Gender and age related differences in the use of medicines for chronic diseases among undocumented migrants

Purpose The purpose of this paper is to evaluate gender-related differences in the use of drugs for chronic diseases in undocumented migrants. Design/methodology/approach The authors analyzed the databases of two charitable organizations providing medical help and medicines to undocumented migrants. Data were available for 9,822 patients in the period 2014–2016. The authors grouped medicines according to the Anatomical Therapeutic Chemical (ATC) classification. We considered the ATC group as an indicator of a group of diseases. Findings Both males and females needed medicines for chronic diseases in a comparable manner. When we analyzed the age distribution, The authors noticed that males showed a tendency to begin to be affected at an earlier age; however, this cumulative difference was not statistically significant. But when we looked at six groups of drugs separately (cardiovascular, respiratory, anti-thrombotic, neurologic, psychiatric, anti-diabetic), the authors found that females always needed drugs for chronic diseases at a later age, always with a significant difference (p<0.0001 for cardiovascular, antithrombotic, antidiabetic and psychoactive drugs; p<0.002 for neurologic products; p<0.04 for drugs used in chronic respiratory conditions). Research limitations/implications This is a retrospective study based on the analysis of existing databases, but the peculiar features of this population (undocumented migrants) do not allow at the moment controlled studies. Practical implications Our observations could be important when planning public health strategies, especially in the field of prevention. Originality/value This is the first report of gender differences in the use of medicines for chronic diseases within a large sample of undocumented migrants.

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Does an impaired capacity for self-care impact the prevalence of social and emotional loneliness among elderly people?

Working with Older People ◽

10.1108/wwop-01-2018-0001 ◽

2018 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Irena Canjuga ◽

Danica Železnik ◽

Marijana Neuberg ◽

Marija Božicevic ◽

Tina Cikac

Keyword(s):

Health Care ◽

Elderly People ◽

Age Distribution ◽

Self Care ◽

The Elderly ◽

The Self ◽

Content Type ◽

Care Assessment ◽

Significant Difference ◽

The Impact

Purpose The purpose of this paper is to explore the impact of self-care on the prevalence of loneliness among elderly people living in retirement homes and older people living in their homes/communities. Design/methodology/approach The research was conducted through standardized SELSA-L assessment loneliness questionnaires and the Self Care Assessment Worksheet for self-care assessment. The results were processed using the Kruskal–Wallis test. Findings The obtained results have shown that impaired self-care ability affects the prevalence of loneliness among the elderly almost the same in both groups of participants. However, regarding the relationship between the state of health and self-care, only a statistically significant difference in the prevalence of loneliness is found in the case of the participants living in their homes, with the worst health condition affecting the poorer psychological care. Research limitations/implications It is necessary to point out the limitations of the research, primarily sample limitations and the selected design of the study. The sample consisted of two different and relatively small groups of participants which could adversely affect the representativeness of the sample and reduce the possibility of generalising the results. The next limiting factor is the age distribution the authors used in the research, where the age of the participants as a very important variable was collected by age range and not precisely which consequently resulted in inequality in subgroup sizes. Thus, the middle age (75–85) covers up to ten years, which is a huge range at an older age and can mean major differences in functional ability, and can impact the self-care assessment. Practical implications Nurses are indispensable in care for the elderly and they need to promote and encourage self-care of the elderly through health care. Elderly people living in retirement homes should be allowed to participate equally in health care in order to preserve their own autonomy and dignity. However, to benefit those who live in their homes, nurses should be connected to the local community and thus stimulate various forms of preventative (testing blood sugar levels, blood pressure and educating on the importance of preventive examinations) or recreational activities in the environment of elderly people with the goal of preserving their functional abilities. Originality/value The impact of self-care on loneliness was not sufficiently researched, and this paper contributed to understanding the complexity of loneliness phenomena among the elderly with the aim of developing a model of prevention.

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Evaluation of BCNU and/or radiotherapy in the treatment of anaplastic gliomas

Journal of Neurosurgery ◽

10.3171/jns.1978.49.3.0333 ◽

1978 ◽

Vol 49 (3) ◽

pp. 333-343 ◽

Cited By ~ 1144

Author(s):

Michael D. Walker ◽

Eben Alexander ◽

William E. Hunt ◽

Collin S. MacCarty ◽

M. Stephen Mahaley ◽

...

