Wilkinspowers1138
Stage IV breast cancer, also known as metastatic breast cancer (mBC), is not a curable condition. However, treatment can prolong life, delay the progression of the cancer, or improve quality of life. Currently, patients with mBC are often treated with chemotherapy. Patients often experience adverse events from chemotherapy during the treatment cycle, which leads to chemotherapy modifications such as dose delay, dose reduction, or discontinuation of chemotherapy. Previous studies have evaluated the rates of adverse events that occur from the use of chemotherapy; however, few studies have evaluated the clinical impact on the chemotherapy regimen once the adverse event occurs. This study evaluates the clinical impact on the chemotherapy regimen from chemotherapy-related adverse events in patients with mBC in an integrated health care delivery system.
To assess the adverse events in patients with mBC and evaluate the clinical impact on the chemotherapy regimen from these adverse events in an integrated health than 65 years, having more than 1 comorbidity and having longer duration in days for each episode of care were all associated with clinical impact. Black and Hispanic patients were more likely to have a modification in their chemotherapy compared with white patients.
This retrospective analysis demonstrates that chemotherapy-related adverse events in patients with mBC have an impact on the delivery of chemotherapy regimens. Having multiple comorbidities, increased age, and prolonged hospitalizations because of adverse events appear to be some of the primary factors related to chemotherapy modification.
This retrospective analysis demonstrates that chemotherapy-related adverse events in patients with mBC have an impact on the delivery of chemotherapy regimens. Having multiple comorbidities, increased age, and prolonged hospitalizations because of adverse events appear to be some of the primary factors related to chemotherapy modification.
Chemodenervation with botulinum neurotoxin (BoNT) is recommended as first-line treatment for the management of cervical dystonia. The choice of BoNT for treatment is subject to the consideration of several factors, including cost.
To compare the costs incurred by patients and payers for onabotulinumtoxinA (ONA) or abobotulinumtoxinA (ABO) for the treatment of cervical dystonia.
We conducted a retrospective, noninterventional closed cohort study of cervical dystonia patients within a single U.S. private neurological practice. Patient and payer incurred costs from medical billing records for patients satisfying inclusion and exclusion criteria treated from November 1, 2009, through January 1, 2013, were de-identified and included in the analysis. Forty-seven patients initially treated with at least 3 consecutive cycles of ONA, followed by at least 3 consecutive cycles of ABO were included, representing 282 injection cycles available for analysis. Patients were required to have had a positive response to trivate practice with outcomes assumed to be similar.
For patients treated for cervical dystonia, switching from ONA to ABO resulted in payer and patient reimbursement cost reductions in a single U.S. private practice with outcomes assumed to be similar.
The purpose of this study is to examine the relationship between 5-HTTLPR polymorphism (44-bp insertion/deletion polymorphism of serotonin transporter gene) and methylphenidate (MPH) treatment response, as well as the association between the adverse events of MPH treatment and 5-HTTLPR polymorphism in children with attention-deficit/hyperactivity disorder (ADHD).
A total of 114 children with ADHD (mean age 9.08 ± 1.94 years) were recruited from the child psychiatric clinic in a hospital in South Korea. We have extracted the genomic DNA of the subjects from their blood lymphocytes and analyzed 5-HTTLPR polymorphism of the SLC6A4 gene. All children were treated with MPH for 8 weeks, with clinicians monitoring both the improvement of ADHD symptoms and the side effects. We compared the response to MPH treatment and adverse events among those with the genotype of 5-HRRLPR polymorphism.
There was no significant association between the 5-HTTLPR genotype and the response to MPH treatment in children with ADHD. Subjects with the S/L+L/L genotype tended to have tics and nail biting (respectively, p < 0.001, p = 0.017).
The results of this study do not support the association between the 5-HTTLPR polymorphism and treatment response with MPH in ADHD. However, our findings suggest the association between 5-HTTLPR polymorphism and the occurrence of tics and nail-biting as an adverse event of methylphenidate. This may aid in our understanding of the genetic contribution and genetic susceptibility of a particular allele in those ADHD patients with tics or nail biting.
The results of this study do not support the association between the 5-HTTLPR polymorphism and treatment response with MPH in ADHD. However, our findings suggest the association between 5-HTTLPR polymorphism and the occurrence of tics and nail-biting as an adverse event of methylphenidate. This may aid in our understanding of the genetic contribution and genetic susceptibility of a particular allele in those ADHD patients with tics or nail biting.It has long been suggested that face recognition relies on specialized mechanisms that are not involved in visual recognition of other object categories, including those that require expert, fine-grained discrimination at the exemplar level such as written words. But according to the recently proposed many-to-many theory of object recognition (MTMT), visual recognition of faces and words are carried out by common mechanisms [Behrmann, M., & Plaut, D. C. ( 2013 ). Distributed circuits, not circumscribed centers, mediate visual recognition. Trends in Cognitive Sciences, 17, 210-219]. MTMT acknowledges that face and word recognition are lateralized, but posits that the mechanisms that predominantly carry out face recognition still contribute to word recognition and vice versa. MTMT makes a key prediction, namely that acquired prosopagnosics should exhibit some measure of word recognition deficits. We tested this prediction by assessing written word recognition in five acquired prosopagnosic patients. Four patien not contribute to recognition of written words.
