scholarly journals Glioblastoma Treatment in the Elderly in the Temozolomide Therapy Era

2014 ◽  
Vol 41 (3) ◽  
pp. 357-362 ◽  
Author(s):  
Linda Coate ◽  
Mairéad G. McNamara ◽  
Zarnie Lwin ◽  
Derek MacFadden ◽  
Ahmed Al-Zahrani ◽  
...  
Keyword(s):  
The Elderly ◽  
Best Supportive Care ◽  
Phase Iii ◽  
Entire Cohort ◽  
Study Results ◽  
Impact On Survival ◽  
Phase Iii Study ◽  
One Year ◽  
Definition Of ◽  
The Impact

Background:Optimal treatment of glioblastoma (GBM) in the elderly remains unclear. The impact of age on treatment planning, toxicity, and efficacy at a Canadian Cancer Centre was retrospectively reviewed.Methods:Glioblastoma patients treated consecutively between 2004 and 2008 were reviewed. Utilizing 70 years as the threshold for definition of an elderly patient, treatments and outcome were compared in younger and elderly populations.Results:Four hundred and twenty one patients were included in this analysis and median overall survival (OS) for the entire cohort was 9.8 months. 290 patients were aged <70 (median age 57, range 17–69) and 131 were aged ≥70 (median age 76, range 70–93). Patients ≥70 were more likely to receive best supportive care (BSC) and all patients >70 who were treated with radiotherapy received <60 Gy (P<0.001), except one. Patients aged >70 demonstrated inferior survival (one year OS 16% versus 54% for those <70, HR 3.46, P<0.001). In patients treated with BSC only, age had no impact on survival (median survival two months in both groups, HR 0.89, P=0.75). For those treated with higher doses of radiotherapy (>30 Gy to <60 Gy), one year survival was 19% versus 24% in patients aged >70 versus <70 (HR 1.47, P=0.02) respectively.Conclusions:In this retrospective single institution series, elderly patients were more likely to be treated with BSC or palliative doses of radiotherapy. Randomized phase III study results are required for guidance in treatment of this population of patients.

scholarly journals Survival Analysis of Hospitalized Elderly People with Fractures in Brazil Over One Year

Geriatrics ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 10
Author(s):  
Brenda Kelly Gonçalves Nunes ◽  
Brunna Rodrigues de Lima ◽  
Lara Cristina da Cunha Guimarães ◽  
Rafael Alves Guimarães ◽  
Claci Fátima Weirich Rosso ◽  
...  
Keyword(s):  
Elderly People ◽  
Cox Regression ◽  
Age Groups ◽  
The Elderly ◽  
Diabetic Patients ◽  
Related Factors ◽  
Hospitalized Elderly ◽  
Study Results ◽  
One Year ◽  
The Impact

Objective: This study analyzes the causes of death, survival, and other related factors in hospitalized elderly people with fractures over the course of one year. Methods: We followed 376 fracture patients for one year in a prospective cohort study to a reference hospital in central Brazil. The Cox regression model was used to analyze factors associated with survival. Results: The results indicate that the one-year mortality rate was high (22.9%). The independent factors linked to lower overall survival were as follows: patients aged ≥80 years with previous intensive care unit (ICU) admission and presence of comorbidities (diabetes mellitus [DM] and dementia). Conclusion: Our study results may contribute to a better understanding of the impact of fractures on the elderly population and reinforce the need to oversee age-groups, diabetic patients, and patients with complications during hospitalization.

scholarly journals Тhe effects of auditory amplification on subjective assessments of hearing impairment and anxiety in people with presbycusis

2019 ◽  
Vol 147 (7-8) ◽  
pp. 461-467
Author(s):  
Ivana Maletic-Sekulic ◽  
Stasa Petkovic ◽  
Ninoslava Dragutinovic ◽  
Ivana Veselinovic ◽  
Ljiljana Jelicic
Keyword(s):  
Hearing Loss ◽  
Hearing Impairment ◽  
Statistical Significance ◽  
Later Life ◽  
The Elderly ◽  
Favorable Effect ◽  
Hearing Disability ◽  
Study Results ◽  
Auditory Amplification ◽  
The Impact

Introduction/Objective. Presbycusis, elderly hearing loss, is a progressive, bilateral sensoryneural hearing loss characterized by reduced sensitivity of hearing and understanding speech in a noisy environment, thereby impairing communication and inducing anxiety. The objective was to examine the impact of hearing amplification on subjective hearing disability assessment and anxiety in people with presbycusis. Method. Sample consisted of 120 respondents aged 47?85 with presbycusis, 60 subjects with and 60 subjects with no auditory amplification. The standardized Hearing Handicap Inventory for the Elderly and the Spielberger State Trait Anxiety Inventory were used in the study. Results. In subjects with hearing amplification, test/retest has no statistical significance in the STAI and HHIE scales and subscales, except the HHIE-S (p = 0.004) with a lower score on the retest. Respondents in whom hearing amplification was performed during the year was statistically significant in HHIE (p = 0.016), HHIE-S (p = 0.004) and STAI-S (p = 0.029) which speaks of favorable effect of hearing amplification. In the group with no hearing amplification, statistical significance was observed in relation to the HHIE scores (p = 0.002), HHIE-E (p = 0.000), STAI (p = 0.000), STAI-S (p = 0.001) and STAI-T (p = 0.001) and it was noticed that anxiety, loss of emotional contacts, and more pronounced degree of hearing impairment were the result of unassisted hearing rehabilitation. Conclusion. Audiological practice should include tests for assessment of hearing disability and anxiety in order to preserve health in later life.

