Hopkinsroberson3136

The prognostic value and molecular landscape of human epidermal growth factor receptor 2 (HER2) low-expressing (HER2-L) metastatic colorectal cancer (mCRC) remain unclear.

This study enrolled patients with mCRC who had undergone surgical resection of primary tumor. Using the specimen, we evaluated HER2 expression by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH). HER2 positivity was defined as follows HER2 positivity (HER2-Pos) as IHC 3+ or IHC 2+/FISH positive, HER2-L as IHC 2+/FISH negative or IHC 1+, and HER2 negativity (HER2-Neg) as IHC 0+. Gene alterations were determined by next-generation sequencing.

Between 2005 and 2015, a total of 370 patients were analyzed, comprising 15 patients (4%) with HER2-Pos, 21 (6%) with HER2-L, and 334 (90%) with HER2-Neg disease. The clinicopathologic characteristics among groups had no differences. HER2-L had a significantly higher proportion of coaltered RAS mutation than HER2-Pos (P= .037). With a median follow-up of 101.8 months, HER2-LRC.In 2015, 2 proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, alirocumab and evolocumab, were approved by the Food and Drug Administration (FDA). Both therapies reduce low-density lipoprotein cholesterol (LDL-C) by approximately 60% and reduce atherosclerotic cardiovascular disease (ASCVD) risk in patients with established ASCVD when added to background statin therapy. The initial cost of these medications was approximately $15,000 per year, which made them largely cost-prohibitive for many patients and the overall health care system. In recent years, the cost of both agents has been reduced by 60%, and they are no longer only available through specialty pharmacies. In addition, a third PCSK9-modulating therapy, inclisiran, is nearing FDA approval. Ongoing inclisiran therapy only requires biannual subcutaneous administration and achieves LDL-C reductions of approximately 50%. As the use of PCSK9-modulating therapies increases, models that improve adherence and persistence over time will be critical to ensure patient access and maximize their value. Community pharmacists can play an important role helping patients not only obtain access to these therapies by navigating previous authorization requests but also adhere to therapy by offering administration. Community pharmacists can also provide therapeutic monitoring using point-of-care lipid testing to ensure efficacy over time. Such a service could potentially be sustained through reimbursement for administration and point-of-care lipid testing. Given the cost of these therapies, innovative models involving community pharmacists will be necessary to ensure patient access to these preventive therapies and minimize overall costs to the health care system.

Children with medical complexity (MC) must rely on others to notice and address pain. Parents are aware of child pain behaviors and can serve as reliable proxy reporters. Thus, there is a critical need to understand parent perspectives to improve pain practices.

Individual interviews were used as a data collection method in this qualitative study.

Participants were recruited via mail and social media postings. Interviews were audio-recorded and transcribed verbatim. Transcribed documents were imported to NVIVO for qualitative analysis. Conventional and directed approaches to qualitative content analysis were used.

From the data analysis, major themes included pain experiences, confidence in caregivers, parents are partners, proactive communication, and a spontaneous theme, "they can hear us." Emotional pain and challenges identifying the source pain were identified as sub-themes of pain experiences.

Parents in this study shared methods helpful to identifying pain in their children, as well as sugges Going forward, conversations about pain should be a key part of any admission assessment or first encounter. As pain episodes among children with MC can be complex and may not always be re-created in front of a provider, nurses may advise parents to take photos or videos to share with caregivers.

Pain prevalence in pediatric hospitals has been investigated in many developed countries, but little is known about this topic in China.

This study sought to describe the frequency and pain intensity of procedures for medical care in hospitalized children in a Chinese children's hospital.

Across-sectional study was designed to includeinterviews with children, their parents and the nurses.

This survey was administered in a teaching hospital in southeast China.

Infants and children up to 16 years old who were admitted to the study units for more than 6 days were eligible for inclusion.

Information regarding patient demographics, painful proceduresand pain management strategies was obtainedduringtheday shiftsof thechildren's hospitalization.

A total of 3886procedures were performed on 342 children during thedata collection period. Thereuseof intravenous indwelling needles( n= 577), removal of tape from the skin(n= 420) and venipuncture on the back ofthehand( n= 401) were the most frequently performed procedureson children. A total of 1941 procedures, accounting for 49.9% (1941/3886) of painful procedurescaused moderate to severe pain (pain score ≥4.0). However, only 25.3% (984/3886) received a valid pain assessment, and only 14.4% (560/3886) receivedpain interventions.

Most children, especially those who areyounger(<4 years old),experienced moderate or severe pain during their hospitalization, but did not receive appropriate interventions.

Most children, especially those who are younger ( less then 4 years old), experienced moderate or severe pain during their hospitalization, but did not receive appropriate interventions.

Patients with premature ejaculation (PE) are often diagnosed as having a comorbid erectile dysfunction (ED). selleck When evaluating erectile function in PE patients with the popular International Index of Erectile Function-5 (IIEF-5, or Sexual Health Inventory for Men [SHIM]), question #5 (Q5) about sexual satisfaction in the intercourse often lowers the total score of the questionnaire, giving false-positive results for the presence of ED.

We aimed to compare SHIM with the other abridged form of IIEF, which is IIEF-EF, and to discriminate which tool has the best diagnostic accuracy in the evaluation of erectile function in PE patients.

The study was conducted from March 2019 to January 2020. A total of 189 heterosexual males with lifelong PE (117, 61.9%) or acquired PE (72, 38.1%) were included. They all compiled Premature Ejaculation Diagnostic Tool, IIEF-15, SHIM, and IIEF-EF and underwent a full clinical examination to evaluate their erectile function.

The scores of the 2 erectile function assessment questionnaires (SHIM and IIEF-EF) were compared in terms of their sensitivity and specificity in the diagnosis of ED in PE patients.