may promote future epidemiology studies and strategies to improve women's lifestyle and consume paraben-free products.

关键词： Paraben Breast cancer Malignant tissues Normal tissues Demography Risk factors

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