scholarly journals Feeding ecology of pine shoot beetles (Tomicus spp.) in tree crowns of Scots pine (Pinus sylvestris L.) stands under one-year outbreak

2008 ◽  
Vol 53 (No. 10) ◽  
pp. 445-451
Author(s):  
A. Borkowski
Keyword(s):  
Scots Pine ◽  
Average Length ◽  
Age Distribution ◽  
Similar Proportion ◽  
Tree Crowns ◽  
Marginal Part ◽  
The Difference ◽  
One Year ◽  
Pine Shoot Beetles

Studies were carried out in southern Poland during 2002–2006 in Scots pine stands under the effect of an outbreak of pine shoot beetles. The qualitative aspects of beetle feeding in tree crowns, studied on the basis of fallen shoots collected on experimental plots, are presented in this paper. The beetle numbers affected the age distribution of damaged shoots and the proportion of multiple attacks. The proportions of one-year-old shoots and the numbers of shoots with more than two attacks increased in the marginal part of the stand in the year of intensive feeding of beetles and in the subsequent year. A similar proportion of shoots with two attacks in both stands under investigations in individual study periods, with no relation to beetle numbers, does not permit to use this characteristic for forecasting purposes. The average length of tunnels in shoots attacked once reached 20 mm at maximum. The average length of tunnels (measured from the place of shoot disruption) was greater in shoots with two attacks than in shoots with a single one (<i>P</I> < 0.0001). The difference was not significant (<I>P</I> = 0.3429) only in stand B during the study season 2004–2005. The majority of the tunnels made in apical portions of shoots with two attacks damaged the tissue of apical shoots. The distance between the base of the second tunnel and the shoot apex in shoots with two attacks, and its significant (<I>P</I> < 0.01) linear relationship with the length of beetle tunnels, indicated a high nutritional quality of apical portions of shoots.

Identifying Effectors of Outcomes in Patients with Large Umbilical Hernias

2016 ◽  
Vol 82 (7) ◽  
pp. 613-621 ◽  
Author(s):  
Steven A. Groene ◽  
Davis W. Heniford ◽  
Tanushree Prasad ◽  
Amy E. Lincourt ◽  
Vedra A. Augenstein
Keyword(s):  
Umbilical Hernia ◽  
Defect Size ◽  
Long Term Outcomes ◽  
Preoperative Pain ◽  
The Mean ◽  
The Difference ◽  
One Year

Quality of life (QOL) has become an important focus of hernia repair outcomes. This study aims to identify factors which lead to ideal outcomes (asymptomatic and without recurrence) in large umbilical hernias (defect size ≥9 cm2). Review of the prospective International Hernia Mesh Registry was performed. The Carolinas Comfort Scale was used to measure QOL at 1-, 6-, and 12-month follow-up. Demographics, operative details, complications, and QOL data were evaluated using standard statistical methods. Forty-four large umbilical hernia repairs were analyzed. Demographics included: average age 53.6 ± 12.0 and body mass index 34.9 ± 7.2 kg/m2. The mean defect size was 21.7 ± 16.9 cm2, and 72.7 per cent were performed laparoscopically. Complications included hematoma (2.3%), seroma (12.6%), and recurrence (9.1%). Follow-up and ideal outcomes were one month = 28.2 per cent, six months = 42.9 per cent, one year = 55.6 per cent. All patients who remained symptomatic at one and two years were significantly symptomatic before surgery. Symptomatic preoperative activity limitation was a significant predictor of nonideal outcomes at one year ( P = 0.02). Symptomatic preoperative pain was associated with nonideal outcomes at one year, though the difference was not statistically significant ( P = 0.06). Operative technique, mesh choice, and fixation technique did not impact recurrence or QOL. Repair of umbilical hernia with defects ≥9 cm2 had a surprising low rate of ideal outcomes (asymptomatic and no recurrence). All patients with nonideal long-term outcomes had preoperative pain and activity limitations. These data may suggest that umbilical hernia should be repaired when they are small and asymptomatic.

scholarly journals Spatial distribution of losses in growth of trees caused by the feeding of pine shoot beetles Tomicus piniperda and T. minor (Col., Scolytidae) in Scots pine stands growing within range of the influence of a timber yard in southern Poland

2012 ◽  
Vol 52 (No. 3) ◽  
pp. 130-135 ◽  
Author(s):  
A. Borkowski
Keyword(s):  
Spatial Distribution ◽  
Scots Pine ◽  
Basal Area ◽  
Tomicus Piniperda ◽  
Pine Trees ◽  
Pine Stands ◽  
The Difference ◽  
High Level ◽  
Pine Shoot Beetles ◽  
Scots Pine Stands

