Cost-effectiveness analysis of Vaborem in Carbapenem-resistant Enterobacterales (CRE) -Klebsiella pneumoniae infections in Italy

Background: Vaborem is a fixed dose combination of vaborbactam and meropenem with potent activity against target Carbapenem-resistant Enterobacterales (CRE) pathogens, optimally developed for Klebsiella pneumoniae carbapenemase (KPC). The study aims to evaluate the cost-effectiveness of Vaborem versus best available therapy (BAT) for the treatment of patients with CRE-KPC associated infections in the Italian setting. Methods: A cost-effectiveness analysis was conducted based on a decision tree model that simulates the clinical pathway followed by physicians treating patients with a confirmed CRE-KPC infection in a 5-year time horizon. The Italian National Health System perspective was adopted with a 3% discount rate. The clinical inputs were mostly sourced from the phase 3, randomised, clinical trial (TANGO II). Unit costs were retrieved from the Italian official drug pricing list and legislation, while patient resource use was validated by a national expert. Model outcomes included life years (LYs) and quality adjusted life years (QALYs) gained, incremental costs, incremental cost- effectiveness ratio (ICER) and incremental cost-utility ratio (ICUR). Deterministic and probabilistic sensitivity analyses were also performed. Results: Vaborem is expected to decrease the burden associated with treatment failure and reduce the need for chronic renal replacement therapy while costs related to drug acquisition and long-term care (due to higher survival) may increase. Treatment with Vaborem versus BAT leads to a gain of 0.475 LYs, 0.384 QALYs, and incremental costs of €3549, resulting in an ICER and ICUR of €7473/LY and €9246/QALY, respectively. Sensitivity analyses proved the robustness of the model and also revealed that the probability of Vaborem being cost-effective reaches 90% when willingness to pay is €15,850/QALY. Conclusions: In the Italian setting, the introduction of Vaborem will lead to a substantial increase in the quality of life together with a minimal cost impact, therefore Vaborem is expected to be a cost-effective strategy compared to BAT

La tecnologia del forno intelligente (iEAF®): concetti di base, descrizione generale e dettagli della prima installazione

L’iEAF® di Tenova è un innovativo sistema di automazione per il controllo dinamico e l’ottimizzazione olisticadel forno elettrico ad arco. I modelli matematici del processo vengono utilizzati, unitamente alla composizionechimica dei fumi ( acquisita tramite il sistema di analisi proprietario EFSOP™ ), ed insieme anche ad altreinformazioni relative allo stato del processo ottenute tramite sensori innovativi sviluppati appositamente perl’applicazione sull’EAF, al fine di calcolare i bilanci di massa ed energia in modo dinamico ed in tempo reale.L’insieme dei modelli e dei sensori permette all’operatore di disporre di informazioni critiche per la produzionequali l’energia netta fornita alla carica metallica, la percentuale di fusione del rottame, la temperaturae composizione del bagno e della scoria

Altilix\uae Supplement Containing Chlorogenic Acid and Luteolin Improved Hepatic and Cardiometabolic Parameters in Subjects with Metabolic Syndrome: A 6 Month Randomized, Double-Blind, Placebo-Controlled Study

The objective was to evaluate the eects of 6 months of supplementation with Altilix\uae, containing chlorogenic acid and its derivatives, and luteolin and its derivatives, on cardiovascular risk and hepatic markers in subjects with metabolic syndrome (MetS). A randomized, double-blind, placebo-controlled study was performed in 100 subjects with MetS with a follow-up period of 6 months; 50 subjects were randomized to Altilix\uae (26 men and 24 women, mean age 63 8 years) and the other 50 to placebo (28 men and 22 women, mean age 63 11 years). Anthropometric, cardiometabolic, and hepatic parameters were assessed at baseline and at the end of follow-up. Carotid intima-media thickness and endothelial function were assessed by doppler ultrasound and by flow-mediated dilation of the brachial artery, respectively. The presence and degree of non-alcoholic fatty liver disease (NAFLD) was assessed by the fatty liver index (FLI), and subjects were divided into three subgroups: (1) without NAFLD; (2) with borderline NAFLD; and (3) with NAFLD. After 6 months of Altilix\uae supplementation, we found a significant improvement vs. placebo in most of the evaluated parameters, including body weight (2.40% (95% CI 3.79, 1.01); p < 0.001), waist circumference (2.76% (95% CI 4.55, 0.96); p = 0.003), HbA1c (0.95% (95% CI 1.22, 0.67); p < 0.001), plasma lipids, FLI (21.83% (95% CI 27.39, 16.27); p < 0.001), hepatic transaminases, flow-mediated dilation (10.56% (95% CI 5.00, 16.12); p < 0.001), and carotid intima-media thickness (39.48% (95% CI 47.98, 30.97); p < 0.001). Further, the improvement in cardiometabolic variables was independent of the degree of hepatic steatosis. Altilix\uae supplementation improved hepatic and cardio-metabolic parameters in MetS subjects. Altilix\uae supplementation was a beneficial approach in the management of hepatic and cardiometabolic alterations in MetS subjects

