S3 of lung cancer cases and deaths were obtained from the Global Burden of Disease Study. RESULTS: The total SAE of lung cancer was estimated as US $9527.1 million in China in 2015 (accounting for 0.09% of the local gross domestic product), the decomposed direct and indirect SAE were estimated as $2505.0 million (accounting for 0.4% of total healthcare expenditure in local) and $7022.1 million (73.7% of total SAE), respectively. With 42.0% and 2.4% smoking prevalence among male and female in 2005, 93.5% of the total SAE occurred in male lung cancer in 2015 ($8903.3 million). Mainly due to the variation of burden of disease, age-specific total SAE peaked at 60-64 years group, urban areas' total SAE higher than rural areas'. In 2025, the SAE of lung cancer, compared with that in 2015, would increase by 30.9% ($12471.0 million). CONCLUSIONS: This might be the most detailed estimation on economic burden of lung cancer attributable to smoking in China. SAE caused by lung cancer accounted at least one tenth of all-diseases-caused SAE, compared to previous study. Without main population-level smoking intervention introduced, the economic burden of lung cancer attributable to smoking will continually increase over the next ten years.
Based on the rapid simulation of Markov Chain on samples in failure region, a novel method of reliability analysis combining Monte Carlo Markov Chain (MCMC) with random forest algorithm was proposed. Firstly, a series of samples distributing around limit state function are generated by MCMC. Then, the samples were taken as training data to establish the random forest model. Afterwards, Monte Carlo simulation was used to evaluate the failure probability. Finally, examples demonstrate the proposed method possesses higher computational efficiency and accuracy.
The new direct oral anticoagulants (DOACs) are increasingly used to treat and prevent thromboembolic disorders, and monitoring concentrations may be valuable in some special scenarios to prevent clinical adverse events. This study aimed to develop generic methods for the rapid and simultaneous analysis of four DOACs in human plasma and urine. Protein precipitation and one-step dilution were used to prepare the plasma and urine; the extracts were injected to ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) for analysis. Chromatographic separation was performed on an Acquity™ UPLC BEH C18 column (2.1 × 50 mm, 1.7 μm) with gradient elution of 7 min. A triple quadrupole tandem mass spectrometer with an electrospray ionization source was employed to analyze DOACs in a positive ion mode. The methods showed great linearity in the plasma (1~500 ng/mL) and urine (10~10,000 ng/mL) for all analytes (R2 ≥ 0.99). The intra- and inter-day precision and accuracy were within acceptance criteria. The matrix effect and extraction recovery were 86.5~97.5% and 93.5~104.7% in the plasma, while 97.0~101.9% and 85.1~99.5% in the urine. The stability of samples during the routine preparation and storage were within the acceptance criteria of less than ±15%. The methods developed were accurate, reliable, and simple for the rapid and simultaneous measurement of four DOACs in human plasma and urine, and successfully applied to patients and subjects with DOACs therapy for anticoagulant activity assessment.
Research assessing health-related quality of life (HRQoL) (or health state utility) which can be applied for economic evaluation in patients with Barretts esophagus (BE)and esophageal cancer is limited. This study derived health state utilities for patients with various 'stages' of BE and Cancer. Methods: A crosssectional survey was conducted with potential participants sought from South Australia, including patients with non-dysplastic BE (NDBE), low-grade dysplasia (LGD), high-grade dysplasia (HGD), or esophageal adenocarcinoma. HRQoL was assessed using two generic instruments, the EQ-5D-5L and the SF-36, and a cancerspecific instrument -the EORTC QLQ-C30. Health state utilities were derived by applying the general population preference-based scoring algorithms pertaining to all three instruments. Outcomes were compared for health states and following different treatments. Results: Ninety-seven respondents (80% male, mean age: 68 years) returned questionnaires. The mean (standard deviation) health state utilities for the total sample were 0.79 (0.24) for the EQ-5D-5L, 0.57 (0.29) for the SF-6D (derived from SF-36) and 0.73 (0.20) for the QLU-C10D (derived from EORTC QLQ-C30). No statistically significant differences were observed when different stages of BE or type of intervention received (surveillance, endoscopic treatment, surgery). However, patients who had undergone surgery for cancer reported better psychological wellbeing than those under surveillance or following endoscopic treatments. Conclusions: HRQoL for patients under surveillance for BE and following treatment of cancer was similar. Oesophagectomy was associated with better post-treatment psychological functioning, compared to endoscopic interventions, which can be attributed to a reduction in the perceived risk of cancer.
This quantitative study aimed to determine the degree of adherence to antiretroviral therapy (ART) by recording dispensation in HIVinfected patients attending in a reference for Secondary Center Health in Fortaleza, Ceará, Brazil. Monitoring of adherence should be a strategic goal in caring for patients infected with HIV. METHODS: A Pharmaceutical Care Service in José de Alencar Specialty Medical Center (JAMSC) were recruited in 100 naïve patients starting antiretroviral therapy between December 2008 and February 2012. These were evaluated monthly for 09 months as adherence through the registry to ARV Dispensing Service Pharmacy and classified according to the scale of Steiner (1988) and adapted by Saldanha et al ( 2009) as to their profile. This study was approved by the Ethics Committee of the Federal University of Ceará. Data analyzed in Excell and SPSS ® . RESULTS: The profile analysis showed that most patients were male (62%, n=62), single (55%, n=55) and were living with their family (66%, n=66). Regarding adherence, 84 patients (84%) were classified as Good Adherence -less than 29 days late (>95% adherence) and 06 infected (06%) in Critical Zone -between 29/74 days late (between 95 -70% compliance), ten patients with Bad Adherence -more than 74 days late (<70% adherence) and no patient had more than 180 days late to receive ARVs, with no interruption of treatment for this classification. CONCLUSIONS: Pharmacy records are important indicators of potential non-adherence and should be incorporated in such clinical practice. The pharmaceutical and clinical attention in the care and treatment of the infection by the HIV should be prioritized to reach out to poor compliance and adherence or irregular patients with ARV pickups.
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