Health-State Utilities in Liver Disease

Objectives. Health-state utilities are essential for cost-utility analysis. Few estimates exist for liver disease in the literature. The authors' aim was to conduct a systematic review of health-state utilities in liver disease, to look at the variation of study designs used, and to pool utilities for some liver disease states. Methods. A search of MED-LINE, EMBASE, and CINAHL from 1966 to September 2006 was conducted including key words related to liver disease and utility measuring tools. Articles were included if health-state utility tools or expert opinion were used. Variance-weighted mean utility estimates were pooled using metaregression adjusting for disease state and utility assessment method. Results. Thirty studies measured utilities of liver diseases/disease states. Half of these estimated utilities for hepatitis viruses: hepatitis A (n = 1), hepatitis B (n = 4), and hepatitis C (n = 10). Others included liver transplant (n= 6) and chronic liver disease (n= 5) populations. Twelve utility methods were used throughout. The EQ-5D (n = 10) was most popular method, followed by visual analogue scale (n = 9), time tradeoff (n = 6), and standard gamble (n = 4). Respondents were patients (n= 16), an expert panel (n = 10), non—liver diseases adults ( n=2), patient and expert (n = 1), and patient and healthy adult (n = 1). Type of perspective included community (n=21), patient (n=4), and both (n = 5). The pooled mean estimates in hepatitis C with moderate disease, compensated cirrhosis, decompensated cirrhosis, and post—liver transplant using the EQ-5D were 0.75, 0.75, 0.67, and 0.71, respectively. The change in these utilities using different methods were -0.07 (visual analogue scale), -0.01 (health utilities index version 3), +0.04 (standard gamble), + 0.08 (health utilities index version 2), + 0.12 (time tradeoff), and + 0.15 (standard gamble—transformed visual analogue scale). Conclusions. The authors have created a valuable liver disease— based utility resource from which researchers and policy makers can easily view all available utility estimates from the literature. They have also estimated health-state utilities for major states of hepatitis C.

Key Words: health-state utility • liver disease • systematic review • meta-analysis • hepatitis C.

SLEISENGER & FORDTRAN'S GASTROINTESTINAL AND LIVER DISEASE REVIEW AND ASSESSMENT

Featuring the experience of new editor Anthony J. DiMarino, MD, the 3rd Edition of this interactive review book helps you study, update, and test your knowledge of gastrointestinal and liver disease. More than 1,000 multiple-choice questions - each cross referenced to the parent text - include an answer with a short explanation to help fill in any gaps in your understanding. A bonus web site includes all the questions online, plus instant scoring and feedback, and links through to the supporting material in the parent text.

Audience
Gastroenterologists and Residents and Internists

Contents
Section 1 Nutrition and Biliary
Section 2 Multiple Organs
Section 3 Esophagus
Section 4 Stomach and Duodenum
Section 5 Pancreas
Section 6 Liver
Section 7 Small and Large Intestine

Bibliographic details
Paperback, 288 pages, publication date: JUN-2007 ISBN-13: 978-1-4160-3366-0 ISBN-10: 1-4160-3366-1 Imprint: SAUNDERS

Treatment Algorithms 2002: Hepatitis B and C

Treatment Algorithm 2002:Hepatitis B and C is an analysis of the treatment patterns of hepatitis B (HBV) and hepatitis C (HCV) infection, in seven of the worlds major markets, namely the US, Japan, France, Germany, Italy Spain and the UK. The report is based on extensive primary physician research across these regions, and validated through secondary research, with NGOs, government agencies and clinical and research journals. Structure of report: The report is broken down into 4 sections, as described below: * Clinical overview - Complete epidemiological analysis, by incidence and prevalence for the seven major markets. The patient group is analyzed and split by diagnosis and treatment. * Presentation, Screening and Diagnosis - provides a breakdown of physician types involved in presentation, diagnosis and treatment. Screening programs and diagnostic guidelines are analyzed for each country. * Global Treatment patterns - Breakdown of patient share between first line therapy treatment, including dosage amount, frequency and length of therapy. Response and relapse rates to each therapy are provided, along with a further breakdown of second line treatment. Analysis of global treatment patterns and variations are followed by a more in depth view of each of the seven major markets. * Analyst insight - The key impacts on future treatment of HBV and HCV, both from a physician perspective, and from Datamonitors viewpoint. Unmet needs in the treatment of hepatitis are identified, and the health economics of both diseases are discussed, specifically the growth of the diseased population in the major markets, the impact of vaccination on the progression of HBV disease, the increasing significance of HIV comorbidity and the prospective for prophylactic and therapeutic vaccine development for HCV infection.

