scholarly journals role of telehealth services in the treatment of rare disease: analysis of 1 year of work on the example of anal cancer

2020 ◽  
Vol 10 (2) ◽  
pp. 28-32
Author(s):  
S. S. Gordeev ◽  
M. Yu. Fedyanin ◽  
E. V. Glazkova ◽  
V. A. Amosova ◽  
A. V. Petrovskiy
Keyword(s):  
Real Number ◽  
Anal Cancer ◽  
Treatment Strategy ◽  
Initial Treatment ◽  
Anal Carcinoma ◽  
Correct Choice ◽  
Subsequent Treatment ◽  
The Real ◽  
Treatment Errors ◽  
Number Of Patients

Objective: to assess the potential need for telehealth consultations in regions for the treatment of patients diagnosed with anal cancer and to analyze the most common treatment errors. Materials and methods. We analyzed telehealth consultations provided for 3 Federal districts between April 2019 and April 2020. The following parameters were evaluated: the ratio between the predicted need for telehealth consultations and the real number of requests, the number of medical errors in patients who had already undergone first and / or subsequent treatment stages (according to relevant clinical guidelines). Results. Fifteen telehealth consultations were provided during this year: 13 of them (86.7 %) for disease progression or complications and 2  of them (13.3 %) to determine the initial treatment strategy. Treatment errors were registered in 11 out of 13 cases (84.6 %). The predicted need based on the population size was 565 consultations per year; the predicted need based on the real number of patients visited cancer clinics was 81 consultations. Conclusions. We found many significant errors in treatment regimens of patients with squamous cell anal carcinoma. Wider use of telehealth consultations with Federal centers will ensure the correct choice of the initial treatment strategy. 

scholarly journals The transition in the etiologies of hepatocellular carcinoma-complicated liver cirrhosis in a nationwide survey of Japan

2020 ◽  
Author(s):  
Hirayuki Enomoto ◽  
◽  
Yoshiyuki Ueno ◽  
Yoichi Hiasa ◽  
Hiroki Nishikawa ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Viral Hepatitis ◽  
Real Number ◽  
Nationwide Survey ◽  
Hcv Infection ◽  
Annual Number ◽  
The Real ◽  
Number Of Patients ◽  
Viral Etiologies

Abstract Background We recently reported the real-world changes in the etiologies of liver cirrhosis (LC) based on nationwide survey data and assessed the etiologies of LC with hepatocellular carcinoma (HCC). Methods Fifty-five participants from 68 institutions provided data on 23,637 patients with HCC-complicated LC. The changing trends in etiologies were assessed. We further analyzed the data from 29 hospitals that provided the annual number of newly identified HCC-complicated LC patients from 2008 to 2016 (N = 9362) without any missing years and assessed the transition in the real number of newly identified HCC-complicated LC cases. Results In the overall cohort, hepatitis C virus (HCV) infection (60.3%) and hepatitis B virus (HBV) infection (12.9%) were the leading and third-most common causes of HCC-complicated LC in Japan, respectively. HCV infection was found to be the leading cause throughout Japan. The rate of viral hepatitis-related HCC decreased from 85.3 to 64.4%. Among non-viral etiologies, notable increases were observed in nonalcoholic steatohepatitis (NASH)-related HCC (from 1.5 to 7.2%) and alcoholic liver disease (ALD)-related HCC (from 8.5 to 18.6%). Regarding the real number of newly diagnosed patients, the number of patients with viral hepatitis-related HCC decreased, while the number of patients with non-viral HCC, particularly NASH-related HCC, increased. Conclusions Viral hepatitis has remained the main cause of HCC in Japan. However, the decrease in viral hepatitis-related HCC, particularly HCV-related HCC highly contributed to the etiological changes. In addition, the increased incidence of non-viral HCC, particularly NASH-related HCC, was involved in the changing etiologies of HCC-complicated LC in Japan.

scholarly journals Management of Patients with Pancreatic Ductal Adenocarcinoma in the Real-Life Setting: Lessons from the French National Hospital Database

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3515
Author(s):  
Christelle de la Fouchardière ◽  
Mustapha Adham ◽  
Anne-Marie Marion-Audibert ◽  
Antoine Duclos ◽  
Claude Darcha ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Real Life ◽  
Ductal Adenocarcinoma ◽  
University Hospitals ◽  
National Hospital ◽  
Curative Intent ◽  
The Real ◽  
Oncological Treatment ◽  
Real Life Setting ◽  
Number Of Patients