This study deals with the assessment of increment losses in Scots pine trees caused by the maturation feeding of pine shoot beetles Tomicus piniperda (L.) and T. minor (Hart.) (Col., Scolytidae) in even-aged stands growing during their entire life span within range of the influence of a sawmill and its timber yard. In spring 2004, on three sample plots, 0.2 ha in size, situated 60, 200, and 500 m from the yard, height and dbh of all trees were measured and increment cores were taken from randomly selected sample trees. An agreement between the spatial distribution of losses in tree increments and the distribution of damage to crowns of investigated stands indicated that the losses resulted from the maturation feeding of pine shoot beetles migrating from the sawmill timber yard. Divergence of growth in the about 25-years-old stand indicated the beginning of intensive feeding of beetles in pine shoots with a high level of probability. In comparison with the control stand the basal area losses in stands growing 60 and 200 m from the beetle source amounted to 57% and 46%, respectively. The difference in the height of trees was as large as almost 100%.

Once-Daily Oral Deferasirox (Exjade®, ICL670) Versus Infusional Deferoxamine as Iron Chelation Therapy in Patients with Sickle-Cell Disease Receiving Frequent Transfusions: A Cost-Effectiveness Analysis.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5584-5584 ◽  
Author(s):  
Thomas E. Delea ◽  
Simu K. Thomas ◽  
Jean-Francois Baladi ◽  
Thomas D. Coates
Keyword(s):  
Quality Of Life ◽  
Chelation Therapy ◽  
Iron Chelation ◽  
Iron Chelator ◽  
Cell Disease ◽  
Once Daily ◽  
The Difference ◽  
One Year ◽  
The Cost

Abstract Background. Patients with sickle-cell disease (SCD) receiving chronic transfusions require chelation therapy to prevent complications from iron overload. Although deferoxamine (DFO) is an effective iron chelator, it must be administered as an 8–12 hour infusion 5–7 times per week, leading to poor compliance and/or reduced quality of life. Deferasirox (DSX) is an investigational once-daily oral iron chelator that has been shown to produce reductions in liver iron concentrations and serum ferritin similar in magnitude to those obtained with DFO. Cost-effectiveness (CE) analysis is a technique used to determine whether the benefits of new therapies are worth their additional costs. The objective of this analysis was to evaluate from a US perspective the CE of DSX versus DFO in SCD patients receiving frequent transfusions. Methods. Data from a variety of published and unpublished sources were used to estimate the CE of chelation therapy with DSX versus DFO in SCD patients receiving frequent transfusions (≥8 per year). As there are no long-term studies describing the complications of iron overload in patients with SCD, we focused on the short term (i.e., one year) costs and quality-of-life effects of chelation therapy. We assumed that patients would receive dosages (mg/kg/d) of DSX and DFO that have been found to be similarly effective in patients with SCD. To be conservative we assumed that all patients would be fully compliant with chelation therapy. CE was measured in terms of the ratio of the difference (DSX vs DFO) in costs to the difference in quality adjusted life years (QALYs) over one year of treatment. Analyses were based on the wholesale acquisition cost of generic DFO and the anticipated cost of DSX in the US. Mean weight was estimated to be 52 kg, based on data from deferasirox clinical studies. The cost of DFO administration was based on analyses of health insurance claims data for patients with transfusion-dependent anemias. Utilities (weights representing patient quality of life) were based on results of a study that used time-trade-off methods to estimate community-based preferences for oral versus infusional iron chelation therapy. Results. Total annual costs were estimated to be $1,486 greater with DSX ($22,922 vs $21,436 with DFO). Annual costs of DFO included $13,628 for drug acquisition and $7,808 for drug administration. One year of treatment with DSX is estimated to result in a gain of 0.25 QALYs (0.82 vs 0.57 with DFO). The CE of DSX versus DFO is therefore estimated to be $5,944 per QALY gained. CE of DSX versus DFO was sensitive to the assumed dosages of DSX and DFO and the cost of infusional therapy. Conclusion. In patients with SCD receiving frequent transfusions, DSX versus DFO is highly cost-effective compared with other generally-accepted treatments for patients with hematologic and oncologic disorders. These results may understate the CE of DSX, as they did not consider the potential benefits of improved compliance or side effects of infusion therapy. Further research is needed to assess the potential implication of DSX on the risk-benefit profile of transfusion therapy in patients with SCD.