Hepatitis in China - Liver Let Die?

Hepatitis is a major health problem in China, which is home to one third of hepatitis B patients and one quarter of hepatitis C patients globally. HBV vaccination, together with HBV and HCV screening have helped to reduce transmission, but continued transmission from mother to child (for HBV) and transmission via blood transfusions (HCV) means that HBV and HCV are likely to remain a problem.

Scope of this title:
- Analysis of the current dynamics of the Chinese hepatitis market through primary research data from 176 physicians, supported by key opinion leaders
- Identification of drivers and resistors of the Chinese hepatitis market, and how the Chinese healthcare system impacts these market-shaping factors
- Examination of key hepatitis drug regimens for hepatitis in China, and factors affecting prescription trends underlying these regimens
- Assessment of the differences between China and the 7 major markets in terms of HBV and HCV transmission and diagnosis

Highlights of this title:
Our physician research indicated that HBV incidence is decreasing in China. In contrast to the seven major markets, where most patients acquire HBV sexually, perinatal transmission is the dominant HBV transmission route, which impacts on HBV disease progression and effectiveness of drug therapy.

Chinese physicians believe that HCV incidence may be increasing in China. Blood transfusion is though to be the dominant HCV transmission route in China, while in the seven major markets, HCV is mainly acquired through intravenous drug use.

Chinese physicians do not consider any HBV therapy a gold-standard, although lamivudine is the most prescribed first-line therapy, while adefovir is the most prescribed second-line therapy. While treatment choice is more limited for HCV, the Chinese HCV market is highly fragmented, with treatment differing significantly between regions.

Reasons to order your copy:
- Review the clinical and commercial factors shaping the uptake of hepatitis products in China, and the opportunities and threats facing the market
- Gain insight into HBV and HCV prevalence, transmission and coinfection in China
- Evaluate unmet needs in Chinas hepatitis market and capitalize on these opportunities to develop commercial strategies to increase market penetration

Disease and Therapy Review: Hepatitis B

The Hepatitis B Disease and Therapy Review provides incidence and prevalence numbers and percentages for major countries worldwide, information on diagnosis, and an overview of treatments. Dosing information is provided for Intron A, lamivudine, Hepsera, and Baraclude. General information is included on sales of Hepsera. Disease and Therapy Reviews were developed to provide a basic understanding of the key facts about a disease and market in a quick, easy-to-read format. These reports are prepared by a senior market research team. Each Disease and Therapy Review provides a concise analysis of the most important information about a particular disease, its treatment, and the market opportunities. Reports begin with an overview of the condition, and also contain tables that summarize the available worldwide incidence and prevalence data for the condition, a review of current diagnosis strategies and treatment options, general information about the market size, and information about important market trends. The data contained in these reports comes from key industry secondary data sources, such as the Timely Data Resources Incidence and Prevalence Database, and Langes Current Medical Diagnosis and Treatment. This information is supplemented by reviews of analyst reports, company reports, and medical websites. Sources and references are provided.

Evolution in Health and Disease

A fully revised edition of a volume written by the worlds leading authorities on this subject. It discusses how the evolution of humans and their pathogens have generated important medical issues, covering both infectious and degenerative diseases. It presents important ideas that are not yet sufficiently appreciated in the medical community.

