ICES (International Carboplatin Emesis Survey) for the evaluation of the emetogenicity of continuous cycles of carboplatin-based chemotherapy with focus on nausea: A MASCC emesis study group, prospective, observational, real-world multi-centric study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24086-e24086
Author(s):  
Bernardo Leon Rapoport ◽  
Alexandre Chan ◽  
Martin Robert Chasen ◽  
Teresa Smit ◽  
Liezl Heyman ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Final Analysis ◽  
Morning Sickness ◽  
Antiemetic Prophylaxis ◽  
Medical Need ◽  
Delayed Nausea ◽  
Considerable Problem ◽  
History Of ◽  
The Impact

e24086 Background: Chemotherapy induced nausea and vomiting (CINV) following carboplatin containing chemotherapy regimen remains a considerable problem for cancer patients (pts) despite standard antiemetic prophylaxis. This study was undertaken to prospectively evaluate the incidence of CINV in pts undergoing carboplatin-based chemotherapy receiving guidelines consistent CINV prophylaxis (GCCP). All sites did not prescribe NK1-RA as it is not included in all institutional guidelines. Methods: The study enrolled 207 pts undergoing carboplatin-based chemotherapy, the final analysis evaluated cycle 1 - 6 with a total of 183 evaluable pts from 6 countries. Pt diaries were used to collect data from day 1-10 beginning with cycle 1. Nausea was reported by the pts using a visual analog scale (VAS) with the end-point being no nausea. Vomiting episodes were recorded in the pts’ diaries. Demographic, occurrence and severity of emesis, numbers of emetic episodes and time to the onset of emesis, were summarized using descriptive statistics. Results: There were 129 females and 54 males. The overall incidence of acute and delayed nausea for was 17% and 25% respectively. The incidence of nausea of entire population was significantly higher than vomiting (58% vs. 14%; Chi2 22.271 p<0.000). The use of NK1-RA was associated with a significant decrease in time to first vomiting for cycle 1 (p<0.041) and subsequent cycle 2-6 (p<0.0075). Additional results are reported in the Table. In a logistic regression model factors associated with acute nausea in cycle 1 included history of motion sickness (p< 0.0090), comorbidities (p< 0.0084), history of morning sickness (p< 0.0090), previous chemotherapy (p< 0.0096), anemia (p< 0.0209). A separate logistic regression analysis for delayed nausea in cycle 1 showed that prior radiotherapy (p<0.0093) and a history of morning sickness (p<0.0195) were also significant. During subsequent cycles (1 – 6), the incidence of nausea remained higher than vomiting and was documented in the acute and delayed phases ranging from 6% to 25%. The use of NK1-RA was associated with a lower incidence of vomiting during cycle 1-6 with 91% patient receiving NK1-RA experiencing no vomiting vs 78% of patients not receiving NK1-RA with no vomiting (log rank = 0.0287). Conclusions: Despite GCCP and the usage of NK1-RA, carboplatin induced nausea remains a major unmet medical need in cancer pts. Further research should focus on management of nausea, risk factors and the impact of nausea on quality of life and in pts undergoing carboplatin-based treatment.[Table: see text]

Patients With a History of Oronasal Fistula Repair Exhibit Lower Oral Health Measured With Patient-Centric Outcomes Measures

2020 ◽  
pp. 105566562098133
Author(s):  
Alyssa Fritz ◽  
Diana S. Jodeh ◽  
Fatima Qamar ◽  
James J. Cray ◽  
S. Alex Rottgers
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Cleft Palate ◽  
Fistula Repair ◽  
Old Patients ◽  
Oronasal Fistula ◽  
Patient Reported ◽  
History Of ◽  
The Impact

