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The opioid overdose crisis underscores the need for health services among people who use drugs (PWUD) with concurrent pain.

Investigating the effect of pain on barriers to accessing health services among PWUD.

Prospective cohort study.

A setting of universal access to no-cost medical care in Vancouver, Canada from June 2014 to May 2016.

PWUD who completed at least one study interview.

Data derived from interviewer-administered questionnaires were used for multivariable generalized linear mixed-effects multiple regression (GLMM) analyses.

Among 1,348 PWUD, 469 (34.8%) reported barriers to accessing health services at least once during the study period. The median average pain severity was 3 (IQR 0-6) out of 10. A dose-response relationship was observed between greater pain and increased odds of reporting barriers to accessing health services (adjusted odds ratio [AOR] 1.59, 95% confidence interval [CI] 1.15-2.21,p = .005 for mild versus no pain; AOR 1.76, 95% CI 1.30-2.37,p < .001 for moderate versus no pain; AOR 2.55, 95% CI 1.92-3.37,p < .001 for severe versus no pain). Common barriers included poor treatment by health professionals, socio-structural barriers such as transportation or mobility, and long wait lists or wait times.

Pain may be a significant risk factor associated with increased barriers to accessing health services among PWUD. Attention to pain management may improve access to health services, and reducing barriers to health services may conversely improve pain management and its related risks and harms.

Pain may be a significant risk factor associated with increased barriers to accessing health services among PWUD. Attention to pain management may improve access to health services, and reducing barriers to health services may conversely improve pain management and its related risks and harms.

This study aimed to explore parental attitudes toward children's pain and analgesic drugs and parental self-efficacy and use of pain relief strategies in children's postoperative pain management in Korea, and to identify the relationships among these variables.

A cross sectional descriptive study was conducted. Participants were 124 parents of hospitalized children (aged 4-9years) undergoing tonsillectomy in Korea.

A considerable proportion of parents held misconceptions about how children express pain. For example, 87.9% of parents perceived that children always tell their parents when they are in pain. Moreover, parents reported significant attitudinal barriers to analgesic use with 60.5% of parents believed that side effects are something to worry about when giving children pain medication. Parental attitudes to use analgesics were significantly different by children's gender, family income, and length of hospital stay. Emotional support methods such as touch, parental presence, and comfort/reassuraning children's pain.

An increasing number of treatment-determining biomarkers has been identified in non-small cell lung cancer (NSCLC) and molecular testing is recommended to enable optimal individualized treatment. However, data on implementation of these recommendations in the "real-world" setting are scarce. This study presents comprehensive details on the frequency, methodology and results of biomarker testing of advanced NSCLC in Germany.

This analysis included 3,717 patients with advanced NSCLC (2,921 non-squamous; 796 squamous), recruited into the CRISP registry at start of systemic therapy by 150 German sites between December 2015 and June 2019. Evaluated were the molecular biomarkers EGFR, ALK, ROS1, BRAF, KRAS, MET, TP53, RET, HER2, as well as expression of PD-L1.

In total, 90.5 % of the patients were tested for biomarkers. BAY 2666605 research buy Testing rates were 92.2 % (non-squamous), 70.7 % (squamous) and increased from 83.2 % in 2015/16 to 94.2% in 2019. Overall testing rates for EGFR, ALK, ROS1, and BRAF were 72.5 %, 74.5 %, 66.1a significant portion of patients, who could potentially benefit. Thus, specific measures are needed to increase implementation.

Testing rates in Germany are high nationwide and acceptable in international comparison, but still leave out a significant portion of patients, who could potentially benefit. Thus, specific measures are needed to increase implementation.The sperm epigenome contains a highly unique and specialized epigenetic landscape. Insightful questions need be asked about these epigenetic signatures and their predictive potential to assess the approximately 1 in 6 couples who experience infertility. Among those couples that do experience infertility, approximately half of the cases involve a male factor. Unfortunately, there is a significant lack of effective diagnostic tools in the male infertility space and thus clinicians are left with little data upon which they can formulate data driven treatment plans. Taking together this information and the striking prevalence of male infertility it's obvious that there is a need for improved diagnostic techniques for male infertility. Many studies have identified what appear to be clinically meaningful epigenetic alterations in sperm that may add utility in the diagnoses of infertility and improvement of pregnancy outcomes. Many researchers believe that continued analysis of these various epigenetic mechanisms may provide powerful predictive insight. In fact, there is promising current data suggesting that the predictive power of DNA methylation, Nuclear Proteins, and miRNA signatures in sperm likely can improve what is currently found with traditional diagnosis of male infertility. The focus of this review is to give a brief understanding to the field of epigenetics and the potential predictive power the sperm epigenome may hold in relation to improving the treatment and diagnosis of male infertility patients.Klinefelter syndrome (KS) is defined as the presence of one or more extra "X" chromosome in a male patient. It affects approximately 1 in 600 newborn males and the most common chromosomal abnormality, leading to male hypogonadism and infertility. There is a lack of data supporting best practices for KS patients' care. In this paper we review controversial issues in KS research ranging from mechanisms of variation in KS phenotype to abnormalities resulting in reduced sperm production to successful sperm retrieval disparities after testicular sperm extraction (TESE). Translation to live birth and offspring health is also examined. Finally, medical therapies used to optimize the hormonal status and chances of fertility in KS patients are reviewed. We will also discuss the experimental spermatogonial stem cell (SSC) treatments, which are considered the future for TESE negative patients.