Ravnterkelsen4448

BACKGROUND The clinical significance of discordant radiological and pathological response to preoperative chemotherapy of colorectal liver metastases (CLM) is unknown. METHODS From 2011 to 2016, all eligible patients undergoing resection for CLM after preoperative chemotherapy were included at two centres. Patients were categorized according to radiologic response using RECIST as Rad-responders (complete/partial response) or Rad-non responders (stable disease) and according to Blazer et al. pathologic response grade as Path-responders (complete/major response) or Path-non responders (minor response). Survival outcome was analysed according to radiologic and pathologic response. RESULTS Among 413 patients undergoing resection of CLM, 119 fulfilled the inclusion criteria. CHR-2845 HDAC inhibitor Among these, 52 (44%) had discordant radiologic and pathologic response including 27 Rad-non responders/path responders and 25 Rad-responders/Path-non responders. Rad-non responders/path responders and Rad-responders/Path-non responders had similar characteristics except for the proportion receiving more than 6 cycles of preoperative chemotherapy (7/27 vs 16/25; P = 0.017). Median disease-free survival was not different in patients with or without discordant radiologic and pathologic responses (P = 0.195) but the type of discordance had an impact on oncologic outcome as median disease-free survival was 13.9 months (95% CI 5.7-22.2 months) in Rad-non responders/Path responders and 8.6 (6.2 - 10.9 months) in Rad-responders/Path-non responders (P = 0.034). Univariate and multivariate analysis showed that major pathologic response was associated with improved disease-free survival (OR 0.583, 95% CI 0.36-0.95, P = 0.031). CONCLUSION A discordant radiologic and pathologic response is common after preoperative chemotherapy for CLM. In these patients, pathologic response drives oncologic outcome.Few healthcare systems provide integrated, comprehensive addiction treatment for patients with opioid-related infections (e.g., endocarditis) requiring long-term intravenous antibiotic treatment. Accordingly, this study outlines preliminary findings from a psychosocial intervention provided to patients hospitalized for opioid-related infections. Twenty-seven (56.5% female) patients aged 23-64 [M(SD) = 40.43(11.72)] years inducted on medication-assisted therapy by an addiction consult service participated in a weekly group intervention while hospitalized. These patients demonstrated gains in relevant knowledge from admission to discharge, 100% identified a follow-up plan at discharge, and 81.5% followed up in outpatient the next day. Immediate, 1-month, 3-month, and 6-month retention rates are presented, as well as comparisons to historical patients who did not receive the group intervention in the year prior to the study. This preliminary research outlines a group intervention that may be implemented into existing addiction consult services to improve integrated, comprehensive addiction treatment for patients with opioid-related infections.Acceptance and Commitment Therapy (ACT) is an established psychological therapy, but its effectiveness for carers of people with multiple sclerosis (MS) experiencing carer-related strain has not been established. This study assessed the acceptability and feasibility of conducting a randomised controlled trial comparing ACT self-help, telephone-supported ACT self-help, and usual care. We describe a mixed-method, parallel three-armed feasibility randomised controlled trial. Participants were carers (i.e. caregivers) of people with MS. The self-help group received an ACT self-help text (covered over 8 weeks), the enhanced self-help group additionally received weekly telephone support. All participants completed questionnaires at baseline, 3-month, and 6-month post-randomisation, assessing carer strain, health-related quality of life, and ACT-related processes. A sample of participants was also interviewed. Twenty-four carers were randomised. Participants found the study procedures to be acceptable, but highlighted difficulties with the self-help text and timing of the intervention. An exploratory, group-level analysis indicated effectiveness for the enhanced self-help group on carer strain (consistent across both follow-ups), with convergent qualitative reports to support this. A full trial of ACT-based, telephone-supported self-help is warranted, including both the self-help and enhanced self-help design, following significant adaptions to the self-help itself. An internal pilot would, therefore, be recommended to further assess the feasibility after changes are incorporated.Trial registration The trial was registered on ClinicalTrials.gov (NCT03077971).Post-traumatic growth (PTG) may favor the psychological adaptation to chronic illnesses. However, few studies investigated PTG in Parkinson's Disease (PD). This study aims to investigate PTG in patients with PD, by exploring disease-specific features and assessing its impact on distress, well-being, and quality of life. A mixed methodology with a convergent parallel design was used. 54 patients were classified according to their level of PTG (low PTG, medium PTG, and high PTG). PD patients with high PTG showed a more positive psychological adaptation and less distress when compared to patients with less PTG. Forty-nine patients were interviewed and their transcripts were analyzed using Thematic Analysis. The emerged themes confirmed the traditional dimensions of PTG model, but a specific theme connected to a new body awareness was identified. Patients with high PTG were more likely to report positive statements following PD diagnosis, particularly concerning spirituality and maintaining a good physical functioning. PTG presents peculiar characteristics in PD and it may favor a better psychological adjustment following the diagnosis.OBJECTIVE Using data from the nationwide, cross-sectional KiGGS (German Health Interview and Examination Survey for Children and Adolescents) study, we investigated whether hormonal contraception in adolescents aged 15 to 17 years was linked to health-related quality of life and mental health problems. METHODS Study participants had undergone standardized recordings of blood pressure and measurements of serum 25-hydroxyvitamin D [25(OH)D]. Quality of life was assessed by self- and parent-rated KINDL-R questionnaires, whereas mental health problems were screened by means of the Strengths and Difficulties Questionnaire (SDQ). RESULTS Self-rated quality of life was similar between users (n = 522) and non-users (n = 1173, 69.2%) of oral contraceptives (69.2 ± 11.2 vs. 69.2 ± 11.0, p = 0.943), as was the parent-rated version (72.9 ± 10.6 vs. 72.9 ± 10.5, p = 0.985). Likewise, no significant differences were observed between the two groups with respect to both self- (10.9 ± 4.4 vs. 10.8 ± 4.6, p = 0.732) and parent-rated SDQ scores (7.