What cancer patients actually know regarding medical cannabis? A cross-sectional survey with a critical analysis of the current attitudes

2019 ◽  
Vol 25 (6) ◽  
pp. 1439-1444 ◽  
Author(s):  
Alessio Cortellini ◽  
Giampiero Porzio ◽  
Vincenza Cofini ◽  
Stefano Necozione ◽  
Raffaele Giusti ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Cancer Patients ◽  
Educational Level ◽  
Odds Ratio ◽  
Healthcare Professionals ◽  
Care Service ◽  
Health Problems ◽  
High Educational Level ◽  
Medical Cannabis ◽  
Active Disease

Background In Italy medical cannabis is a prescription drug since 1998. Even though it could not be considered a therapy as such, it is indicated as a symptomatic treatment also in cancer patients, to cure iatrogenic nausea/vomiting and chronic pain. Patients and methods We conducted a knowledge survey about medical cannabis among cancer patients referred to two outpatient cancer care centers and a home care service. Results From February to April 2018, 232 patient were enrolled; 210 patients were on active disease-oriented treatment (90.5%), while 22 (9.5%) not. Eighty-one percent of the patients have heard about medical cannabis, but only 2% from healthcare professionals. Thirty-four percent of responders thought about using cannabis to treat one or more of their own health problems, especially pain (55%). Despite that, 18% of the participants believe that medical cannabis could have negative effects on their own symptoms. Patients with high educational level better knew cannabis (odds ratio = 3.52; 95% confidence interval: 1.07–11.53), and medical cannabis (odds ratio = 3.21; 95% confidence interval: 1.48–6.98), when compared to patient with low educational level. Patients who were on active disease-oriented treatment better knew medical cannabis (odds ratio = 3.91; 95% confidence interval: 1.26–12.11) compared to “out of treatment” patients. Metastatic patients were less informed about medical cannabis compared to patients on adjuvant treatment. Conclusions Our survey shows that most of Italian cancer patients know medical cannabis and a third of them have considered using cannabis to treat one (or more) of their own health problems. In the same time, they are poorly informed and do not tend to ask for information about medical cannabis to healthcare professionals.

Genetic Predisposition to Cervical Cancer and the Association With XRCC1 and TGFB1 Polymorphisms

2017 ◽  
Vol 27 (9) ◽  
pp. 1949-1956 ◽  
Author(s):  
Najla M. Al-Harbi ◽  
Sara S. Bin Judia ◽  
Krishna N. Mishra ◽  
Mohamed M. Shoukri ◽  
Ghazi A. Alsbeih
Keyword(s):  
Confidence Interval ◽  
Cancer Patients ◽  
Genetic Predisposition ◽  
Odds Ratio ◽  
Direct Sequencing ◽  
Trend Test ◽  
Nucleotide Polymorphisms ◽  
Control Subjects ◽  
Allele Dosage ◽  
Increased Risk

ObjectiveCervical carcinoma (CC), a multifactorial cancer, is assumed to have a host genetic predisposition component that modulates its susceptibility in various populations. We investigated the association between CC risk in Saudi women and 6 single-nucleotide polymorphisms (SNPs) in hypothesis-driven candidate genes.MethodsA total of 545 females were included, comprising 232 CC patients and 313 age-/sex-matched control subjects. Six SNPs (CDKN1A C31A, ATM G1853A, HDM2 T309G, TGFB1 T10C, XRCC1 G399A, and XRCC3 C241T) were genotyped by direct sequencing.ResultsOf the 6 SNPs studied, TGFB1 T10C (odds ratio, 0.74; 95% confidence interval, 0.57–0.94) and XRCC1 G399A (odds ratio, 1.45; 95% confidence interval, 1.11–1.90) displayed different frequencies in cancer patients and control subjects and showed statistically significant association in univariate (P = 0.017, P = 0.005, respectively) analysis. The Cochran-Armitage trend test had confirmed the results (P = 0.027 and P = 0.006, respectively), indicating an ordering in the effect of the risk alleles in CC patients. The 2 SNPs, TGFB1 T10C and XRCC1 G399A, showed also degrees of deviation from Hardy-Weinberg equilibrium in cancer patients (P = 0.001 and P = 0.083, respectively) but not in the control subjects. Furthermore, correction for multiple testing using multivariate logistic regression to assess the joint effect of all SNPs has sustained significant statistical association (P = 0.025 and P = 0.009, respectively).ConclusionsTGFB1 T10C and XRCC1 G399A SNPs were associated with CC risk in univariate and multivariate analysis and displayed allele-dosage effects and coselection in cancer patients. Patients harboring the majority allele TGFB1 T10 (Leu) or the variant allele XRCC1 399A (Gln) have approximately 1.5-fold increased risk to develop CC. Host SNPs genotyping may provide relevant biomarkers for CC risk assessment in personalized preventive medicine.