Introduction: Oronasal fistulae following palatoplasty may affect patients’ quality of life by impacting their ability to eat, speak, and maintain oral hygiene. We aimed to quantify the impact of previous oronasal fistula repair on patients’ quality of life using patient-reported outcome psychometric tools. Methods: A cross-sectional study of 8- to 9-year-old patients with cleft palate and/or lip was completed. Patients who had a cleft team clinic between September 2018 and August 2019 were recruited. Participants were divided into 2 groups (no fistula, prior fistula repair). Differences in the individual CLEFT-Q and Child Oral Health Impact Profile-Short Form 19 (COHIP-SF 19) Oral Health scores between the 2 groups were evaluated using a multivariate analysis controlling for Veau classification and syndromic diagnosis. Results: Sixty patients with a history of cleft palate were included. Forty-two (70%) patients had an associated cleft lip. Thirty-two (53.3%) patients had no history of fistula and 28 (46.7%) patients had undergone a fistula repair. CLEFT-Q Dental, Jaw, and Speech Function were all higher in patients without a history of a fistula repair; however, none of these differences were statistically significant. The COHIP-SF 19 Oral Health score demonstrated a significantly lower score in the fistula group, indicating poorer oral health ( P = .05). Conclusions: One would expect that successful repair of a fistula would result in improved function and patient satisfaction, but the consistent trend toward lower CLEFT-Q scores and significantly increased COHIP-SF 19 Oral Health scores in our study group suggests that residual effects linger and that the morbidity of a fistula may not be completely treated with a secondary correction.

P007 CROHN’S DISEASE: PREDICTORS OF HOSPITAL DISPOSITION AND COSTS USING DEMOGRAPHIC, CLINICAL, AND TREATMENT DATA

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S48-S48
Author(s):  
Hartman Brunt ◽  
Mason Adams ◽  
Michael Barker ◽  
Diana Hamer ◽  
J C Chapman
Keyword(s):  
Logistic Regression ◽  
Crohn’S Disease ◽  
Abdominal Pain ◽  
Crohn's Disease ◽  
Hospital Admission ◽  
Categorical Variables ◽  
History Of ◽  
The Difference ◽  
The Impact ◽  
Total Charges

Abstract Purpose Crohn’s disease (CD) is an inflammatory bowel disease (IBD) caused by an abnormal immune response to intestinal microbes in a genetically susceptible host. The objective of this cohort analysis is to compare demographic characteristics, cost difference, and treatment modalities between patients who were discharged from the Emergency Department (ED) and those who were admitted to the hospital. Methods This study is a retrospective chart review of adult patients diagnosed with CD who were discharged from the ED and those who were admitted to the hospital between January 1, 2014 and January 1, 2017. We compared demographic and clinical characteristics as well as total charges incurred by these patients. A chi square test of independence and a Mann Whitney U-Test were used to compare categorical variables. Linear and logistic regression analyses were utilized to identify predictors of hospitalization and total charges. Results Of a total 195 patients, 97 were discharged from the ED and 98 were admitted to the hospital (Table 1). Patients who presented with fever, nausea/vomiting, or abdominal pain or who had a history of a fistula or stenosis were more likely to be hospitalized, as were patients who presented on steroids, 5-ASA compounds, or narcotics (Table 2). A logistic regression adjusted for these factors showed patients presenting with abdominal pain (OR=0.239, 95% CI 0.07 – 0.77) are less likely, while patients presenting with fever (OR=7.0, 95% CI 1.9 – 24.5) and history of stenosis (OR=17.8, 95% CI 5.7 – 55.9) are more likely to have a hospital admission. An increase in age and white blood cell count was associated with an increase in likelihood of admission (OR=1.04, 95% CI 1.01 – 1.07 and OR=1.2, 95% CI 1.1 – 1.4), while an increase in HGB was associated with a decrease in likelihood of admission (OR=0.682, 95% CI 0.55 – 0.83). Patients on 5-ASA compounds had the strongest association with hospital admission (OR=4.5, 95% CI 1.03 – 20.4). A linear regression analysis predicting total charges of hospitalization identified an increase of $37,500 (95% CI 6,600 – 68,489) for obese patients and of $29,000 (95% CI 20 – 57,000) for patients on narcotics prior to hospitalization. Notably, blacks were on average 6 years younger than whites (μ=36.2, st.d.=13.2 v μ=42.7, st.d.=18.2, p=0.031, respectively). No other differences in presentation or outcomes of CD were identified between these races. Conclusion This study describes the difference between CD patients who were admitted to the hospital compared to those who were discharged from the ED. The impact that 5-ASA compound, steroid, and narcotic use prior to presentation has on hospital admission and charges highlights the need for consistent outpatient care to manage the symptoms and disease progression in patients with CD in Baton Rouge. The difference in age at presentation between blacks and whites should also be considered in future research.

