Cost of illness of metastatic prostate cancer: a perspective of costs for new treatment options in The Netherlands

AIM: To assess the resource use and associated costs of treating patients with metastatic prostate cancer with a focus on skeletal-related events (SREs). METHODS: We performed a bottom-up cost of illness study in The Netherlands. RESULTS: A total of 136 patients were studied. The mean total costs were euro17,931 per patient. SREs that required hospitalization (n = 53) were, at median costs of euro2039-9346, depending on care. These SREs had median costs of euro200-1912. CONCLUSION: Our data provide a basis to investigate the cost-effectiveness of novel treatment options for metastatic prostate cancer. The impact of SREs on total costs could justify policy aimed at actively preventing SREs, possibly resulting in better quality of life and cost-reduction

Evolution of the diatoms: insights from fossil, biological and molecular data

Molecular sequence analyses have yielded many important insights into diatom evolution, but there have been few attempts to relate these to the extensive fossil record of diatoms, probably because of unfamiliarity with the data available, which are scattered widely through the geological literature. We review the main features of molecular phylogenies and concentrate on the correspondence between these and the fossil record; we also review the evolution of major morphological, cytological and life cycle characteristics, and possible diatom origins. The first physical remains of diatoms are from the Jurassic, and well-preserved, diverse floras are available from the Lower Cretaceous. Though these are unequivocally identifiable as centric diatoms, none except a possible Stephanopyxis can be unequivocally linked to lineages of extant diatoms, although it is almost certain that members of the Coscinodiscophyceae (radial centrics) and Mediophyceae (polar centrics) were present; some display curious morphological features that hint at an unorthodox cell division mechanism and life cycle. It seems most likely that the earliest diatoms were marine, but recently discovered fossil deposits hint that episodes of terrestrial colonization may have occurred in the Mesozoic, though the main invasion of freshwaters appears to have been delayed until the Cenozoic. By the Upper Cretaceous, many lineages are present that can be convincingly related to extant diatom taxa. Pennate diatoms appear in the late Cretaceous and raphid diatoms in the Palaeocene, though molecular phylogenies imply that raphid diatoms did in fact evolve considerably earlier. Recent evidence shows that diatoms are substantially underclassified at the species level, with many semicryptic or cryptic species to be recognized; however, there is little prospect of being able to discriminate between such taxa in fossil material

Poor Compliance with Guidelines on Anemia Treatment in a Cohort of Chronic Hemodialysis Patients

Item does not contain fulltextBACKGROUND/AIMS: Guidelines for the management of anemia and iron deficiency in chronic hemodialysis (HD) patients have been developed to standardize therapy and improve clinical outcome. The present study evaluated compliance with anemia guidelines and investigated whether differences between centers were present. METHODS: Data on anemia management from patients in the baseline cohort of the CONTRAST study (NCT00205556) were analyzed. 598 chronic HD patients (62% male, age 63.6 +/- 14.0 years) from 26 Dutch dialysis centers were included. RESULTS: Mean hemoglobin (Hb) level was 11.9 +/- 1.3 g/dl and Hb was >/=11.0 g/dl in 81% of the patients. Compliance with all anemia targets (Hb 11.0-12.0 g/dl, transferrin saturation ratio >/=20%, ferritin 100-500 ng/ml) was reached in 11.6% (95% CI 7.8-17.0) of the patients, with a wide range among centers (4-26%, adjusted for case mix, treatment-related factors and center-specific characteristics). CONCLUSION: Compliance with anemia targets in stable HD patients was poor and showed a wide variation between treatment facilities

Qualidade física de um Latossolo Vermelho cultivado com soja submetido a níveis de compactação e de irrigação

Manter uma boa qualidade física do solo é importante para preservar o meio ambiente, além de maximizar a produtividade das plantas. Um solo compactado poderá interferir na densidade, na porosidade e na resistência do solo à penetração, influenciando no crescimento radicular. A presente pesquisa objetivou avaliar a qualidade física de um Latossolo Vermelho eutroférrico, textura argilosa, com a cultivar de soja CAC-1, submetido a quatro níveis de compactação e três níveis de irrigação, utilizando os atributos físicos do solo, assim como a correlação do sistema radicular com a produtividade da cultura. O delineamento experimental foi em blocos ao acaso, com parcelas subdivididas, com quatro repetições. Os níveis de compactação foram: C0 = 0, C2 = 2, C4 = 4 e C6 = 6 passadas, no mesmo local, de um trator de 11 t. Foram coletadas amostras indeformadas de solo nas entrelinhas da cultura da soja, para determinação dos atributos físicos, nas camadas de 0-0,10 e 0,10-0,20 m. A produtividade máxima da soja foi obtida com a resistência do solo à penetração de 0,71 MPa. O sistema radicular correlacionou-se inversamente com a produtividade da soja