Toxoplasmosis en animales de granja en la provincia de San Luis, Argentina

La toxoplasmosis es una enfermedad producida por un parásito protozoario unicelular eucariota, llamado Toxoplasma gondii, que puede afectar a todos los animales de sangre caliente inclusive al ser humano y es de distribución mundial. Entre los animales de importancia epidemiológica todos los de consumo habitual (cerdo, ovino, bovino, caprinos etc.) y los no tradicionales (como la liebre, vizcacha, etc.), también las aves y los insectos (moscas, cucarachas, etc.) pueden ser vectores y diseminadores del parásito. Los felinos son los únicos animales donde el parásito produce ooquistes, por esto se llaman hospedadores definitivos; en el resto de los animales el parásito no produce ooquistes y actúan como hospedadores intermediarios. El objetivo del presente trabajo fue estimar la prevalencia de la Toxoplasmosis en las poblaciones animales domésticas que conviven con el hombre en la zona rural del Departamento La Capital de la Provincia de San Luis.Facultad de Ciencias Veterinaria

Toxoplasmosis en animales de granja en la provincia de San Luis, Argentina

La toxoplasmosis es una enfermedad producida por un parásito protozoario unicelular eucariota, llamado Toxoplasma gondii, que puede afectar a todos los animales de sangre caliente inclusive al ser humano y es de distribución mundial. Entre los animales de importancia epidemiológica todos los de consumo habitual (cerdo, ovino, bovino, caprinos etc.) y los no tradicionales (como la liebre, vizcacha, etc.), también las aves y los insectos (moscas, cucarachas, etc.) pueden ser vectores y diseminadores del parásito. Los felinos son los únicos animales donde el parásito produce ooquistes, por esto se llaman hospedadores definitivos; en el resto de los animales el parásito no produce ooquistes y actúan como hospedadores intermediarios. El objetivo del presente trabajo fue estimar la prevalencia de la Toxoplasmosis en las poblaciones animales domésticas que conviven con el hombre en la zona rural del Departamento La Capital de la Provincia de San Luis.Facultad de Ciencias Veterinaria

Estudio exploratorio de la toxoplasmosis y leptospirosis en pequeños rumiantes y animales de granja en el Departamento La Capital, San Luis.

La Toxoplasmosis y la Leptospirosis como enfermedades zoonóticas afectan a animales y seres humanos, por lo que el conocimiento de factores causales y consecuencias de su existencia en una localidad o región implica el trabajo interdisciplinario. La toxoplasmosis es una enfermedad producida por un parásito protozoario unicelular eucariota, llamado Toxoplasma gondii, que puede afectar a todos los animales de sangre caliente inclusive al ser humano y es de distribución mundial

