Abstract:
OBJECTIVE:Evaluate costs and benefits of rituximab in combination with cyclophosphamide/vincristine/prednisolone chemotherapy regimen (R-CVP), in previously untreated patients with indolent non-Hodgkin lymphoma (NHL), compared to CVP alone from a Portuguese National Health System (NHS) perspective. METHODS:Cost-effectiveness (Life Years Gained--LYG) and cost-utility analysis (Quality Adjusted Life Years--QALYs) were performed for a time horizon of 10 years, according to a Markov economic model with three health states (progression free survival, progression and death) and monthly cycles for a population of previously untreated patients with indolent NHL. Data from a phase III clinical trial was used and expanded to include unpublished 53-month median follow-up data. Survival after first-line therapy was estimated from the Scotland and Newcastle Lymphoma Group registry data and utilities were derived from a study in the UK performed in patients with follicular lymphoma. Resource consumption was estimated by a Portuguese expert panel (Delbecq Panel). Costs were calculated from the Portuguese NHS perspective through official data with prices updated to 2008. Only direct medical costs were considered. Costs and clinical outcomes were discounted at 5% per annum. Deterministic and probabilistic sensitivity analysis were performed around assumptions on the time horizon, costs, utilities and excess mortality rate due to progression applied in the base-case analysis. RESULTS:The 10-year base-case analysis showed a lower total cost per patient with CVP alone (€ 85,838) in comparison with R-CVP (€ 87,774). Life expectancy and Quality adjusted life expectancy per patient were higher with R-CVP (6.361 and 4.166, respectively) than with CVP alone (5.557 and 3.438, respectively), representing increases of 0.804 in LYG and 0.728 (8.7 months) in QALYs gained. The incremental cost per LYG was € 2,407 and the incremental cost per QALY gained was € 2,661. The probabilistic sensitivity analysis confirmed the robustness of the base-case analysis results. CONCLUSIONS:This study demonstrates that the combination R-CVP in previously untreated indolent NHL patients improves life expectancy and is a cost-effective alternative to CVP in Portugal.
journal_name
Acta Med Portjournal_title
Acta medica portuguesaauthors
Braga P,Carvalho S,Gomes M,Guerra L,Lúcio P,Marques H,Negreiro F,Pereira C,Silva C,Teixeira Asubject
Has Abstractpub_date
2010-11-01 00:00:00pages
1025-34issue
6eissn
0870-399Xissn
1646-0758journal_volume
23pub_type
杂志文章abstract::In Portugal, piroxicam is one of the most prescribed non-steroidal anti-inflammatory agents (NSAIDs) and is frequently associated to photosensitivity skin reactions, well known by all dermatologists. The authors review the physiopathology and clinical patterns of this adverse drug reaction. Importance is given to the ...
journal_title:Acta medica portuguesa
pub_type: 杂志文章,评审
doi:
更新日期:1998-11-01 00:00:00
abstract::Appropriate nutritional support is crucial in the therapeutic approach of multiple conditions, which justifies the frequent and increasing use of specific access routes for enteral and parenteral nutrition. This article reviews the relevant literature concerning indications, procedures, effectiveness and complications...
journal_title:Acta medica portuguesa
pub_type: 杂志文章,评审
doi:
更新日期:2014-09-01 00:00:00
abstract:INTRODUCTION:Intertrochanteric fractures incidence has been increasing over the past few years and therefore so have all the problems associated with it. It is important to search for possible ways to reduce comorbidities as well as postoperative mortality. We decided to assess the impact of some routine pre-operative ...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:10.20344/amp.4280
更新日期:2014-03-01 00:00:00
abstract::Correct food intake and physical exercise, together with insulin or oral antidiabetics constitute the basic triad of diabetes treatment. The authors discuss the general rules of dietetic measures in diabetes and review the importance of physical exercise, its indications and limitations in the metabolic control of the...
