Cost-effectiveness analysis of once-weekly semaglutide vs. once-daily liraglutide administered subcutaneously in patients with overweight and obesity: a decision analysis.

OBJECTIVE: Obesity presents an enduring and multifaceted dilemma that impacts individuals, society, economies, and healthcare systems alike. Glucagon-like peptide-1 (GLP-1) receptor agonists, including liraglutide and semaglutide, have received FDA approval for obesity treatment. This study aims to present a cost-effectiveness analysis to compare the cost and clinical outcomes of semaglutide vs. liraglutide on weight loss in people with overweight and obesity. MATERIALS AND METHODS: A cost-effectiveness analysis was conducted to compare the cost and the clinical outcomes of adding weekly 2.4 mg SC semaglutide vs. daily 3.0 mg SC liraglutide or placebo to physical activity and diet control in overweight and obese patients. A clinical outcome of achieving ≥15% weight loss was chosen. A simple decision analysis model from a third-payer perspective was applied. Drug costs were based on the retail price of the USA market. One-way sensitivity analyses were performed. RESULTS: Results showed that 2.4 mg weekly semaglutide, when added to physical activity and diet control, was the most cost-effective choice in terms of ≥15% weight loss (ICER: $ 7,056/patient/68 weeks). The model was robust against the 50% increase in the unit cost of semaglutide and the 50% decrease in the unit cost of liraglutide, as well as the changes in probabilities by the corresponding 95% confidence intervals across the model. CONCLUSIONS: This cost-effectiveness analysis suggests that employing once-weekly 2.4 mg semaglutide emerges as a remarkably cost-effective option when contrasted with once-daily 3.0 mg liraglutide in patients with overweight and obesity when added to physical activity and diet control.

Photo-curable carboxymethylcellulose composite hydrogel as a promising biomaterial for biomedical applications.

A series of carboxymethylcellulose (CMC) functionalized with glycidyl methacrylate (GMA) was successfully synthesized for producing of CMC-g-GMA copolymer. Water-soluble CMC-g-GMA copolymer was photo-crosslinked while Irgacure-2959 was used as a UV-photo-initiator at 365 nm. On the other hand, cellulose nanocrystals (CNCs) from sugarcane were graft-copolymerized in an aqueous solution utilizing cerium ammonium nitrate (CAN) as an initiator in a redox-initiated free-radical approach. CNCs were grafted with GMA to enhance their physicochemical and biological characteristics. Factors affecting hydrogel formation, e.g. CMC-g-GMA copolymer concentration, irradiation time and incorporation of different concentration of CNCs-g-GMA nano-filler, were discussed in dependance on the swelling degree and gel fraction of the produced hydrogels. Notably, the addition of CNCs-g-GMA nanofillers increased progressively thermal stability of the prepared hydrogel. CMC-g-GMA filled with CNCs-g-GMA composite hydrogel showed antimicrobial activity against multidrug resistance pathogens. Thus, CMC-g-GMA filled with CNCs-g-GMA composite hydrogel could be endorsed as compatible biomaterials for versatile biomedical applications.

Retentiveness of metal coping luted to teeth of uremic patients undergoing hemodialysis using five different luting cements.

OBJECTIVES: This study aimed to assess the retention of metal copings luted to uremic teeth with five different luting agents. METHODS: A total of 35 sound natural molars was collected from uremic patients and randomly assigned into five groups (n=7). The teeth were prepared for metal copings using diamond tips and water coolant. Metal copings with a loop on the occlusal surface were fabricated using base metal alloy (Rexillium III). The copings were luted using Fuji I, glass ionomer (GI); Fuji Plus, resin-modified glass ionomer (RMGI); Panavia F 2.0, resin cement; Rely X Unicem, self-adhesive cement (SA); and Adhesor, zinc phosphate cement (ZPh). All specimens were incubated at 37°C for 24 hours, conditioned in artificial saliva for 7 days, and then thermocycled for 5000 cycles (5°C-55°C). The dislodging force was measured using a universal testing machine at a crosshead speed of 2 mm/min. The mode of failure of the loaded adhesive copings was evaluated. Statistical analyses were performed using one-way analysis of variance and Tukey post hoc test. RESULTS: GI and SA cements had the highest and the lowest mean retentive strength, respectively (580.90±17.3, 406.6±12.7). There was no significant difference between ZPh, SA, and resin cements. These cements were inferior to GI and RMGI cements (p<0.05), which showed statistically similar retentive strengths. CONCLUSIONS: The results of this study support the use of glass ionomer and resin-modified glass ionomer cements for luting of metal copings to uremic teeth with retentive preparations.

Does nickel allergy play a role in the development of in-stent restenosis?

OBJECTIVES: It was suggested that coronary in-stent restenosis might be triggered by allergy to nickel and molybdenum ions released from stainless-steel stents. We sought to explore any possible relationship between nickel allergy and in-stent restenosis. MATERIALS AND METHODS: 50 patients were studied, who underwent elective follow-up coronary angiography for recurrent symptoms after prior coronary stenting, at least 3 months following the index procedure. Consecutively, we enrolled 25 patients with > or = 50% in-stent restenosis (study group), and 25 others with < 50% restenosis (control group), as revealed by coronary angiography. Evaluation for nickel allergy was performed using 5% nickel sulphate solution in petroleum applied as a patch test to the interscapular region by the Finn chamber method. A positive test was defined as an inflammatory response with erythema, edema, papulovesicles, or infiltration after 48 or 72 hours. RESULTS: The mean age of the whole study cohort was 55.9 +/- 13.9 years, 44 (88%) being males. Two patients of the study group (8%) had a history of contact allergy to metals. However, both of them showed a negative patch test result. No patient in the control group had a history of metal allergy (p > 0.05). Only one patient in the study group (4%) had a positive patch test result for nickel contact allergy, whereas all patients in the control group had a negative result (p > 0.05). CONCLUSIONS: Based on the available evidence, a cause-effect relationship between nickel allergy and in-stent restenosis cannot be confirmed.