RESUMO
BACKGROUND: Screening potential live kidney donors is an intense process for both candidates and the healthcare system. It is conventionally implemented using a standard generic protocol. Efficiencies in this process could potentially be achieved using personalized protocols that are optimized for a given candidate. Aim: To create personalized protocols (by age, sex, and paired exchange status) and evaluate them relative to the standard generic protocol. METHODS: Two personalized protocols were created. One sequenced tests according to probability (high to low) of excluding a given candidate. The other sequenced tests according to the expected cost (low to high) per exclusion. Test costs and exclusion probabilities were extracted predominantly from Australian sources. These were integrated into a decision analysis incorporating Markov processes. This estimated the expected financial cost and expected number of tests performed to exclude an ineligible candidate in the standard generic and personalized protocols. RESULTS: The standard generic protocol consistently ranked poorest in terms of expected costs and expected tests per exclusion across all ages, sexes, and paired exchange status. Compared with the most efficient personalized protocol, the standard generic protocol was on average A$1767.49 more expensive and required 3.53 more tests. CONCLUSIONS: Personalized protocols enhance the ability of a kidney transplant unit to effectively exclude live kidney donor candidates more quickly and cost effectively compared with the conventional standard generic protocol.
Assuntos
Neoplasias das Glândulas Suprarrenais/patologia , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/cirurgia , Neoplasias das Glândulas Suprarrenais/complicações , Neoplasias das Glândulas Suprarrenais/cirurgia , Adrenalectomia , Idoso , Feminino , Tumor de Células da Granulosa/patologia , Tumor de Células da Granulosa/cirurgia , Humanos , Hipertensão/complicações , Neoplasias Ovarianas/diagnóstico , Resultado do TratamentoRESUMO
Low risk localised prostate cancer may be able to be observed rather than treated according to the Prostate Cancer Intervention Versus Observation Trial (PIVOT). This review summarises the key issues surrounding the debate in the management of localised prostate cancer, and contextualises the PIVOT's contribution.
RESUMO
This case report documents the use of the CIMAvax Epidermal Growth Factor vaccine regimen in a 54 y old female with stage IIIb non-small cell lung carcinoma. Even after 48 mo since diagnosis her ECOG performance remains at zero. Further, this report documents a reaction to the vaccine of grade 3 severity not previously documented.
Assuntos
Vacinas Anticâncer/administração & dosagem , Carcinoma Pulmonar de Células não Pequenas/terapia , Fatores Imunológicos/administração & dosagem , Imunoterapia/métodos , Carcinoma Pulmonar de Células não Pequenas/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Radiografia Torácica , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
This case report records 2 discrete episodes of spontaneous remission of metastatic endometrial cancer (into peritoneum and omentum) in a 41-yr-old female following the "Lim Lifestyle" therapy alone. This lifestyle is an originally formulated holistic approach toward cancer consisting of nutritional, spiritual, and mental therapies. Cancer regression was measured symptomatologically, serologically, and radiologically (resolved ascites and reduced omental cake).
