Adamswilloughby3663
Objectives While several authors have suggested using a multi-criteria approach for orphan drug assessment and proposed lists of determinants of orphan drug value, studies on social preferences regarding these determinants remain limited. The current study aimed to identify preferences of the French general population regarding attributes characterizing the value of orphan drugs in a discrete choice experiment. Methods The list of attributes was formed based on a literature search and was refined through expert interviews, a focus group, and a pilot study. The final list included nine attributes disease-associated disability, disease-associated mortality, number of patients, availability of alternative treatments, treatment impact on disease disability, treatment impact on mortality, treatment safety, uncertainty around therapeutic effect, and annual treatment cost per patient. Members of the General Public were presented with 12 choice sets containing two drug profiles described according to the attributes aven by the impact on mortality and the degree of certainty regarding the available evidence.Background The aim of this study is to evaluate the clinical efficacy of vitamin D (VitD) supplementation in terms of response to treatment and improvement of disease activity in rheumatoid arthritis (RA). Methods This study analyzed 1180 RA patients' records treated at Mianyang Central Hospital from February 2015 to July 2019. The patients were allocated into VitD group and control group based on their medical regimens. The outcome measures were primary efficacy, defined as treatment response-based EULAR response criteria in RA, and secondary efficacy, defined as improvement in disease activity indicators. Safety was evaluated according to the incidence of all-cause infections. Results At month 6, the primary efficacy revealed that there were 22.8% good responders and 19.0% moderate responders in the VitD group, and 22.3% good responders and 22.3% moderate responders in the control group; there were no differences between the two groups (p = 0.754). The similar primary efficacy outcomes were observed at months 3, 12, and >12. The secondary efficacy indicated that there were no differences in most indexes between the two groups at months 1, 3, 6, 12, and >12. The subgroups (based on baseline DAS28 (CRP), glucocorticoids use and disease duration) analysis results suggested that VitD group didn't have the advantage for treating RA. The incidence of infections was similar in the two groups. Conclusion VitD supplementation did not provide additional benefit for anti-rheumatic treatment. These data supported the need for prospective, randomized, controlled trials to evaluate the role of VitD supplementation in treating RA.Purpose This study aimed to investigate the overall prevalence of symptomatic knee osteoarthritis (OA) in China by conducting a meta-analysis. Methods Six databases were searched for articles published from the date of inception to October 1, 2017, based on the Population, Intervention, Comparator, Outcomes (PICO) framework. The review was in line with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The χ2-based Q statistic and I2 metrics were used for exploring the sources of heterogeneity. Random models were utilized to obtain prevalence estimates due to the heterogeneity that was observed. Comprehensive Meta-Analysis version 2.0 was used for assessing publication bias by inspecting funnel plots and Egger's tests. Results Twenty-one eligible studies (74,908 participants in total) were identified. The overall pooled prevalence of symptomatic knee OA in China was 14.6%. The prevalence of symptomatic knee OA presented a rapid growth trend between the periods of 1990-2008 and 2008-2013 (9.1 vs. Selleckchem CI-1040 20.1%, p = 0.005). However, after 2013, the prevalence dropped to 14.9% (p = 0.01). The prevalence rates of symptomatic knee OA increased with age and presented an almost linear growth after 40 years of age. Compared with males (10.9%), females (19.1%) exhibited a higher prevalence of symptomatic knee OA (p = 0.015). The symptomatic knee OA prevalence was significantly higher in rural than it was in urban areas (16.9 vs. 11.1%, p = 0.037). Conclusion For symptomatic knee OA intervention, more attention should be paid to females, people in rural areas, and people aged over 40 years.Background The role of [18F] fluoro-deoxyglucose [[18F] FDG] positron emission tomography (PET)/computed tomography (CT) in pediatric rhabdomyosarcoma (RMS) is not well-established. This manuscript explores the role of staging and therapy response evaluation of PET/CT in a series of patients with RMS. Methods Thirteen consecutive patients with pathologically proven RMS underwent baseline PET/CT scan and a second PET/CT for evaluation of therapy response. Maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), highest standardized uptake peak value (SUVpeak), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were obtained from baseline PET/CT and were used as potential predictors for evaluation of metabolic treatment response. Results On baseline PET/CT, most RMSs are located in the pelvic cavity, and upper arms ranked second. The primary lesions were large and showed invasion to the surrounding tissues. Lymph node metastases were seen in eight patients, and eight patients showed distant metastasis to the lung, liver, and bone. The median SUVmax, SUVmean, and SUVpeak of primary sites were 7.1, 4.0, and 5.9, respectively. The median MTV and TLG were 196.6 cm3 and 780.2, respectively. After therapy, six patients received complete metabolic response (CMR) and non-CMR occurred in seven patients on the second PET/CT. SUVmax, SUVpeak, MTV, and TLG in patients with CMR were significantly lower than those in patients with non-CMR. Conclusions Primary sites and metastatic lesions of RMS demonstrate increased glycolytic activity, which may allow them to be imaged using [18F] FDG PET/CT. Metabolic parameters derived from the baseline PET/CT have potential value for predicting CMR to therapy in pediatric RMS.