Keyword(s):

Performance Status ◽

Randomized Study ◽

Cranial Nerves ◽

Age Distribution ◽

Treated Group ◽

Conventional Care ◽

Surgical Biopsy ◽

Content Type ◽

Anaplastic Gliomas ◽

Significant Difference

✓ A controlled, prospective, randomized study evaluated the use of 1,3-bis(2-chloroethyl)-l-nitrosourea (BCNU) and/or radiotherapy in the treatment of patients who were operated on and had histological confirmation of anaplastic glioma. A total of 303 patients were randomized into this study, of whom 222 (73%) were within the Valid Study Group (VSG), having met the protocol criteria of neuropathology, corticosteroid control, and therapeutic approach. Patients were divided into four random groups, and received BCNU (80 mg/sq m/day on 3 successive days every 6 to 8 weeks), and/or radiotherapy (5000 to 6000 rads to the whole brain through bilateral opposing ports), or best conventional care but no chemotherapy or radiotherapy. Analysis was performed on all patients who received any amount of therapy (VSG) and on the Adequately Treated Group (ATG), who had received 5000 or more rads radiotherapy, two or more courses of chemotherapy, and had a minimum survival of 8 or more weeks (the interval that would have been required to have received either the radiotherapy or chemotherapy). Median survival of patients in the VSG was, best conventional care: 14 weeks (ATG: 17.0 weeks); BCNU: 18.5 weeks (ATG: 25.0 weeks); radiotherapy: 35 weeks (ATG: 37.5 weeks); and BCNU plus radiotherapy: 34.5 weeks (ATG: 40.5 weeks). All therapeutic modalities showed some statistical superiority compared to best conventional care. There was no significant difference between the four groups in relation to age distribution, sex, location of tumor, diagnosis, tumor characteristics, signs or symptoms, or the amount of corticosteroid used. An analysis of prognostic factors indicates that the initial performance status (Karnofsky rating), age, the use of only a surgical biopsy, parietal location, the presence of seizures, or the involvement of cranial nerves II, III, IV, and VI are all of significance. Toxicity included acceptable, reversible thrombocytopenia and leukopenia.

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Evaluation of mithramycin in the treatment of anaplastic gliomas

Journal of Neurosurgery ◽

10.3171/jns.1976.44.6.0655 ◽

1976 ◽

Vol 44 (6) ◽

pp. 655-667 ◽

Cited By ~ 45

Author(s):

Michael D. Walker ◽

Eben Alexander ◽

William E. Hunt ◽

Carl M. Leventhal ◽

M. Stephen Mahaley ◽

...

Keyword(s):

Randomized Study ◽

Age Distribution ◽

Gastrointestinal Symptoms ◽

Treated Group ◽

Anaplastic Glioma ◽

Control Group ◽

Duration Of Symptoms ◽

Content Type ◽

Anaplastic Gliomas ◽

Significant Difference

✓ A controlled, prospective, randomized study evaluated the use of mithramycin in the treatment of anaplastic glioma compared to a similar group of patients receiving best conventional care. From a total of 116 patients in the study, 96 were within the valid study group. All patients were operated on, had histological confirmation of anaplastic glioma, and received radiotherapy at the discretion of the principal investigator. Fifty-two patients received mithramycin at a dose of 25 µg/kg/day for 21 days, while 44 patients were in the control group. There was no significant difference in the median survival from time of randomization in those receiving mithramycin (21 weeks) as compared to those not receiving mithramycin (26 weeks). There was no significant difference between the two groups in relation to age distribution, sex, location, diagnosis, tumor characteristics, signs or symptoms, or radiotherapy received. Duration of symptoms correlates positively with survival and was also significantly longer in the control group than in the treated group. This, however, did not account for the failure of mithramycin to be found an effective agent. Although the study was not designed to evaluate the efficacy of radiotherapy, patients who were so treated had a significant improvement in survival. The toxic complications of mithramycin included gastrointestinal symptoms, dermatological involvement, anemia, and liver dysfunction, indicating the need for close supervision.

