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Tariq U, Sarkar S, Malladi N, Kumar R, Bugga P, Chakraborty P, Banerjee SK. Knockdown of SCN5A alters metabolic-associated genes and aggravates hypertrophy in the cardiomyoblast. Mol Biol Rep 2024; 51:661. [PMID: 38758505 DOI: 10.1007/s11033-024-09594-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/29/2024] [Indexed: 05/18/2024]
Abstract
SCN5A mutations have been reported to cause various cardiomyopathies in humans. Most of the SCN5A mutations causes loss of function and thereby, alters the overall cellular function. Therefore, to understand the loss of SCN5A function in cardiomyocytes, we have knocked down the SCN5A gene (SCN5A-KD) in H9c2 cells and explored the cell phenotype and molecular behaviors in the presence and absence of isoproterenol (ISO), an adrenergic receptor agonist that induces cardiac hypertrophy. Expression of several genes related to hypertrophy, inflammation, fibrosis, and energy metabolism pathways were evaluated. It was found that the mRNA expression of hypertrophy-related gene, brain (B-type) natriuretic peptide (BNP) was significantly increased in SCN5A-KD cells as compared to 'control' H9c2 cells. There was a further increase in the mRNA expressions of BNP and βMHC in SCN5A-KD cells after ISO treatment compared to their respective controls. Pro-inflammatory cytokine, tumor necrosis factor-alpha expression was significantly increased in 'SCN5A-KD' H9c2 cells. Further, metabolism-related genes like glucose transporter type 4, cluster of differentiation 36, peroxisome proliferator-activated receptor alpha, and peroxisome proliferator-activated receptor-gamma were significantly elevated in the SCN5A-KD cells as compared to the control cells. Upregulation of these metabolic genes is associated with increased ATP production. The study revealed that SCN5A knock-down causes alteration of gene expression related to cardiac hypertrophy, inflammation, and energy metabolism pathways, which may promote cardiac remodelling and cardiomyopathy.
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Affiliation(s)
- Ubaid Tariq
- Non-communicable Disease Group, Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana, 121001, India
| | - Soumalya Sarkar
- Non-communicable Disease Group, Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana, 121001, India
| | - Navya Malladi
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research (NIPER), Guwahati, Assam, 781101, India
| | - Roshan Kumar
- Non-communicable Disease Group, Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana, 121001, India
| | - Paramesha Bugga
- Non-communicable Disease Group, Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana, 121001, India
| | - Praloy Chakraborty
- Department of Cardiac Electrophysiology, Adult Cardiology, Toronto General Hospital, Toronto, ON, Canada
| | - Sanjay K Banerjee
- Non-communicable Disease Group, Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana, 121001, India.
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research (NIPER), Guwahati, Assam, 781101, India.
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Faraji M, Sharifi T, Mohammad-Pour S, Javan-Noughabi J, Aboutorabi A, Yousefi S, Jakovljevic M. Out-of-pocket pharmaceutical expenditure and its determinants among Iranian households with elderly members: a double-hurdle model. Cost Eff Resour Alloc 2024; 22:15. [PMID: 38373969 PMCID: PMC10877920 DOI: 10.1186/s12962-024-00521-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 01/30/2024] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVES The population of older adults continues to grow in Iran, with pharmaceutical costs as a leading driver of household health-related costs. The present study was conducted to estimate the out-of-pocket pharmaceutical expenditure and its socioeconomic predictors among households with the elderly in Iran. METHOD This study is a secondary analysis using 2019 national household expenditure and income survey data in Iran. The sample size was 9381 households with at least one member older than 65. The double-hurdle model in STATA 16 was used to examine the association between independent variables and households' out-of-pocket pharmaceutical expenditures. RESULTS The mean out-of-pocket pharmaceutical expenditures for each household with elderly member was $8065 per year. There was a positive association between the (female) gender of the household head, urban residence, employment status, insurance expenditure and a higher level of education of the head of the household with the out-of-pocket pharmaceutical expenditures (P < 0.05). The income of elderly households did not affect these expenditures (P > 0.05). CONCLUSIONS This study showed that the socioeconomic characteristics of elderly families not only influenced their decision to enter the medicine market, but also the rate of medicine purchase. It is helpful to manage and control the pharmaceutical costs among the elderly.