The impact of parental mental health problems on the educational outcomes of their offspring: Findings from the Raine Study

2021 ◽  
pp. 000486742110256
Author(s):  
Getinet Ayano ◽  
Ashleigh Lin ◽  
Berihun Assefa Dachew ◽  
Robert Tait ◽  
Kim Betts ◽  
...  
Keyword(s):  
Mental Health ◽  
Confidence Interval ◽  
Educational Outcomes ◽  
Odds Ratio ◽  
Mental Health Problems ◽  
Tertiary Education ◽  
Health Problems ◽  
Anxiety Symptoms ◽  
Parental Mental Health ◽  
The Impact

Objectives: There is limited evidence on the impact of parental mental health problems on offspring’s educational outcomes. We investigated the impact of maternal anxiety and depressive symptoms, as well as paternal emotional problems on the educational outcomes of their adolescent and young adult offspring. Methods: We used data from a longitudinal birth cohort recruited between 1989 and 1991 in Australia (the Raine Study). The Depression, Anxiety and Stress Scale was used to assess maternal depressive and anxiety symptoms, and a self-reported question was used to measure paternal mental health problems. Both were assessed when the offspring was aged 10 years. Outcomes included offspring’s self-reported education attainment—not completing year 10 at age 17, not attending tertiary education at ages 17 and 22 and primary caregiver’s reports of offspring’s academic performance at age 17. Results: A total of 1033, 1307 and 1364 parent–offspring pairs were included in the final analysis exploring the association between parental mental health problems and offspring’s academic performance at school, completing year 10 and attending tertiary education, respectively. After adjusting for potential confounders, the offspring of mothers with anxiety symptoms were 3.42 times more likely than the offspring of mothers without anxiety symptoms to have poor or below-average academic performance (odds ratio = 3.42; 95% confidence interval = [1.31, 8.92]) and more than 2 times more likely to not attend tertiary education (odds ratio = 2.55; 95% confidence interval = [1.10, 5.5.88]) and not to have completed year 10 (odds ratio = 2.13; 95% confidence interval = [1.04, 4.33]). We found no significant associations between maternal depressive symptoms or paternal emotional problems and offspring educational attainment. Conclusion: Maternal anxiety symptoms, but not depression and paternal emotional problems, are associated with poor educational attainment and achievement in adolescent offspring. The findings highlight that efforts to improve the outcomes of offspring of mothers with anxiety could focus on educational attainment.

scholarly journals Gestational Age, Parent Education, and Education in Adulthood

PEDIATRICS ◽  
2021 ◽  
Author(s):  
Josephine Funck Bilsteen ◽  
Suvi Alenius ◽  
Magne Bråthen ◽  
Klaus Børch ◽  
Claus Thorn Ekstrøm ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Educational Attainment ◽  
Parent Education ◽  
Gestational Age ◽  
Educational Level ◽  
Parental Education ◽  
Reference Group ◽  
Socioeconomic Background ◽  
High Educational Level ◽  
Parental Educational Level