Pancreatic ductal adenocarcinoma (PDAC) remains a major public health challenge, and faces disparities and delays in the diagnosis and access to care. Our purposes were to describe the medical path of PDAC patients in the real-life setting and evaluate the overall survival at 1 year. We used the national hospital discharge summaries database system to analyze the management of patients with newly diagnosed PDAC over the year 2016 in Auvergne-Rhône-Alpes region (AuRA) (France). A total of 1872 patients met inclusion criteria corresponding to an incidence of 22.6 per 100,000 person-year. Within the follow-up period, 353 (18.9%) were operated with a curative intent, 743 (39.7%) underwent chemo- and/or radiotherapy, and 776 (41.4%) did not receive any of these treatments. Less than half of patients were operated in a high-volume center, defined by more than 20 PDAC resections performed annually, mainly university hospitals. The 1-year survival rate was 47% in the overall population. This study highlights that a significant number of patients with PDAC are still operated in low-volume centers or do not receive any specific oncological treatment. A detailed analysis of the medical pathways is necessary in order to identify the medical and territorial determinants and their impact on the patient’s outcome.

scholarly journals Late survival benefit of percutaneous coronary intervention compared with medical therapy in patients with coronary chronic total occlusion: a 10-year follow-up study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T.K Park ◽  
S.H Choi ◽  
J.M Lee ◽  
J.H Yang ◽  
Y.B Song ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Treatment Strategy ◽  
Initial Treatment ◽  
Cardiac Death ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Total Occlusion ◽  
Percutaneous Coronary

Abstract Background As an initial treatment strategy, percutaneous coronary intervention (PCI) for coronary chronic total occlusion (CTO) did not show mid-term survival benefits compared with optimal medical therapy (OMT). Purpose To compare 10-year clinical outcomes between OMT and PCI in CTO patients. Methods Between March 2003 and February 2012, 2,024 patients with CTO were enrolled in a single center registry and followed for about 10 years. We excluded CTO patients who underwent coronary artery bypass grafting, and classified patients into the OMT group (n=664) or PCI group (n=883) according to initial treatment strategy. Propensity-score matching was performed to minimize potential selection bias. The primary outcome was cardiac death. Results In the PCI group, 699 patients (79.2%) underwent successful revascularization. Clinical and angiographic characteristics revealed more comorbidities and more complex lesions in the OMT group than in the PCI group. At 10 years, the PCI group had lower risks of cardiac death (10.4% versus 22.3%; HR 0.43; 95% CI 0.32 to 0.57; p<0.001) than the OMT group. After the propensity-score matching analyses, the PCI group had lower risks of cardiac death (13.6% versus 20.8%; HR 0.62; 95% CI 0.44 to 0.88; p=0.007), acute myocardial infarction (6.3% versus 11.2%; HR 0.55; 95% CI 0.34 to 0.91; p=0.02), any revascularization (23.9% versus 32.2%; HR 0.67; 95% CI 0.51 to 0.88; p=0.004) than the OMT group. The beneficial effects of CTO PCI were consistent across various subgroups (all p-values for interaction: non-significant). Conclusions As an initial treatment strategy, PCI reduced late cardiac death compared with OMT in CTO patients. Cardiac death in matched population Funding Acknowledgement Type of funding source: None

scholarly journals Radiotherapy with Intensity-Modulated (IMRT) Techniques in the Treatment of Anal Carcinoma (RAINSTORM): A Multicenter Study on Behalf of AIRO (Italian Association of Radiotherapy and Clinical Oncology) Gastrointestinal Study Group

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1902
Author(s):  
Luciana Caravatta ◽  
Giovanna Mantello ◽  
Francesca Valvo ◽  
Pierfrancesco Franco ◽  
Lucrezia Gasparini ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Clinical Outcomes ◽  
Anal Cancer ◽  
Treatment Time ◽  
Histological Grade ◽  
Anal Carcinoma ◽  
Nodal Involvement ◽  
Free Survival ◽  
Intensity Modulated ◽  
Grade 3