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Affiliation(s)
- Mehran Faraji
- Department of Health Economics, School of Management and Medical Information, Iran University of Medical Sciences, Tehran, Iran
| | - Tahereh Sharifi
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Saeed Mohammad-Pour
- Department of Health Economics, School of Management and Medical Information, Iran University of Medical Sciences, Tehran, Iran
| | - Javad Javan-Noughabi
- Department of Health Economics and Management Sciences, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Ali Aboutorabi
- Department of Health Economics, School of Management and Medical Information, Iran University of Medical Sciences, Tehran, Iran
| | - Shaghayegh Yousefi
- Kenneth Levene Graduate School of Business, Faculty of Graduate Studies and Research, University of Regina, Regina, SK, Canada
| | - Mihajlo Jakovljevic
- UNESCO-TWAS, Trieste, 34100, Italy
- Shaanxi University of Technology, Hanzhong, 723099, China
- Department of Global Health Economics and Policy, University of Kragujevac, 34000, Kragujevac, Serbia
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Jalali FS, Keshavarz K, Seif M, Akrami M, Jafari A, Ravangard R. Economic burden of breast cancer: a case of Southern Iran. Cost Eff Resour Alloc 2023; 21:58. [PMID: 37644546 PMCID: PMC10466748 DOI: 10.1186/s12962-023-00470-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 08/23/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Breast cancer is one of the main causes of death from cancer around the world, imposing a significant economic burden on the families and healthcare system. The present study aimed at determining the economic burden of breast cancer in the patients referred to the medical centers in Fars province in southern Iran in 2021. METHODS This cross-sectional study is a partial economic evaluation and a cost-of-illness study with a bottom-up and prevalence-based approach, conducted in Fars province in southern Iran in 2021 from the societal perspective. A total of 230 patients were randomly included in the study, and a researcher-made data collection form was used to collect the required data. The data on direct medical costs were collected using the information on patients' medical and financial records. On the other hand, the data on direct non-medical and indirect costs were obtained using self-reports by the patients or their companions. The Excel 2016 software was used to analyze the collected data. RESULTS The results showed that the annual cost of each breast cancer patient in the studied sample was 11,979.09 USD in 2021. Direct medical costs accounted for the largest share of costs (70.69%, among which the cost of radiotherapy was the highest one. The economic burden of the disease in the country was estimated at 193,090,952 USD. CONCLUSIONS In general, due to the high prevalence of breast cancer and the chronicity of this disease, its medical costs can impose a heavy economic burden on society, the health system, the insurance system, and patients. Thus, in order to reduce the costs, the following suggestions can be offered: the use of advanced radiotherapy techniques, increasing the insurance coverage of required services, establishing low-cost accommodation centers near medical centers for the patients and their companions, providing specialized medical services for the patients in towns, using the Internet and virtual space to follow up the treatment of the patients, and carrying out free screening programs and tests for faster diagnosis of the infected patients and susceptible or exposed people.
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Affiliation(s)
- Faride Sadat Jalali
- Student Research Committee, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Khosro Keshavarz
- Health Human Resources Research Centre, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mozhgan Seif
- Non-communicable Disease Research Center, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Majid Akrami
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abdosaleh Jafari
- Health Human Resources Research Centre, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ramin Ravangard
- Health Human Resources Research Centre, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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Varmaghani M, Amiri M, Ebrahimpour H, Salek R, Javan-Noughabi J. The cost effectiveness of intensity-modulated radiation therapy and three-dimensional conformal radiotherapy in the treatment of head and neck cancers. Radiat Oncol 2023; 18:138. [PMID: 37608291 PMCID: PMC10463868 DOI: 10.1186/s13014-023-02327-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023] Open
Abstract
PURPOSE Intensity-modulated radiotherapy is developed as a replacement for 3-dimensional conformal radiation therapy. Considering the difference in costs and effectiveness of these interventions, the aim of this study was to compare the cost effectiveness of intensity-modulated radiation therapy and three-dimensional conformal radiotherapy in the treatment of head and neck cancer in east of Iran. METHODS A Markov model including six states based on xerostomia and dysphagia was developed to estimate the incremental cost effectiveness ratio from the perspective of societal. Cost and quality of life data were collected from 97 respondents via a checklist and EuroQol-5Dimension questionnaire. The robustness of results was examined by deterministic and probabilistic sensitivity analysis. All analysis were conducted with Treeage software. RESULTS The results of this study showed that the cost and quality adjusted life years for 3-dimensional conformal radiation therapy were 9209.76 and 3.63 respectively. However, the cost and quality adjusted life years for intensity-modulated radiotherapy were 12562.90 and 3.17 respectively. Therefore, 3-dimensional conformal radiation therapy produced 0.45 more quality adjusted life years than intensity-modulated radiotherapy and saved $3353. According to the incremental cost effectiveness ratio, 3-dimensional conformal radiation therapy as compared to intensity-modulated radiotherapy saved $7367.27 per quality adjusted life years. These results confirmed by sensitivity analysis. CONCLUSION This study concluded that in the treatment of head and neck cancer, the 3-dimensional conformal radiation therapy method appears to be cost-effective when compared with intensity-modulated radiotherapy.
