Parental Grief After Losing a Child to Cancer: Impact of Professional and Social Support on Long-Term Outcomes

2007 ◽  
Vol 25 (22) ◽  
pp. 3307-3312 ◽  
Author(s):  
Ulrika C. Kreicbergs ◽  
Patrizia Lannen ◽  
Erik Onelov ◽  
Joanne Wolfe

Purpose It is still uncertain whether or not parents can ever come to terms with the loss of a child and whether professional or social support facilitate the long-term grief process. Methods A Swedish population-based study, which sent an anonymous, mail-in questionnaire to parents who had lost a child to a malignancy 4 to 9 years earlier, gained the participation of 449 (80%) of 561 parents. Parents were asked whether, and to what extent, they had worked through their grief. Questions were also asked regarding those who provided parents with support. We examined candidate factors to determine their associations with greater likelihood of working through parental grief. Results Overall, most parents (74%) stated that they had worked through their grief “a lot” or “completely” at the time of the follow-up. Parents who had shared their problems with others during the child's illness (fathers: relative risk [RR], 3.0; 95% CI, 1.8 to 5.0; mothers: RR 1.9; 95% CI, 1.2 to 2.8) and who had access to psychological support during the last month of their child's life (fathers: RR 1.4; 95% CI, 1.0 to 1.8; mothers: RR 1.3; 95% CI, 1.1 to 1.6) were more likely to have worked through their grief. In cases where health care staff offered parents counseling during the child's last month, the parents were more likely to have worked through their grief (fathers: RR 1.5; 95% CI, 1.2 to 1.8; mothers; RR 1.2; 95% CI, 1.1 to 1.4). Conclusion Most parents eventually work through the grief associated with losing a child to cancer. In the long term, sharing the emotional burden with others facilitates the grieving process.

Blood ◽  
2020 ◽  
Vol 136 (8) ◽  
pp. 1006-1010 ◽  
Author(s):  
Andrea C. Lo ◽  
Belinda A. Campbell ◽  
Tom Pickles ◽  
Christina Aquino-Parsons ◽  
Laurie H. Sehn ◽  
...  

With a median follow-up of 16.6 years, Lo and colleagues report excellent long-term outcomes with primary radiotherapy for limited-stage follicular lymphoma in this month’s CME article.


Author(s):  
Chaithanya K Pamidimukala ◽  
Emad F Aziz ◽  
Balaji Pratap ◽  
Joseph H Bastawrose ◽  
Shuaib Mohamed ◽  
...  

BACKGROUND: To look for the association between Insurance coverage (IC) and Long term Outcomes (O) after discharge following ACS admission from ACAP-PAIN (AP) registry. METHODS: The AP registry had 5526 hospitalized patients admitted with a diagnosis of ACS enrolled between 2006-2010. Long-term outcomes (composite of death, AMI, and ACS readmission) were evaluated during a Follow-up period of 4 yrs. Patients were stratified into 5 medical insurance groups: Government (Gov) (n = 2571), Managed Government (MGov) (n = 1229), HMO (n = 630), Commercial (Com) (n = 863), and other (O) (n = 233). RESULTS: Composite endpoint at the end of the follow up was seen in 29%, 23%, 16%, 15%, and 12%, (p <0.0001), and all-cause mortality was seen in 6.5%, 6.2%, 3.9%, 3.1%, and 1.2%, (p<0.001), of the 5 medical insurance groups, respectively. Patients with Gov and MGov care coverage were older, with higher incidence of CAD, hypertension and diabetes. After adjusting for confounding variables, the multivariable-adjusted odds for composite endpoint was 1.73 (95% confidence interval [CI], 0.56-1.36) for Gov patients, 1.07 (95% CI, 0.93-1.24) for MGov patients, 0.56 (95% CI, 0.45-0.70) for HMO patients, 0.55 (95% CI, 0.46-0.67) for Com patients, and, 0.42 (95% CI, 0.29-0.63) for O patients. (See Graph) CONCLUSIONS: The results of this population-based study demonstrate that ACS patients with any government insurance status have an increased long term morbidity and mortality. This may be explained at least partially by the patients’ characteristics.


