scholarly journals A Pharmacological Analysis of the Activity and Failure of the Medical Treatment of High-Grade Osteosarcoma

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 141
Author(s):  
Alessandro Comandone ◽  
Antonella Boglione ◽  
Tiziana Comandone ◽  
Fausto Petrelli
Keyword(s):  
Bone Cells ◽  
Age Groups ◽  
The Elderly ