Recenti progressi in medicina
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The CoViD-19 pandemic has provided the opportunity for the health care's digital revolution with the unprecedented accelerated expansion of telehealth, telemedicine and other digital health tools. Several tools have been developed and launched at national and international level to face the emergency, including tools to perform online triage, symptoms checking, video visits and remote monitoring, and to conduct local and national epidemiological surveillance studies. ⋯ The growth in telemedicine services and in digital health technologies could not have occurred without important telehealth regulatory changes that have occurred in some countries aimed at promoting their use to face the CoViD-19 emergency, such as the deregulation of the use of video conferencing and video chat systems to carry out video visits, and the payment parity between telehealth and in clinic care. In order to decide whether to continue using these tools even after the pandemic is over, it could be useful to perform validation and efficacy studies of these tools to study their implications on the doctor-patient relationship, to understand if the new features can be integrated with the other technological tools already in use, and if they can improve clinical practice and quality of care.
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Checkpoint inhibitors immunotherapy was a breakthrough in anti-tumor treatments. Anti-PD-1 monoclonal antibodies are now a standard of treatment for advanced melanoma patients, with a 3-year overall survival of over 50% and a low rate (<20%) of severe toxicities in the phase 3 studies. The aim of this review was to report the most important updates on anti-PD-1 drug pembrolizumab from ASCO (American Society of Clinical Oncology) and ESMO (European Society for Medical Oncology) 2017 Annual Meetings.
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The treatment of advanced melanoma underwent a complete revolution over the last years. Targeted therapy and immunotherapy marked the beginning of a new management model for cancer. Targeted therapies are drugs directed exclusively against specific molecules in order to modulate their action. ⋯ Since Food and Drug Administration (FDA) approval of ipilimumab in 2011, many other molecules have been investigated. Recently, anti-PD-1 (nivolumab and pembrolizumab) achieved promising results. The aim of this review is to trace the history of nivolumab, through major Phase I, II and III studies until FDA and European Medicines Agency approval.
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The respiratory allergies, including allergic rhinitis and allergic asthma, represent a substantial medical and economic burden worldwide. Despite their dimension and huge economic-social burden, no data are available on the costs associated with the management of respiratory allergic diseases in Italy. The objective of this study was to estimate the average annual cost incurred by the National Health Service (NHS), as well as society, due to respiratory allergies and their main co-morbidities in Italy. ⋯ To our knowledge, this is the first study in which direct costs (incurred by NHS) and indirect ones (incurred by the society) were taken into account to estimate the overall burden associated with respiratory allergies and their main co-morbidities in our Country. In conclusion, this work may be considered an efficient tool for public decision-makers to correctly understand the economic aspects involved by the management and treatment of respiratory allergies-induced diseases in Italy.
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The respiratory allergies, including allergic rhinitis and allergic asthma, represent a substantial medical and economic burden worldwide. Despite their dimension and huge economic-social burden, no data are available on the costs associated with the management of respiratory allergic diseases in Italy. The objective of this study was to estimate the average annual cost incurred by the National Health Service (NHS), as well as society, due to respiratory allergies and their main co-morbidities in Italy. ⋯ To our knowledge, this is the first study in which direct costs (incurred by NHS) and indirect ones (incurred by the society) were taken into account to estimate the overall burden associated with respiratory allergies and their main co-morbidities in our Country. In conclusion, this work may be considered an efficient tool for public decision-makers to correctly understand the economic aspects involved by the management and treatment of respiratory allergies-induced diseases in Italy.