scholarly journals Comparison of planting success in one-year-old spring, summer and autumn plantings of Norway spruce and Scots pine under boreal conditions

Silva Fennica ◽  
2020 ◽  
Vol 54 (1) ◽  
Author(s):  
Laura Pikkarainen ◽  
Jaana Luoranen ◽  
Antti Kilpeläinen ◽  
Teppo Oijala ◽  
Heli Peltola
Keyword(s):  
Norway Spruce ◽  
Scots Pine ◽  
Growing Season ◽  
Early Summer ◽  
Tree Planting ◽  
Central Regions ◽  
One Year ◽  
Species Specific ◽  
Planting Season

In Nordic countries, tree planting of seedlings is mainly performed during spring and early summer. Interest has increased in extending the planting window throughout the unfrozen growing season. This study compared the success of one-year-old spring, summer and autumn plantings in practical forestry in Norway spruce ( (L.) Karst.) and Scots pine ( L.) in southern and central Finland. Planting success was based on the number of viable seedlings per hectare relative to a species-specific target density. The influence of different factors to poor planting results were determined, including quality of site preparation and planting, and sources of natural damage. Overall, in Norway spruce, 85, 69 and 84% and in Scots pine 53, 55 and 40% of spring, summer and autumn plantings succeeded. In Norway spruce, the planting results were consistent between the southern and central regions, whereas in Scots pine, the success was slightly lower in the south. The poor work quality and a low density of appropriate planting spots, contributed to poor planting results, regardless of planting season, region or tree species. Considering different damages, especially mammal damage contributed to the failure of Scots pine spring plantings, whereas in summer plantings, corresponding single failure reason could not be identified. Based on our findings, extending the planting season of Norway spruce could be recommended in both regions. For Scots pine, there is still significant uncertainty about the success of summer and autumn plantings, partially due to the limited number of plantings available for analyses.Picea abiesPinus sylvestris

scholarly journals P239 A study to evaluate uptake of PROMS for IBD patients on Biologics: a sample United Kingdom district general hospital experience

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S284-S285
Author(s):  
T Mahmood ◽  
Q Muhammad
Keyword(s):  
United Kingdom ◽  
General Hospital ◽  
Leisure Activity ◽  
District General Hospital ◽  
Medical Product ◽  
Biologic Treatment ◽  
The Difference ◽  
Healthcare Interventions ◽  
One Year

Abstract Background In order to guide industry on medical product development, FDA developed an instrument to measure effectiveness as an endpoint of clinical trials. This patient oriented tool is called “Patient Related Outcomes Measures”. (PROMS). In 2009 NHS England adopted PROMS declaring that “the purpose is to collect information, from patients themselves, about how well the health service is treating them. Moreover “PROMs allows to understand the difference that healthcare interventions make to people’s quality of life”. Initially related to only certain surgical procedures, it eventually rolled out to many other conditions including IBD. This research looks at degree of success in implementation of PROMS for IBD patients on treatment with biologics in a sample district hospital of United Kingdom. Methods The IBD PROMs questionnaire is filled by patients themselves when treated with biologics. The questionnaire asks overall health status, treatment of bowel condition, effectiveness in controlling bowel condition, satisfaction with quality of treatment, Crohn’s and Colitis questionnaire CCQ12 and uses 12 dimensions: sleeping, appetite, energy level, rushing to the toilet, being bloated, incomplete emptying of bowels, blood in stool, generally unwell, faecal incontinence, nocturnal diarrhoea, passing wind and effect on leisure activity. It also has questions for patients with a stoma. We collected data from a sample district general hospital in United Kingdom for one year in retrospect and analysed the implementation of PROMS. We hoped at least 90% of patients would fill the PROMS questionnaire. Results 45 patients with IBD who were on biologics were recruited in the study. They had repeated admissions for treatment and we kept check points at 3, 6 and 12 month follow up treatments. There were 21 patients on infliximab, 23 on vedolizumab, and 1 on ustekinumab with overall total number of infusions being 352 due to their recurrent admissions for biologic treatment. A minimum of 45 PROM responses could have been achieved and maximum of 352 for good implementation. In our data only 4 were filled (8.89% of minimum and 1.1 of maximum required). Thus PROMS for IBD was not implemented to any useful extent. Conclusion Our study did not look at the outcomes, but simply whether the PROMS was utilised sufficiently for IBD patients on biologics. We demonstrated low uptake by one sample district general hospital of United Kingdom. Further studies to evaluate practice of other IBD units in the country would help to understand the situation better. There can be various reasons for this low uptake including lack of resource, not knowing importance of PROMS or deficient motivation in staff.