scholarly journals Формирование среды реализации цифровых инициатив сотрудников банка

2019 ◽  
pp. 48-54
Author(s):  
Тарас Гриценко ◽  
Жанна Передера ◽  
Анна Теряева
Keyword(s):  
Banking Sector ◽  
Economic Security ◽  
New Professionals ◽  
Advantages And Disadvantages ◽  
Study Results ◽  
The Matrix ◽  
Banking Business ◽  
The Stability ◽  
Definition Of ◽  
The Impact

В работе рассматривается возможность формирования в банковском секторе среды, в которой сотрудники смогут самостоятельно реализовывать цифровые инициативы для развития компании и самообучения. Обоснована необходимость её наличия. Проведен анализ соответствия поставленной проблемы российским и мировым трендам на основе изучения федеральных программ и оценок рейтинговых агентств. В результате исследования разработан бизнес-процесс реализации цифровых инициатив, про-веден конкурентный анализ его преимуществ и недостатков перед традиционным подходом к обучению. The article discusses the possibility of forming in the banking business an environment in which employees will be able to in-dependently implement digital initiatives for the development of the company and self-learning. The necessity of its presence is grounded. The analysis of compliance of the problem with the trends in Russia and the world based on the study of Federal programs and ratings agencies. To attract new staff with the necessary knowledge, banks have a number of tools - business classes, sponsorship programs, mentoring, hackathons, man-agement fights, case-championships, etc. It has been revealed that new professionals with technical skills can solve complex problems and generate products. But it’s difficult for them to dive into the banking sector, study its features and offer their own solutions to problems. It was also revealed that the company is interested in product results that are practice oriented. Com-bining product results and training is only possible by creating an environment in which they can discuss their ideas, find sup-port and implement them. As a result, a business process for the implementation of digital initiatives has been formed, a competi-tive analysis of its advantages and disadvantages over the tradi-tional approach to training has been conducted. strategies. The leading method of research is the definitions according grouping to the principles of the matrix method. It was revealed that the economic security concept is disclosed using factors freely com-bined into three groups (includes: sustainability, protection of interests, ensuring sovereignty), and the most common definitions are built using words-markers: state, security, advantage, process. One of the main study results is an algorithm for constructing the definition of the economic security concept, which allows to model and refine the definition of the concept based on the initial categories, consider-ing the economic context. The author's definition is also formulated, which reflects the interrelation of such components as the protection of interests, the impact of threats, the stability preservation, inde-pendence, ensuring development, self-adaptation and self-reproduction.

scholarly journals Health-Related Quality of Life in Patients With Progressive Midgut Neuroendocrine Tumors Treated With 177Lu-Dotatate in the Phase III NETTER-1 Trial

2018 ◽  
Vol 36 (25) ◽  
pp. 2578-2584 ◽  
Author(s):  
Jonathan Strosberg ◽  
Edward Wolin ◽  
Beth Chasen ◽  
Matthew Kulke ◽  
David Bushnell ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Status ◽  
Global Health ◽  
Phase Iii ◽  
High Dose ◽  
Health Related Qol ◽  
Health Related ◽  
Phase Iii Study ◽  
The Impact

Purpose Neuroendocrine tumor (NET) progression is associated with deterioration in quality of life (QoL). We assessed the impact of 177Lu-Dotatate treatment on time to deterioration in health-related QoL. Methods The NETTER-1 trial is an international phase III study in patients with midgut NETs. Patients were randomly assigned to treatment with 177Lu-Dotatate versus high-dose octreotide. European Organisation for Research and Treatment of Cancer quality-of-life questionnaires QLQ C-30 and G.I.NET-21 were assessed during the trial to determine the impact of treatment on health-related QoL. Patients completed the questionnaires at baseline and every 12 weeks until tumor progression. QoL scores were converted to a 100-point scale according to European Organisation for Research and Treatment of Cancer instructions, and individual changes from baseline scores were assessed. Time to QoL deterioration (TTD) was defined as the time from random assignment to the first QoL deterioration ≥ 10 points for each patient in the corresponding domain scale. All analyses were conducted on the intention-to-treat population. Patients with no deterioration were censored at the last QoL assessment date. Results TTD was significantly longer in the 177Lu-Dotatate arm (n = 117) versus the control arm (n = 114) for the following domains: global health status (hazard ratio [HR], 0.406), physical functioning (HR, 0.518), role functioning (HR, 0.580), fatigue (HR, 0.621), pain (HR, 0.566), diarrhea (HR, 0.473), disease-related worries (HR, 0.572), and body image (HR, 0.425). Differences in median TTD were clinically significant in several domains: 28.8 months versus 6.1 months for global health status, and 25.2 months versus 11.5 months for physical functioning. Conclusion This analysis from the NETTER-1 phase III study demonstrates that, in addition to improving progression-free survival, 177Lu-Dotatate provides a significant QoL benefit for patients with progressive midgut NETs compared with high-dose octreotide.

