scholarly journals Chromosomal instability in the prediction of pituitary neuroendocrine tumors prognosis

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Hélène Lasolle ◽  
Mad-Hélénie Elsensohn ◽  
Anne Wierinckx ◽  
Eudeline Alix ◽  
Clément Bonnefille ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Genome Instability ◽  
Copy Number Variations ◽  
Transcriptomic Analysis ◽  
P Value ◽  
Tumor Type ◽  
Cgh Array ◽  
Array Analysis ◽  
Post Surgery ◽  
The Impact

Abstract The purpose of this study was to analyze the impact of copy number variations (CNV) on sporadic pituitary neuroendocrine tumors (PitNETs) prognosis, to identify specific prognosis markers according to the known clinico-pathological classification. CGH array analysis was performed on 195 fresh-frozen PitNETs (56 gonadotroph, 11 immunonegative, 56 somatotroph, 39 lactotroph and 33 corticotroph), with 5 years post-surgery follow-up (124 recurrences), classified according to the five-tiered grading classification (invasion, Ki-67, mitotic index and p53 positivity). Effect of alterations on recurrence was studied using logistic regression models. Transcriptomic analysis of 32 lactotroph tumors was performed. The quantity of CNV was dependent on tumor type: higher in lactotroph (median(min–max) = 38% (0–97) of probes) compared to corticotroph (11% (0–77)), somatotroph (5% (0–99)), gonadotroph (0% (0–10)) and immunonegative tumors (0% (0–17). It was not predictive of recurrence in the whole cohort. In lactotroph tumors, genome instability, especially quantity of gains, significantly predicted recurrence independently of invasion and proliferation (p-value = 0.02, OR = 1.2). However, no specific CNV was found as a prognostic marker. Transcriptomic analysis of the genes included in the CNV and associated with prognosis didn’t show significantly overrepresented pathway. In somatotroph and corticotroph tumors, USP8 and GNAS mutations were not associated with genome disruption or recurrence respectively. To conclude, CGH array analysis showed genome instability was dependent on PitNET type. Lactotroph tumors were highly altered and the quantity of altered genome was associated with poorer prognosis though the mechanism is unclear, whereas gonadotroph and immunonegative tumors showed the same ‘quiet’ profile, leaving the mechanism underlying tumorigenesis open to question.

Pre- vs. Post-National Coverage Determination (NCD) Blood Utilization and Hemoglobin Values among Medicare Patients Treated with Erythropoietic-Stimulating Agents (ESAs) for Chemotherapy-Induced Anemia (CIA)

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1301-1301 ◽  
Author(s):  
Tanya Burton ◽  
Kay Larholt ◽  
Elizabeth Apgar ◽  
Chris Pashos ◽  
Brahim Bookhart ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Clinical Trial Data ◽  
Study Patient ◽  
P Value ◽  
Tumor Type ◽  
Time Period ◽  
Hospital Systems ◽  
Utilization Patterns ◽  
Blood Utilization ◽  
The Impact

Abstract Background: In July 2007, the Centers for Medicare and Medicaid Services issued ESA coverage limitations for cancer patients with CIA through a national coverage determination (NCD). Clinical outcomes based on ESA dosing described in the NCD have not been reported in prospective observational or clinical trial data. To understand hematologic outcomes in the Medicare population treated in pre- and post-NCD time period, an analysis of hematologic outcomes from the DOSE (Dosing and Outcomes Study of Erythropoiesis-Stimulating Therapies) registry, an ongoing prospective observational study, was conducted. Methods: ESA-treated cancer patients with CIA were selected based on Medicare primary coverage, available baseline hemoglobin (Hb) value, and receipt of at least two ESA administrations. Data were categorized into two timeframes based on date of initial ESA administration: pre-NCD (4/06-4/07) and post-NCD (10/07-5/08). Baseline demographics, Hb values during ESA treatment, and blood utilization patterns were analyzed. Results: 288 patients were identified (Pre-NCD – 230; Post-NCD – 58) from 41 sites. Patient groups were similar with respect to age, gender, weight, and tumor type. ESA treatment duration was significantly greater in the pre-NCD group (70 days vs. 54 days, p = 0.0011). As shown in the table, differences with regard to blood utilization and Hb values were observed between the Pre-NCD and Post-NCD populations. A significantly greater proportion of patients required a blood transfusion and the number of units administered per study patient was significantly higher in the Post-NCD group. Hb levels were significantly lower at all time points of observation in the Post-NCD group. Pre-NCD Post-NCD p-value Transfusion Outcomes Proportion of Patients Transfused 18.3% 32.8% p = 0.0157 Mean No. of Units per Study Patient 0.5 1.1 p = 0.0089 Hematologic Outcomes: Mean Hb (SD) Baseline 10.6 (0.8) 9.6 (0.5) < 0.0001 Week 4 11.1 (1.3) 9.9 (1.1) < 0.0001 Week 8 11.2 (1.3) 10.4 (1.3) 0.013 Week 12 11.1 (1.3) 9.8 (1.2) 0.0002 Week 16 11.0 (1.1) 9.7 (0.2) 0.018 Conclusion: Greater blood utilization and lower Hb values were observed in Medicare CIA patients treated with ESAs during the Post-NCD time period compared to the Pre- NCD time period. The impact of the NCD on patient outcomes is important to providers and hospital systems and warrants further research.