BACKGROUND: Adults born preterm (<37 weeks) have lower educational attainment than those born term. Whether this relationship is modified by family factors such as socioeconomic background is, however, less well known. We investigated whether the relationship between gestational age and educational attainment in adulthood differed according to parents’ educational level in 4 Nordic countries. METHODS: This register-based cohort study included singletons born alive from 1987 up to 1992 in Denmark, Finland, Norway, and Sweden. In each study population, we investigated effect modification by parents’ educational level (low, intermediate, high) on the association between gestational age at birth (25–44 completed weeks) and low educational attainment at 25 years (not having completed upper secondary education) using general estimation equations logistic regressions. RESULTS: A total of 4.3%, 4.0%, 4.8%, and 5.0% singletons were born preterm in the Danish (n = 331 448), Finnish (n = 220 095), Norwegian (n = 292 840), and Swedish (n = 513 975) populations, respectively. In all countries, both lower gestational age and lower parental educational level contributed additively to low educational attainment. For example, in Denmark, the relative risk of low educational attainment was 1.84 (95% confidence interval 1.44 to 2.26) in adults born at 28 to 31 weeks whose parents had high educational level and 5.25 (95% confidence interval 4.53 to 6.02) in adults born at 28 to 31 weeks whose parents had low educational level, compared with a reference group born at 39 to 41 weeks with high parental educational level. CONCLUSIONS: Although higher parental education level was associated with higher educational attainment for all gestational ages, parental education did not mitigate the educational disadvantages of shorter gestational age.

scholarly journals Predictors of At-Home Death for Cancer Patients in Rural Clinics in Japan

2021 ◽  
Vol 18 (23) ◽  
pp. 12703
Author(s):  
Jun Watanabe ◽  
Hiroyuki Teraura ◽  
Kenichi Komatsu ◽  
Hironori Yamaguchi ◽  
Kazuhiko Kotani
Keyword(s):  
Palliative Care ◽  
Confidence Interval ◽  
Cancer Patients ◽  
Clinical Pathway ◽  
Rural Areas ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Home Death ◽  
Rural Clinics ◽  
At Home

Background: The prediction of at-home deaths has become an important topic in rural areas of Japan with an advanced aging society. However, there are no well-established predictors to explain how these factors influence intention. This study aims to investigate the possible predictors of at-home death for cancer patients in rural clinics in Japan. Methods: This is a nationwide cross-sectional survey. A self-administered questionnaire was sent to 493 rural clinics in Japan. The main outcome was the realization of at-home deaths for cancer patients. Results: Among the 264 clinics (54%) that responded to the survey, there were 194 clinics with the realization of at-home death. The use of a clinical pathway (adjusted odds ratio 4.19; 95% confidence interval 1.57–11.19) and the provision of organized palliative care (adjusted odds ratio 19.16; 95% confidence interval 7.56–48.52) were associated with the prediction of at-home death, irrespective of island geography or the number of doctors and nurses. Conclusions: Having a clinical pathway and systematizing palliative care could be important to determine the possibility of at-home deaths for cancer patients in rural clinics in Japan.

scholarly journals Integrated palliative care networks from the perspectives of patients: A cross-sectional explorative study in five European countries

2018 ◽  
Vol 32 (6) ◽  
pp. 1103-1113 ◽  
Author(s):  
Marlieke den Herder-van der Eerden ◽  
Anne Ebenau ◽  
Sheila Payne ◽  
Nancy Preston ◽  
Lukas Radbruch ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Palliative Care ◽  
Confidence Interval ◽  
Pulmonary Disease ◽  
Odds Ratio ◽  
Healthcare Professionals ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Lower Odds