Retrospective Chart Review of Cryopreserved Amniotic Membrane for Knee Pain

2020 ◽  
Author(s):  
Ruben Berrocal Timmons
Keyword(s):  
Quality Of Life ◽  
Adverse Events ◽  
Amniotic Membrane ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Final Analysis ◽  
Mean Values ◽  
Number Of Patients ◽  
The Impact

Objective: Treatment of joint pain with an injection of the amniotic membrane has not been adequately studied. This study retrospectively reviewed Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and analgesic usage data from patients treated with the injection of cryopreserved amniotic membrane (CAM) in their knees to determine the impact of treatment on patients’ pain, quality of life, and analgesic usage. Methods: Chart review was conducted on 40 patients. Institutional Review Board (IRB) approval was obtained prior to initiation of the project. The membrane was utilized as per the FDA guidance of 21CFR1271. Retrospective data, including demographics, medical history, pain score, quality of life score, analgesic usage and adverse events, were collected from their medical records for each consenting patient through 6 months after CAM injection. Results: A total of 40 patients were considered in the final analysis. Mean VAS for pain level improved from 7.0 to 2.6 (p<0.001). WOMAC daily activity function score improved from a mean score of 52 to 28 (p<0.001). Opioid and non-steroidal anti-inflammatory drug (NSAID) usage decreased from 97% to 25% (p<0.001). No adverse events were reported. Conclusion: Mean values for VAS and WOMAC scores significantly improved at all time points and the number of patients who used analgesics decreased as compared to baseline. CAM injection into painful knee joints decreases pain, improves physical function, and decreases the use of analgesics in the absence of adverse events.

scholarly journals THE EFFECT OF YOGA ON FALL PREVENTION OUTCOMES IN ADULTS 50 YEARS AND OLDER: A SYSTEMATIC REVIEW OF THE LITERATURE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S289-S290
Author(s):  
Chinelo K Nsobundu ◽  
Margaret J Foster ◽  
Yan Hong
Keyword(s):  
Older Adults ◽  
Fall Prevention ◽  
Fear Of Falling ◽  
Final Analysis ◽  
Exclusion Criteria ◽  
Face To Face ◽  
Ovid Medline ◽  
The Impact ◽  
Fall Prevention Intervention

Abstract Falls constitute a multitude of injuries irrespective of age. To combat these challenges, older adults are encouraged to engage in recreational activities. Yoga has been identified as an effective physical activity to promote mobility and balance for older adults. This study aims to systematically review the literature about yoga as a fall prevention intervention and synthesize the outcomes. Major databases (Ovid Medline & CINAHL) were searched for relevant articles. Studies were included if they met the criteria of 1) being a face to face yoga program, 2) aimed to recruit participants 50 years or older, and 3) reported at least one fall-related outcome (e.g., balance, mobility, fear of falling) as a result of the yoga program. 57 studies were identified: 32 from Ovid Medline and 25 from CINAHL. After removing the duplicates and applying a strict inclusion and exclusion criteria, 11 articles were included in the final analysis. A detailed synthesis of the results will be presented and quality assessment of included articles will be performed using the Modified Downs and Black checklist which appraises the methodological quality of both randomized and non-randomized studies. More research is needed to understand the impact of yoga in preventing falls among older adults at least 50 years of age. Additionally, research should establish a gold standard index that identifies which specific yoga programs ( based on type- individual vs. group; hatha, iyengar, kundalini, ashtanga, and etc.; frequency, and duration) have an enhanced effect on fall prevention.