Octreotide LAR dosage and survival among elderly patients with distant-stage neuroendocrine tumors.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 392-392
Author(s):  
Chan Shen ◽  
Ya-Chen T. Shih ◽  
Ying Xu ◽  
James C. Yao
Keyword(s):  
Elderly Patients ◽  
Neuroendocrine Tumors ◽  
Dosage Level ◽  
Population Based ◽  
Rank Test ◽  
P Value ◽  
Octreotide Lar ◽  
The Difference ◽  
Long Acting ◽  
The Impact

392 Background: Octreotide long-acting repeatable (LAR) is approved for the management of symptoms due to carcinoid syndrome and may delay tumor progression among patients with neuroendocrine tumors (NETs). It is unknown whether dosage of octreotide LAR has an impact on survival. The current analysis evaluates the impact of initial octreotide LAR dosage on survival of elderly patients with NETs. Methods: Distant stage NET patients diagnosed between 1/1999 and 12/2009 who had received octreotide LAR treatment within 12 months of diagnosis were identified from the SEER-Medicare database. Those under age 65, enrolled in HMOs, or without continuous enrollment in Medicare Parts A and B were excluded. We compared the five-year survival of NET patients based on dose per 28 days averaged over the initial 3 months: Group A, <= 20 mg; B, 21 to 30 mg; C, > 30 mg. Kaplan-Meier estimations and Cox proportional hazard modeling were used to examine the association between octreotide LAR dose and survival. Results: Among 214 distant stage patients (mean and median age at 74 years old) with octreotide LAR treatment, 73 (34%) received <= 20 mg, 82 (38%) received 21 – 30 mg, while 59 (28%) received >30 mg. Median survival for patients who received low, medium and high dosage levels were 20.8 (95% CI: 13.2 – 31.5), 32.6 (95% CI: 20.5 – 51.1), and 36.3 (95% CI: 24.8 – N/A) months respectively. The log rank test had a p-value of 0.006. Multivariate analyses showed that higher octreotide LAR dosage levels were associated with significant survival improvement for distant stage patients. Compared to patients with the low dosage level, patients with medium dosage (HR=0.52, P=0.002) and patients with high dosage (HR=0.48, P=0.004) had better five-year survival. The difference in survival between Groups B and C was not statistically significant. Conclusions: This population-based study suggests potential survival benefits for octreotide LAR 30 mg dosage level among elderly distant stage NET patients.

scholarly journals A Multicenter Analysis of the Outcome of Cancer Patients with Neutropenia and COVID-19 Optionally Treated with Granulocyte-Colony Stimulating Factor (G-CSF): A Comparative Analysis

Cancers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 4205
Author(s):  
María Sereno ◽  
Ana María Jimenez-Gordo ◽  
Javier Baena-Espinar ◽  
Carlos Aguado ◽  
Xabier Mielgo ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Logistic Model ◽  
Distress Syndrome ◽  
Bivariate Analysis ◽  
P Value ◽  
Tumor Type ◽  
Multicenter Analysis ◽  
Support Methods ◽  
The Impact ◽  
Stimulating Factor