In this fully revised and updated edition, the editors have integrated a completely new set of contributions from the leading researchers in the field to describe the latest research in evolutionary medicine, providing a fresh summary of this rapidly expanding field 10 years after its predecessor was first compiled. It continues to adopt a broad approach to the subject, drawing on medically relevant research from evolutionary genetics, human behavioural ecology, evolutionary microbiology (especially experimental evolution of virulence and resistance), the evolution of aging and degenerative disease, and other aspects of biology or medicine where evolutionary approaches make important contributions.

‘Evolution in Health and Disease’ describes how evolutionary thinking gives valuable insights and fresh perspectives into human health and disease, establishing evolutionary biology as an essential complementary science for medicine. Integrating evolutionary thought into medical research and practice helps to explain the origins of many medical conditions, including diabetes, obesity, cardiovascular disease, asthma, allergies, other autoimmune diseases, and aging. It also provides life-saving insights into the evolutionary responses of pathogens to antibiotics, vaccinations, and other human interventions. Why do we grow old? How can we stay healthy as we age? The book discusses these and many other fascinating questions, as well as suggesting exciting possibilities for future treatment and research.

This research level text is suitable for graduate level students and researchers in the fields of evolutionary (Darwinian) medicine, evolutionary biology, anthropology, developmental biology and genetics. It will also be of relevance and use to medical researchers and doctors.

Disease and Therapy Review: Hepatitis C

The Hepatitis C Disease and Therapy Review provides incidence and prevalence numbers and percentages for major countries worldwide, and an overview of treatments. Dosing information and treatment costs are provided for Peg-Intron, Pegasys, Rebetol, Copegus, and generic ribavirin capsules. General information on sales of peginterferon and ribavirin is provided. Disease and Therapy Reviews were developed to provide a basic understanding of the key facts about a disease and market in a quick, easy-to-read format. These reports are prepared by a senior market research team. Each Disease and Therapy Review provides a concise analysis of the most important information about a particular disease, its treatment, and the market opportunities. Reports begin with an overview of the condition, and also contain tables that summarize the available worldwide incidence and prevalence data for the condition, a review of current diagnosis strategies and treatment options, general information about the market size, and information about important market trends. The data contained in these reports comes from key industry secondary data sources, such as the Timely Data Resources Incidence and Prevalence Database, and Langes Current Medical Diagnosis and Treatment. This information is supplemented by reviews of analyst reports, company reports, and medical websites. Sources and references are provided.

Hepatitis C virus and transfusion transmitted liver disease

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the (682K), or click on a page image below to browse page by page. Links to PubMed are also available for Sellected Refrenses

Hepatitis C: A Multifaceted Disease: Review of Extrahepatic Manifestations

Purpose: To review the available data on the association between hepatitis C virus (HCV) infection and conditions reportedly related to infection with the virus and to assess the clinical implications of these associations.

Data Sources: Pertinent articles were identified using the Paperchase database, which simultaneously searches the MEDLINE (1966 to present), Health (1975 to present), AIDSLINE (1980 to present), and Cancerlit databases.

Study Selection: All studies for a given association were reviewed, but special attention was paid to randomized controlled trials where applicable.

Results: According to the available data, HCV infection appears to be strongly associated with essential mixed cryoglobulinemia, membranoproliferative glomerulonephritis, and porphyria cutanea tarda. Evidence strongly suggests that HCV has a direct pathogenetic role in some patients with the first two conditions. The association with Mooren corneal ulcers and autoimmune thyroiditis is suggested, but more data are needed to confirm it. The data for the association between HCV infection and the Sjogren syndrome, lichen planus, and idiopathic pulmonary fibrosis remain weak. Although interferon therapy has been effective in patients with both essential mixed cryoglobulinemia and membranoproliferative glomerulonephritis, a high relapse rate has been noted in the latter condition.

Conclusions: Patients with essential mixed cryoglobulinemia, membranoproliferative glomerulonephritis, and porphyria cutanea tarda should be tested for HCV infection. Conversely, signs and symptoms of these conditions should be sought in patients with chronic HCV infection. Interferon therapy is currently recommended only for patients with symptomatic essential mixed cryoglobulinemia.

