Vadcates1718

Despite in vivo studies suggesting that obesity increases carboplatin (CBDCA) bone marrow toxicity, the American Society of Clinical Oncology recommends that full weight-based cytotoxic chemotherapy doses be used to treat obese patients with cancer. Accordingly, the present study retrospectively investigated the effect of body mass index (BMI) on bone marrow toxicity in patients with gynecological cancer who underwent paclitaxel and carboplatin (TC) therapy after eliminating the effect of the target area under the curve (AUC). Risk factors for CBDCA bone marrow toxicity were also identified. A total of 110 patients with primary gynecological cancer or gynecological cancer of unknown primary origin who underwent TC therapy with a target AUC of 5-6 were included herein. Patients with a BMI of ≥25 and less then 25 kg/m2 were assigned to the obesity and control groups, respectively, and evaluated according to changes in hematological test values (platelet, white blood cell, and hemoglobin counts) starting from initial TC therapy administration until 21 days after the second treatment course. The obesity group had a significantly higher thrombocytopenia rate than the control group. Risk factors for thrombocytopenia ≥ grade 2 included BMI ≥ 25 kg/m2. Among patients with primary gynecological cancer or gynecological cancer of unknown primary origin who had a BMI of ≥25 kg/m2, those receiving CBDCA may be at increased risk for thrombocytopenia ≥ grade 2 when the dosage is calculated using the Calvert formula with the creatinine clearance level.Toluene-sensing properties of mixed-potential type yttria-stabilized zirconia (YSZ)-based sensors attached with a thin CeO2-added Au sensing electrode (SE, CeO2 content 4 - 16 mass%, thickness 30 - 100 nm), which was fabricated by using a spin-coating method, were examined and the effects of their SE thickness and the additive amount of CeO2 on their toluene response were discussed in this study. The toluene response of the sensors attached with a 16 mass% CeO2-added Au SE increased with an increase in the SE thickness, and the sensor attached with the thickest 16 mass% CeO2-added Au SE showed the largest response, among all the sensors tested. This behavior probably arises from the increase in the number of active sites for electrochemical toluene oxidation in the CeO2-added Au SE.We examined clinical and geospatial factors associated with frequent emergency department (ED) use and identified neighborhood ED "hotspots" over a two-year period (2014-16). Emergency department patients were classified into three categories (1) infrequent users ( less then 3 ED visits); (2) semi-frequent users (3 or more visits in a year); and (3) persistent users (3 or more visits in both years). Persistent users were more likely to be female, aged 45-64, and have insurance compared with infrequent and semi-frequent users. Thirty percent of persistent users had both a mental and chronic health condition. Persistent and semi-frequent users were no more likely than infrequent users to use the ED for non-emergent conditions, but were more likely to use the ED for primary care treatable and preventable conditions. Emergency department hotspots were located closer to federally qualified health centers, closer to the main ED, had higher rates of mental health and other chronic conditions.Black populations in the United States are disproportionately affected by HIV. This disparity may be affected by social and structural barriers to HIV testing, leading to undiagnosed infection and prolonged HIV transmissibility. Using data from a nationally representative sample of 1,727 Black men in the 2015 Behavioral Risk Factor Surveillance System we tested for differences in poverty, depression, and health care barriers between Black men who had been HIV tested in the past year and those who had not. We also tested a syndemic index of these factors. Number of syndemic factors was linearly associated with less HIV testing (aPR=0.79, 95% CI 0.66-0.95). Assumptions of unidimensionality were met. The use of a syndemic index was a superior approach to analyzing these factors individually, both in terms of model fit and associations detected. The accumulation of poverty, depression, and health care barriers has an adverse impact on HIV testing among Black men.We assessed the ability of high-risk criteria developed by Boston Health Care for the Homeless Program to identify increased mortality during a 10-year cohort study (January 2000-December 2009) of 445 unsheltered adults. To qualify as high-risk for mortality, an individual slept unsheltered for six consecutive months or longer plus had one or more of the following characteristics tri-morbidity, defined as co-occurring medical, psychiatric, and addiction diagnoses; one or more inpatient or respite admissions; three or more emergency department visits; 60 years old or older; HIV/AIDS; cirrhosis; renal failure; frostbite, hypothermia, or immersion foot. A total of 119 (26.7%) individuals met the high-risk criteria. The remaining 326 individuals in the cohort were considered lowerrisk. During the study, 134 deaths occurred; 52 (38.8%) were among high-risk individuals. Compared with sheltered individuals, the age-standardized mortality ratio for the high-risk group was 4.0 (95% confidence interval 3.0, 5.2) times higher and for the lower-risk group was 2.2 (1.8, 2.8) times higher. The hazard ratio, a measure of survival, for the high-risk group was 1.7 (1.2, 2.4) times that of the lower-risk group. High-risk criteria predicted an increased likelihood of mortality among unsheltered individuals. The lower-risk group also had high mortality rates compared with sheltered individuals.OBJECTIVE Study occurrence and consequences of deductibles and medical debt among privately insured under the Affordable Care Act. METHODS Analysis of 2012-2016 National Health Interview Survey data on privately insured adults younger than age 65 on the effect of deductibles on medical debt, deferred medical care, and office visits, by demographic characteristics, and treatable chronic diseases. RESULTS Rates of medical debt and deferred care decreased. Medical debt is greater for those with any type of high deductible (HD) insurance, and among those more vulnerable (lower income, minority, treatable chronic diseases). learn more Medical debt with HD's increased deferred needed medical care 6 fold and is highest for those with more treatable chronic diseases. CONCLUSION While medical debt and deferred care decreased for all privately insured, those HD-insured and vulnerable report higher medical debt rates markedly increasing deferred needed medical care. Highdeductible insurance risks adverse health and social consequences for those vulnerable.