Pearsonhelms0080
Colorectal cancer (CRC) is a serious health problem, and various screening programs to reduce CRC have been introduced worldwide. However, the cost‑effectiveness of a program based on once‑in‑a‑lifetime colonoscopy in Poland is unknown.
The main aim of this study was to assess the cost‑effectiveness of Polish Colonoscopy Screening Platform (PCSP), the colonoscopy screening program in Poland.
A Markov model was constructed to compare the strategy of colonoscopy screening as compared with no screening in 100 000 subjects. The model was based on data collected from the nationwide Polish CRC screening program whenever possible. The incremental cost‑effectiveness ratio (ICER) was calculated and compared with the willingness‑to‑pay thresholds. A sensitivity analysis was also performed using the Monte Carlo simulation.
Colonoscopy screening within PCSP resulted in a 18.9% reduction in CRC incidence and 19.8% reduction in CRC mortality. The strategy allowed a gain of 2317 life‑years saved (1959 after discount‑ ing). The cost of colonoscopy screening per participant examined was estimated at 267.70 USD (95% CI, 263.08-272.32 USD). The ICER was less than 6500 USD, which was much lower than the accepted willingness‑to‑pay thresholds, indicating that the screening was cost‑effective.
Colonoscopy screening within the PCSP is cost‑effective and may have a substantial impact on the Polish society due to life‑years saved. The results have good informative value not only for health policy makers and medical practitioners, but also for health technology assessment.
Colonoscopy screening within the PCSP is cost‑effective and may have a substantial impact on the Polish society due to life‑years saved. The results have good informative value not only for health policy makers and medical practitioners, but also for health technology assessment.
The number of elderly patients requiring treatment of aortic stenosis is expected to grow steadily due to increasing lifespan. Transcatheter aortic valve implantation (TAVI) is an alternative treat‑ ment for patients with aortic stenosis considered nonoptimal candidates for surgical valve replacement.
We aimed to assess age‑related differences in 30‑day and 1‑year cardiovascular mortality, Valve Academic Research Consortium‑2 (VARC‑2)-defined complications in patients undergoing TAVI, by comparing outcomes in patients younger than 85 years and those aged 85 years or older.
The study group included patients who underwent TAVI at the Institute of Cardiology, Warsaw from January 2009 to July 2019. Clinical, procedural, and follow‑up data were retrospectively collected and compared in 2 groups defined according to age group 1, younger than 85 years (417) and group 2, aged 85 or older (200).
The surgical risk profile assessed by the EuroSCORE II was significantly higher in the group of older patients (median [interquartile range], 6.5% [3.5%-17.3%] vs 7.2% [3.4%-18.1%]; P = 0.002); 30‑day and 1‑year cardiovascular mortality was 4.3% in group 1 as compared with 5% in group 2 (P = 0.69) and 10.8% in group 1 as compared with 9.4% in group 2 (P = 0.51), respectively. The rate of VARC‑2‑defined complications was similar in both groups, with the exception of major vascular com‑ plications (3.12% vs 8.5%; P = 0.004) and major bleeding (10.8% vs 18.5%; P = 0.008), which were more prevalent in older patients.
Cardiovascular mortality at 1 month and 1 year following TAVI is similar in patients aged 85 years or older and in those younger than 85 years.
Cardiovascular mortality at 1 month and 1 year following TAVI is similar in patients aged 85 years or older and in those younger than 85 years.Smile reconstruction is achieved using rigorous and detailed methodologies that are technically demanding and both time and cost intensive. These methodologies do not include the patient during the primary conception phase. New digital technologies using augmented reality (AR) offer the option of immediate diagnosis and pre-visualization of the potential outcome before the start of treatment. A 22-year-old patient with a congenitally missing maxillary right canine, peg-shaped maxillary lateral incisors, and multiple visible diastemas required an esthetic rehabilitation. An AR virtual mock-up using specialized software was used to preview and modify the restoration proposal in real time. Using the novel 'CAD-link' workflow, the final AR proposal could be imported into CAD software and transformed into a digital wax-up with the new virtual wax copy function. After a minimally invasive preparation, the final veneer reconstructions were precisely planned according to the previously developed design proposal and bonded according to the well-known adhesive protocol. The workflow described in this article links AR with CAD/CAM technology and is expected to be time and cost efficient. This patient-centered approach involves the patient from the very beginning and is therefore an excellent communication tool between the patient and the restorative team.
Granuloma gravidarum (GG) is a benign lesion of the soft tissue. The aim of this technical note is the volumetric assessment and follow-up 3D measurement of a GG in the anterior maxilla.
A 35-year-old female patient who was 7months pregnant was referred due to a soft tissue tumor in the papilla of tooth 21. A biopsy verified a pyogenic granuloma gravidarum. Taurochenodeoxycholic acid Initial and consecutive volumeatric measurements were made with an intraoral scanner during the patient's pregnancy and until 16months postpartum.
The volumetric assessment showed a continuous growth of the tumor and a consecutive volume reduction 16months postpartum. In comparison with the level of the papilla of the contralateral incisor, there was an almost complete remission at the last follow-up.
Intraoral scans can serve for the volumetric assessment of soft tissue tumors of the alveolar crest. Image superimposition enables the quantification of changes in morphology. This supports clinical follow-ups and enables the quantification of clinical observations.
Intraoral scans can serve for the volumetric assessment of soft tissue tumors of the alveolar crest. Image superimposition enables the quantification of changes in morphology. This supports clinical follow-ups and enables the quantification of clinical observations.