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Affiliation(s)
- Mehdi Varmaghani
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Malihe Amiri
- Department of Health Economics and Management Sciences, School of Health, Mashhad University of Medical Sciences, Daneshgah st. between 16-18, Mashhad, Iran
| | - Hossein Ebrahimpour
- Department of Health Economics and Management Sciences, School of Health, Mashhad University of Medical Sciences, Daneshgah st. between 16-18, Mashhad, Iran
| | - Roham Salek
- Radiotherapy and Oncology Department, Mashhad University of Medical Science, Mashhad, Iran
| | - Javad Javan-Noughabi
- Department of Health Economics and Management Sciences, School of Health, Mashhad University of Medical Sciences, Daneshgah st. between 16-18, Mashhad, Iran.
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Mohammadpour S, Soleimanpour S, Javan-Noughabi J, Gallehzan NA, Aboutorabi A, Jahangiri R, Bagherzadeh R, Gorman JF, Nemati A. A systemmatic literature review on indirect costs of women with breast cancer. Cost Eff Resour Alloc 2022; 20:68. [PMID: 36510211 PMCID: PMC9742666 DOI: 10.1186/s12962-022-00408-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION The rising incidence of breast cancer places a financial burden on national health services and economies. The objective of this review is to present a detailed analysis of the research and literature on indirect costs of breast cancer. METHODS English literature databases from 2000 to 2020 were searched to find studies related to the objective of the present review. Study selection and data extraction was undertaken independently by two authors. Also, quality assessment was done using a checklist designed by Stunhldreher et al. RESULTS: The current study chose 33 studies that were eligible from a total of 2825 records obtained. The cost of lost productivity due to premature death based on human capital approach ranged from $22,386 to $52 billion. The cost burden from productivity lost due to premature death based on friction cost approach ranged from $1488.61 to $4,518,628.5. The cost burden from productivity lost due to morbidity with the human capital approach was reported as $126,857,360.69 to $596,659,071.28. The cost of lost productivity arising from informal caregivers with the human capital approach was $297,548.46 to $308 billion. CONCLUSION Evaluation of the existing evidence revealed the indirect costs of breast cancer in women to be significantly high. This study did a thorough review on the indirect costs associated with breast cancer in women which could serve as a guide to help pick the appropriate method for calculating the indirect costs of breast cancer based on existing methods, approach and data. There is a need for calculations to be standardised since the heterogeneity of results in different domains from various studies makes it impossible for comparisons to be made among different countries.
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Affiliation(s)
- Saeed Mohammadpour
- Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Samira Soleimanpour
- Department of Medical Library and Information Science, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Javad Javan-Noughabi
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Health Economics and Management Sciences, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Nasrin Aboulhasanbeigi Gallehzan
- Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Aboutorabi
- Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Jahangiri
- Department of Health Economics, Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Rafat Bagherzadeh
- English Language Department, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Julia F Gorman
- Graduate School of Humanities and Social Sciences, University of Melbourne, Melbourne, Australia
| | - Ali Nemati
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
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Erfani P, Bhangdia K, Stauber C, Mugunga JC, Pace LE, Fadelu T. Economic Evaluations of Breast Cancer Care in Low- and Middle-Income Countries: A Scoping Review. Oncologist 2021; 26:e1406-e1417. [PMID: 34050590 PMCID: PMC8342576 DOI: 10.1002/onco.13841] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/23/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Understanding the cost of delivering breast cancer (BC) care in low- and middle-income countries (LMICs) is critical to guide effective care delivery strategies. This scoping review summarizes the scope of literature on the costs of BC care in LMICs and characterizes the methodological approaches of these economic evaluations. MATERIALS AND METHODS A systematic literature search was performed in five databases and gray literature up to March 2020. Studies were screened to identify original articles that included a cost outcome for BC diagnosis or treatment in an LMIC. Two independent reviewers assessed articles for eligibility. Data related to study characteristics and methodology were extracted. Study quality was assessed using the Drummond et al. checklist. RESULTS Ninety-one articles across 38 countries were included. The majority (73%) of studies were published between 2013 and 2020. Low-income countries (2%) and countries in Sub-Saharan Africa (9%) were grossly underrepresented. The majority of studies (60%) used a health care system perspective. Time horizon was not reported in 30 studies (33%). Of the 33 studies that estimated the cost of multiple steps in the BC care pathway, the majority (73%) were of high quality, but studies varied in their inclusion of nonmedical direct and indirect costs. CONCLUSION There has been substantial growth in the number of BC economic evaluations in LMICs in the past decade, but there remain limited data from low-income countries, especially those in Sub-Saharan Africa. BC economic evaluations should be prioritized in these countries. Use of existing frameworks for economic evaluations may help achieve comparable, transparent costing analyses. IMPLICATIONS FOR PRACTICE There has been substantial growth in the number of breast cancer economic evaluations in low- and middle-income countries (LMICs) in the past decade, but there remain limited data from low-income countries. Breast cancer economic evaluations should be prioritized in low-income countries and in Sub-Saharan Africa. Researchers should strive to use and report a costing perspective and time horizon that captures all costs relevant to the study objective, including those such as direct nonmedical and indirect costs. Use of existing frameworks for economic evaluations in LMICs may help achieve comparable, transparent costing analyses in order to guide breast cancer control strategies.
