Drug cost avoidance analysis of cancer clinical trials in Spain: a study on cost contributors and their impact

© The Author(s) 2022. This manuscript version is made available under the CC-BY 4.0 license http://creativecommons.org/licenses/by/4.0/ This document is the Published version of a Published Work that appeared in final form in BMC Health Services Research. To access the final edited and published work see https://doi.org/10.1186/s12913-022-08222-9Objective Analyze the cost contributors and their impact on the drug cost avoidance (DCA) resulting from cancer clinical trials over the period of 2015–2020 in a tertiary-level hospital in Spain (HCUVA). Methods We performed a cross-sectional, observational, retrospective study of a total of 53 clinical trials with 363 patients enrolled. We calculated the DCA from the price of the best standard of care (i.e.: drugs that the institution would otherwise fund). A linear regression model was used to determine cost contributors and estimate their impact. Results The total DCA was ~ 4.9 million euros (31 clinical trials; 177 enrollees), representing ~ 30% and ~ 0,05% approximately of the annual pharmaceutical expenditures at the HCUVA and for the Spanish Health System, respectively. Cancer type analysis showed that lung cancer had the highest average DCA by trial, indicating that treatments in these trials were the most expensive. Linear regression analysis showed that the number of patients in a trial did not significantly affect that trial's DCA. Instead, cancer type, phase trials, and intention of treatment were significant cost contributors to DCA. Compared to digestive cancer trials, breast and lung trials were significantly more expensive, (p < 0.05 and p < 0.1, respectively). Phase III trials were more expensive than Phase II (p < 0.01) and adjuvant trials were less expensive than palliative (p < 0.05). Conclusion We studied cost contributors that significantly impacted the estimated DCA from cancer clinical trials. Our work provides the groundwork to explore DCA contributors with potential to enhance public relations material and serve as a negotiating tool for budgeting, thus playing an important role to inform decisions about resource allocation

La musicoterapia como asignatura en los estudios de grado en enfermería

Introduction: Music therapy is understood by the use of music or its elements for therapeutic purposes. Its use in nursing is scarce beyond the use of the NIC 4400 intervention. Objective:The research aims to know and analyze the degree of acceptance by nursing students regarding the possible inclusion of music therapy as a subject in the educational programs of the Nursing Degree studies.Method: A cross-sectional, observational, descriptive study was carried out with a sample of n=346 participants. Conclusion: The results show that 93.93% of the students did include music therapy as an optional subject in Nursing Degree studies, making use of it in their professional future. &nbsp;Introducción: La musicoterapia se entiende por el uso de la música o sus elementos con fines terapéuticos. Su empleo en la enfermería es escaso más allá del uso de la intervención NIC 4400. Objetivo: Conocer y analizar el grado de aceptación por parte de los estudiantes de enfermería ante la posible inclusión de la musicoterapia como asignatura en los programas educativos de los estudios de Grado en Enfermería. Método: Se ha realizado un estudio observacional descriptivo de corte transversal con una muestra n=346 participantes.Resultados: Los resultados muestran que el 93,93% de los alumnos sí incluirían la musicoterapia como una asignatura Optativa en los estudios de Grado en Enfermería, haciendo uso de ella en su futuro profesional

Antimicrobial and Antioxidant Potential of Wild Edible Mushrooms

Wild edible mushrooms have a high nutritional property that has been consumed by people from different parts of the world, producing a wide variety of bioactive compounds such as polysaccharides, peptides, glycoproteins, triterpenoids, lipids, and their derivatives. In the world, multidrug-resistant pathogens have been increasing drastically, and it is very urgent to search for alternative solutions to fight against multidrug-resistant pathogens. Moreover, unhealthy foods, ultraviolet radiation, as well as other environmental effects, are responsible for generating free radicals, oxidative stress, and numerous health diseases. Hence, the wild edible mushroom could be an alternative source of new antimicrobial potential and possesses antioxidant properties that can play significant roles in preventing various health diseases. In this book chapter, we focus on investigating the antimicrobial and antioxidant potential of wild edible mushrooms and their bioactive compound production