scholarly journals The Needles and Shoots Structure Variability of Polish Populations of Scots Pine (Pinus sylvestris L.) at a 50-Years-Old Provenance Experiment in Central Poland

2020 ◽  
Vol 3 (1) ◽  
pp. 32
Author(s):  
Włodzimierz Buraczyk ◽  
Marcin Czacharowski ◽  
Agata Konecka ◽  
Mirela Tulik ◽  
Henryk Szeligowski ◽  
...  
Keyword(s):  
Scots Pine ◽  
Dry Mass ◽  
Individual Variability ◽  
Climatic Conditions ◽  
Important Species ◽  
Anatomical Features ◽  
Central Poland ◽  
Pine Trees ◽  
One Year

The analysis of population variability usually concerns the adaptability of trees to changing climatic conditions and their timber production possibilities. It is already known that several phenotypic and genotypic features determine the adaptation possibilities of a population and every population of a given species may have different adaptability to climatic conditions. The assimilation apparatus is an important phenotypic feature that has a large impact on the functioning of tree organisms and their adaptability. Scots pine, which covers vast areas of Europe, is a very important species in the context of ecosystems’ sustainability preservation, especially in the era of global warming. Therefore, in our research, the inter-population and individual variability of morpho-anatomical features of shoots and needles were analyzed. Nine national origins of Scots pine (three populations each from northern, western, and central Poland), which are a part of a 50-year provenance experiment, were compared. Fragments of one-year-old shoots (5 cm long) with needles were collected from the top parts of tree crowns. An extensive analysis of the morphological parameters of the needles (length and width, density, dry mass) and the anatomical features of the shoots (thickness, the share of bark, wood, and pith) was performed. Our surveys showed that the differences between populations are much greater than between regions. The western pine populations, which have shown the highest volume of wood per ha, had the thickest shoots but the lowest dry mass. The northern populations, highly valued for the very good technical quality of wood, had thin shoots. Pine trees from central Poland had the highest density and dry mass of needles and the highest share of wood in shoots.

High Estrogen in Men After Injectable Testosterone Therapy

2014 ◽  
Vol 9 (3) ◽  
pp. 229-234 ◽  
Author(s):  
Robert S. Tan ◽  
Kelly R. Cook ◽  
William G. Reilly
Keyword(s):  
Age Distribution ◽  
Age Groups ◽  
The United States ◽  
Testosterone Therapy ◽  
Chi Square ◽  
Receptor Modulator ◽  
Chi Square Test ◽  
The Difference ◽  
Estradiol Levels

Testosterone replacement improves quality of life and is aromatized in men in adipose tissues to estrogen. Hyperestrogenism is believed to be harmful to male sexuality. This is a description of our experience of screening 34,016 men in the Low T Centers, of which approximately 50% were converted to treatment. Men were treated with injectable testosterone, and we have available data from 2009 to 2014. The data were extracted from our electronic health record (AdvancedMD) of 35 Low T Centers across the United States. In all, 7,215 (20.2%) out of the 34,016 patients had high estradiol levels defined as ≥42.6 pg/ml. Estradiol was measured using electro-chemiluminescence immunoassay. Of the patients who had high estradiol levels, the age distribution was as follows: 132/989 (13.3%) were older than 65 years, 3,753/16,955 (22.1%) were between 45 and 65 years; 2,968/15,857 (18.7%) were between 25 and 44 years, 7/215 (3.3%) were younger than 25 years. The difference between extreme age groups (<25 and ≥65) was statistically significant using a chi-square test ( p = .013). The correlation coefficient of serum estradiol to age was .53, SD = 8.21. It was observed that practitioners used aromatase inhibitor and selective estrogen receptor modulator to treat symptoms of hyperestrogenism, irrespective of blood estradiol levels. Gynecomastia was rarely documented as a reason for the prescription. Our finding was that high estradiol levels were not associated with higher rates of low libido but established higher rates of documented low libido with those with normal or lower estradiol levels. The difference was statistically significant ( p < .05).

scholarly journals The influence of external and internal factors on the quality of semen collection and qualitative indicators of semen in the dog (Canis familiaris)