Background: Approximately 15% of patients infected by SARS-CoV-2 develop a distress syndrome secondary to a host hyperinflammatory response induced by a cytokine storm. Myelosuppression is associated with a higher risk of infections and mortality. There are data to support methods of management for neutropenia and COVID-19. We present a multicenter experience during the first COVID-19 outbreak in neutropenic cancer patients infected by SARS-CoV-2. Methods: Clinical retrospective data were collected from neutropenic cancer patients with COVID-19. Comorbidities, tumor type, stage, treatment, neutropenia severity, G-CSF, COVID-19 parameters, and mortality were analyzed. A bivariate analysis of the impact on mortality was carried out. Additionally, we performed a multivariable logistic regression to predict respiratory failure and death. Results: Among the 943 cancer patients screened, 83 patients (11,3%) simultaneously had neutropenia and an infection with COVID-19. The lungs (26%) and breasts (22%) were the primary locations affected, and most patients had advanced disease (67%). In the logistic model, as adjusted covariates, sex, age, treatment (palliative vs. curative), tumor type, and the lowest level of neutrophils were used. A significant effect was obtained for the number of days of G-CSF treatment (OR = 1,4, 95% CI [1, 1, 03, 92], p-value = 0.01). Conclusions: Our findings suggest that a prolonged G-CSF treatment could be disadvantageous for these cancer patients with infections by COVID-19, with a higher probability of worse outcome.

CGH array analysis of pituitary tumors revealed a highly-disrupted genome

2018 ◽  
Author(s):  
Helene Lasolle ◽  
Mad-Helenie Elsensohn ◽  
Eudeline Alix ◽  
Clement Bonnefille ◽  
Jessica Michel ◽  
...  
Keyword(s):  
Pituitary Tumors ◽  
Cgh Array ◽  
Array Analysis

The effect of brain vitalization activity on dementia incidence in elderly at Budi Luhur Nursing Home of Yogyakarta, Kasongan, Bantul

2020 ◽  
Vol 1 (3) ◽  
pp. 43-50
Author(s):  
Firstyono Miftahul Aziz ◽  
Suratini Suratini
Keyword(s):  
Nursing Home ◽  
The Elderly ◽  
Control Group ◽  
P Value ◽  
Sampling System ◽  
Randomized Sampling ◽  
Care For The Elderly ◽  
Dementia Incidence ◽  
The Family ◽  
The Impact

For some people, dementia is considered as a disease that is common in elderly, regardless the impact of dementia. Taking care for the elderly with dementia brings stress for the family. It can cause and increase the family burden. Brain vitalization gymnastics is one of the methods to improve memory. The study aims to investigate the effect of brain vitalization activity on dementia incidence in elderly at Budi Luhur Nursing Home of Yogyakarta. The study used Quasi Experimental with Pretest-Posttest control group and randomized sampling system. The samples were taken randomly as many as 26 respondents and were divided into two groups namely 13 respondents of experimental group and 13 respondents of control group. The statistical test used Wilcoxon Match Pairs Test. The result showed that Wilcoxon Match pairs test obtained p value 0,003, which is smaller than 0,005. There is an effect of brain vitalization activity on dementia incidence in elderly at Budi Luhur Nursing Home of Yogyakarta

The impact of SPY angiography on intraoperative decision making and outcomes for post-mastectomy reconstruction

2019 ◽  
pp. 1-5
Keyword(s):  
Decision Making ◽  
Logistic Regression ◽  
Skin Necrosis ◽  
Regression Models ◽  
Multivariable Analysis ◽  
P Value ◽  
Flap Necrosis ◽  
Single Institution ◽  
Logistic Regression Models ◽  
The Impact

Objective: While the use of intraoperative laser angiography (SPY) is increasing in mastectomy patients, its impact in the operating room to change the type of reconstruction performed has not been well described. The purpose of this study is to investigate whether SPY angiography influences post-mastectomy reconstruction decisions and outcomes. Methods and materials: A retrospective analysis of mastectomy patients with reconstruction at a single institution was performed from 2015-2017.All patients underwent intraoperative SPY after mastectomy but prior to reconstruction. SPY results were defined as ‘good’, ‘questionable’, ‘bad’, or ‘had skin excised’. Complications within 60 days of surgery were compared between those whose SPY results did not change the type of reconstruction done versus those who did. Preoperative and intraoperative variables were entered into multivariable logistic regression models if significant at the univariate level. A p-value <0.05 was considered significant. Results: 267 mastectomies were identified, 42 underwent a change in the type of planned reconstruction due to intraoperative SPY results. Of the 42 breasts that underwent a change in reconstruction, 6 had a ‘good’ SPY result, 10 ‘questionable’, 25 ‘bad’, and 2 ‘had areas excised’ (p<0.01). After multivariable analysis, predictors of skin necrosis included patients with ‘questionable’ SPY results (p<0.01, OR: 8.1, 95%CI: 2.06 – 32.2) and smokers (p<0.01, OR:5.7, 95%CI: 1.5 – 21.2). Predictors of any complication included a change in reconstruction (p<0.05, OR:4.5, 95%CI: 1.4-14.9) and ‘questionable’ SPY result (p<0.01, OR: 4.4, 95%CI: 1.6-14.9). Conclusion: SPY angiography results strongly influence intraoperative surgical decisions regarding the type of reconstruction performed. Patients most at risk for flap necrosis and complication post-mastectomy are those with questionable SPY results.

