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Background: The rapid development of multiple myeloma (MM) management underscores the value of real-world data. In our study we examined 509 adult MM patients treated with immunochemotherapy (ICT) with/without stem cell transplantation (SCT) from 2013 to 2019 in the Hospital District of Helsinki and Uusimaa, Finland. Materials & methods: Our study was based on computational analyses of data integrated into the hospital data lake. Results: After 2017, treatment pattern diversity increased with improved access to novel treatments. 5-year survivals were 74.4% (95% CI: 65.5-84.5) in SCT-eligible and 44.0% (95% CI: 37.6-51.4) in non-SCT subgroups. In the SCT-eligible subgroup, high first-year hospitalization costs were followed by stable resource requirements. Conclusion: Hospital data lakes can be adapted to carry out complex analysis of large MM cohorts. more...

Background: To assess the cost-utility of vortioxetine versus relevant comparators (agomelatine, bupropion SR, sertraline, and venlafaxine XR) in the finnish setting in major depressive disorder (MDD) patients with inadequate response to selective serotonin- /serotonin-norepinephrine reuptake inhibitors., Methods: A one-year analysis was conducted using a decision tree with a Markov state transition component. The health states were remission, relapse and recovery. A Finnish healthcare payer perspective was adopted., Results: Vortioxetine was less costly and more effective versus all comparators in both direct and societal perspectives. Vortioxetine reduced the average annual direct costs by 4% versus venlafaxine XR and 8% versus sertraline. The greater efficacy associated with vortioxetine was translated into a higher percentage of patients in remission and recovery. The model was most sensitive to changes in remission rates at 8 weeks., Conclusion: This cost-utility analysis showed vortioxetine to be a good alternative for MDD patients switching therapy in Finland. more...

In an experimental study on dogs, effects of intra-aortic balloon pumping (IABP) on acute myocardial ischaemia without marked cardiac failure were analyzed. With the use of epicardial ST-segment recording IABP was shown to significantly reduce ischaemia when pumping was initiated 10 minutes after left anterior descending coronary artery ligation. Prior to coronary ligation the mean ST-segment height was 6.4 +/- 0.8 mV (mean +/- SE) and 10 minutes after the ligation it was 21.5 +/- 4.6 mV. During pumping ST-segment elevation increased to 6.9 +/- 0.7 mV. A dual-chambered intra-aortic balloon was used, and six dogs were treated with IABP. In the control dog no tendency to spontaneous ST-segment decrease was seen. more...

Total oxygen delivery (cardiac output X arterial oxygen content) and oxygen consumption were determined in 22 patients undergoing one-lung ventilation (OLV) during thoracotomy. In 11 patients, anaesthesia was maintained with halothane-oxygen and in another 11 patients with nitrous oxide-oxygen-analgesic combination (FIO2 0.5). During OLV, oxygen delivery was greater in the halothane group and these patients tended to show a decrease in oxygen consumption compared with the patients of the nitrous oxide group. Therefore, as far as total oxygen balance (oxygen delivery/oxygen consumption) during OLV is concerned, halothane-oxygen maintenance provides a greater margin of safety than nitrous oxide-oxygen-analgesic combination. However, in spite of occasional hypoxaemic episodes, none of our patients receiving 50% nitrous oxide in oxygen showed an oxygen delivery coefficient (oxygen delivery/oxygen consumption) significantly smaller than the predicted normal value for an unanaesthetized patient. This finding may explain why this anaesthetic technique has been used without apparent harm during OLV in patients with unimpaired cardiovascular function. more...