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The influence of osteopathic correction on the rate of various rhythms of the body

Russian Osteopathic Journal ◽

10.32885/2220-0975-2019-1-2-64-71 ◽

2019 ◽

pp. 64-71 ◽

Cited By ~ 1

Author(s):

A. E. Chernikova ◽

Yu. P. Potekhina

Keyword(s):

Heart Rate ◽

Respiratory Rate ◽

Age Groups ◽

Biomechanical Properties ◽

Dispersion Analysis ◽

The Body ◽

Body Tissues ◽

Age Related ◽

Significant Difference ◽

Before And After

Introduction. An osteopathic examination determines the rate, the amplitude and the strength of the main rhythms (cardiac, respiratory and cranial). However, there are relatively few studies in the available literature dedicated to the influence of osteopathic correction (OC) on the characteristics of these rhythms.Goal of research — to study the influence of OC on the rate characteristics of various rhythms of the human body.Materials and methods. 88 adult osteopathic patients aged from 18 to 81 years were examined, among them 30 men and 58 women. All patients received general osteopathic examination. The rate of the cranial rhythm (RCR), respiratory rate (RR) heart rate (HR), the mobility of the nervous processes (MNP) and the connective tissue mobility (CTM) were assessed before and after the OC session.Results. Since age varied greatly in the examined group, a correlation analysis of age-related changes of the assessed rhythms was carried out. Only the CTM correlated with age (r=–0,28; p<0,05) in a statistically significant way. The rank dispersion analysis of Kruskal–Wallis also showed statistically significant difference in this indicator in different age groups (p=0,043). With the increase of years, the CTM decreases gradually. After the OC, the CTM, increased in a statistically significant way (p<0,0001). The RCR varied from 5 to 12 cycles/min in the examined group, which corresponded to the norm. After the OC, the RCR has increased in a statistically significant way (p<0,0001), the MNP has also increased (p<0,0001). The initial heart rate in the subjects varied from 56 to 94 beats/min, and in 15 % it exceeded the norm. After the OC the heart rate corresponded to the norm in all patients. The heart rate and the respiratory rate significantly decreased after the OC (р<0,0001).Conclusion. The described biorhythm changes after the OC session may be indicative of the improvement of the nervous regulation, of the normalization of the autonomic balance, of the improvement of the biomechanical properties of body tissues and of the increase of their mobility. The assessed parameters can be measured quickly without any additional equipment and can be used in order to study the results of the OC.

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Gamma knife radiosurgery for intracranial metastatic melanoma: a 6-year experience

Journal of Neurosurgery ◽

10.3171/jns.2002.97.supplement_5.0494 ◽

2002 ◽

Vol 97 ◽

pp. 494-498 ◽

Cited By ~ 24

Author(s):

Jorge Gonzalez-martinez ◽

Laura Hernandez ◽

Lucia Zamorano ◽

Andrew Sloan ◽

Kenneth Levin ◽

...

Keyword(s):

Prognostic Factors ◽

Brain Metastases ◽

Metastatic Melanoma ◽

Gamma Knife Radiosurgery ◽

Tumor Control ◽

Karnofsky Performance Scale ◽

Content Type ◽

Significant Difference ◽

The Mean ◽

Fine Print

Object. The purpose of this study was to evaluate retrospectively the effectiveness of stereotactic radiosurgery for intracranial metastatic melanoma and to identify prognostic factors related to tumor control and survival that might be helpful in determining appropriate therapy. Methods. Twenty-four patients with intracranial metastases (115 lesions) metastatic from melanoma underwent radiosurgery. In 14 patients (58.3%) whole-brain radiotherapy (WBRT) was performed, and in 12 (50%) chemotherapy was conducted before radiosurgery. The median tumor volume was 4 cm3 (range 1–15 cm3). The mean dose was 16.4 Gy (range 13–20 Gy) prescribed to the 50% isodose at the tumor margin. All cases were categorized according to the Recursive Partitioning Analysis classification for brain metastases. Univariate and multivariate analyses of survival were performed to determine significant prognostic factors affecting survival. The mean survival was 5.5 months after radiosurgery. The analyses revealed no difference in terms of survival between patients who underwent WBRT or chemotherapy and those who did not. A significant difference (p < 0.05) in mean survival was observed between patients receiving immunotherapy or those with a Karnofsky Performance Scale (KPS) score of greater than 90. Conclusions. The treatment with systemic immunotherapy and a KPS score greater than 90 were factors associated with a better prognosis. Radiosurgery for melanoma-related brain metastases appears to be an effective treatment associated with few complications.

