Navegando por Palavras-chave "Observational studies"

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    Conducting cost-effectiveness analyses of type 2 diabetes in low- and middle-income countries: can locally generated observational study data overcome methodological limitations?
    (Elsevier B.V., 2010-05-01) Baik, SeiHyun; Chacra, Antonio Roberto [UNIFESP]; Li Yuxiu; White, Jeremy; Gueler, Serdar; Latif, Zafar A.; Novo Nordisk Reg Int Operat AS; Korea Univ Guro Hosp; Universidade Federal de São Paulo (UNIFESP); Beijing Union Med Coll Hosp; Ankara Numune Training & Res Hosp; Bangladesh Inst Res & Rehabil Diabet Endocrine &
    In low- and middle-income countries, the high personal and economic burden of type 2 diabetes is further compounded by inadequate resources for diabetes care when compared with high-income countries. Health technology assessments (HTAs) aim to inform policy decision makers in their efforts to achieve more effective allocation of resources by providing evidence-based input on new technologies. Within the hierarchy of evidence, randomized controlled trials (RCTs) remain the 'gold standard' used to inform HTAs, but are limited by poor external validity (ie, generalizability to real-world populations). Unlike RCTs, observational studies are able to enrol broader patient populations, but their design renders such studies vulnerable to confounding factors and selection bias. However, it is increasingly recognized that observational studies can complement RCTs by supporting and extending efficacy findings from RCTs to real-world clinical practice, particularly across geographical populations. They can also provide locally relevant baseline and disease natural history data to populate health economic models. Thus, observational data are likely to be of considerable informative value to policy makers in developing countries reaching decisions on diabetes care within art environment of scarce resources. (C) 2010 Elsevier Ireland Ltd. All rights reserved.
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    Ocular histoplasmosis-like syndrome: a report from a nonendemic area
    (Conselho Brasileiro de Oftalmologia, 2007-08-01) Amaro, Miguel Hage [UNIFESP]; Muccioli, Cristina [UNIFESP]; Abreu, Mariza Toledo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To report some cases of ocular histoplasmosis-like syndrome from a nonendemica area. DESIGN: Observational case series. METHODS: This is a prospective study of 16 eyes from 8 immunocompetent patients evaluated between January 2001 to September 2005. Six patients were female and 2 male aged between 20 to 44 years, average 28 years. All patients presented clinical features that resembled ocular histoplasmosis. All patients had a negative antibody test for histoplasmosis and negative medical and laboratory evaluation of toxoplasmosis, syphilis, and tuberculosis. All patients were submitted to a complete ocular examination including fluorescein angiography. One patient was submitted to indocyanine green angiography. RESULTS: Five patients presented the classical triad of clinical features that include peripapillary scarring, histo spots, choroidal neovascularization, one patient presentd enlargement of atrophic chorioretina scar, one patient presented multiple retinal pigment epithelial detachment, one, neovascularized retinal pigment epithelial detachment. Another patient presented only histo spots. CONCLUSION: These findings of ocular histoplasmosis-like syndrome in patients with negative antibody serum test from a nonendemica area suggest that other agents could cause these similar fundus findings of ocular histoplasmosis.