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Zaključak: Naša studija je pokazala visoku dijagnostičku vrednost MR enteroklize u predikciji aktivne faze Kronove bolesti. Uvod: Kronova bolest je hronična inflamatorna bolest creva koja ima najveću učestalost u mlađoj populaciji. CT enterokliza je osnovna radiološka metoda koja se koristi u dijagnostici i praćenju pacijenata sa Kronovom bolešču, međutim sa sobom nosi značajno izlaganje pacijenta jonizujućem zračenju. Cilj: Zbog rastućeg značaja MR enteroklize u dijagnostici Kronove bolesti, kao i malog broja dosadašnjih istraživanja, cilj ovog rada bio je da se ispita dijagnostička tačnost ove metode u evaluaciji pacijenata sa akutnom fazom Kronove bolesti. Materijal i metode: Istraživanje je obuhvatilo 25 pacijenata sa Kronovom bolešću (18 muškaraca i 7 žena, prosečne starosti 31±10), a na osnovu kolonoskopskih nalaza svi pacijenti su podeljeni u dve grupe: pacijenti sa aktivnom i pacijenti sa hroničnom Kronovom bolešću. Svi MR pregledi rađeni su na aparatu jačine 1.5T (GE, Healthcare). Kroz nazojejunalni kateter je brzinom od 75ml/sec ubrizgavano 1.5-2 l rastvora polietilen glikola (PEG). Rezultati: Površina ispod ROC krive za predikciju aktivne bolesti iznosila je 0.966 (0.918-1.014), dok su maksimalna senzitivnost i specifičnost bile 91% i 89%.

ImportanceRetinal vein occlusion is the second most common retinal vascular disease. Bevacizumab was demonstrated in the Study of Comparative Treatments for Retinal Vein Occlusion 2 (SCORE2) to be noninferior to aflibercept with respect to visual acuity in study participants with macular edema due to central retinal vein occlusion (CRVO) or hemiretinal vein occlusion (HRVO) following 6 months of therapy. In this study, the cost-utility of bevacizumab vs aflibercept for treatment of CRVO is evaluated.ObjectiveTo investigate the relative cost-effectiveness of bevacizumab vs aflibercept for treatment of macular edema associated with CRVO or HRVO.Design, Setting, and ParticipantsThis economic evaluation study used a microsimulation cohort of patients with clinical and demographic characteristics similar to those of SCORE2 participants and a Markov process. Parameters were estimated and validated using a split-sample approach of the SCORE2 population. The simulated cohort included 5000 patients who were evaluated 100 times, each with a different set of characteristics randomly selected based on the SCORE2 trial. SCORE2 data were collected from September 2014 October 2019, and data were analyzed from October 2019 to July 2021.InterventionsBevacizumab (followed by aflibercept among patients with a protocol-defined poor or marginal response to bevacizumab at month 6) vs aflibercept (followed by a dexamethasone implant among patients with a protocol-defined poor or marginal response to aflibercept at month 6).Main Outcomes and MeasuresIncremental cost-utility ratio.ResultsThe simulation demonstrated that patients treated with aflibercept will have an expected cost $18 127 greater than those treated with bevacizumab in the year following initiation. When coupled with the lack of clinical superiority over bevacizumab (ie, patients treated with bevacizumab had a gain over aflibercept in visual acuity letter score of 4 in the treated eye and 2 in the fellow eye), these results demonstrate that first-line treatment with bevacizumab dominated aflibercept in the simulated cohort of SCORE2 participants. At current price levels, aflibercept would be considered the preferred cost-effective option only if treatment restored the patient to nearly perfect health.Conclusions and RelevanceWhile there will be some patients with CRVO-associated or HRVO-associated macular edema who will benefit from first-line treatment with aflibercept rather than bevacizumab, given the minimal differences in visual acuity outcomes and large cost differences for bevacizumab vs aflibercept, first-line treatment with bevacizumab is cost-effective for this condition.

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