2011 ◽  
Vol 59 (6) ◽  
pp. 373-380 ◽  
Author(s):  
Marie Vágenknechtová ◽  
M. Hošek ◽  
L. Máchal ◽  
G. Chládek
Keyword(s):  
Average Length ◽  
Sperm Concentration ◽  
Internal Factors ◽  
Freedom Of Movement ◽  
The Third ◽  
Semen Collection ◽  
Average Activity ◽  
The Difference ◽  
Police Forces

The influence of external and internal factors on the course of semen collection and quality of ejaculate has been evaluated in this work. This observation included 30 dogs of various breeds, each of which we collected 3 ejaculates from within one week (first, third and fifth day). The internal factors included the weight of the dog, order of semen collection and the age of the dog. The external factors included type of housing, utilization of the dog, point of the collection and type of nutrition. Average length of preparation of a dog for a collection and onset of sexual reflex was 95.7 sec. The observations showed that none of the evaluated internal factors had any influence on the length of preparation for the semen collection. The largest volume of ejaculate was collected from the first collection (10.5cm3), at the second collection it was 8.9 cm3 and the third one the volume was the smallest – with only 6.6 cm3. The average volume of 8.7 cm3 was found in the whole set of observed dogs. No statistically conclusive difference was found among groups. The average activity of sperm in the observed set was 68.8%. Activity declined from the first to the third collection from 73% to 65.5%. The difference in sperm activity was not statistically conclusive in any indicator. Sperm concentration in whole set of dogs was 143.6 103.mm−3 and was not significantly affected by any monitored internal factors.The longest preparation for the collection was found in dogs housed in pens (134.4 sec), dogs living in households (84.7 sec) and the shortest preparation was needed in dogs with freedom of movement. The longest onset of sexual reflexes was found in Police forces dogs, then family dogs and sport dogs (130.0 sec, 97.8 sec and 68.3 sec). In dogs collected in laboratory, the emergence of sexual reflex was longer (110.7 sec) than in dogs collected in their own natural environment (80.7 sec). The average length of the whole ejaculation was 396.0 sec in the whole set of dogs. The longest ejaculation was found in dogs held home (468.0 sec), the shortest in dogs with freedom of movement (290.0 sec). Family dogs had the longest ejaculation time, Police forces dogs had the shortest. The highest volume of semen was found in dogs kept in households (11.0 cm3), the smallest volume was in dogs with freedom of movement (4.2 cm3). Dogs used in sport, family dogs and Police forces dogs had the volume of semen 12.7 cm3, 6.3 cm3 and 5.7 cm3. Statistically highly significant differences in the activity of sperm was found between dogs with freedom of movement (35.0%) and dogs kept in pens and household of the breeder (77.8%, respectively 77.0%), between Police dogs (49.4%) and sport dogs (76.7%) and family dog (77.8%), as well as in the place of collection (P ≤ 0.01). The lowest sperm concentration was found in dogs kept in households (124.103.mm−3), in dogs kept in pens (152.103.mm−3), the highest sperm concentration was in dogs with freedom of movement (180.103.mm−3). Police, sport and family dogs had the concentration of 175.103.mm−3, 126,5.103.mm−3, respectively 135,0.103.mm−3. Dogs collected in household had the average sperm concentration 102.7.103.mm−3, compared to the sperm concentration of dogs collected in the laboratory (184.5.103.mm−3).

scholarly journals Longitudinal Differences in Scots pine Frost Hardiness

2004 ◽  
Vol 53 (1-6) ◽  
pp. 76-80 ◽  
Author(s):  
Bengt Andersson ◽  
A. Fedorkov
Keyword(s):  
Scots Pine ◽  
Komi Republic ◽  
Climatic Conditions ◽  
Frost Hardiness ◽  
Clinal Variation ◽  
Narrow Sense Heritability ◽  
Seed Sources ◽  
Significant Difference ◽  
The Difference ◽  
One Year