Background: Although examining perspectives of patients on integrated palliative care organisation is essential, available literature is largely based on administrative data or healthcare professionals’ perspectives. Aim: (1) Providing insight into the composition and quality of care networks of patients receiving palliative care and (2) describing perceived integration between healthcare professionals within these networks and its association with overall satisfaction. Design: Cross-sectional explorative design. Setting/participants: We recruited 157 patients (62% cancer, 25% chronic obstructive pulmonary disease, 13% chronic heart failure, mean age 68 years, 55% female) from 23 integrated palliative care initiatives in Belgium, Germany, the United Kingdom, Hungary and the Netherlands. Results: About 33% reported contact with a palliative care specialist and 48% with a palliative care nurse. Relationships with palliative care specialists were rated significantly higher than other physicians ( p < 0.001). Compared to patients with cancer, patients with chronic obstructive pulmonary disease (odds ratio = 0.16, confidence interval (0.04; 0.57)) and chronic heart failure (odds ratio = 0.11, confidence interval (0.01; 0.93)) had significantly lower odds of reporting contact with palliative care specialists and patients with chronic obstructive pulmonary disease (odds ratio = 0.23, confidence interval (0.08; 0.71)) had significantly lower odds of reporting contact with palliative care nurses. Perceptions of main responsible healthcare professionals or caregivers in patient’s care networks varied across countries. Perceived integration was significantly associated with overall satisfaction. Conclusion: Palliative care professionals are not always present or recognised as such in patients’ care networks. Expert palliative care involvement needs to be explicated especially for non-cancer patients. One healthcare professional should support patients in understanding and navigating their palliative care network. Patients seem satisfied with care provision as long as continuity of care is provided.

scholarly journals TAVR in Cancer Patients: Comprehensive Review, Meta-Analysis, and Meta-Regression

2021 ◽  
Vol 8 ◽  
Author(s):  
Konstantinos Marmagkiolis ◽  
Dominique J. Monlezun ◽  
Mehmet Cilingiroglu ◽  
Cindy Grines ◽  
Joerg Herrmann ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Confidence Interval ◽  
Cancer Patients ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Pacemaker Implantation ◽  
Control Group ◽  
Cochrane Central Register ◽  
Cancer Group ◽  
Meta Regression

Objectives: This study sought to systematically analyze the available clinical evidence on TAVR therapy in cancer patients with symptomatic severe AS.Background: Aortic stenosis is the most common valvular heart disease in the world. TAVR has expanded the treatment options for this lethal disease process. The safety and efficacy of TAVR in cancer patients has not yet been reliably established. We thus conducted the largest known multi-center meta-analysis on TAVR and cancer status.Methods: We performed a literature search using PubMed, EMBASE, and Cochrane Central Register of Controlled Trials from January 2015 to 2020. Studies that compared the use of TAVR in patients with severe symptomatic aortic stenosis and cancer against patients without cancer were included. Meta-regression was also conducted to determine if common clinical factors modified the possible association between cancer status and TAVR mortality.Results: Five studies with 11,129 patients in the cancer group and 41,706 patients in the control group met inclusion criteria. The short-term mortality in the cancer group was 2.4% compared with 3.3% in the control group (odds ratio: 0.72, 95% confidence interval: 0.63–0.82; p &lt; 0.0001). The frequency of stroke was 2.4% compared with 2.7% (odds ratio of 0.87, 95% confidence interval: 0.76–0.99; p &lt; 0.04). The frequency of AKI was 14.2% in cancer patients vs. 16.4% (odds ratio of 0.81, 95% confidence interval: 0.76–0.85; p &lt; 0.04). The rates of bleeding and need for new pacemaker implantation were not significantly different. Meta-regression demonstrated there was no significant association modifying.Conclusions: On the basis of the results of this meta-analysis TAVR may be a safe and effective therapeutic option for patients with cancer and symptomatic severe aortic stenosis. Larger, longer, and randomized trials are required to adequately test this above hypothesis.

