All amounts were converted to year 2007 dollars. To minimize costs associated with the early learning curve, the Selleck LXH254 initial 50 EVAR patients between December 1995 and 1998 were excluded. Patients with <1 year follow-up were also excluded. Data are expressed as mean +/- standard error.
Results: The mean follow up after EVAR for 152 patients was 38.8 +/- 1.8 months. Medicare, capitated insurance, and commercial insurance provided coverage for 85 (56.0%), 49 (32.2%), and 18 (11.8%) patients,, respectively. The cumulative 5-year postplacement reimbursement received per patient was $9792 meeting 81.4% of the cumulative
cost of $12,027 for a net loss of $2235 per patient. Although 123 (80.9%) patients without secondary procedures generated
a 5-year cumulative gain of $1830 per patient, 29 (19.1%) patients with secondary procedures averaged a 5-year cumulative loss of $9378 per patient. The average reimbursement rate over the S-year period was 35.8% +/- 0.6%, with the lowest reimbursement rate seen in patients with Medicare at 31.6% +/- 0.7%.
Conclusion: Current reimbursement is not sufficient to meet the costs associated with long-term, surveillance and needed secondary procedures after EVAR. Inadequate reimbursement of costs associated with secondary procedures was the primary driver for the net institutional loss. Reimbursement for Outpatient radiological procedures generated a modest surplus. (T Vasc Surg 2008;48:1390-5.)”
“Introduction: The nucleoside analogue [F-18]fluorothymidine MM-102 manufacturer (FLT) has been designed as a marker of cell proliferation that can be imaged buy GW4064 in vivo by positron emission tomography. Clinical pilot studies have demonstrated decreasing FLT uptake following antiproliferative chemotherapy of breast cancer. However, the significance of posttreatment FLT uptake has not been evaluated at the cell level. The aim
of this study was to investigate whether FLT uptake detects proliferation inhibition induced by docetaxel or doxorubicin treatment in an in vitro breast cancer model.
Methods: Breast cancer cells (MCF-7) were treated with docetaxel or doxorubicin for 24 h at drug doses inducing 25-99% inhibition of clonogenic survival (IC25 to IC99). Cellular FLT uptake was estimated at 4 h and at 1, 3 and 5 days interval from chemotherapy. [H-3] Thymidine incorporation and S-phase fraction were measured for comparison. Analysis of variance and the Bland-Altman difference plot were employed for statistical analysis.
Results: After treatment, FLT uptake was declined in dependence of the proliferation inhibition mediated by both chemotherapeutic agents (all P <.0001). The decrease of FLT was greater after doxorubicin treatment than after the corresponding docetaxel dose. With doxorubicin (IC99), FLT accumulation was reduced by 70% as early as 4 h after treatment. FLT uptake was closely correlated to [H-3]thymidine incorporation and S-phase fraction (r=.84 to .93).