Corticotropinoma as the underlying cause of intermittent Cushing’s syndrome in a patient previously diagnosed with primary pigmented nodular adrenocortical disease

Not required for Clinical Vignette

Analysis of synchrotron radiation induced X-ray emission spectra with R environment

10.1016/j.radphyschem.2013.04.026Radiation Physics and Chemistry9382-86RPCH

Nielekowe koszty leczenia pertuzumabem i trastuzumabem pacjentów z HER2- dodatnim rakiem piersi w Polsce

Introduction HER2-positive breast cancer represents 10-20% of all breast tumors. This study aimed to create a model-based cost-minimization analysis that compared non-drug related costs of different therapies used in the treatment of HER2-positive breast cancer in Poland: Pertuzumab SC + Trastuzumab SC (Pert/TrasSC) vs Pertuzumab IV + Trastuzumab IV (PertIV+TrasIV) vs Pertuzumab IV + Trastuzumab SC (PertIV+TrasSC). Materials and methods The cost-minimization analysis was based on the results of a questionnaire addressed to leading oncology centers in Poland. The model was broken down into three categories of cost savings generated from nurses 'work, pharmacists' work, non-drug related consumables, and two categories of time savings: impact on the occupation of infusion chair and the duration of hospital stay. Data on resources used and costs were collected in the first half of 2022 Results Data were obtained from four oncology centers. The savings generated per patient from the healthcare providers work and from non-drug consumables for Pert/TrasSC arm were 178 PLN compared to PertIV+TrasIV and 168 PLN compared to PertIV+TrasSC. A full adaptation of Pert/TrasSC was estimated to result in an average of 8-fold savings in healthcare providers worktime per patient and in a treatment capacity increase of 241 patients. Conclusions Our model shows that Pert/TrasSC treatment is associated with significantly lower labor costs for nurses and pharmacists and lower costs of non-drug consumables compared to the other treatment options. Moreover, it reduced patients' chair time due to shorter administration/observation time and released capacity in chemotherapy infusion sites.Wprowadzenie. HER2-dodatni rak piersi stanowi 10–20% wszystkich nowotworów piersi. Celem badania było przeprowadzenie opartej na modelu decyzyjnym analizy minimalizacji kosztów, porównującej koszty nielekowe różnych terapii stosowanych w leczeniu pacjentów z HER2-dodatnim rakiem piersi w Polsce: pertuzumab SC + trastuzumab SC (Pert/TrasSC) vs. pertuzumab IV + trastuzumab IV (PertIV + TrasIV) vs. pertuzumab IV + trastuzumab SC (PertIV + TrasSC).  Materiał i metody. Analizę minimalizacji kosztów przeprowadzono na podstawie wyników ankiety skierowanej do wiodących ośrodków onkologicznych w Polsce. Model obejmował trzy kategorie oszczędności kosztów — wynikające z pracy pielęgniarek i farmaceutów, a także materiałów eksploatacyjnych niezwiązanych z lekami oraz dwie kategorie oszczędności czasu — związane z czasem zajęcia fotela infuzyjnego i pobytu w szpitalu. Dane dotyczące wykorzystanych zasobów i kosztów zebrano w pierwszym półroczu 2022 roku.  Wyniki. Dane pozyskano z czterech ośrodków onkologicznych. Oszczędności uzyskane w przeliczeniu na pacjenta w odniesieniu do pracy podmiotów udzielających świadczeń opieki zdrowotnej oraz zużycia materiałów nielekowych dla terapii Pert/TrasSC wyniosły 178 zł w porównaniu z PertIV + TrasIV i 168 zł w porównaniu z PertIV + TrasSC. Oszacowano, że zastosowanie terapii Pert/TrasSC u wszystkich pacjentów umożliwi średnio 8-krotną oszczędność czasu pracy świadczeniodawców w przeliczeniu na pacjenta i zwiększenie możliwości leczenia o 241 pacjentów.  Podsumowanie. Przedstawiony model pokazuje, że leczenie Pert/TrasSC wiąże się ze znacznie niższymi kosztami pracy pielęgniarek i farmaceutów oraz niższymi kosztami materiałów nielekowych w porównaniu z innymi opcjami terapeutycznymi. Dodatkowo zastosowanie tej terapii umożliwiło skrócenie czasu przebywania pacjentów w fotelu infuzyjnym z uwagi na krótszy czas podawania leku/obserwacji i zwiększyło możliwości świadczenia usług medycznych w ramach tej samej liczby stanowisk do infuzji chemioterapii.

Non-drug related costs of treatment with pertuzumab and trastuzumab in HER2-positive breast cancer patients in Poland

Introduction. HER2-positive breast cancer represents 10–20% of all breast tumors. This study aimed to create a model-based cost-minimization analysis that compared non-drug related costs of different therapies used in the treatment of HER2-positive breast cancer in Poland: pertuzumab SC plus trastuzumab SC (Pert/TrasSC) vs. pertuzumab IV plus trastuzumab IV (PertIV + TrasIV) vs. pertuzumab IV plus trastuzumab SC (PertIV + TrasSC).  Material and methods. The cost-minimization analysis was based on the results of a questionnaire addressed to leading oncology centers in Poland. The model was broken down into three categories of cost savings: reduced labor costs of nurses, pharmacists and non-drug related consumables, and from two categories of treatment time reduction: occupation of infusion chair and duration of hospital stay. Data on resources used and costs were collected in the first half of 2022.  Results. Data were obtained from four oncology centers. The savings generated per patient from healthcare personnel’s work and from non-drug consumables for the Pert/TrasSC arm were 178 PLN compared to PertIV + TrasIV and 168 PLN compared to PertIV + TrasSC. Full adaptation of Pert/TrasSC was estimated to result in average 8-fold higher savings in healthcare personnel workload per patient and in a treatment capacity increase of 241 patients.  Conclusions. Our model shows that Pert/TrasSC treatment is associated with significantly lower labor costs for nurses and pharmacists and lower costs of non-drug consumables compared to the other treatment options. Moreover, it reduced patients’ chair time due to shorter administration/observation time and released capacity in chemotherapy infusion sites

Distribution of selected elements in atherosclerotic plaques of apoE/LDLR-double knockout mice subjected to dietary and pharmacological treatments

10.1016/j.radphyschem.2011.02.021Radiation Physics and Chemistry80101072-1077RPCH

Regulation of chemerin chemoattractant and antibacterial activity by human cysteine cathepsins

Chemerin, a ligand for the G-protein coupled receptor CMKLR1 (chemokine-like receptor 1), requires C-terminal proteolytic processing to unleash its chemoattractant activity. Proteolytically-processed chemerin selectively attracts specific subsets of immunoregulatory antigen presenting cells, including CMKLR1+ immature plasmacytoid dendritic cells (pDC). Chemerin is predicted to belong to the structural cathelicidin/cystatin family of proteins comprised of antibacterial polypeptide cathelicidins and inhibitors of cysteine proteinases (cystatins). We therefore hypothesized that chemerin may interact directly with cysteine proteases and that it might also function as an antibacterial agent. Here we show that chemerin does not inhibit human cysteine proteases, but rather is a new substrate for cathepsin K and L. Cathepsin K and L-cleaved chemerin triggered robust migration of human blood-derived pDC ex vivo. Furthermore, cathepsin K and L-truncated chemerin also displayed antibacterial activity against Enterobacteriaceae. Cathepsins may therefore contribute to host defense by activating chemerin to directly inhibit bacterial growth and to recruit pDC to sites of infection