scholarly journals Decreasing the Impact of Anxiety on Cancer Prevention through Online Intervention

2020 ◽  
Vol 17 (3) ◽  
pp. 985
Author(s):  
Maksymilian Gajda ◽  
Małgorzata Kowalska
Keyword(s):  
Positive Family History ◽  
Final Analysis ◽  
Global Public Health ◽  
Web Based ◽  
Internet Portal ◽  
Randomized Intervention ◽  
History Of ◽  
Diagnosis Of Cancer ◽  
On Line ◽  
The Impact

Background: Low levels of public knowledge, incorrect beliefs, and anxiety are the most often mentioned factors that may negatively affect the implementation of preventive campaigns and timely diagnosis of cancer. Cancer is a major unresolved problem for global public health. As a result, many effective preventive measures need to be found and implemented. Methods: For a duration of 18 months, readers of the Polish scientific Internet portal were invited to participate in the Polish On-line Randomized Intervention aimed at Neoplasm Avoidance (PORINA) study. Level of cancer-related anxiety was our main measure (self-declared on a simple five-point Likert scale) in this analysis. Results: A total of 463 participants were qualified for the final analysis. Respondents with a positive family history of cancer (p < 0.001) declared the highest level of cancer-related anxiety, whereas lower levels were declared by those previously treated for cancer (p = 0.006). The conducted educational intervention reduced the declared level of cancer-related anxiety. Conclusions: The results of this study provide evidence that the use of web-based interventions aimed at increasing awareness could reduce cancer-related anxiety and may lead to more frequent consent to undergo some of the medical procedures used to diagnose or treat cancer.

Sleep Bruxism and Anxiety Impacts in Quality of Life Related to Oral Health of Brazilian Children and their Families

2017 ◽  
Vol 41 (3) ◽  
pp. 179-185 ◽  
Author(s):  
Nashalie Andrade de Alencar ◽  
Cecília Sued Leão ◽  
Anna Thereza Thomé Leão ◽  
Ronir Raggio Luiz ◽  
Andréa Fonseca-Gonçalves ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Logistic Regression ◽  
Oral Health ◽  
Trait Anxiety ◽  
Sleep Bruxism ◽  
Study Data ◽  
Healthy Children ◽  
Socioeconomic Characteristics ◽  
The Impact

Objective: This study aimed to assess the impact of parent reported sleep bruxism, trait anxiety and sociodemographic/socioeconomic features on quality of life related to oral health (OHRQoL) of children and their families. Study Design: Healthy children aged 3–7 years, with (n=34) and without (n=32) bruxism were select for this study. Data was collected by applying the following instruments: The Early Childhood Oral Health Scale (B-ECOHIS) and Trait-anxiety Scale (TAS). The sociodemographic/socioeconomic characteristics were obtained by interviews with parents. Multiple logistic regression tests were performed to observe the influence of sociodemographic/socioeconomic characteristics, bruxism and trait-anxiety on the children's OHRQoL. Results: No association between sleep bruxism and all evaluated sociodemographic/socioeconomic conditions, with exception of being the only child (p=0.029), were observed. Mean B-ECOHIS and TAS scores were different (p&lt;0.05) between children with (3.41 ± 4.87; 45.09 ± 15.46, respectively) and without (0.63 ± 1.28; 29.53 ± 11.82, respectively) bruxism. Although an association between bruxism and OHRQoL (p=0.015) was observed, it was dropped (p=0.336; OR=1.77) in the logistic regression model. Trait anxiety was the variable responsible for the impact on the OHRQoL of children (p=0.012; OR=1.05). Conclusion: Our results indicated anxiety as the main factor that interfered in the OHRQoL of children with sleep bruxism

Stuttering Impact: A Shared Perception for Parents and Children?