Una experiencia en la gestión de residuos en la facultad

La problemática de la “basura” y la localización de rellenos sanitarios es consecuencia del modelo de producción e industrialización, aumento de la población, promoción del consumo desmedido, etc. La separación en origen es una estrategia que soluciona un problema puntual pero es necesario trabajar sobre todos los aspectos de esta problemática. En la Facultad de Ciencias Naturales y Museo de la UNLP se lleva a cabo un Programa Integral de Gestión de Residuos. Fue elaborado por estudiantes de distintas carreras con el apoyo y asesoramiento de Secretaria de Extensión. Otros actores son personal no-docente y organizaciones sociales. El objetivo general del Programa es generar conciencia sobre la problemática de residuos, el consumo desmedido y las estrategias de producción, y traducirla en un cambio de hábitos ligado a un proceso de aprendizaje; particularmente, reducir la cantidad de deshechos enviados a disposición final, reutilización y reciclaje de materiales. El Programa consiste en separar los residuos en tres compartimentos, con un destino concreto para cada grupo: “orgánico vegetal” comprende yerba y cáscaras de frutas, etc., la recolección y procesado (mediante lombricompuesto) está a cargo de estudiantes; “seco” comprende cartones, botellas y envases plásticos, telgopor, tetrapack, etc, y son retirados por cooperativas de recuperación; “generales” comprende residuos que no se incluyen en los otros cestos, que son retirados por el servicio de recolección municipal. Estos compartimentos están representados por tachos plásticos de colores indicativos ubicados estratégicamente en el predio del Edificio. Se estima la calidad de la separación con una escala cualitativa según la cantidad de residuos incorrectos en los tachos verdes y se contabilizan los kilos de material orgánico. Además de la separación se realizan otras actividades, como charlas, videos-debate y talleres en el Curso de Ingreso de la Facultad, como estrategia de Educación Ambiental, las cuales se consideran en la evaluación; se pudo observar que luego de las actividades educativas se logra una mejor separación. La importancia del Programa radica en el abordaje de una problemática social, con una acción local y concreta, en la participación de toda la comunidad de la institución, que implica tanto a docentes, estudiantes y personal administrativo. Se busca lograr un cambio en el ámbito de la Facultad, que pueda perpetuarse hacia otros y, de esta manera, aportar a formas de trabajo organizadas en cooperativas, al mejoramiento de la calidad ambiental local, preservación de recursos naturales y el ahorro de energía

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Estudio sobre la calidad de vida en mujeres supervivientes al cáncer de mama