Differentiated squamous intraepithelial neoplasia (DSIN) has been described in several sites, including the upper aerodigestive tract and vulva, so this study investigated whether it also occurred in the anal canal.
All cases of squamous cell carcinoma (SCC) involving the anal canal diagnosed between 2009 and 2015 at our institution were reviewed. Eighty-six cases were included, and 13 (15%) showed features consistent with DSIN 10 were 'pure' DSIN, and three were 'mixed' DSIN and squamous intraepithelial lesion. DSIN was characterized by atypical keratinocytes limited to the basal/parabasal layers, acanthosis, and a 'cobblestone' appearance. Among specimens with pure DSIN, the surface was flat in eight cases. In five cases, the DSIN was extensive, and associated with deeply invasive SCC requiring radical surgical resection. Immunohistochemically, the epithelia showing changes consistent with DSIN were p16-negative, whereas the invasive component was p16-positive in 12 cases. Both Ki67 and p53 showed strong nuclear positivity in the basal/parabasal layers of DSIN.
Invasive SCC associated with DSIN often presents at an advanced stage of disease, requiring radical surgical treatment. The neoplastic changes in DSIN are limited to the basal/parabasal layers, which may account for the negative diagnoses by anal cytopathology and late clinical diagnosis. The recognition of anal DSIN is important in order to avoid underdiagnosis in superficial biopsies.
Invasive SCC associated with DSIN often presents at an advanced stage of disease, requiring radical surgical treatment. The neoplastic changes in DSIN are limited to the basal/parabasal layers, which may account for the negative diagnoses by anal cytopathology and late clinical diagnosis. The recognition of anal DSIN is important in order to avoid underdiagnosis in superficial biopsies.
Work-related stress is a growing social challenge and has been associated with reduced employee health, well-being, and productivity. One tool to measure the stress-related wear and tear of the body is the Allostatic Load Index (ALI). This review summarizes recent evidence on the association between work-related stress and ALI in working adults.
A systematic literature search following the PRISMA-Statement was conducted in 21 databases including Medline, PubPsych, MedPilot, and Cochrane Register. Publications addressing work related-stress and medical parameters using ALI were considered. Data on study population, analytic techniques, and results were tabulated. Methodological quality was evaluated using a standardized checklist.
9 articles were identified with a total of 3 532 employees from 5 countries reporting cross-sectional data from the years 2003-2013. Overall, 7 studies reported a positive and significant association between work-related stress and ALI, while 2 studies showed no or an insignificant association. Substantial heterogeneity was observed in methods applied and study quality.
This systematic review provides evidence that work-related stress is associated with ALI in cross-sectional studies. This association needs to be demonstrated by future studies using longitudinal data on working populations.
This systematic review provides evidence that work-related stress is associated with ALI in cross-sectional studies. This association needs to be demonstrated by future studies using longitudinal data on working populations.Introduction Assessing resource utilisation and costs for treating mental disorders in Germany is difficult. This pertains especially to the numerous non-medical services that are financed by a considerable number of payers. To standardise and simplify cost calculation, we created a database of unit costs for the most important services for mental disorders. Method We performed a literature and internet search to identify services provided to persons with mental disorders. Unit costs were calculated either by means of public statistics or data directly obtained from payers. If data could not be obtained that way, health care providers were interviewed to collect data relevant for cost estimation. Results Unit costs were calculated for medical and vocational rehabilitation, assisted living, sociopsychiatric services, counselling centres, daycare facilities, ambulant psychiatric nursing care, occupational therapy, sociotherapy, psychoeducation, caretaker, domestic help, creative therapies, physical therapy, and relaxation techniques. Discussion and Conclusion Calculating unit costs for non-medical services was essential, since these services constitute a central element in the treatment of persons with mental disorders. Nevertheless, the large amount of different services and payers complicated a comprehensive assessment of costs. Thus, uncertainty associated with the calculation of costs should be taken into account.
Migrants are an important target group for mailed surveys but also difficult to reach. For planning these surveys and invitational health measures, we assessed response figures for women with and without Turkish migration background.
Women aged 50 years living in Westphalia-Lippe were invited to a postal survey at 2 time points about mammography screening. Turkish migrant women were identified in the contact database by a name-based algorithm. Evofosfamide concentration Possible differences in sample revision and response among women with and without Turkish migration background were assessed.
Women with Turkish migration background had unknown addresses significantly more often (4.6 vs. 1.7%) and responded to the questionnaires less often (first questionnaire 14.3 vs. 35.9%; second questionnaire 70.7 vs. 85.6%).
For postal invitation to participate in healthcare measures, or recruitment of Turkish migrants for studies, differences in current address and readiness to respond must be taken into consideration.
For postal invitation to participate in healthcare measures, or recruitment of Turkish migrants for studies, differences in current address and readiness to respond must be taken into consideration.