2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S374-S374
Author(s):  
Y S Jung ◽  
M Han ◽  
S Park ◽  
J H Cheon

Abstract Background Data on the comparative effectiveness of infliximab (IFX) or adalimumab (ADA) in patients with Crohn’s disease (CD) are rare, particularly for Asian patients. We compared the clinically key outcomes (surgery, hospitalisation, and corticosteroid use) of these two drugs in biologic-naive Korean patients with CD. Methods Using National Health Insurance claims, we collected data on patients who were diagnosed with CD and exposed to IFX or ADA between 2010 and 2016. Results We included 1488 new users of biologics (1000 IFX users and 488 ADA users). Over a median follow-up of 2.1 years after starting biological therapy, there were no significant differences in the risk of surgery (ADA vs. IFX; adjusted hazard ratio [aHR], 1.30; 95% confidence interval [CI], 0.86–1.95), hospitalisation (aHR, 1.05; 95% CI, 0.84–1.32), and corticosteroid use (aHR, 0.84; 95% CI, 0.58–1.22) between IFX and ADA users. These results were unchanged even when only patients who used biologics for over 6 months were analysed (aHR [95% CI]; surgery: 1.41 [0.88–2.26], hospitalisation: 1.06 [0.83–1.35], and corticosteroid use: 0.82 [0.56–1.21]). Additionally, these results were stable in patients treated with biological monotherapy or combination therapy with immunomodulators. Conclusion In this nationwide population-based study, there was no significant difference in the long-term effectiveness of IFX and ADA in the real-world setting of biologic-naive Korean patients with CD. In the absence of trials to directly compare IFX and ADA, our study supports that the choice of one of these two biologics may be allowed to be determined by the preference of patients and/or physicians.


VASA ◽  
2017 ◽  
Vol 46 (4) ◽  
pp. 291-295 ◽  
Author(s):  
Soumia Taimour ◽  
Moncef Zarrouk ◽  
Jan Holst ◽  
Olle Melander ◽  
Gunar Engström ◽  
...  

Abstract. Background: Biomarkers reflecting diverse pathophysiological pathways may play an important role in the pathogenesis of abdominal aortic aneurysm (aortic diameter ≥30 mm, AAA), levels of many biomarkers are elevated and correlated to aortic diameter among 65-year-old men undergoing ultrasound (US) screening for AAA. Probands and methods: To evaluate potential relationships between biomarkers and aortic dilatation after long-term follow-up, levels of C-reactive protein (CRP), proneurotensin (PNT), copeptin (CPT), lipoprotein-associated phospholipase 2 (Lp-PLA2), cystatin C (Cyst C), midregional proatrial natriuretic peptide (MR-proANP), and midregional proadrenomedullin (MR-proADM) were measured in 117 subjects (114 [97 %] men) aged 47–49 in a prospective population-based cohort study, and related to aortic diameter at US examination of the aorta after 14–19 years of follow-up. Results: Biomarker levels at baseline did not correlate with aortic diameter after 14–19 years of follow up (CRP [r = 0.153], PNT [r = 0.070], CPT [r = –.156], Lp-PLA2 [r = .024], Cyst C [r = –.015], MR-proANP [r = 0.014], MR-proADM [r = –.117]). Adjusting for age and smoking at baseline in a linear regression model did not reveal any significant correlations. Conclusions: Tested biomarker levels at age 47–49 were not associated with aortic diameter at ultrasound examination after 14–19 years of follow-up. If there are relationships between these biomarkers and aortic dilatation, they are not relevant until closer to AAA diagnosis.


