Perceptions of indirect treatment comparisons as an evidence base in oncology decision-making: results of an international survey of health technology assessment and payer decision-makers.

Health technology assessment (HTA) and payer organizations are often faced with early decision-making in oncology. To design and conduct robust indirect treatment comparisons (ITCs), it is important to better understand HTA and payer decision-maker perceptions of ITCs. Here we aim to describe what individuals with HTA and payer experience see as the acceptability of ITCs for HTA and payer organization coverage and reimbursement decision-making.

Real-world evidence in the reassessment of oncology therapies: payer perceptions from five countries.

This study explored the perceived value of real-world evidence (RWE) in the reassessment of oncology therapies by collecting the perspectives of health technology assessment/payer decision-makers. A web-based survey was conducted using the Market Access Transformation Rapid Payer Response online portal. 30 participants from France, Germany, Spain, the UK and the USA were recruited based on their expertise.

A large adrenal myelolipoma: case report and review of the literature.

Adrenal myelolipoma is a rare benign neoplasm composed of mature adipose tissue and myeloid tissue with a variable amount of hematopoietic elements. Most patients are asymptomatic although some present with pain or even endocrine dysfunction. The rising use of CT and MRI scans has led to an increase of the detection of adrenal myelolipomas in recent years.

Small bowel intussusception due to metastatic renal cell carcinoma.

Metastases from renal cell carcinoma (RCC) are rarely located in the small bowel and usually present either with iron deficiency anaemia due to occult bleeding or obstructive symptoms. A 65-year-old man with not known malignancy was admitted to our hospital with symptoms of intermittent bowel obstruction. The abdominal computed tomography (CT) scan depicted a large tumour of the right kidney and obstruction of the small intestine at the level of the proximal jejunum.

Factors associated with lymph node retrieval in surgery for colorectal cancer.

Purpose: Accurate staging of cancers of the colon and rectum (CRC) requires adequate lymph node (LN) evaluation, and many studies have demonstrated an association between the number of LNs examined and survival. The number of lymph nodes which are retrieved during resections for CRC may however vary and has been associated with various factors in the literature. The aim of the present study was to identify such factors in our CRC surgical practice.

Extragastrointestinal stromal tumour of the lesser omentum: A case report and literature review.

Introduction: Extragastrointestinal stromal tumours (EGISTs) are very uncommon compared to their gastrointestinal counterparts. Most of them originate from the intestinal mesentery and the omentum.

Case Report: A 70 year-old Caucasian woman presented with a bulky abdominal mass which on laparotomy was found to originate from the lesser omentum and was completely resected.

Management and treatment of relapsed or refractory Ph(-) B-precursor ALL: a web-based, double-blind survey of EU clinicians.

Background: The prognosis for adult patients with Ph(-) B-precursor acute lymphoblastic leukaemia (ALL) who are refractory to treatment or experience relapse (R/R), is poor; over 90% of these patients die from the disease, typically within a few months. While there are some national guidelines published for the treatment of adult patients with ALL, and local working group recommendations do exist, there is very little detail and no preferred treatment regimens for adult patients with R/R Ph(-) B-precursor ALL. The aim of this study was to describe current real-world clinical practice in Europe for the management and treatment of adult R/R Ph(-) B-precursor ALL.

Dutasteride plus tamsulosin fixed-dose combination first-line therapy versus tamsulosin monotherapy in the treatment of benign prostatic hyperplasia: a budget impact analysis in the Greek healthcare setting.

Background: The purpose of this study was to explore the budget impact of dutasteride plus tamsulosin fixed-dose combination (DUT + TAM FDC) versus tamsulosin monotherapy, in the treatment of patients with benign prostatic hyperplasia (BPH) from the perspective of the Greek healthcare insurance system.

Methods: A Microsoft Excel-based model was developed to estimate the financial consequences of adopting DUT + TAM FDC within the Greek healthcare setting. The model, compared six mutually exclusive health states in two alternative treatment options: current standard of care and the introduction of DUT + TAM FDC in the market.

Rationally designed less toxic SPD-304 analogs and preliminary evaluation of their TNF inhibitory effects.

SPD-304 was discovered as a promising tumor necrosis factor alpha (TNF) antagonist that promotes dissociation of TNF trimers and therefore blocks the interaction of TNF and its receptor. However, SPD-304 contains a potentially toxic 3-alkylindole moiety, which can be bioactivated to a reactive electrophilic intermediate. A series of SPD-304 analogs was synthesized with the aim to diminish its toxicophore groups while maintaining the binding affinity for TNF.

Extensive colonic necrosis following cardiac arrest and successful cardiopulmonary resuscitation: report of a case and literature review.

Non-occlusive colonic ischaemia is a recognized albeit rare entity related to low blood flow within the visceral circulation and in most reported cases the right colon was affected. This is the second case report in the literature of extensive colonic necrosis following cardiac arrest and cardiopulmonary resuscitation (CPR). A 83-year-old Caucasian woman was admitted to our hospital due to a low energy hip fracture.

A bidirectional approach to the synthesis of polypropionates: synthesis of C1-C13 fragment of zincophorin and related isomers.

