Treatment plan comparison in acute and chronic respiratory tract diseases : an observational study of doxophylline vs. theophylline

BACKGROUND: The main objective of this article is to estimate the global cost related to the use of the two drugs (associated drugs, specialist visits, hospital admissions, plasma drug monitoring). METHODS: The drug prescriptions were extracted from the Information System of the Pharmaceutical Prescriptions of the Marche Region for each ATC code in the years 2008-2012 and the number of patients per year and other outcomes measure were obtained. RESULTS: 13,574 patients were treated with theophylline and 19,426 patients with doxophylline. The number of patients treated was approximately 5,000 per year. Co-prescription with other drugs, use of corticosteroids, mean number of visits and hospital admissions (per 100 patients) were lower for doxophylline vs theophylline (1.55vs5.50, 0.3vs0.7, 2.05vs3.73 and 1.57vs3.3 respectively). The annual mean cost per patient was €187.4 for those treated with doxophylline and €513.5 for theophylline. CONCLUSIONS: In our study, doxophylline resulted to be associated with a reduction of the overall cost

Reduced order modeling for cardiac electrophysiology and mechanics: New methodologies, challenges and perspectives

Reduced-order modeling techniques enable a remarkable speed up in the solution of the parametrized electromechanical model for heart dynamics. Being able to rapidly approximate the solution of this problem allows to investigate the impact of significant model parameters querying the parameter-to-solution map in a very inexpensive way. The construction of reduced-order approximations for cardiac electromechanics faces several challenges from both modeling and computational viewpoints, because of the multiscale nature of the problem, the need of coupling different physics, and the nonlinearities involved. Our approach relies on the reduced basis method for parametrized PDEs. This technique performs a Galerkin projection onto low-dimensional spaces built from a set of snapshots of the high-fidelity problem by the Proper Orthogonal Decomposition technique. Snapshots are obtained for different values of the parameters and computed, e.g., by the finite element method. Then, suitable hyper-reduction techniques, in particular the Discrete Empirical Interpolation Method and its matrix version, are called into play to efficiently handle nonlinear and parameter-dependent terms. In this work we show how a fast and reliable approximation of both the electrical and the mechanical model can be achieved by developing two separate reduced order models where the interaction of the cardiac electrophysiology system with the contractile muscle tissue, as well as the sub-cellular activation-contraction mechanism, are included. Open challenges and possible perspectives are finally outlined

Modeling the dynamics of mouse iron body distribution: hepcidin is necessary but not sufficient

Abstract Background Iron is an essential element of most living organisms but is a dangerous substance when poorly liganded in solution. The hormone hepcidin regulates the export of iron from tissues to the plasma contributing to iron homeostasis and also restricting its availability to infectious agents. Disruption of iron regulation in mammals leads to disorders such as anemia and hemochromatosis, and contributes to the etiology of several other diseases such as cancer and neurodegenerative diseases. Here we test the hypothesis that hepcidin alone is able to regulate iron distribution in different dietary regimes in the mouse using a computational model of iron distribution calibrated with radioiron tracer data. Results A model was developed and calibrated to the data from adequate iron diet, which was able to simulate the iron distribution under a low iron diet. However simulation of high iron diet shows considerable deviations from the experimental data. Namely the model predicts more iron in red blood cells and less iron in the liver than what was observed in experiments. Conclusions These results suggest that hepcidin alone is not sufficient to regulate iron homeostasis in high iron conditions and that other factors are important. The model was able to simulate anemia when hepcidin was increased but was unable to simulate hemochromatosis when hepcidin was suppressed, suggesting that in high iron conditions additional regulatory interactions are important