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Affiliation(s)
- Parsa Erfani
- Harvard Medical School, Boston, Massachusetts, USA.,Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Kayleigh Bhangdia
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | | | - Jean Claude Mugunga
- Harvard Medical School, Boston, Massachusetts, USA.,Partners In Health, Boston, Massachusetts, USA
| | - Lydia E Pace
- Harvard Medical School, Boston, Massachusetts, USA.,Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Temidayo Fadelu
- Harvard Medical School, Boston, Massachusetts, USA.,Dana-Farber Cancer Institute, Boston, Massachusetts, USA
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Hashempour R, Raei B, Safaei Lari M, Abolhasanbeigi Gallezan N, AkbariSari A. QALY league table of Iran: a practical method for better resource allocation. Cost Eff Resour Alloc 2021; 19:3. [PMID: 33441153 PMCID: PMC7807517 DOI: 10.1186/s12962-020-00256-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 11/24/2020] [Accepted: 12/11/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The limited health care resources cannot meet all the demands of the society. Thus, decision makers have to choose feasible interventions and reject the others. We aimed to collect and summarize the results of all cost utility analysis studies that were conducted in Iran and develop a Quality Adjusted Life Year (QALY) league table. METHODS A systematic mapping review was conducted to identify all cost utility analysis studies done in Iran and then map them in a table. PubMed, Embase, Cochrane library, Web of Science, as well as Iranian databases like Iran Medex, SID, Magiran, and Barakat Knowledge Network System were all searched for articles published from the inception of the databases to January 2020. Additionally, Cost per QALY or Incremental Cost Utility Ratio (ICUR) were collected from all studies. The Joanna Briggs checklist was used to assess quality appraisal. RESULTS In total, 51 cost-utility studies were included in the final analysis, out of which 14 studies were on cancer, six studies on coronary heart diseases. Two studies, each on hemophilia, multiple sclerosis and rheumatoid arthritis. The rest were on various other diseases. Markov model was the commonest one which has been applied to in 45% of the reviewed studies. Discount rates ranged from zero to 7.2%. The cost per QALY ranged from $ 0.144 in radiography costs for patients with some orthopedic problems to $ 4,551,521 for immune tolerance induction (ITI) therapy in hemophilia patients. High heterogeneity was revealed; therefore, it would be biased to rank interventions based on reported cost per QALY or ICUR. CONCLUSIONS However, it is instructive and informative to collect all economic evaluation studies and summarize them in a table. The information on the table would in turn be used to redirect resources for efficient allocation. in general, it was revealed that preventive programs are cost effective interventions from different perspectives in Iran.
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Affiliation(s)
- Reza Hashempour
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, 0000-0002-2043-8451, Tehran, Iran
| | - Behzad Raei
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, 0000-0002-2043-8451, Tehran, Iran
| | - Majid Safaei Lari
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, 0000-0002-2043-8451, Tehran, Iran
| | - Nasrin Abolhasanbeigi Gallezan
- Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Ali AkbariSari
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, 0000-0002-2043-8451, Tehran, Iran.