A multi-institutional retrospective study was conducted to evaluate the pattern of care and clinical outcomes of anal cancer patients treated with intensity-modulated radiotherapy (IMRT) techniques. In a cohort of 987 patients, the clinical complete response (CR) rate (beyond 6 months) was 90.6%. The 3-year local control (LC) rate was 85.8% (95% CI: 84.4–87.2), and the 3-year colostomy-free survival (CFS) rate was 77.9% (95% CI: 76.1–79.8). Three-year progression-free survival (PFS) and overall survival (OS) rates were 80.2% and 88.1% (95% CI: 78.8–89.4) (95% CI: 78.5–81.9), respectively. Histological grade 3 and nodal involvement were associated with lower CR (p = 0.030 and p = 0.004, respectively). A statistically significant association was found between advanced stage and nodal involvement, and LC, CFS, PFS, OS and event-free survival (EFS). Overall treatment time (OTT) ≥45 days showed a trend for a lower PFS (p = 0.050) and was significantly associated with lower EFS (p = 0.030) and histological grade 3 with a lower LC (p = 0.025). No statistically significant association was found between total dose, dose/fraction and/or boost modality and clinical outcomes. This analysis reports excellent clinical results and a mild toxicity profile, confirming IMRT techniques as standard of care for the curative treatment of anal cancer patients. Lymph node involvement and histological grade have been confirmed as the most important negative prognostic factors.

scholarly journals An algebraic proof of the real number PCP theorem

2017 ◽  
Vol 40 ◽  
pp. 34-77 ◽  
Author(s):  
Martijn Baartse ◽  
Klaus Meer
Keyword(s):  
Real Number ◽  
Algebraic Proof ◽  
The Real ◽  
Pcp Theorem

scholarly journals Significance of Parallel Computing on the Performance of Digital Image Correlation Algorithms in MATLAB

Designs ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 15
Author(s):  
Andreas Thoma ◽  
Abhijith Moni ◽  
Sridhar Ravi
Keyword(s):  
Digital Image Correlation ◽  
Real Time ◽  
Digital Image ◽  
Correct Choice ◽  
Image Correlation ◽  
Particle Swarm Algorithm ◽  
Processing Unit ◽  
Time Analysis ◽  
The Real ◽  
Real Time Analysis

Digital Image Correlation (DIC) is a powerful tool used to evaluate displacements and deformations in a non-intrusive manner. By comparing two images, one from the undeformed reference states of the sample and the other from the deformed target state, the relative displacement between the two states is determined. DIC is well-known and often used for post-processing analysis of in-plane displacements and deformation of the specimen. Increasing the analysis speed to enable real-time DIC analysis will be beneficial and expand the scope of this method. Here we tested several combinations of the most common DIC methods in combination with different parallelization approaches in MATLAB and evaluated their performance to determine whether the real-time analysis is possible with these methods. The effects of computing with different hardware settings were also analyzed and discussed. We found that implementation problems can reduce the efficiency of a theoretically superior algorithm, such that it becomes practically slower than a sub-optimal algorithm. The Newton–Raphson algorithm in combination with a modified particle swarm algorithm in parallel image computation was found to be most effective. This is contrary to theory, suggesting that the inverse-compositional Gauss–Newton algorithm is superior. As expected, the brute force search algorithm is the least efficient method. We also found that the correct choice of parallelization tasks is critical in attaining improvements in computing speed. A poorly chosen parallelization approach with high parallel overhead leads to inferior performance. Finally, irrespective of the computing mode, the correct choice of combinations of integer-pixel and sub-pixel search algorithms is critical for efficient analysis. The real-time analysis using DIC will be difficult on computers with standard computing capabilities, even if parallelization is implemented, so the suggested solution would be to use graphics processing unit (GPU) acceleration.

scholarly journals II. On the Number of the Lost Books of Tacitus. By the Lord Mahon

Archaeologia ◽  
1838 ◽  
Vol 27 ◽  
pp. 15-17
Author(s):  
Mahon
Keyword(s):  
Real Number ◽  
The Real

The historical works of Tacitus which remain to us are, as is well known, besides the Life of Agricola, the four first books of the Annals, part of the fifth, the sixth, the eleventh, twelfth, thirteenth, fourteenth, fifteenth, and part of the sixteenth, the four first books of the History, and part of the fifth. It is asserted by Brotier, in his excellent edition, that the total number of books must have been sixteen of Annals and fourteen of History, and this assertion has never yet, so far as I know, been doubted or called in question. I think, however, that there are strong grounds for presuming that the real number of books was eighteen of Annals and twelve of History; and, though the point be of small importance, it may perhaps not be without some interest to the admirers of the greatest of Historians.

Sign in / Sign up

Export Citation Format

Share Document