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Gamma knife radiosurgery for metastatic brain tumors from lung cancer: a comparison between small cell and non—small cell carcinoma

Journal of Neurosurgery ◽

10.3171/jns.2002.97.supplement_5.0484 ◽

2002 ◽

Vol 97 ◽

pp. 484-488 ◽

Cited By ~ 46

Author(s):

Toru Serizawa ◽

Junichi Ono ◽

Toshihiko Iichi ◽

Shinji Matsuda ◽

Makoto Sato ◽

...

Keyword(s):

Lung Cancer ◽

Brain Tumors ◽

Gamma Knife ◽

Gamma Knife Radiosurgery ◽

Small Cell ◽

Metastatic Brain Tumors ◽

Cell Lung Carcinoma ◽

Content Type ◽

Significant Difference ◽

Fine Print

Object. The purpose of this retrospective study was to evaluate the effectiveness of gamma knife radiosurgery (GKS) for the treatment of metastatic brain tumors from lung cancer, with particular reference to small cell lung carcinoma (SCLC) compared with non-SCLC (NSCLC). Methods. Two hundred forty-five consecutive patients meeting the following five criteria were evaluated in this study: 1) no prior brain tumor treatment; 2) 25 or fewer lesions; 3) a maximum of three tumors with a diameter of 20 mm or larger; 4) no surgically inaccessible tumor 30 mm or greater in diameter; and 5) more than 3 months of life expectancy. According to the same treatment protocol, large tumors (≥ 30 mm) were surgically removed and the other small lesions (< 30 mm) were treated with GKS. New lesions were treated with repeated GKS. Chemotherapy was administered, according to the primary physician's protocol, as aggressively as possible. Progression-free, overall, neurological, qualitative, and new lesion—free survival were calculated with the Kaplan—Meier method and were compared in the SCLC and NSCLC groups by using the log-rank test. The poor prognostic factors for each type of survival were also analyzed with the Cox proportional hazard model. Conclusions. Tumor control rate at 1 year was 94.5% in the SCLC group and 98% in the NSCLC group. The median survival time was 9.1 months in the SCLC group and 8.6 months in the NSCLC group. The 1-year survival rates in the SCLC group were 86.5% for neurological survival and 68.9% for qualitative survival; those in the NSCLC group were 87.9% for neurological and 78.9% for qualitative survival. The estimated median interval to emergence of a new lesion was 6.9 months in the SCLC group and 9.8 months in the NSCLC group. There was no significant difference between the two groups for any type of survival; this finding was verified by multivariate analysis. The results of this study suggest that GKS appears to be as effective in treating brain metastases from SCLC as for those from NSCLC.

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Residents’ perception towards tourism impacts in Kashmir

International Journal of Tourism Cities ◽

10.1108/ijtc-11-2019-0202 ◽

2020 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Asif Hamid Charag ◽

Asif Iqbal Fazili ◽

Irfan Bashir

Keyword(s):