scholarly journals Insights into PCDD/Fs and PAHs in Biomass Boilers Envisaging Risks of Ash Use as Fertilizers

2020 ◽  
Vol 10 (14) ◽  
pp. 4951
Author(s):  
Helena Lopes ◽  
Susana Proença
Keyword(s):  
Unburned Carbon ◽  
Fly Ashes ◽  
Power Stations ◽  
Polycyclic Aromatic ◽  
Toxic Equivalents ◽  
One Year ◽  
Definition Of ◽  
And Control ◽  
The Impact ◽  
Biomass Ashes

Since ashes are a possible source of Persistent Organic Pollutants (POPs) contamination, their application in soils must be subject to more study and control. In this scope, feed residual forest biomasses and biomass ashes, collected along one year in four biomass power stations, were characterized mainly for their polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs) and Polycyclic Aromatic Hydrocarbons (PAHs) contents. The biomasses present concerning levels of Cl (0.04–0.28%) that may lead to PCDD/Fs formation. The biomasses also contain OCDD (29–260 ng/kg) and 1,2,3,4,6,7,8-HpCDD (35 ng/kg) that may contribute to increased Toxic Equivalents (TEQs) of ashes, possibly involving dechlorination and ash enrichment mechanisms. While the WHO2005-TEQs in bottom ashes (14–20 ng TEQ/kg) reaches the proposed limit (20 ng TEQ/kg) for ash use as fertilizers, in fly ashes (35–1139 ng TEQ/kg) the limit is exceeded. PAHs are below 0.02 mg/kg in bottom ashes and 1.5–2.5 mg/kg in fly ashes, complying with the proposed limit of 6 mg/kg. As bottom and fly ash streams may contain different ash flows, a clear definition of ash mixes is required. Correlations between unburned carbon (C), PAHs and PCDD/Fs were not found, which highlights the need for compulsory PCDD/Fs analysis in ashes, independently of their origin, burnout degree or levels of other contaminants. A sensitivity analysis was performed to evaluate the impact of handling non-detected values, which showed more impact for TEQs values close to the proposed regulatory limit of PCDD/Fs. These findings highlight the need to define reporting protocols of analytical results for risk assessments and conformity evaluation.

Irradiation Fields and Doses in Glioblastoma Multiforme: Are Current Standards Adequate?

2001 ◽  
Vol 87 (2) ◽  
pp. 85-90 ◽  
Author(s):  
Michele Reni ◽  
Cesare Cozzarini ◽  
Maria Grazia Panucci ◽  
Giovanni Luca Ceresoli ◽  
Andrés José María Ferreri ◽  
...  
Keyword(s):  
Glioblastoma Multiforme ◽  
Performance Status ◽  
Phase Iii ◽  
Control Group ◽  
Whole Brain ◽  
Female Ratio ◽  
Brain Irradiation ◽  
Impact On Survival ◽  
Prospective Trials ◽  
The Impact

Aims and background The optimum conventional radiotherapy in glioblastoma multiforme patients has not been clearly defined by prospective trials. To better characterize a standard radiotherapy in glioblastoma multiforme, the impact on survival of different fields and doses was analyzed in a retrospective single center series. Methods One hundred and forty-seven patients with glioblastoma multiforme, submitted to biopsy only (n = 15), subtotal (n = 48) or total resection (n = 82) and who completed the planned postsurgical radiotherapy, were considered. The median age was 57 years, the male/female ratio 1.5/1, and the performance status ≥70 in 76%. Whole brain irradiation, followed by a boost to partial brain, was used in 75 cases with a whole brain dose of 44–50 Gy (median, 46) and a partial brain dose of 56–70 Gy (median, 60 Gy). Partial brain irradiation alone was used in 72 patients with a dose of 56–70 Gy (median, 61 Gy). Ninety-eight patients received 56–60 Gy (median, 59 Gy) to partial brain whereas 49 patients received 61–70 Gy (median, 63 Gy). Results There was an almost significantly longer survival in patients irradiated to the partial brain alone with respect to those also receiving whole brain radiotherapy (P = 0.056). Doses <60 Gy significantly prolonged survival (P = 0.006). Multivariate analysis confirmed that the impact on survival of radiation dose was independent of age, performance status, extent of surgery, field of irradiation and the use of chemotherapy. The extent of irradiation field was not independently related to improved survival. Conclusions Our retrospective findings suggest that we reflect on the adequacy of the current standard irradiation parameters. Well-designed prospective trials are necessary to standardize the radiotherapy control group in patients with glioblastoma multiforme to be compared in phase III trials with innovative therapeutic approaches.

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