2021 ◽  
Vol 10 (12) ◽  
pp. 2685
Author(s):  
Andre J. Burnham ◽  
Phillip A. Burnham ◽  
Edwin M. Horwitz

Olfactory neuroblastoma (ONB) is a rare neuroepithelial-derived malignancy that usually presents in the nasal cavity. The rarity of ONB has led to conflicting reports regarding associations of patient age and ONB survival and outcome. Moreover, long-term outcomes of chemotherapy and other treatment modalities are speculated. Here, we aimed to compare survival outcomes across age groups through time and determine associations between treatment modality and survival. In this retrospective population-based study, we analyzed the SEER 2000–2016 Database for patients with ONB tumors. Using Kaplan–Meier survival analysis, a significant effect of age and cancer-specific survival (CSS) was observed; geriatric ONB patients had the lowest CSS overall. Generalized linear models and survival analyses demonstrated that CSS of the pediatric patient population was similar to the geriatric group through 100 months but plateaued thereafter and was the highest of all age groups. Radiation and surgery were associated with increased CSS, while chemotherapy was associated with decreased CSS. GLM results showed that tumor grade, stage and lymph node involvement had no CSS associations with age or treatment modality. Our results provide insight for future investigations of long-term outcomes associated with ONB patient age and treatment modality, and we conclude that survival statistics of ONB patients should be analyzed in terms of trends through time rather than fixed in time.


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
A. Langerth ◽  
L. Brandt ◽  
A. Ekbom ◽  
B.-M. Karlson

In order to assess the risk of long-term complications following endoscopic sphincterotomy (ES) for common bile duct stones (CBDS), we conducted a cohort study. The study included 1,113 patients who underwent ES for CBDS in six different hospitals in central Sweden between 1977 and 1990. Through the use of the Swedish population registry, each patient was assigned five population-based controls matched for sex and age. Linkage to the Inpatient Registry yielded information on morbidity and mortality for the patients as well as for the controls. After one year of washout, there were 964 patients available for follow-up. The mean age was 70.6 years, 57% were women, and the mean length of follow-up was 8.9 years. The patients’ overall morbidity was significantly higher and we observed a tendency towards increased mortality as well. Recurrent CBDS was diagnosed in 4.1% of the patients. Acute cholangitis with a hazard ratio (HR) of 36 (95%CI 11–119.4) was associated with recurrent CBDS in 39% of the patients. HR for acute pancreatitis was 6.2 (95%CI 3.4–11.3) and only one patient had CBDS at the same time. In conclusion, we consider acute pancreatitis and cholangitis both as probable long-term complications after ES.


PLoS ONE ◽  
2013 ◽  
Vol 8 (1) ◽  
pp. e52755 ◽  
Author(s):  
Hélène Amieva ◽  
Céline Meillon ◽  
Catherine Helmer ◽  
Pascale Barberger-Gateau ◽  
Jean François Dartigues

2015 ◽  
Vol 29 (18) ◽  
pp. 2924-2928 ◽  
Author(s):  
Inbal Sasson ◽  
Ofer Beharier ◽  
Ruslan Sergienko ◽  
Irit Szaingurten-Solodkin ◽  
Roy Kessous ◽  
...  

Author(s):  
R Srivastava ◽  
T Rajapakse ◽  
J Roe ◽  
X Wei ◽  
A Kirton

Background: Neonatal arterial ischemic stroke (NAIS) is a leading cause of brain injury and cerebral palsy. Diffusion-weighted imaging (DWI) has revolutionized NAIS diagnosis and outcome prognostication. Diaschisis refers to changes in brain areas functionally connected but structurally remote from primary injury. We hypothesized that acute DWI can demonstrate cerebral diaschisis and evaluated associations with outcome. Methods: Subjects were identified from a prospective, population-based research cohort (Calgary Pediatric Stroke Program). Inclusion criteria were unilateral middle cerebral artery NAIS, DWI MRI within 10 days of birth, and >12-month follow-up (Pediatric Stroke Outcome Measure, PSOM). Diaschisis was quantified using a validated software method. Diaschisis-scores were corrected for infarct size and compared to outcomes (Mann-Whitney). Results: From 20 eligible NAIS, 2 were excluded for image quality. Of 18 remaining, 16 (89%) demonstrated diaschisis. Thalamus (88%) was most often involved. Age at imaging was not associated with diaschisis. Long-term outcomes available on 13 (81%) demonstrated no association between diaschisis score and PSOM categories. Conclusion: Cerebral diaschisis occurs in NAIS and can be quantified with DWI. Occurrence is common and should not be mistaken for additional infarction. Determining additional clinical significance will depend on larger samples with long-term outcomes.


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