Planning Process ◽

Economic Impacts ◽

Tourism Development ◽

Policy Framework ◽

Social Implications ◽

Cultural Economic ◽

Tourism Impacts ◽

Content Type ◽

City Tourism ◽

Significant Difference

Purpose The purpose of this study is to understand the residents’ perception towards environmental, social, cultural and economic impacts of tourism development in Kashmir. Design/methodology/approach The research instrument containing 27 items pertaining to six variables is adopted from the literature. A mix-method survey approach is used to solicit residents’ perceptions regarding environmental, social, cultural and economic impacts of the current level of tourism development. A total of 326 useful responses were subjected to descriptive statistics, analysis of variance (ANOVA) and post hoc analysis using SPSS (Version 22.0). Findings In general, the negative and positive impacts of tourism development are well perceived by the residents. The results indicate that the residents display positive perception regarding economic impacts, however, social and environmental impacts are negatively perceived. Furthermore, barring level of education, the study found no significant difference in the residents’ perception towards tourism impacts (environmental, social, cultural, economic, quality of life and cost of living). Research limitations/implications The paper identifies perceived impacts and issues of tourism development thereby, proposing possible mitigating measures. Also, the study identifies the need to develop a comprehensive policy framework addressing the issues related to the resident’s negative feelings towards tourism impacts. Further, the study envisages the need for engaging residents in developing a progressive and participatory planning process for future tourism activities in the area. Social implications The study offers critical social implications for city tourism development. It suggests a community-based approach should be adopted to sensitize residents about the positive benefits of tourism. Originality/value The study is a novel attempt concerning residents’ residents perceptual differences towards tourism impacts. Furthermore, this study investigated socio-cultural impacts of tourism under two separate categories for better understanding. in doing so, this study provides finer understanding of perception of residents towards tourism impacts in Indian context. The findings of the study will prove critical for different stakeholders in developing future tourism framework and policies in the region.

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Updated Incidence of Thyroid Cancer in the North East Region of Romania after 35 Years of Chernobyl Fallout. Is There a Link between?

Diagnostics ◽

10.3390/diagnostics11050907 ◽

2021 ◽

Vol 11 (5) ◽

pp. 907

Author(s):

Laura Teodoriu ◽

Maria Christina Ungureanu ◽

Letitia Leustean ◽

Cristina Preda ◽

Delia Ciobanu ◽

...

Keyword(s):

Thyroid Cancer ◽

Age Distribution ◽

Age Groups ◽

Chernobyl Fallout ◽

Statistical Correlations ◽

North East ◽

The North ◽

East Region ◽

Radioactive Cloud ◽

The Moment

Thyroid cancer (TC) represents a worldwide problem, the consistent growth of the incidence increment issues about management of risk factors and curative treatment. Updated statistical data are not complete in the North East region of Romania and need to be improved. Therefore, through this study, we aim to renew the existing data on thyroid cancer. We conducted a retrospective study covering a period of 10 years. Data were collected from a hospital information system (InfoWorld) between 2009 and 2019. Patients’ age groups were stratified in relation with the age at the moment of the Chernobyl event. A database was obtained (Microsoft Excel) and statistical correlations were applied. In the studied period, 1159 patients were diagnosed: 968 females and 191 males, distributed by region, with the highest addressability in Iasi (529), followed by neighboring counties. Age distribution displayed that most of the thyroid cancers were in the range 4060 years old (50.94%), followed by 60–80 years old (32.41%). Most patients were diagnosed with papillary carcinoma 63.10%, then follicular 14.7%, medullary 6.74% and undifferentiated 1.02%. Romania was in the vicinity of the radioactive cloud at Chernobyl fallout, so we must deliberate whether the increased incidence of thyroid cancer in the age group 40–60 years is associated with radiogenicity (iodine 131) given the fact that over has 35 years and the half-life of other radioisotopes like Caesium-137 and Strontium -90 is completed.

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Age-Related Biology of Early-Stage Operable Breast Cancer and Its Impact on Clinical Outcome

Cancers ◽

10.3390/cancers13061417 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1417

Author(s):

Binafsha M. Syed ◽

Andrew R. Green ◽

Emad A. Rakha ◽

David A.L. Morgan ◽

Ian O. Ellis ◽

...