2019 ◽  
Vol 72 (6) ◽  
pp. 478-486 ◽  
Author(s):  
Mónica Rocha ◽  
J. Scott Yaruss ◽  
Joana R. Rato
Keyword(s):  
Quality Of Life ◽  
Treatment Approach ◽  
Individualized Treatment ◽  
Negative Attitudes ◽  
School Aged Children ◽  
European Portuguese ◽  
Parents And Children ◽  
History Of ◽  
The Impact

<b><i>Background/Aims:</i></b> Previous research has provided information about how school-aged children perceive their own stuttering; however, less is known about how stuttering is perceived by their parents. The ways that parents view their children’s stuttering could influence how the children themselves react to it. This study proceeds to assess how parents’ perceptions of the impact of stuttering relate to the perceptions of children. <b><i>Method:</i></b> Participants were 50 children who stutter aged 7–12 years (mean = 9.10; SD = 1.7) and their parents, recruited from different cities in Portugal. The European Portuguese version of the Overall Assessment of the Speaker’s Experience of Stuttering was administered to the children, and an adapted version of the tool was administered to their parents. <b><i>Results:</i></b> Both parents and children showed generally similar overall impact ratings, typically falling in the mild and moderate ranges. Differences were observed in families with a history of stuttering: for those families, a comparison of parents’ and children’s scores revealed, in some domains, that parents perceived the impact of stuttering to be greater than the children did, especially related with children’s reactions to stuttering and their quality of life. <b><i>Conclusion:</i></b> Knowledge about how parents perceive the impact of stuttering on their children is important because families can play a key role in helping children cope with stuttering. These findings highlight the benefits of using an individualized treatment approach for each child that focuses on their perceptions, as well as on those of the parents, in order to address negative attitudes toward children’s stuttering.

Journey to the East: A Philosophical Inquiry into the Early Reception of St. Augustine in China

2019 ◽  
Vol 16 (2) ◽  
pp. 117-129
Author(s):  
Yuan Gao
Keyword(s):  
Additional Advantage ◽  
Philosophical Inquiry ◽  
Christianity In China ◽  
Catholic Faith ◽  
Maritime Silk Road ◽  
History Of ◽  
Indigenous Religions ◽  
The Impact

AbstractIn modern scholarship, much ink has been spilled over the significance of St. Augustine in the history of Western philosophy and theology. However, little effort has been made to clarify the legacy of Augustine in East Asia, especially his contribution to China during the early Jesuit missionary work through the Maritime Silk Road. The present article attempts to fill this lacuna and provide a philosophical analysis of the encounter of Chinese indigenous religions with St Augustine, by inquiring into why and how Augustine was taken as a model for the Chinese in their acceptance of the Christian faith. The analysis is split into three parts. The first part reflects on the contemporary disputations over the quality of the paraphrasing work of the early Jesuits, analyzing the validity of the allegedly careless inaccuracies in their introduction of Augustine's biography. The second part analyses some rarely discussed Chinese translations of Augustine, which I recently found in the Nanjing Union Theological Seminary, with particular focus on their ideological context. In particular, the paraphrased text concerning Augustine's theory of sin and the two cities will be highlighted. The third part goes a step further in exploring the reason why Augustine was considered an additional advantage in dealing with the conflicts between Christian and Confucian values. The primary contribution this essay makes is to present a philosophical inquiry into the role of Augustine in the early acceptance of Christianity in China by suggesting that a strategy of “Confucian-Christian synthesis” had been adopted by the Jesuit missionaries. Thereby, they accommodated Confucian terms without dropping the core values of the orthodox Catholic faith. The conclusion revisits the critics’ arguments and sums up with an evaluation of the impact of Augustine's religious values in the indigenization of Christianity in China.

scholarly journals An electronic documentation system improves the quality of admission notes: a randomized trial

