INTRODUCTION:Medication availability and costs can be highly variable across countries and in different time periods. We aimed to conduct a survey among local experts to obtain information on the availability and costs of allergic rhinitis medications in different countries. METHODS:We sent a survey to members of the Allergic Rhinitis and its Impact on Asthma (ARIA) group, asking for the availability and the lowest cost of specific allergic rhinitis medications in their respective countries. Data in local currencies were converted to 2024 US Dollars adjusted for Purchasing Power Parity (PPP). We compared the costs of different medication classes, assuming, for each class, the least expensive drug in each country, as well as full treatment adherence. RESULTS:We received responses from ARIA experts in 51 different countries. Intranasal corticosteroids (INCS) and oral antihistamines (OAH) were available in all countries, but this was not observed for intranasal antihistamines (INAH) or for INAH+INCS. In most countries, OAH was the least costly drug class, while INAH+INCS was the most expensive. Among INCS, beclomethasone was the medication most frequently identified as the cheapest, while cetirizine and loratadine were the OAH most frequently reported as the least expensive. Among INAH+INCS, azelastine-fluticasone was more frequently identified as less costly than olopatadine-mometasone. CONCLUSION:There is an important across-country and across-class variability in terms of costs of allergic rhinitis medications. The results of this study will inform the ARIA-EAACI 2024-2025 guidelines.
Anatomical segmentectomy has been established as a valid surgical option for early-stage lung cancer. However, this procedure could be technically demanding due to the anatomical variability of segmental bronchovascular structures. Misinterpretation of segmental anatomy could result in numerous postoperative complications. The routine use of three-dimensional reconstruction and preoperative planning is recommended to overcome this problem. We present a surgical case of a successfully conducted minimally invasive segmentectomy by utilizing three-dimensional reconstruction and preoperative planning.
Abstract Objectives: Management of extensive soft tissue defects in open tibial fractures is challenging, particularly when flap-based reconstruction is contraindicated. Artificial deformity creation method combines controlled angulation, rotation, translation, and shortening to achieve primary soft tissue closure, followed by gradual deformity correction. This study experimentally evaluated the deformity parameters required for closure of transverse and longitudinal defects. Methods: Full-size tibial models with simulated soft tissue defects were mounted in circular external fixation with an orthopaedic hexapod. Defects were progressively enlarged, and the magnitudes of angulation, shortening, translation, and rotation needed for closure were measured. Regression analysis defined relationships between defect geometry and deformity components. Results: Transverse defects of soft tissues ≤20 mm were closed with angulation alone; larger defects required combined angulation and shortening to maintain safe angulation (<60°). Rotation had minimal value in transverse defects but was essential in closing longitudinal wounds, where angulation, rotation, and shortening interacted nonlinearly. Safe practical limits of artificial deformity for soft tissue defect closure were identified: angulation 60°, rotation 90°, shortening 80 to 90 mm. Conclusion: Artificial deformity creation represents a reliable alternative when flap reconstruction is not possible. These experimental data offer guidance for selecting deformity components based on defect size and orientation during limb-salvage procedures.