journal_title:Acta medica portuguesa
pub_type: 杂志文章,评审
doi:
更新日期:1989-09-01 00:00:00
abstract::We describe a case report of a 69 year old woman with atrial myxoma, presented as a cerebellar syndrome caused by ischemic infarctions of the posterior circulation. The transthoracic 2D echocardiogram provided the diagnosis of a left atrial myxoma. Seven months after surgical removal of the cardiac tumor, the cerebell...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1995-12-01 00:00:00
abstract::Fabry disease (FD) is a rare disorder resulting from mutations of the alpha-Galactosidase A lysosomal enzyme gene. Accumulation of enzyme substrates leads to multisystemic clinical manifestations and multiorgan progressive damage with high morbidity and mortality. Recombinant enzyme replacement therapy (RERT) now avai...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2010-05-01 00:00:00
abstract::A case of a 44 years old patient with inoperable gastric adenocarcinoma and exuberant lesions of Acanthosis Nigricans is described. He died nine months after the diagnosis, having experienced disappearance of the cutaneous manifestations after the cytostatic treatment done. The literature about Acanthosis Nigricans is...
journal_title:Acta medica portuguesa
pub_type: 杂志文章,评审
doi:
更新日期:1989-01-01 00:00:00
abstract:INTRODUCTION:The consumption of potentially inappropriate medicines is high among institutionalized elderly, predisposing to potential drug interactions, adverse drug events, risk of iatrogenic cascade, increased morbidity and mortality and health costs. Medication review is a promising strategy for therapeutic optimiz...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:10.20344/amp.13030
更新日期:2020-07-30 00:00:00
abstract::Essencial Thrombocytemia is a rare chronic myeloproliferative disease of unknown etiology, characterized by markedly elevated platelet production (> 600,000/ml). It is more frequent among women above 50 years of age and may be associated with hemorrhagic or thrombotic tendencies. The authors report a case of Essencial...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2003-03-01 00:00:00
abstract::The availability of scientific information is growing exponentially. Healthcare professionals who wish to keep up-to-date with scientific literature and find the best information should spend their time finding resources that summarize the best available evidence. This manuscript aims to provide bibliographic research...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2013-07-01 00:00:00
abstract::In an attempt to discern the paradigms underlying our medical practice (more specifically paediatrics) over the last 30 years, it was found that these are rather similar to the ones prevailing at the beginning of this period--all wrong-doings were attributed to outside forces which had to be neutralized; the obsession...
journal_title:Acta medica portuguesa
pub_type: 历史文章,杂志文章
doi:
更新日期:2000-07-01 00:00:00
abstract:INTRODUCTION:Current practice guidelines recommend using Current Opioid Misuse Measure to screen aberrant opioid-related behaviors in chronic pain patients. Our aims were to translate, adapt and validate it to be used in Portuguese chronic pain patients. MATERIAL AND METHODS:Translation and cultural adaptation process...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:10.20344/amp.12015
更新日期:2020-04-01 00:00:00
abstract::This paper describes the process followed to create and validate the Portuguese versión of a quality of life measurement instrument for patients in palliative care. After a literature review about the measurement of the quality of life in this particular and very specific kind of patients, we opt by the Irene Higginso...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2008-03-01 00:00:00
abstract::Spontaneous ileopsoas hematoma is a rare and potentially lethal complication of liver cirrhosis, with exceptional mention in medical literature. In this article we present a clinical case diagnosed in a patient with alcoholic liver cirrhosis. ...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract::The authors present the experience of 63 clinical cases of microsurgical reconstruction of the head and neck. These reconstructions were accomplished by different microvascular free flaps which were selected according to the type, size and location of the defects. Fasciocutaneous, osteofasciocutaneous, adipofascial, m...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1998-10-01 00:00:00
abstract::The authors describe the ambulatory treatment of a young man, the son of a divorced mother, where they used a methodology called Combined Treatment of Heroin Addicts, which was done in stages. They used family sessions, with a concomitant hearing of the patient alone, combined with the use of an opioid antagonist, cal...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1993-02-01 00:00:00