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Zhang J, Zhang P, Zou Q, Li X, Fu J, Luo Y, Liang X, Jin Y. Co-Delivery of Gemcitabine and Paclitaxel in cRGD-Modified Long Circulating Nanoparticles with Asymmetric Lipid Layers for Breast Cancer Treatment. Molecules 2018; 23:molecules23112906. [PMID: 30405089 PMCID: PMC6278289 DOI: 10.3390/molecules23112906] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 11/05/2018] [Accepted: 11/05/2018] [Indexed: 12/19/2022] Open
Abstract
Combination chemotherapy is a common clinical practice in cancer treatment. Here, cyclic RGD (arginylglycylaspartic acid) peptide was introduced to the surface of lipid/calcium/phosphate (LCP) asymmetric lipid layer nanoparticles for the co-delivery of paclitaxel (PTX) and gemcitabine monophosphate (GMP) (P/G-NPs). The sphere-like morphology of P/G-NPs displays a well-distributed particle size, and high entrapment efficiency and drug loading for both PTX and GMP, with a positive zeta potential. P/G-NPs were stable for up to 15 days. The cellular uptake of these cyclic RGD-modified nanoparticles was significantly higher than that of unmodified nanoparticles over 2 h incubation. Compared with the combination of free PTX and GMP (P/G-Free), P/G-NPs exhibited a longer circulation lifetime and improved absorption for PTX and GMP. Polyethylene glycol was responsible for a higher plasma concentration and a decreased apparent volume of distribution (Vz). Nanoparticles enhanced the drug accumulation in tumors compared with other major organs after 24 h. P/G-NPs nearly halted tumor growth, with little evidence of general toxicity, whereas P/G-Free had only a modest inhibitory effect at 16 mg/kg of GMP and 2.0 mg/kg of PTX. Increased levels of apoptosis within tumors were detected in P/G-NPs group by approximately 43.6% (TUNEL assay). When compared with GMP NPs, PTX NPs, and P/G-Free, P/G-NPs decreased expression of B-cell lymphoma-2 and B-cell lymphoma-extra large proteins, and increased expression of cleaved poly-ADP-ribose polymerase-1. Calreticulin expression in tumors also increased upon the co-delivery of PTX and GMP. The antitumor effect of P/G-NPs is more powerful than P/G-Free, GMP NP, or PTX NP alone, without obvious toxicity.
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Affiliation(s)
- Jing Zhang
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, China.
| | - Peng Zhang
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, China.
| | - Qian Zou
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, China.
| | - Xiang Li
- State Key Laboratory of Innovative Drug and Efficient Energy-Saving Pharmaceutical Equipment, Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, China.
| | - Jianjiang Fu
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, China.
| | - Ying Luo
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, China.
| | - Xinli Liang
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, China.
| | - Yi Jin
- National Pharmaceutical Engineering Center for Solid Preparation in Chinese Herbal Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, China.
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Hatam N, Fanusi T, Dehghani M, Vojdani R, Ramzi M, Askarian M. Economic Burden of Avoidable Hospitalizations among Patients with Cancer at Namazi Hospital in Shiraz, 2013. Asian Pac J Cancer Prev 2017; 18:177-182. [PMID: 28240514 PMCID: PMC5563097 DOI: 10.22034/apjcp.2017.18.1.177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction: Hospitalization of patients with cancer has a significant economic impact and avoidance where
unnecessary has great potential for significant cost savings for patients, individual hospitals and the health system in
general. Methods: Demographic, clinical and economical data were collected from medical records in our hospital
retrospectively. Oncology clinicians reviewed medical records to categorize each hospitalization as “potentially
avoidable” or “not avoidable.” Patient demographic and clinical data were abstracted and quantitative and qualitative
analyses were performed to identify patient characteristics and outcomes associated with potentially avoidable
hospitalizations. Finally data on the cost of the latter were estimated. Results: Of 451 hospitalizations, medical
oncologists identified 55 (12.2%) as potentially avoidable. Avoiding these and caring for the patients in alternative
locations would save some $ US 641,240 yearly. Among patients with avoidable hospitalization, 70.9% were males
and the median age and median length of stay was 55 years and 4.7 days. Most of them had general signs (83.6%) and
a fever body temperature lower than 38.5’C (96.4%). Lung, kidney and urinary tract cancers were the most common
diagnoses (10.9%). The majority of avoidable hospitalized patients had local cancer (85.5%) and poor performance
status (43.6%). The most prevalent procedure for patients with avoidable hospitalization was sonography and the least
frequent were laboratory tests and MRI. Most cases received no treatment. Conclusion: Avoidable hospitalizations are
common in patients with cancer. Age, final results of hospitalization and length of stay were established as significant
variables for patients with avoidable hospitalization.
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Affiliation(s)
- Nahid Hatam
- Department of Health Service Administration, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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