Pengaruh Terapi Dzikir Terhadap Tingkat Kecemasan Pada Pasien Pre Dan Post Operasi

2019 ◽  
Vol 4 (1) ◽  
pp. 17-29
Author(s):  
Nurlina ◽  
Nursyamsi
Keyword(s):  
Sampling Method ◽  
T Test ◽  
P Value ◽  
Psychological Reactions ◽  
Paired Sample ◽  
Time Treatment ◽  
Post Surgery ◽  
Nursing Services ◽  
Preoperative Stage ◽  
Experimental Group

Postoperative surgery and trauma are stressors that can cause physiological and psychological reactions to the patient. Psychological reactions in the form of anxiety usually arise in the preoperative stage when the patient anticipates surgery and at the postoperative stage because of pain and discomfort, changes in body image and bodily functions. Handling anxiety with spiritual aspects in the form of dzikir therapy is an effort to reduce anxiety levels in patients pre and post surgery. This study used a pre-experimental research design with a one group pre and posttest design study design. The sample of this study was 15 respondents in the experimental group taken by consecutive sampling method. The experimental group received a dzikir therapy 1 time treatment with a duration of 12 minutes. Data collection is done using a questionnaire sheet. Analysis of the data used in this study is univariate and bivariate by using a paired sample t test. The results of the analysis used a statistical test paired sample t test with a level of confidence (α = 0.05). Based on the results of this test, the p value is 0,000, thus p <α (0,000 <0,05). The conclusion of this study is that there is an effect of giving dzikir therapy to the level of anxiety in patients pre and post surgery. Researchers suggest that the results of this study can be used as a reference for application in the scope of nursing services, especially handling anxiety.

The Impact of Mobile Phone Technology in Bridging the Gaps in The Health Care Service Delivery in Kenya: A Case of Nairobi County. (Preprint)

2019 ◽  
Author(s):  
Alice Ndwiga
Keyword(s):  
Service Delivery ◽  
Mobile Phone ◽  
Care Service ◽  
Health Care Service ◽  
Informal Settlements ◽  
Healthcare Services ◽  
P Value ◽  
Delivery Of Healthcare ◽  
Mobile Phone Technology ◽  
The Impact

BACKGROUND INTRODUCTION: The Kenyan constitution seeks to guarantee every citizen the right to quality healthcare services. Quite often this delivery is hampered by geographical location, socio-economic statuses among other factors. The country has a high mobile phone penetration rate. Digitalization of the healthcare sector is a vital aspect that contributes to effective delivery of care services. This study set out to assess the impact of mobile technology in closing the gaps within the health care service delivery. The objective of the study was to investigate the impact of mobile phone technology in bridging the gap in healthcare service delivery in Kenya with a focus on Nairobi, Kibera informal settlements. Hypothesis testing using P-value of 0.05 also showed that use of mobile phone technology positively impacted the delivery of healthcare services. OBJECTIVE The objective of the study was to investigate the impact of mobile phone technology in bridging the gap in healthcare service delivery in Kenya with a focus on Nairobi, Kibera informal settlements. Hypothesis testing using P-value of 0.05 also showed that use of mobile phone technology positively impacted the delivery of healthcare services. METHODS The target population were patients visiting Médecins Sans Frontières (MSF) clinic in Kibera informal settlements. A cross-sectional study design was employed. Purposive and simple random sampling method was used to select the study sample of 210 participants and 3 healthcare providers. Data were collected using survey questionnaire that was provider-administered and Data were analyzed using SPSS version. RESULTS The characteristics of the respondents were general (mean age, education level, social economic status) to only patients who visited the clinics for HIV tests and other related services such as going for ARVs. The main findings showed that 66.12% of the respondents (14.29% strongly agreed + 55.24% agreed) that the use of mobile phone technology improved their access to healthcare services. Using chi square, there was a statistical difference due to the positive impact of mobile technology on healthcare delivery (p=0.05). CONCLUSIONS The study findings showed that 66.12% of the respondents agreed that the use of mobile phone technology and SMS improved their access to healthcare services. The results hypothesis also proved that use of mobile phone technology positively impacts the delivery of healthcare services.