2016 ◽  
Vol 24 (1) ◽  
pp. 123-129 ◽  
Author(s):  
Trevor Jamieson ◽  
Jonathan Ailon ◽  
Vince Chien ◽  
Ophyr Mourad
Keyword(s):  
Clinical Teaching ◽  
Free Text ◽  
Clinical Documentation ◽  
Electronic Documentation ◽  
Documentation System ◽  
General Internal ◽  
History Of ◽  
Text Content ◽  
The Impact

Objective: There are concerns that structured electronic documentation systems can limit expressivity and encourage long and unreadable notes. We assessed the impact of an electronic clinical documentation system on the quality of admission notes for patients admitted to a general medical unit. Methods: This was a prospective randomized crossover study comparing handwritten paper notes to electronic notes on different patients by the same author, generated using a semistructured electronic admission documentation system over a 2-month period in 2014. The setting was a 4-team, 80-bed general internal medicine clinical teaching unit at a large urban academic hospital. The quality of clinical documentation was assessed using the QNOTE instrument (best possible score = 100), and word counts were assessed for free-text sections of notes. Results: Twenty-one electronic-paper note pairs (42 notes) written by 21 authors were randomly drawn from a pool of 303 eligible notes. Overall note quality was significantly higher in electronic vs paper notes (mean 90 vs 69, P &lt; .0001). The quality of free-text subsections (History of Present Illness and Impression and Plan) was significantly higher in the electronic vs paper notes (mean 93 vs 78, P &lt; .0001; and 89 vs 77, P = .001, respectively). The History of Present Illness subsection was significantly longer in electronic vs paper notes (mean 172.4 vs 92.4 words, P = .0001). Conclusions: An electronic admission documentation system improved both the quality of free-text content and the overall quality of admission notes. Authors wrote more in the free-text sections of electronic documents as compared to paper versions.

scholarly journals Atrial fibrillation and clinical outcomes 1 to 3 years after myocardial infarction

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001726
Author(s):  
Anthony P Carnicelli ◽  
Ruth Owen ◽  
Stuart J Pocock ◽  
David B Brieger ◽  
Satoshi Yasuda ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Clinical Outcomes ◽  
Oral Anticoagulants ◽  
Adverse Outcomes ◽  
Increased Risk ◽  
History Of ◽  
The Impact

ObjectiveAtrial fibrillation (AF) and myocardial infarction (MI) are commonly comorbid and associated with adverse outcomes. Little is known about the impact of AF on quality of life and outcomes post-MI. We compared characteristics, quality of life and clinical outcomes in stable patients post-MI with/without AF.Methods/resultsThe prospective, international, observational TIGRIS (long Term rIsk, clinical manaGement and healthcare Resource utilization of stable coronary artery dISease) registry included 8406 patients aged ≥50 years with ≥1 atherothrombotic risk factor who were 1–3 years post-MI. Patient characteristics were summarised by history of AF. Quality of life was assessed at baseline using EQ-5D. Clinical outcomes over 2 years of follow-up were compared. History of AF was present in 702/8277 (8.5%) registry patients and incident AF was diagnosed in 244/7575 (3.2%) over 2 years. Those with AF were older and had more comorbidities than those without AF. After multivariable adjustment, patients with AF had lower self-reported quality-of-life scores (EQ-5D UK-weighted index, visual analogue scale, usual activities and pain/discomfort) than those without AF. CHA2DS2-VASc score ≥2 was present in 686/702 (97.7%) patients with AF, although only 348/702 (49.6%) were on oral anticoagulants at enrolment. Patients with AF had higher rates of all-cause hospitalisation (adjusted rate ratio 1.25 [1.06–1.46], p=0.008) over 2 years than those without AF, but similar rates of mortality.ConclusionsIn stable patients post-MI, those with AF were commonly undertreated with oral anticoagulants, had poorer quality of life and had increased risk of clinical outcomes than those without AF.Trial registration numberClinicalTrials: NCT01866904.

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