RESUMO
Background and Aims: Treatments for ulcerative colitis (UC) differ in safety, efficacy, and route of administration; patient preferences for treatment attributes should be considered in treatment decisions. No study to date has explored patient preferences for moderate-to-severe UC treatment in Middle Eastern countries. Methods: A discrete-choice experiment aimed to quantify treatment preferences in patients with moderate-to-severe UC in 5 Middle Eastern countries (Saudi Arabia, Kuwait, Jordan, the United Arab Emirates, and Lebanon). Respondents chose between experimentally designed profiles for hypothetical UC treatments with varying efficacy (time until UC symptoms improve and chance of UC symptom control after 1 year), side effects (annual risk of serious infection, 5-year risk of malignancy), mode and frequency of administration, and need for occasional steroid use. A random-parameters logit model was used to estimate preference weights for these attributes, from which conditional relative importance estimates and maximum acceptable increases in risks of serious infection and malignancy were derived. Results: Among 365 adults with moderate-to-severe UC who completed the survey (mean age, 36 years; 50% female), 5-year risk of malignancy and symptom control after 1 year had the greatest conditional relative importance. Respondents were generally willing to accept statistically significant increases in annual risk of serious infection and 5-year risk of malignancy in exchange for better efficacy, changes in mode of administration and dosing schedule, and avoiding occasional steroid use. Conclusion: Of the attributes evaluated, individuals with UC in Middle Eastern countries most value avoiding 5-year risk of malignancy and a higher probability of symptom control, on average.
RESUMO
The literature on male reproductive medicine is continually expanding, especially regarding the diagnosis and treatment of infertility due to non-obstructive azoospermia. The advent of in vitro fertilization with intracytoplasmic sperm injection has dramatically improved the treatment of male infertility due to nonobstructive azoospermia. Assisted reproduction using testicular spermatozoa has become a treatment of hope for men previously thought to be incapable of fathering a child due to testicular failure. In addition, numerous studies on non-obstructive azoospermia have reported that varicocelectomy not only can induce spermatogenesis but can also increase the sperm retrieval rate; however, the value of varicocelectomy in patients with non-obstructive azoospermia still remains controversial. The purpose of this review is to present an overview of the current status of varicocele repair in men with non-obstructive azoospermia.