Keyword(s):

Breast Cancer ◽

Early Stage ◽

Histological Grade ◽

Survival Rates ◽

Growth Factor Receptor ◽

Progesterone Receptors ◽

Biological Characteristics ◽

Cancer Specific Survival ◽

Age Related ◽

Significant Difference

As age advances, breast cancer (BC) tends to change its biological characteristics. This study aimed to explore the natural progression of such changes. The study included 2383 women with clinically T0-2N0-1M0 BC, managed by primary surgery and optimal adjuvant therapy in a dedicated BC facility. Tissue micro-arrays were constructed from their surgical specimens and indirect immunohistochemistry was used for analysis of a large panel (n = 16) of relevant biomarkers. There were significant changes in the pattern of expression of biomarkers related to luminal (oestrogen receptor (ER), progesterone receptors (PgR), human epidermal growth factor receptor (HER-2), E-cadherin, MUC1, bcl2 CK7/8, CK18 and bcl2) and basal (CK5/6, CK14, p53 and Ki67) phenotypes, lymph node stage, histological grade and pathological size when decade-wise comparison was made (p < 0.05). The ages of 40 years and 70 years appeared to be the milestones marking a change of the pattern. There were significantly higher metastasis free and breast cancer specific survival rates among older women with ER positive tumours while there was no significant difference in the ER negative group according to age. Biological characteristics of BC show a pattern of change with advancing age, where 40 years and 70 years appear as important milestones. The pattern suggests <40 years as the phase with aggressive phenotypes, >70 years as the less aggressive phase and 40–70 years being the transitional phase.

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Impact of Cochlear Implantation on Neurocognitive Subdomains in Adult Cochlear Implant Recipients

Audiology and Neurotology ◽

10.1159/000510855 ◽

2021 ◽

pp. 1-10

Author(s):

Christiane Völter ◽

Lisa Götze ◽

Imme Haubitz ◽

Janine Müther ◽

Stefan Dazert ◽

...

Keyword(s):

Hearing Loss ◽

Cochlear Implant ◽

Cochlear Implantation ◽

Verbal Fluency ◽

Homogeneous Population ◽

Delayed Recall ◽

Hearing Status ◽

Age Related ◽

Significant Difference ◽

The Impact

Introduction: Age-related hearing loss affects about one-third of the population worldwide. Studies suggest that hearing loss may be linked to cognitive decline and auditory rehabilitation may improve cognitive functions. So far, the data are limited, and the underlying mechanisms are not fully understood. The study aimed to analyze the impact of cochlear implantation on cognition in a large homogeneous population of hearing-impaired adults using a comprehensive non-auditory cognitive assessment with regard to normal-hearing (NH) subjects. Material and Methods: Seventy-one cochlear implant (CI) candidates with a postlingual, bilateral severe or profound hearing loss aged 66.3 years (standard deviation [SD] 9.2) and 105 NH subjects aged 65.96 years (SD 9.4) were enrolled. The computer-based neurocognitive tool applied included 11 subtests covering attention (M3), short- and long-term memory (recall and delayed recall), working memory (0- and 2-back, Operation Span [OSPAN] task), processing speed (Trail Making Test [TMT] A), mental flexibility (TMT B), inhibition (cFlanker and iFlanker), and verbal fluency. CI patients underwent a neurocognitive testing preoperatively as well as 12 months postoperatively. Impact of hearing status, age, gender, and education on cognitive subdomains was studied. Additionally, after controlling for education and age, cognitive performance of CI subjects (n = 41) was compared to that of NH (n = 34). Results: CI users achieved significantly better neurocognitive scores 12 months after cochlear implantation than before in most subtests (M3, [delayed] recall, 2-back, OSPAN, iFlanker, and verbal fluency; all p < 0.05) except for the TMT A and B. A significant correlation could be found between the postoperative improvement in speech perception and in the attentional task M3 (p = 0.01). Hearing status (p = 0.0006) had the strongest effect on attention, whereas education had a high impact on recall (p = 0.002), OSPAN (p = 0.0004), and TMT A (p = 0.005) and B (p = 0.003). Inhibition was mainly age-dependent with better results in younger subjects (p = 0.016). Verbal fluency was predicted by gender as females outperformed men (p = 0.009). Even after controlling for age and education NH subjects showed a significantly better performance than CI candidates in the recall (p = 0.03) and delayed recall (p = 0.01) tasks. Postoperatively, there was no significant difference between the 2 groups anymore. Conclusion: Impact of cochlear implantation on neurocognitive functions differs according to the cognitive subdomains. Postoperatively, CI recipients performed as good as age- and education-matched NH subjects.

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