abstract::An opinion article of health care programmes questioning the effects and benefits of their management. The AA, based on their experience in management/administration, present suggestions to identify, quantify and analyse a problem in health care. After characterising a health care problem, the AA point out the fundame...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND:In experimental ageing models an inverse relationship between age and alkaline phosphatase activity has been observed. OBJECTIVE:To characterize serum levels of alkaline phosphatase activity in humans according to age and gender. METHODS:Serum alkaline phosphatase was determined in a random sample of 203 c...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:Abdominal trauma is a major cause of morbi-mortality all over the world which makes it essential an approach focused on rapid diagnosis and treatment. The main goals of this study are to identify global epidemiologic data of abdominal trauma in our tertiary trauma center and to study traumatic lesions, treat...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2013-11-01 00:00:00
abstract::The authors present their clinical experience of leg and foot reconstruction with 227 clinical cases. Based on these cases the authors analyse the use of 18 musculocutaneous, 53 axial, 72 septocutaneous and 84 free flaps, totalling 29 different kinds of flaps performed. Although no definitive conclusions can be drawn ...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1998-02-01 00:00:00
abstract:OBJECTIVE:To evaluate, in an elderly Portuguese population, the diagnostic capacities of the most popular treadmill stress test protocols. DESIGN:Retrospective study of an elderly Portuguese population submitted to a stress test. PATIENTS AND METHODS:A population of 45 patients (35 male), aged 65 or more years, conse...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1997-04-01 00:00:00
abstract::The exercise tolerance test (ETT) is the ancillary test of choice for the evaluation of the patient with ischaemic heart disease. When faced with complaints suggestive of angina pectoris, ETT is useful in confirming or excluding such a diagnosis, frequently reproducing the complaints while recording the tell-tale elec...
journal_title:Acta medica portuguesa
pub_type: 杂志文章,评审
doi:
更新日期:1997-04-01 00:00:00
abstract::The recent improvement in surgical of therapy of carriers of hepatocellular carcinoma is due to both an early diagnosis of the illness and in the evaluation of set of prognostic and resectability factors. On describing a clinical case of a hepatocellular carcinoma localized on the left lobe of a healthy liver, the imp...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1989-05-01 00:00:00
abstract:INTRODUCTION:Functional foods are those that promote health and well-being and/or decrease the risk of certain chronic diseases. It is known that young people' knowledge about functional foods is low. The aim of this study is to assess the psychometric proprieties of the "Attitudes towards Functional Foods Scale" in a ...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:10.20344/amp.9284
更新日期:2019-04-30 00:00:00
abstract:INTRODUCTION:Scientific evidence regarding children's understanding of the concept of death is scarce. This has recently been pointed out by the International Children's Palliative Care Network as a priority area of research. In particular, the avoidance of emotion in this area of research is an important shortcoming. ...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:10.20344/amp.12815
更新日期:2020-10-01 00:00:00
abstract:INTRODUCTION:Amyotrophic lateral sclerosis is a rare neurodegenerative disease affecting motor neurons. Patients present with progressive physical impairment, respiratory failure being the main cause of death. A significant portion of patients presents neurobehavioral problems as well. As severe impairment occurs, pati...
journal_title:Acta medica portuguesa
pub_type: 杂志文章,评审
doi:10.20344/amp.6590
更新日期:2016-01-01 00:00:00
abstract::In this paper we discuss a non-invasive method to localize neural electrical sources using EEG data. In this method, the human head is modelled by a set of four concentric spheres with different conductivities which represent the scalp, the skull, the CSF and the brain or by three triangulated surfaces which approxima...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1996-07-01 00:00:00
abstract:OBJECTIVE:To assess peak systolic velocity values in middle cerebral artery (PSMCA) of normal fetuses from 22nd to 38th week of gestation. MATERIAL AND METHODS:We made a prospective study of 33 healthy fetuses from 22nd to 38th to determine peak systolic velocity by Doppler velocimetry. Doppler ultrasound was performe...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2006-03-01 00:00:00
abstract:INTRODUCTION:The purpose of postoperative surveillance programs after curative treatment for colorectal cancer is to detect asymptomatic recurrences with the premise that an important rate will be eligible for curative resection, improving overall survival. We have implemented a surveillance program for patients with c...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:10.20344/amp.7889
更新日期:2017-09-29 00:00:00
abstract:INTRODUCTION:Perfectionism and intolerance to frustration are the main factors of vulnerability to psychological stress observed in students of the Integrated Master Degree in Medicine of the Faculty of Medicine, University of Coimbra, a study claims. We aimed to ascertain their reasons, seeking for their prevention. ...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:10.20344/amp.9976
更新日期:2018-10-31 00:00:00