Risk of Mortality and Institutionalization in Demented Patients with Delusions

1996 ◽  
Vol 9 (3) ◽  
pp. 123-126 ◽  
Author(s):  
Eugenio Magni ◽  
Giuliano Binetti ◽  
Angelo Bianchetti ◽  
Marco Trabucchi
Keyword(s):  
Longitudinal Study ◽  
Alzheimer Disease ◽  
Confidence Interval ◽  
Educational Level ◽  
Odds Ratio ◽  
Prognostic Value ◽  
Common Symptom ◽  
Confounding Factors ◽  
Risk Of Mortality ◽  
Impact On Survival

Delusions are a common symptom during the course of dementia. Despite their clinical relevance, however, it is still unclear whether they are of prognostic value. This longitudinal study involving, at baseline, 99 demented Alzheimer disease (AD) and multi-infarct dementia (MID) patients, investigates the risk of mortality and institutionalization at 2 years after discharge from a dementia unit in patients with and without delusions at baseline. Results indicate that the presence of delusions is a significant predictor of future institutionalization (odds ratio 3.6, confidence interval 1.3-9.6), even when confounding factors such as age, educational level, and severity of cognitive and functional impairment are statistically controlled. No significant impact on survival was found.

Aspiration pneumonia related deaths in head and neck cancer patients: a retrospective analysis of risk factors from a tertiary care centre in North India

2015 ◽  
Vol 129 (7) ◽  
pp. 710-714 ◽  
Author(s):  
R Madan ◽  
A K Kairo ◽  
A Sharma ◽  
S Roy ◽  
S Singh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Head And Neck Cancer ◽  
Confidence Interval ◽  
Head And Neck ◽  
Cancer Patients ◽  
Cause Of Death ◽  
Aspiration Pneumonia ◽  
Neck Cancer ◽  
Odds Ratio ◽  
Hospital Death

AbstractBackground:Aspiration pneumonia is an important cause of death in head and neck cancer patients. This study therefore aimed to evaluate the risk factors associated with aspiration pneumonia in head and neck cancer patients.Methods:Hospital death records from 12 years (2000–2012) were reviewed to obtain the number of deaths. Treatment details and cause of death were analysed. Statistical analysis was performed to identify the risk factors for aspiration pneumonia.Results:The records revealed that aspiration pneumonia was the cause of death in 51 out of 85 patients. Primary tumour site (oropharynx and hypopharynx, odds ratio 3.3; 95 per cent confidence interval 1.17–9.4, p = 0.02) and advanced tumour stage (odds ratio 4.2, 95 per cent confidence interval 1.16–15.61, p = 0.02) had significant negative impacts on aspiration pneumonia related mortality.Conclusion:Advanced pharyngeal cancer patients are at an increased risk of aspiration pneumonia related death. Investigations for the early detection of this condition are recommended in these high-risk patients.

Thromboembolic Events During Chemotherapy for Germ Cell Cancer: A Cohort Study and Review of the Literature

2000 ◽  
Vol 18 (10) ◽  
pp. 2169-2178 ◽  
Author(s):  
Nir I. Weijl ◽  
Marc F. J. Rutten ◽  
Aeilko H. Zwinderman ◽  
H. Jan Keizer ◽  
Marianne A. Nooy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Confidence Interval ◽  
Germ Cell ◽  
Cancer Patients ◽  
Odds Ratio ◽  
Cell Cancer ◽  
Germ Cell Cancer ◽  
Thromboembolic Events ◽  
Thromboembolic Complications ◽  
High Doses

