Recombinant Erythropoietin and Survival in Myelodysplastic Syndromes.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2539-2539 ◽  
Author(s):  
Pellegrino Musto
Keyword(s):  
Overall Survival ◽  
Clinical Outcome ◽  
Myelodysplastic Syndromes ◽  
Causes Of Death ◽  
Lower Percentage ◽  
Recombinant Erythropoietin ◽  
Long Term Effects ◽  
Published Evidence ◽  
The Impact

Abstract Several reports have recently raised the question of whether the use of recombinant erythropoietin (r-EPO) may influence clinical outcome and survival of neoplastic patients who receive this drug along with the therapy for their disease. r-EPO is frequently employed for the treatment of anemia in myelodysplastic syndromes (MDS). The efficacy of r-EPO in these patients have been extensively investigated in terms of improvement of Hb levels and quality of life parameters and its use is now recommended in selected settings of MDS. However, there is very small published evidence about the long term effects of r-EPO in patients with MDS and, above all, about its possible relationship with survival. In particular, low-risk MDS, which generally do not receive cytostatic treatments, represent an interesting model to evaluate the impact of r-EPO on the natural history of these diseases. We performed a retrospective analysis on our patients with MDS which was focused on determining overall survival and causes of death in relationship to the use or not of r-EPO. Between 1986 and 2001, 346 patients affected by MDS were identified in our database. Among them, we selected 169 anemic (Hb < 10 g/dl) patients with well defined diagnosis of MDS according to FAB criteria (excluding CMMoL and RAEB-T), low-intermediate IPSS score (retrospectively assessed) and regular follow-up. Ninety-nine patients belonged to the pre-r-EPO era or had never received r-EPO for other reasons. Seventy patients had instead received r-EPO for at least 8 weeks during the course of their disease. The two groups (r-EPO no/r-EPO yes) resulted comparable for age, type of diagnosis, additional treatments, Hb levels and transfusion requirement. Among patients who received r-EPO, 22 (31.4%) achieved an hematological erythroid improvement (HI-E), according to IWG criteria. In these patients the drug was given for 5–51 months (median 19). There was no difference between the two groups in terms of leukemic evolution (19% vs 21% at 4 years) and causes of death (infections, hemorrhages, second tumors, cardiovascular events). No death could be directly attributable to r-EPO. Median overall survival was also not statistically different between patients who had received (45 months) or not (41 months) r-EPO. However, when survival was analysed according to response to r-EPO, it was found significantly longer (p < 0.02) in responders (median 54 months) than in non-responders (median 37 months), as well as than in subjects who had never received the drug. Such a difference was not modified by the time (early, during the first year from diagnosis, or later) of r-EPO administration. Response to r-EPO was associated with baseline lower levels of endogenous EPO, lower percentage of marrow blasts and higher Hb values. At multivariate analysis, however, response to r-EPO maintained an independent favourable prognostic value on survival. This is the first large study focused on the long-term clinical outcome of MDS analysed according to the role of r-EPO. Our data indicate that the prolonged administration of this drug is safe and that response to r-EPO is significantly associated with better survival in MDS patients.

scholarly journals Long-Term Effects of Pedicle Clamping during Major Hepatectomy for Colorectal Liver Metastases

2021 ◽  
Vol 10 (13) ◽  
pp. 2778
Author(s):  
Piotr Krawczyk ◽  
Marcin Morawski ◽  
Maciej Krasnodębski ◽  
Damian Sieńko ◽  
Michał Grąt ◽  
...  
Keyword(s):  
Overall Survival ◽  
Pringle Maneuver ◽  
Primary Outcome Measure ◽  
Tumor Burden ◽  
Colorectal Metastases ◽  
Long Term Effects ◽  
Negative Effects ◽  
Liver Resections ◽  
The Impact

The use of the Pringle maneuver (PM) varies widely among surgical departments. Its use depends on the operator and type of liver resection. The aim of this study was to determine the impact of the PM on patient outcomes when undergoing major liver resections. This retrospective study comprised 179 colorectal liver metastasis patients from two liver centers from Leeds and Warsaw. Only right or right extended hepatectomies with negative oncological margins were included. The primary outcome measure was the 5-year overall survival (OS). The PM was applied during 60 (33.5%) major hepatectomies included in the study and was associated with a higher peak 3-day postoperative bilirubin concentration (p = 0.002), yet not with the peak 3-day alanine aminotransferase activity (p = 0.415). The 5-year OS after liver resections with the PM and without the PM were 55.0% and 33.4%, respectively (p = 0.019). Following stratification by the Tumor Burden Score, after resections with the use of the PM, superior survival was particularly found in the subgroup of patients at intermediate risk of recurrence (p = 0.004). However, the use of the PM had no significant effect on the 5-year overall survival following adjustment for the confounding effect of the carcinoembryonic antigen concentration (p = 0.265). The use of the PM had no negative effects on the long-term outcomes in patients undergoing major, oncologically radical liver resections for colorectal metastases.