Abstract The autumn frost hardiness of Scots pine (Pinus sylvestris L.) populations from Scandinavia (57°28’-68°54’ N, 13°00’-27°00’ E) and the Komi Republic in Russia (61°30’-64°20’ N, 49°10’-54°50’ E), and open pollinated families from a population in Komi (61°43’ N, 51°07’ E) were examined in artificial freezing tests with one-year-old seedlings. The aims were to estimate genetic variation in hardiness between families of Russian origin and to compare populations of Russian (continental) and Scandinavian (maritime) origins. The longitudinal distance between the Scandinavian and Russian seed sources was associated with a significant difference in climatic conditions. At latitude 63°N the degree of continentality (the difference between July and January monthly mean temperatures) was 23.7°C for longitude 15°E in Sweden and 35.2°C for longitude 54°E in Komi. The narrow-sense heritability of frost hardiness calculated for the Russian families was 0.22. This indicates relatively high genetic control of the trait, of similar magnitude as earlier shown for populations of Scandinavian origin. Both Scandinavian and Russian populations showed a strong clinal variation in frost hardiness, northern populations being the hardiest. In addition, Russian populations were more frost hardy than Scandinavian ones from corresponding latitudes and attained the same level of hardiness as Scandinavian populations from 4.1° latitude further north. The results indicate that the longitude or continentality of the origins of Scots pine populations is associated with adaptive pressures that have significant effects on hardiness and are distinct from photoperiodic effects. When enriching breeding or production populations by including populations from remote origins it is essential to recognize not only latitudinal origin, but also longitudinal origin or temperature regime, in order to match material to the planned utilization areas.

Cost-Effectiveness Analysis of Oral Iron Chelation Therapy with Deferasirox (Exjade®, ICL670) Versus Infusional Chelation Therapy with Deferoxamine in Patients with Transfusion-Dependent Myelodysplastic Syndrome.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5585-5585 ◽  
Author(s):  
Thomas E. Delea ◽  
Simu K. Thomas ◽  
Jean-Francois Baladi ◽  
Pradyumna D. Phatak
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
Chelation Therapy ◽  
Iron Chelation ◽  
Iron Chelator ◽  
Iron Chelation Therapy ◽  
The Difference ◽  
One Year ◽  
The Cost

Abstract Background. Patients with symptomatic myelodysplastic syndrome (MDS) frequently receive chronic transfusions, along with chelation therapy to prevent complications of iron overload. Deferoxamine (DFO) is an effective iron chelator, but must be administered as an 8–12 hour infusion 5–7 times per week, leading to poor compliance and/or reduced quality of life. Deferasirox (DSX) is an investigational once-daily oral iron chelator that has been shown to produce reductions in liver iron concentrations and serum ferritin similar to those obtained with DFO. The objective of this analysis was to evaluate from a US perspective the cost-effectiveness (CE) of DSX vs DFO in patients with transfusion-dependent MDS. Methods. Data from a variety of published and unpublished sources were used to estimate the CE of chelation therapy with DSX vs DFO in MDS patients receiving frequent transfusions (≥8 per year). As there are no long-term studies describing the complications of iron overload in MDS, we focused on the short-term (i.e., one year) cost and quality-of-life effects of chelation therapy. As comparative data for DSX vs DFO in MDS are unavailable, we estimated the average dose (mg/kg/d) of DSX based on results for MDS patients in a non-comparative Phase II study. The relative dose of DFO that would result in similar efficacy was based on data from comparative studies in other transfusion-dependent anemias. To be conservative, we assumed that all patients would be fully compliant with chelation therapy. CE was measured in terms of the ratio of the difference (DSX vs DFO) in costs of chelation therapy to the difference in quality adjusted life years (QALYs) over one year of treatment. Analyses were based on the wholesale acquisition cost of generic DFO and the anticipated cost of DSX in the US. Mean weight was estimated to be 70 kg, based on data for MDS patients in DSX clinical studies. The cost of DFO administration was based on analyses of health insurance claims data for patients with transfusion-dependent anemias. Utilities (weights representing patient quality of life) for MDS patients receiving transfusions were based on published data for patients with anemia from metastatic cancer. The difference in quality of life for DSX vs DFO was based on results of a study that used time-trade-off methods to estimate community-based preferences for oral vs infusional iron chelation therapy. Results. Total annual costs are estimated to be $7,679 greater with DSX ($35,672 vs $27,993 with DFO). Annual costs of DFO included $20,185 for drug acquisition and $7,808 for drug administration. One year of treatment with DSX is estimated to result in a gain of 0.23 QALYs (0.78 vs 0.55 with DFO). The CE of DSX vs DFO is therefore estimated to be $33,387 per QALY gained. CE of DSX vs DFO was sensitive to the assumed dosages of DSX and DFO, the cost of infusional therapy, and the decrement in quality of life associated with infusional therapy. Conclusion: The CE of DSX versus DFO in patient with transfusion-dependent MDS is favorable compared with that of other generally-accepted treatments for patients with hematologic/oncologic disorders. These results may be conservative, as they did not consider the potential benefits of improved compliance with DSX or side effects of infusion therapy.

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