Impact of firm’s specific factors on audit fee of quoted consumer goods firms

2020 ◽  
Vol 4 (1) ◽  
pp. 47-55
Author(s):  
Wasiu Ajani Musa ◽  
Ramat Titilayo Salman ◽  
Ibrahim Olayiwola Amoo ◽  
Muhammed Lawal Subair
Keyword(s):  
Consumer Goods ◽  
Audit Quality ◽  
Audit Fees ◽  
Ordinary Least Squares ◽  
P Value ◽  
Chi Square ◽  
Ifrs Adoption ◽  
Audit Fee ◽  
Specific Factors ◽  
The Impact

Greater pricing presume on audit service has been put by the regulations of the auditing and accounting practices for the disclosure of audit fees, since audit fee is directly related to audit quality. However, the audit fees perceived by the client is often different from the amount charged by the auditors. Hence, this study investigated the impact of firm-specific characteristics on audit fees of quoted consumer goods firms in Nigeria using a purposive sampling technique. Secondary data were obtained from annual reports of the companies for the period from 2009-2016. The empirical result from Breusch-Pagan Lagrange Multiplier Test (BP-LM) produced a chi-square value of 13.94 with p-value of 0.0001 indicating that pooled ordinary least squares (OLS) will not be appropriate for the study. The Hausman test showed a chi-square of 23.55 with a p-value of 0.001 indicating that the null hypothesis is strongly rejected. Thus, the only estimate from the fixed effect model was interpreted to explain the relationship between firm-specific characteristics and audit fees of quoted consumer goods firms in Nigeria. The result revealed that auditee size, auditee risk, auditee profitability and IFRS adoption are the firm specific characteristics that impact on audit fees with only auditee size and IFRS adoption being positively related to audit fees while the other factors are negatively related to audit fees. Based on this finding, this study concluded that the firm’s specific factors are the major drivers of audit fees in Nigeria consumer goods firms. This study recommends among others that companies should implement corporate governance principles that address issues relating to board independence and committee sizes to guide activities in the consumer goods sector since profitability behave negatively with audit fees.

scholarly journals QOL-36. USE OF CANNABINOIDS IN THE PEDIATRIC CENTRAL NERVOUS SYSTEM TUMOR POPULATION

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii438-iii438
Author(s):  
Kathleen Dorris ◽  
Jessica Channell ◽  
Ashley Mettetal ◽  
Molly Hemenway ◽  
Natalie Briones ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Central Nervous System ◽  
Nervous System ◽  
Cell Activity ◽  
Cns Tumors ◽  
Low Grade ◽  
Tumor Type ◽  
Central Nervous System Tumor ◽  
The Impact

Abstract BACKGROUND Cannabinoids, including cannabidiol (CBD) and tetrahydrocannabinol (THC), are a class of compounds found in marijuana. Numerous studies in adults have examined cannabinoid use in management of cancer-related symptoms such as nausea, anorexia, and pain. Less is known about the use in the pediatric oncology population. METHODS A prospective observational study has been ongoing since 2016 at Children’s Hospital Colorado to evaluate cannabinoids’ impact using PedsQL™ modules on quality of life of pediatric patients with central nervous system (CNS) tumors who are 2–18 years old. Laboratory assessments of T-cell activity and pharmacokinetics of CBD, THC and associated metabolites are in process. Diaries with exploratory information on cannabinoid use patterns are being collected. RESULTS Thirty-three patients (14:19; male:female) have been enrolled with a median age of 6.4 years (range, 2.9–17.7 years). The most common tumor type in enrolled patients is embryonal tumors (13/33; 39%). Nine (27%) patients have low-grade glial/glioneuronal tumors, and eight (24%) had high-grade/diffuse midline gliomas. The remaining patients had ependymoma or craniopharyngioma. The median time on cannabinoids is 9 months. Most (n=20) patients have used oral products with CBD and THC. One patient continues on cannabinoid therapy in follow up. Preliminary immune function analyses identified impaired neutrophil superoxide anion production and chemotaxis in patients taking cannabinoids at early time points on therapy. CONCLUSIONS Families of children with various CNS tumors are pursuing cannabinoid therapy for both antitumor and supportive care purposes. Analysis of the impact of cannabinoids on patients’ quality of life is ongoing.

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