We studied a case of leiomyoma of the bladder floor in a woman with excretion urography, voiding cystourethrography, abdominal echography, computed tomography scan, and transvaginal echography. This last technique gave us the most accurate information about localization of the mass and its relation to adjacent organs. With these data we were able to indicate the most suitable surgical access. We think that this new application of the transvaginal echography should be included in the study of bladder flow masses in the female.
ObjectivesPatient involvement in drug evaluation decision making is increasing. The aim of the current study was to develop a multi-criteria decision analysis (MCDA) framework that would enable the inclusion of the patient perspective in the selection of appropriate criteria for MCDAs being used in the value assessments of oncologic drugs.MethodsA literature review was conducted to identify and define criteria used in drug assessments from patient perspectives. The Evidence and Value: Impact on Decision Making methodology was used to develop a MCDA framework. Identified criteria were discussed by a sample of oncology patient association representatives who decided which criteria were important from patient perspectives. Selected criteria were rated by importance. The preliminary MCDA framework was tested through the assessment of a hypothetical oncology treatment. A discussion was carried out to agree on a final pilot MCDA framework.ResultsTwenty-two criteria were extracted from the literature review. After criteria discussion, sixteen criteria remained. The most important criteria were comparative patient reported outcomes (PRO), comparative efficacy and disease severity. After the discussion generated by the scoring of the hypothetical oncology treatment, the final pilot MCDA framework included seven quantitative criteria (“disease severity”, “unmet needs”, “comparative efficacy / effectiveness”, “comparative safety / tolerability”, “comparative PROs”, “contribution of oncological innovation”) and one contextual criterion (“population priorities and access”).ConclusionsThe present study developed a pilot reflective MCDA framework that could increase patient's capability to participate in the decision-making process by providing systematic drug assessments from the patient perspective.
Cancer is a major public health problem and the second leading cause of death worldwide. The burden of cancer continues to grow and is projected to double by 2040. This situation calls for coordinated action and emphasizes the need to join efforts on worldwide initiatives, including World Cancer Research Day (WCRD), which aims to create and consolidate a yearly momentum to raise awareness and commitment for research on cancer. Cancer research is a key driver of advances in prevention and therapeutic strategies that will benefit tomorrow's cancer patients. In 2016, 10 international organizations partnered to launch the WCRD initiative. Five years later, a total of 89 organizations and more than half a million people have joined this global movement that helps raise awareness of the importance of cancer research, demonstrating that a collaborative research culture is essential to address current challenges and create opportunities to accelerate impactful cancer research for a better future.
A cross-sectional multicentre study based on computer-assisted telephone or face-to-face interviews with RRMM patients was undertaken. A Discrete-Choice-Experiment (DCE) with four attributes (drug administration: application 1 (tablet once/day+once/week, 2-hour physician visit once/month), application 2 (tablet once/ day+twice/week, 2-hour physician visit once/month) or application 3 (tablet once/ day+once/week, physician visit twice/week lasting 3-4 hours incl. infusion); time without disease progression: 26/20/17 months; possibility of side effects affecting the blood: 12%/19% probability; possibility of heart failure: 2%/4%) was implemented. Preferences were analysed based on conditional logit regression models. Results: Analysis was conducted for 84 patients (mean age: 62.75 years; 63.10% male; mean disease duration: 5.51 years). Drug administration was the most important attribute for patients' choices (relative importance 38.83%). Patients strongly preferred application 1 (utility: 1.79; p< 0.001), followed by application 2 (1.46; p< 0.001), both compared to application 3. The second most important attribute was disease-progression-free time (38.63%) with utilities of 1.78 for 26 months (p< 0.001) and 0.81 for 20 months (p< 0.001), both compared to 17 months. Possibility of heart failure occurrence had an importance of 13.92% (utility of 2% vs. 4%: 0.64; p< 0.001), and possibility of side effects affecting the blood had the lowest importance (8.62%; utility of 12% vs. 19%: 0.40; p< 0.001). Derived utilities for currently available RRMM treatment options were 3.21 for Ixazomib+Lenalidomide+Dexamethasone, 2.75 for Lenalidomide+Dexamethasone and 1.89 for Carfilzomib+Lenalidomide+Dexamet hasone. ConClusions: RRMM patients prefer treatment options with an all-oral application mode, a longer disease-progression-free time and a lower probability of side effects. In order to receive a more convenient therapy, patients are willing to accept slightly less efficacy.
Ya no se trata de que una clase tome el poder social e imponga su modo de apropiación de la realidad, como había ocurrido siempre, sino de abolir todo modo de apropiación existente hasta nuestros días y construir otro esencialmente nuevo (Ancada, 2008:52) El socialismo es una opción, y existirá a partir de la voluntad y de la acción que sean capaces de crear nuevas realidades (Martínez Heredia, 2008:28) RESUMEN ¿Qué es el socialismo? ¿A qué se denomina "socialismo del siglo XXI"? ¿Cuáles son las principales características de este "tipo" de socialismo? ¿Cuáles han sido sus desarrollos en América Latina y qué desafíos debe enfrentar de Este artículo tiene como objetivo responder esas preguntas para dar cuenta de la posibilidad, la viabilidad, la existencia y las condiciones que dicho socialismo debería encarnar de cara a una necesaria transformación de la realidad social, política, económica y cultural de América. El punto de partida del escrito coincide con la línea de investigación que durante varios años ha venido adelantando el argentino Atilio Borón (2000 y 2008), y que se puede sintetizar en la "inviabilidad del capitalismo como modo de producción conducente al desarrollo de América Latina" (2008:17). De ahí que el aquí denominado "socialismo de siglo XXI" emerja como el camino más expedito y directo para cambiar de rumbo y encaminar definitivamente a nuestros pueblos hacia un desarrollo integral; es decir, social, humano y económico.Palabras clave: Socialismo, socialismo del siglo XXI, democracia, burguesía, capitalismo, neoliberalismo, América Latina. XXI CENTURY SOCIALISM IN LATIN AMERICA: CHARACTERISTICS, DEVELOPMENTS AND CHALLENGES ABSTRACTWhat is socialism? What is "socialism of the XXI century"? What are the main characteristics of this "type" of socialism? What has been its evolution in Latin America and what challenges must face in the future? These are some of the questions addressed in this article. It aims to answer these questions to account for the possibility, feasibility, existence and conditions that said socialism should stand for when facing a necessary transformation of the social, political, economic and cultural life of America. The starting point of the article coincides with the line of research that for several years has been carrying the Argentine Atilio Boron (2000 and, which can be synthesized as "non-viability of capitalism as a mode of production leading to the development of Latin America" (2008:17). Hence, the so called "XXI century socialism" emerges as the most expeditious and direct way to change course and definitely lead our people towards an integral development; ie social, human and economic.Keywords: Socialism, XXI century socialism, democracy, bourgeoisie, capitalism, neoliberalism, Latin America.SOCIALISMO DO SÉCULO XXI NA AMÉRICA LATINA: CARACTERÍSTICAS, DESENVOLVIMENTOS E DESAFIOS. RESUMOO que é o socialismo? O que se denomina "socialismo do século XXI"? Quais são as principais características deste "tipo" de socialismo? Como foi seu desenvolver na América...
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