Is training doctors in medical certification effective? Evidence from a prospective study in the Philippines

2021 ◽  
pp. 183335832110592
Author(s):  
Jomilynn Rebanal ◽  
Tim Adair ◽  
Lene Mikkelsen
Keyword(s):  
Large Scale ◽  
Causes Of Death ◽  
Assessment Tool ◽  
International Classification Of Diseases ◽  
The Philippines ◽  
Long Term Effects ◽  
Medical Certification ◽  
The Impact

Background Correct certification of causes of death by physicians according to International Classification of Diseases (ICD) rules is essential to generate mortality statistics of the quality needed to guide public health policy debates and reliably monitor the impact of health interventions. Several efforts to train doctors have been undertaken in the Philippines to improve Medical Certification of Causes of Death (MCCOD). However, there is very little evidence about the long-term effects of training interventions for medical certification. Objective To test whether there were measurable long-term impacts of this large-scale training intervention for improving medical certification and reducing different types of certification errors. Method We assessed the quality of 2100 MCCOD completed before face-to-face training with those written by the same doctors 6 months after the training. An assessment tool was used to evaluate the quality of MCCOD. Results Less than 1% of the 2100 MCCOD assessed prior to the training were completely error-free, increasing to 19.2% 6 months after the training. On average, the number of errors per certificate fell from 2.2 pre-training to 1.3, six months after training. Importantly, there was a 38% decrease in writing ill-defined causes on the last line, which is particularly important for the policy utility of data. Conclusion Training doctors in correct medical certification can have a long-term impact on medical certification practices. Implications Shorter, more focused, trainings that address the most common medical certification errors could have an even greater impact on medical certification practices.

SUMBER-SUMBER RESILIENSI PADA REMAJA AKHIR YANG MENGALAMI KEKERASAN DARI ORANGTUA PADA MASA KANAK-KANAK

Psibernetika ◽  
2018 ◽  
Vol 11 (1) ◽  
Author(s):  
Devina Calista ◽  
Garvin Garvin
Keyword(s):  
Late Adolescents ◽  
Long Term Effects ◽  
Short Term ◽  
Parental Affection ◽  
Resilience Factors ◽  
Childhood Violence ◽  
Past Experiences ◽  
The Impact ◽  
Depth Interviews

<p><em>Child abuse by parents is common in households. The impact of violence on children will bring short-term effects and long-term effects that can be attributed to their various emotional, behavioral and social problems in the future; especially in late adolescence that will enter adulthood. Resilience factors increase the likelihood that adolescents who are victims of childhood violence recover from their past experiences</em><em>,</em><em> become more powerful individuals and have a better life. The purpose of this study was to determine the source of resilience in late adolescents who experienced violence from parents in their childhood. This research uses qualitative research methods with in-depth interviews as a method of data collection. The result shows that the three research participants have the aspects of "I Have", "I Am", and "I Can"; a participant has "I Can" aspects as a source of resilience, and one other subject has no source of resilience. The study concluded that parental affection and acceptance of the past experience have role to the three sources of resilience (I Have, I Am, and I Can)</em></p><p><em> </em></p><p><strong><em>Keyword : </em></strong><em>Resilience, adolescence, violence, parents</em></p>

The Quantification of Structural Reforms in OECD Countries

2018 ◽  
Author(s):  
Balázs Égert ◽  
Peter Gal
Keyword(s):  
Product Market ◽  
Physical Capital ◽  
Oecd Countries ◽  
Market Regulation ◽  
Structural Reforms ◽  
Long Term Effects ◽  
Per Capita ◽  
Product Market Regulation ◽  
The Impact

