Browsing by Author "Silva, C"
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- Análise económica do rituximab, em associação com ciclofosfamida, vincristina e prednisolona no tratamento de doentes com linfoma folicular avançado em PortugalPublication . Braga, P; Carvalho, S; Gomes, M; Guerra, L; Lúcio, P; Marques, H; Negreiro, F; Pereira, C; Silva, C; Teixeira, AOBJECTIVE: Evaluate costs and benefits of rituximab in combination with cyclophosphamide/vincristine/prednisolone chemotherapy regimen (R-CVP), in previously untreated patients with indolent non-Hodgkin lymphoma (NHL), compared to CVP alone from a Portuguese National Health System (NHS) perspective. METHODS: Cost-effectiveness (Life Years Gained--LYG) and cost-utility analysis (Quality Adjusted Life Years--QALYs) were performed for a time horizon of 10 years, according to a Markov economic model with three health states (progression free survival, progression and death) and monthly cycles for a population of previously untreated patients with indolent NHL. Data from a phase III clinical trial was used and expanded to include unpublished 53-month median follow-up data. Survival after first-line therapy was estimated from the Scotland and Newcastle Lymphoma Group registry data and utilities were derived from a study in the UK performed in patients with follicular lymphoma. Resource consumption was estimated by a Portuguese expert panel (Delbecq Panel). Costs were calculated from the Portuguese NHS perspective through official data with prices updated to 2008. Only direct medical costs were considered. Costs and clinical outcomes were discounted at 5% per annum. Deterministic and probabilistic sensitivity analysis were performed around assumptions on the time horizon, costs, utilities and excess mortality rate due to progression applied in the base-case analysis. RESULTS: The 10-year base-case analysis showed a lower total cost per patient with CVP alone (€ 85,838) in comparison with R-CVP (€ 87,774). Life expectancy and Quality adjusted life expectancy per patient were higher with R-CVP (6.361 and 4.166, respectively) than with CVP alone (5.557 and 3.438, respectively), representing increases of 0.804 in LYG and 0.728 (8.7 months) in QALYs gained. The incremental cost per LYG was € 2,407 and the incremental cost per QALY gained was € 2,661. The probabilistic sensitivity analysis confirmed the robustness of the base-case analysis results. CONCLUSIONS: This study demonstrates that the combination R-CVP in previously untreated indolent NHL patients improves life expectancy and is a cost-effective alternative to CVP in Portugal.
- Carcinoma do rim. Experiência do serviço de urologia do Hospital de São Marcos (1997-2002)Publication . Cabral-Ribeiro, J; Sousa, L; Carvalho, AP; Mendes, V; Silva, C; Garcia, P; Ribeiro dos Santos, A
- Cistite Incrustada Alcalina: Caso clínicoPublication . Cabral-Ribeiro, J; Mendes, V; Silva, C; Ribeiro dos Santos, AA cistite incrustrada alcalina é uma patologia inflamatória crónica pouco frequente caracterizada pela incrustação de sais inorgânicos na mucosa vesical. São factores condicionantes do seu aparecimento a existência de lesão mucosa prévia, infecção urinária por bactérias urealíticas e urina alcalina. Apresenta-se caso clínico de cistite incrustada alcalina associada a infecção urinária por Staphylococcus simulans, a propósito do qual se faz breve referência aos aspectos clínicos, etiopatogénicos e de tratamento desta patologia.
- Fístulas enterovesicais. Revisão a propósito de dois casos clínicos.Publication . Cabral-Ribeiro, J; Silva, C; Sousa, L; Mesquita Robrigues, A; Ribeiro dos Santos, A
- Leiomioma da bexiga simulando neoplasia do úracoPublication . Cabral-Ribeiro, J; Sousa, L; Silva, C; Garcia, P; Mendes, V; Ribeiro dos Santos, AAs neoplasias de origem mesenquimatosa da bexiga são raras. Os leiomiomas representam a neoplasia mesenquimatosa benigna mais frequente da bexiga compreendendo de 0.2 a 0.5% de todos os tumores vesicais. A apresentação clínica é extremamente variável dependendo sobretudo da localização do tumor (intramural, extramural ou submucoso). Apresentamos um caso clínico de um leiomioma de localização ao nível da cúpula/superfície anterior de bexiga, de crescimento extramural que simulou neoformação do úraco.
- Penile fracture: review of 7 casesPublication . Cabral-Ribeiro, J; Sousa, L; Silva, C; Mendes, V; Garcia, P; Santos, A
- Squamous cell carcinoma in bladder extrophyPublication . Cabral-Ribeiro, J; Silva, C; Sousa, L; Pérez García, D; Ribeiro dos Santos, ABladder extrophy is a rare congenital malformation that nowadays is surgically corrected in neonatal period. We present a case report of a 71-year-old male with a verrucous squamous cell carcinoma arising in a classical uncorrected form of bladder extrophy.
- Testicular epidermoid cyst: Ultrasound and MR typical findings with macroscopy correlationPublication . Pires-Gonçalves, L; Silva, C; Teixeira, M; Costa-Dias, S; Sousa-Mendes, V
- Testicular epidermoid cyst: Ultrasound and MR typical findings with macroscopy correlationPublication . Pires-Gonçalves, L; Silva, C; Teixeira, M; Costa-Dias, S; Sousa-Mendes, V