PURPOSE: To evaluate the risk of major thromboembolic complications in male germ cell cancer patients receiving cisplatin-based chemotherapy and to review the literature on this subject. PATIENTS AND METHODS: One hundred seventy-nine germ cell cancer patients treated between January 1979 and May 1997 in our hospital were analyzed with respect to risk factors for developing thromboembolic events, such as baseline tumor characteristics, prior tumor therapy, administration of cytostatic agents, and the use of antiemetic drugs. The patients were treated with a variety of combination chemotherapy regimens, primarily cisplatin-containing combination regimens. RESULTS: Of the 179 patients, 15 patients (8.4%) were identified who developed a total of 18 major thromboembolic complications in the time period between the start of chemotherapy and 6 weeks after administration of the last cytostatic drug in first-line treatment. Of these 18 events, three (16.7%) were arterial events, including two cerebral ischemic strokes, and 15 (83.3%) were venous thromboembolic events, including 11 pulmonary embolisms. One (5.6%) of the 18 events was fatal. Liver metastases (odds ratio, 4.9; 95% confidence interval, 1.1 to 20.8) and the administration of high doses of corticosteroids (≥ 80 mg dexamethasone per cycle; odds ratio, 3.5; 95% confidence interval, 1.2 to 10.3) as antiemetic therapy were identified as risk factors for the development of major thromboembolic complications. CONCLUSION: Germ cell cancer patients who receive chemotherapy, in particular those who have liver metastases or receive high doses of corticosteroids, are at considerable risk of developing thromboembolic complications.

P6535Atrial fibrillation and its impact in hospitalised cancer patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A H Malik ◽  
N Siddiqui ◽  
S Shetty ◽  
A Godara ◽  
Z Khan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Confidence Interval ◽  
Hospital Mortality ◽  
Cancer Patients ◽  
Odds Ratio ◽  
Independent Risk Factor ◽  
Multivariate Model ◽  
P Value ◽  
Patients With Cancer

Abstract Background Atrial fibrillation (AF) is associated with increased morbidity and mortality. However, its impact on outcomes of cancer patients is largely unknown. We sought to determine the prevalence and effect of AF on in-hospital outcomes of patients admitted with AF in the United States. Methods We obtained and analyzed data from Nationwide Inpatient Sample (NIS 2002- 2014). The study population included all adults (>18 years old) with the discharge diagnosis of cancer and the associated secondary diagnosis of AF. The associations of AF with in-hospital complications, procedures, discharge outcomes, and mortality, were analyzed after adjusting for potential confounders using logistic regression analyses. Results During the study period, 12,410,290 patients were admitted with cancer; of which, 1,013,735 (8.2%) had AF. Patients with AF were likely to be male (51.1% vs 42.7%), white (86.3% vs 73.6%), and had significantly higher rates comorbidities including hypertension (59.6% vs 44.6%), diabetes (20.9% vs 15.8%), heart failure (23.8% vs 4.5%), and stroke (1.3% vs 0.7%). Similarly, in-hospital complications (including infections, venous thromboembolism, gastrointestinal bleeding, myocardial infarction) and hospital procedures (including cardiac catheterization, intubation, blood transfusion, percutaneous coronary intervention) were found at a significantly higher rate in cancer patients with AF compared to without AF (p-value for all <0.0001). After adjusting for all confounding factors, cancer patients in the AF group had higher odds of in-hospital death (odds ratio, 1.26; 95% confidence interval, 1.23–1.28; P<0.0001). The presence of AF conferred on average three days of extra inpatient stay in patients with cancer. Mortality in the cancer patients admitted with a concomitant diagnosis of AF has gradually increased from 7.2% to 9.7% over the 13-year study period. Table 1. Multivariate model showing Atrial fibrillation as an independent risk factor of inpatient mortality in cancer patients Unadjusted univariate model Multivariate model adjusted for age, sex, race and potential confounders* Odds ratio (95% confidence interval P-value Odds ratio (95% confidence interval P-value Discharged alive Reference Reference In-hospital mortality 2.08 (2.07, 2.10) <0.0001 1.26 (1.23, 1.28) <0.0001 *Confounders adjusted for include all clinical comorbidities and in-hospital complications and procedures. Conclusions In patients with cancer, AF confers significant in-hospital burden by increasing the hospital stay by 3 days. AF is also associated with significantly higher rates of in-hospital procedures and complications in cancer patients and is an independent risk factor of in-hospital mortality. Acknowledgement/Funding None

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