This chapter describes and discusses a new supply-side framework that quantifies the impact of structural reforms on per capita income in OECD countries. It presents the overall macroeconomic impacts of reforms by aggregating over the effects on physical capital, employment, and productivity through a production function. On the basis of reforms defined as observed changes in policies, the chapter finds that product market regulation has the largest overall single policy impact five years after the reforms. But the combined impact of all labour market policies is considerably larger than that of product market regulation. The paper also shows that policy impacts can differ at different horizons. The overall long-term effects on GDP per capita of policies transiting through capital deepening can be considerably larger than the five- to ten-year impacts. By contrast, the long-term impact of policies coming only via the employment rate channel materializes at a shorter horizon.

scholarly journals Antibiotics at birth and later antibiotic courses: effects on gut microbiota

2021 ◽  
Author(s):  
Sofia Ainonen ◽  
Mysore V Tejesvi ◽  
Md. Rayhan Mahmud ◽  
Niko Paalanne ◽  
Tytti Pokka ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Control Group ◽  
List Type ◽  
Antibiotic Exposure ◽  
Microbiota Composition ◽  
Long Term Effects ◽  
The Impact ◽  
Antibiotic Courses ◽  
Gut Microbiota Composition

Abstract Background Intrapartum antibiotic prophylaxis (IAP) is widely used, but the evidence of the long-term effects on the gut microbiota and subsequent health of children is limited. Here, we compared the impacts of perinatal antibiotic exposure and later courses of antibiotic courses on gut microbiota. Methods This was a prospective, controlled cohort study among 100 vaginally delivered infants with different perinatal antibiotic exposures: control (27), IAP (27), postnatal antibiotics (24), and IAP and postnatal antibiotics (22). At 1 year of age, we performed next-generation sequencing of the bacterial 16S ribosomal RNA gene of fecal samples. Results Exposure to the perinatal antibiotics had a clear impact on the gut microbiota. The abundance of the Bacteroidetes phylum was significantly higher in the control group, whereas the relative abundance of Escherichia coli was significantly lower in the control group. The impact of the perinatal antibiotics on the gut microbiota composition was greater than exposure to later courses of antibiotics (28% of participants). Conclusions Perinatal antibiotic exposure had a marked impact on the gut microbiota at the age of 1 year. The timing of the antibiotic exposure appears to be the critical factor for the changes observed in the gut microbiota. Impact Infants are commonly exposed to IAP and postnatal antibiotics, and later to courses of antibiotics during the first year of life. Perinatal antibiotics have been associated with an altered gut microbiota during the first months of life, whereas the evidence regarding the long-term impact is more limited. Perinatal antibiotic exposure had a marked impact on the infant’s gut microbiota at 1 year of age. Impact of the perinatal antibiotics on the gut microbiota composition was greater than that of the later courses of antibiotics at the age of 1 year.

Parental alienation: the impact on men’s mental health

2015 ◽  
Vol 29 (3) ◽  
Author(s):  
Leo Sher
Keyword(s):  
Mental Health ◽  
Separation Anxiety ◽  
Self Esteem ◽  
Long Term Effects ◽  
Parental Alienation ◽  
Adult Men ◽  
Self Confidence ◽  
High Conflict ◽  
The Impact

Abstract Parental alienation is defined as a mental state in which a child, usually one whose parents are engaged in a high-conflict separation or divorce, allies himself strongly with one parent (the preferred parent) and rejects a relationship with the other parent (the alienated parent) without legitimate justification. Parental alienation may affect men’s mental health: a) parental alienation negatively influences mental health of male children and adolescents who are victims of parental alienation. Alienated children/adolescents display guilt, sadness, and depressed mood; low self-esteem and lack of self-confidence; distress and frustration; lack of impulse control, substance abuse and delinquent behavior; separation anxiety, fears and phobias; hypochondria and increased tendency to develop psychosomatic illness; suicidal ideation and suicide attempt; sleep and eating disorders; educational problems; enuresis and encopresis; b) parental alienation negatively affects the mental health of adult men who were victims of parental alienation when they were children and/or adolescents. Long-term effects of parental alienation include low self-esteem, depression, drug/alcohol abuse, lack of trust, alienation from own children, divorce, problems with identity and not having a sense of belonging or roots, choosing not to have children to avoid being rejected by them, low achievement, anger and bitterness over the time lost with the alienated parent; c) parental alienation negatively influences mental health of men who are alienated from their children. Fathers who have lost some or all contact with their children for months or years following separation or divorce may be depressed and suicidal.

scholarly journals Cancer Care and Survivorship Planning: Promises and Challenges