Observation of the TeV gamma-ray source MGRO J1908+06 with ARGO-YBJ

The extended gamma ray source MGRO J1908+06, discovered by the Milagro air shower detector in 2007, has been observed for about 4 years by the ARGO-YBJ experiment at TeV energies, with a statistical significance of 6.2 standard deviations. The peak of the signal is found at a position consistent with the pulsar PSR J1907+0602. Parametrizing the source shape with a two-dimensional Gauss function we estimate an extension \sigma = 0.49 \pm 0.22 degrees, consistent with a previous measurement by the Cherenkov Array H.E.S.S.. The observed energy spectrum is dN/dE = 6.1 \pm 1.4 \times 10^-13 (E/4 TeV)^{-2.54 \pm 0.36} photons cm^-2 s^-1 TeV^-1, in the energy range 1-20 TeV. The measured gamma ray flux is consistent with the results of the Milagro detector, but is 2-3 times larger than the flux previously derived by H.E.S.S. at energies of a few TeV. The continuity of the Milagro and ARGO-YBJ observations and the stable excess rate observed by ARGO-YBJ along 4 years of data taking support the identification of MGRO J1908+06 as the steady powerful TeV pulsar wind nebula of PSR J1907+0602, with an integrated luminosity above 1 TeV about 1.8 times the Crab Nebula luminosity.Comment: 6 pages, accepted for pubblication by ApJ. Replaced to correct the author lis

Estudio exploratorio de la toxoplasmosis y leptospirosis en pequeños rumiantes y animales de granja en el departamento La Capital, San Luis

La Toxoplasmosis y la Leptospirosis como enfermedades zoonóticas afectan a animales y seres humanos, por lo que el conocimiento de factores causales y consecuencias de su existencia en una localidad o región implica el trabajo interdisciplinario. La toxoplasmosis es una enfermedad producida por un parásito protozoario unicelular eucariota, llamado Toxoplasma gondii, que puede afectar a todos los animales de sangre caliente inclusive al ser humano y es de distribución mundial. Entre los animales de importancia epidemiológica todos los de consumo habitual (cerdo, ovino, bovino, caprinos etc.) y los no tradicionales (como la liebre, vizcacha, etc.), también las aves y los insectos (moscas, cucarachas, etc.) pueden ser vectores y diseminadores del parásito. Los felinos son los únicos animales donde el parásito produce ooquistes, por esto se llaman hospedadores definitivos; en el resto de los animales el parásito no produce ooquistes y actúan como hospedadores intermediarios. La leptospirosis es una antigua enfermedad producida por Leptospira interrogans, espiroqueta ampliamente distribuida en la naturaleza y que afecta al hombre y a varias especies animales. Se presume que es la zoonosis de mayor difusión en el mundo. La orina de animales infectados es la fuente de infección más común. Los reservorios son los animales, con especial importancia en roedores y mamíferos domésticos. El hombre es un hospedador accidental ya que la transmisión interhumana carece de importancia epidemiológica. El objetivo de este trabajo es estimar la Prevalencia de enfermedades Toxoplasmosis y Leptospirosis en las poblaciones animales domésticas que conviven con el hombre en la zona rural del Departamento La Capital de la Provincia de San Luis.Facultad de Ciencias Veterinaria

Pain and Frailty in Hospitalized Older Adults

Introduction: Pain and frailty are prevalent conditions in the older population. Many chronic diseases are likely involved in their origin, and both have a negative impact on quality of life. However, few studies have analysed their association. Methods: In light of this knowledge gap, 3577 acutely hospitalized patients 65 years or older enrolled in the REPOSI register, an Italian network of internal medicine and geriatric hospital wards, were assessed to calculate the frailty index (FI). The impact of pain and some of its characteristics on the degree of frailty was evaluated using an ordinal logistic regression model after adjusting for age and gender. Results: The prevalence of pain was 24.7%, and among patients with pain, 42.9% was regarded as chronic pain. Chronic pain was associated with severe frailty (OR = 1.69, 95% CI 1.38–2.07). Somatic pain (OR = 1.59, 95% CI 1.23–2.07) and widespread pain (OR = 1.60, 95% CI 0.93–2.78) were associated with frailty. Osteoarthritis was the most common cause of chronic pain, diagnosed in 157 patients (33.5%). Polymyalgia, rheumatoid arthritis and other musculoskeletal diseases causing chronic pain were associated with a lower degree of frailty than osteoarthritis (OR = 0.49, 95%CI 0.28–0.85). Conclusions: Chronic and somatic pain negatively affect the degree of frailty. The duration and type of pain, as well as the underlying diseases associated with chronic pain, should be evaluated to improve the hospital management of frail older people