The structure-activity study of a bioactive natural product containing polypropionate subunits requires that its stereoisomers also be evaluated. Therefore, a general approach to synthesize these motifs is necessary. We describe herein the synthesis of the C1-C13 polypropionate subunit of zincophorin and isomers thereof using a two-reaction sequence: an aldol reaction using a mixture of tetrasubstituted enoxysilanes and a hydrogen-transfer reaction, both under Lewis acid control.

Designed spiro-bicyclic analogues targeting the ribosomal decoding center.

The bacterial ribosome represents the confirmed biological target for many known antibiotics that interfere with bacterial protein synthesis. Aminoglycosides represent a lead paradigm in RNA molecular recognition and constitute ideal starting points for the design and synthesis of novel RNA binders. Previous rational design approaches of RNA-targeting small molecules have been mainly concentrated on direct functionalization of aminoglycosidic substructures.

Retrorectal endometrioid cyst: a case report.

Introduction: Developmental cysts are the most common retrorectal cystic lesions in adults, whereas reports of endometrioid cysts in this anatomic location are extremely rare.

Case Presentation: A 21-year-old nulliparous Greek woman presented with chronic noncyclic pelvic pain, and a retrorectal cyst was diagnosed. The lesion was resected through a laparotomy and, on histologic examination, was found to be an endometrioid cyst.

Second generation analogs of rigid 6,7-spiro scaffolds targeting the bacterial ribosome.

Previous work from our group described the synthesis and biological evaluation of new rigid, 6,6- and 6,7-spiro aminoglycosidic scaffolds targeting the bacterial ribosome. Herein we describe an improved synthetic protocol for their construction, and extend our study by further amino-functionalization of their 6,7-spiro analogs. The synthetic strategy, preparation and evaluation of some representative examples are reported.

Serum profiles of C-reactive protein, interleukin-8, and tumor necrosis factor-alpha in patients with acute pancreatitis.

Background/aims: Early prediction of the severity of acute pancreatitis would lead to prompt intensive treatment resulting in improvement of the outcome. The present study investigated the use of C-reactive protein (CRP), interleukin IL-8 and tumor necrosis factor-alpha (TNF-alpha) as prognosticators of the severity of the disease.

Methods: Twenty-six patients with acute pancreatitis were studied.

Non-operative management of blunt abdominal trauma. Is it safe and feasible in a district general hospital?

Background: To evaluate the feasibility and safety of non-operative management (NOM) of blunt abdominal trauma in a district general hospital with middle volume trauma case load.

Methods: Prospective protocol-driven study including 30 consecutive patients who have been treated in our Department during a 30-month-period. Demographic, medical and trauma characteristics, type of treatment and outcome were examined.

Arthritis of the sternoclavicular joint masquerading as rupture of the cervical oesophagus: a case report.

Introduction: Sternoclavicular septic arthritis is a rare condition and accounts only for 1% of cases of septic arthritis in the general population. The most common risk factors are intravenous drug use, central-line infection, distant-site infection, immunosuppression, trauma and diabetes mellitus. This is a report of an unusual case where this type of arthritis was masquerading as rupture of the cervical oesophagus.

Postpartum spontaneous colonic perforation due to antiphospholipid syndrome.

The antiphospholipid syndrome (APS) is a multi-systemic disease being characterized by the presence of antiphospholipid antibodies that involves both arterial and venous systems resulting in arterial or venous thrombosis, fetal loss, thrombocytopenia, leg ulcers, livedo reticularis, chorea, and migraine. We document a previously unreported case of a 37-year-old female in whom APS was first manifested by infarction and cecal perforation following cesarean section. At laparotomy the underlying cause of colonic perforation was not clear and after resection of the affected bowel an ileo-colostomy was performed.

Does the expression of cyclin E, pRb, and p21 correlate with prognosis in gastric adenocarcinoma?

Background: Cyclin E is a protein that plays a key role in the G1 --> S transition of the normal cell cycle. The product of retinoblastoma gene (pRb) is the master regulator of entry into the cell cycle and p21 protein is a cyclin-dependent kinase inhibitor that disturbs the progression through the cell cycle. The expression of these proteins, among many others, is being deregulated in tumorogenesis.

Multiple jejuno-jejunal fistulae of uncertain origin: a case report.

A 43 year-old male patient presented with small bowel obstruction while being treated for cervical tuberculous lymphadenopathy. Laparotomy revealed multiple adhesions and multiple jejuno-jejunal fistulae. Absence of previous abdominal surgery or other abdominal insult favoured an 'idiopathic' origin of these unusual lesions, although treated tuberculosis may have been the underlying cause.

Hereditary long QT syndrome in pregnancy: antenatal and intrapartum management options.

Long QT syndrome is a rare but severe cardiac arrhythmia. We report the antenatal and intrapartum management of a primigravida carrying the hereditary form of the disease and specifically the Romano-Ward syndrome. A multidisciplinary approach and close obstetric surveillance are mandatory for a good maternal and perinatal outcome.

Takayasu arteritis in pregnancy: safe management options in antenatal care. Case report.

Takayasu arteritis is a nonspecific chronic inflammatory vascular disease of unknown etiology with a higher incidence during the child-bearing years. It usually involves the branches of the aortic arch. Most of the patients enter the pregnancy being already diagnosed as having the disease and being on medication.