2009 ◽  
Vol 5 (3) ◽  
pp. 116-118 ◽  
Author(s):  
Len Lichtenfeld
Keyword(s):  
Cancer Care ◽  
Long Term Effects ◽  
Cancer Treatments ◽  
The Impact

Although we have made some progress in understanding long-term effects of some cancer treatments, there is still much more to learn about the impact of our treatments on our patients.

scholarly journals Transient inhibition and long-term facilitation of locomotion by phasic optogenetic activation of serotonin neurons

eLife ◽  
2017 ◽  
Vol 6 ◽  
Author(s):  
Patrícia A Correia ◽  
Eran Lottem ◽  
Dhruba Banerjee ◽  
Ana S Machado ◽  
Megan R Carey ◽  
...  
Keyword(s):  
Motor Behavior ◽  
Motor Impairment ◽  
Long Term Effects ◽  
Strong Suppression ◽  
Serotonin Neurons ◽  
Short And Long Term ◽  
Rapid Kinetics ◽  
Long Term Facilitation ◽  
The Impact

Serotonin (5-HT) is associated with mood and motivation but the function of endogenous 5-HT remains controversial. Here, we studied the impact of phasic optogenetic activation of 5-HT neurons in mice over time scales from seconds to weeks. We found that activating dorsal raphe nucleus (DRN) 5-HT neurons induced a strong suppression of spontaneous locomotor behavior in the open field with rapid kinetics (onset ≤1 s). Inhibition of locomotion was independent of measures of anxiety or motor impairment and could be overcome by strong motivational drive. Repetitive place-contingent pairing of activation caused neither place preference nor aversion. However, repeated 15 min daily stimulation caused a persistent increase in spontaneous locomotion to emerge over three weeks. These results show that 5-HT transients have strong and opposing short and long-term effects on motor behavior that appear to arise from effects on the underlying factors that motivate actions.

Biomolecular Modeling and Simulation: A Prospering Multidisciplinary Field

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Tamar Schlick ◽  
Stephanie Portillo-Ledesma ◽  
Christopher G. Myers ◽  
Lauren Beljak ◽  
Justin Chen ◽  
...  
Keyword(s):  
Modeling And Simulation ◽  
Annual Review ◽  
Publication Date ◽  
Long Term Effects ◽  
Short Term ◽  
Biomolecular Modeling ◽  
Productive Phase ◽  
The Impact ◽  
New Algorithms

We reassess progress in the field of biomolecular modeling and simulation, following up on our perspective published in 2011. By reviewing metrics for the field's productivity and providing examples of success, we underscore the productive phase of the field, whose short-term expectations were overestimated and long-term effects underestimated. Such successes include prediction of structures and mechanisms; generation of new insights into biomolecular activity; and thriving collaborations between modeling and experimentation, including experiments driven by modeling. We also discuss the impact of field exercises and web games on the field's progress. Overall, we note tremendous success by the biomolecular modeling community in utilization of computer power; improvement in force fields; and development and application of new algorithms, notably machine learning and artificial intelligence. The combined advances are enhancing the accuracy and scope of modeling and simulation, establishing an exemplary discipline where experiment and theory or simulations are full partners. Expected final online publication date for the Annual Review of Biophysics, Volume 50 is May 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

scholarly journals The Long-Term Effects of Long Terms – Compulsory Schooling Reforms in Sweden

2019 ◽  
Vol 18 (6) ◽  
pp. 2776-2823
Author(s):  
Martin Fischer ◽  
Martin Karlsson ◽  
Therese Nilsson ◽  
Nina Schwarz
Keyword(s):  
Gender Gap ◽  
Labor Market Outcomes ◽  
Instructional Time ◽  
Long Term Effects ◽  
Compulsory Schooling ◽  
Market Outcomes ◽  
Term Length ◽  
Annual Term ◽  
The Impact

Abstract We evaluate the impact on earnings, pensions, and further labor market outcomes of two parallel educational reforms increasing instructional time in Swedish primary school. The reforms extended the annual term length and years of compulsory schooling by comparable amounts. We find striking differences in the effects of the two reforms: at 5% the returns to the term length extension were sizeable and benefited broad ranges of the population. The compulsory schooling extension had small (2%) albeit significant effects, which were possibly driven by an increase in post-compulsory schooling. Both reforms led to increased sorting into occupations with heavy reliance on basic skills and the term extension reduced the gender gap in employment and earnings.

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