Introducción El cáncer de mama constituye un problema de salud de gran repercusión en la población femenina por su alta incidencia. Debido a que su pronóstico ha mejorado notablemente en los últimos años y la supervivencia actualmente es elevada, el propio proceso y los tratamientos que se aplican tienen importantes repercusiones personales y familiares. En la actualidad, el cáncer de mama no es percibido como una enfermedad terminal, sino como un proceso crónico de larga duración, las estadísticas confirman que se trata de una grave amenaza para la mujer por las secuelas que produce. Objetivos 1) Estudiar la calidad de vida (CV) en mujeres supervivientes entre 5 y 8 años al cáncer de mama, identificando las secuelas físicas y psicológicas que sufren. 2) Determinar el porcentaje de las mujeres supervivientes al cáncer de mama entre 5 y 8 años que padecen cada una de las secuelas. 3) Determinar el porcentaje de las mujeres supervivientes al cáncer de mama entre 5 y 8 años que tienen alterada su CV. 4) Estudiar qué factores sociodemográficos y clínicos están relacionados con la gravedad que presentan las secuelas y por lo tanto influyen en la CV de estas mujeres. Metodología Es un estudio observacional y transversal. Con 120 mujeres supervivientes al cáncer de mama entre 5 y 8 años de diagnóstico. Instrumento de medida: cuestionarios de la EORTC QLQ-C30+ BR23 adaptados. Para el análisis de los datos se realizaron diferentes pruebas estadísticas (estudio descriptivo, distribución de frecuencias absolutas y relativas, análisis factorial, estimaciones de parámetros con un nivel de confianza al 95%, contrastes de una proporción, contrastes del Coeficiente de Correlación de Pearson, el Test de la χ2 de Pearson, la T de Student combinada y el test no exacto de Brown-Forsythe) Resultados La edad media de la muestra es de 51,76 años (D.E. 8,97), el 72,5% están casadas, el 46,7% tienen 2 hijos, 38,3% han sido sometidas a cirugía conservadora, y el 58,3% recibieron quimioterapia+ radioterapia+ terapia hormonal. Tras la realización del análisis factorial se destacan las siguientes dimensiones: problemas del brazo (22,5% de estas mujeres tienen alterada la CV), estado físico (20%), satisfacción de la imagen corporal (22,5%), estado emocional (20,8%), funcionamiento social (7,5%), funcionamiento sexual (60%), problemas de alimentación (2,5%) y molestias en la mama (38,3%). Conclusión Tres de cada cuatro mujeres supervivientes entre 5 y 8 años al cáncer de mama, tienen alterada su CV que se ve afectada por las siguientes secuelas: problemas del brazo, estado físico, problemas de alimentación, problemas de la mama, insatisfacción de la imagen corporal, el estado emocional, el funcionamiento social y sexual. Todas estas mujeres presentan una o más secuelas aunque sean en un grado leve. Más del 80% de estas mujeres, padecen problemas del brazo, alteraciones del estado físico, mal estado emocional. Palabras clave: cáncer de mama, calidad de vida, supervivientes, enfermería. “A STUDY OF THE QUALITY OF LIFE OF WOMEN WHO HAVE SURVIVED BREAST CANCER” Introduction Breast cancer is a health problem with great repercussions given its high rate of prevalence in the female population. Given that its prognosis has improved notably in recent years and survival is currently high, the process itself and the treatments that can be applied have important repercussions for patients and their relatives. Currently, breast cancer is not perceived as being a terminal illness, but rather as a long term chronic process with statistics confirming that this is a serious threat for women given the after-effects it causes. Aims 1) To study the Quality of Life (QOL) of women who have survived a 5 to 8 year period of breast cancer, identifying the physical and psychological after-effects that they suffer from. 2) To determine the percentage of women who have survived a 5 to 8 year period of breast cancer and suffer from all of the kinds of after-effects. 3) To determine the percentage of women who have survived between 5 and 8 years of breast cancer and who have an altered QOL. 4) To analyze which sociodemographic and clinical factors are related to the severity of the after-effects and therefore have an influence on the QOL of these women. Methodology The study was observational and transversal including 120 women who had survived between 5 and 8 years of diagnosed breast cancer. Instrument of measurement: adapted EORTC QLQ-C30+ BR23 questionnaires. Data analysis was carried out using different statistical tests (a descriptive analysis, absolute and relative frequency distribution, factor analysis, parameter estimates with a confidence intervals of 95%, the contrast of proportion, the Pearson Correlation Coefficient calculator, Pearson's χ2 test , T-Student's combined test and the Brown-Forsythe non-exact test). Results The mean age of the subjects in the sample was 51.76 years (SD 8.97), 72.5% were married, 46.7% had 2 children, 38.3% had been subjected to conservative surgery, and 58.3% received chemotherapy+radiotherapy+hormone therapy. After carrying out the factor analysis the following most notable dimensions were affected: problems with one's arm (22.5% of these women had an altered QOL), physical state (20%), satisfaction with one's body image (22.5%), emotional state (20.8%), social functioning (7.5%), sexual functioning (60%), eating disorders (2.5%) and discomfort in the breast (38.3%). Conclusion Three out of four women who had survived between 5 and 8 years of breast cancer had an altered QOL that was affected by the following after-effects: problems with one's arm, eating disorders, breast problems, dissatisfaction with one's body image, one's emotional state, and social and sexual functioning. All the women had at least one of these after-effects even if they were only slight. More than 80% of these women suffered from problems with their arms, had an alteration in their physical state, or were in a poor emotional state. Key words: breast cancer, quality of life, survivors, nursing

Comercialización de peces ornamentales proyecto aplicado empresa Alpez

Colombia al ser el segundo país con mayor biodiversidad tiene un gran potencial de comercialización de productos ecológicos el cual aún no ha sido explotado. Dentro de esta de gama de productos potenciales se encuentran los peces ornamentale