Colorectal Cancer in Crohn's Disease—Review of a 56-Year Experience in Karolinska Institute University Hospital

ABSTRACT

We previously reported that the frequency of colorectal carcinomas (CRC) in Crohn's disease (CD) had increased at this hospital between 1951 and May 1996. The aim was to compare the frequency of CRC in CD between June 1996 and September 2007 to that found between 1951 and May 1996. For that purpose colectomy specimens with an IBD-CRC diagnosis filed during the last 11 years were reviewed. It was found that 29 patients with IBD developed a CRC at this hospital: 21 had CD (or 1.91 cases/year) and the remaining eight, ulcerative colitis (or 0.72 cases/year). At this hospital, the number of cases of CRC in Crohn's colitis increased from 0.28/year between 1951 and the end of 1989, to 1.69 patients/year between 1990 and May 1996, and to 1.91 patients/year between June 1996 and September 2007 (present report). The marginal increase number of patients with CRC in Crohn's colitis/year during the last 11 years at this hospital might be only apparent, considering that the incidence of Crohn's disease in the county has dramatically increased, and that the localization of Crohn's disease has changed in later years, with a predilection for the colon and rectum.

Dangerous Grains (Celiac Disease Books)

Points Credit : 15 points Currently valued at $1.50

Gluten-Free Food / Product added to the Gluten-Free Mall on: Wednesday 13 April, 2005.

Dangerous Grains turns the U.S. Food Guide Pyramid upside down by exposing the myriad health risks posed by gluten grains (wheat, rye, barley, spelt, kamut, and triticale). The authors, leading experts in the field of food allergies, and celiac disease, present compelling evidence that our grain-centered diet is to blame for a host of chronic illnesses. Largely misunderstood and frequently misdiagnosed, these disorders can be prevented and reversed by the useful program outlined in this important new book. James Braly, M.D., has helped develop and popularize food allergy testing and celiac disease screening. He is also the author of Food Allergy Relief. Ron Hoggan, M.A., lectures extensively on the topic of gluten sensitivity and has been published in numerous journals. Category: Celiac Disease Books and gluten free books.

Foot and Mouth Disease Outbreak Tied to Biosecurity Breach

Last month's frightening UK outbreak of foot and mouth disease has been traced to nearby labs.

Findings from two official investigations are scheduled to be published tomorrow, and the BBC reports that they point to a broken pipe between a lab run by pharmaceutical company Merial and another run by the government.

Both labs were working on the same disease strain later identified in infected cows. Lab contractors also used a road that passed by affected farms, and may have carried the virus on their vehicles' tires.

Accidents are inevitable in the course of research, and it's unrealistic to expect that they can be prevented with 100 percent certainty. However, this doesn't let the labs off the hook: the pipe transferred untreated waste from Merial to sterilization equipment at the government lab -- an extra step that should have been avoided by treating Merial's waste on-site.

So much for the convenient bogeymen of, who some government officials originally.

The Most Dangerous Bacteria

New York -

Athletes with infected scrapes that won't go away. Hundreds of soldiers returning from Iraq with wound infections that don't respond to most antibiotics. Often deadly pneumonias. Ninety-thousand patients who die in hospitals every year. That's the toll in the U.S. from germs that are resistant to existing medicines.

The problem is that many common bacteria and fungi have evolved into being resistant to the drugs that have kept them at bay for a half-century. The problem is not new (see), but it is still getting worse, even as a spattering of new antibiotics and anti-fungal drugs reach the market. Now, doctors are trying to get more attention for the problem, hoping that comprehensive legislation could stimulate drug firms to put more effort into developing new antibiotics.

Today, the Infectious Diseases Society of America, an association of 8,000 infectious-disease specialists, is announcing a hit list of the six most worrisome germs doctors now face in clinical practice. The list, which includes five bacteria and one fungus, is described in the current issue of Clinical Infectious Diseases, a medical journal, and will also be unveiled as part of a press conference today. For all of these germs, the authors see very few new drugs being developed and rising rates of illness.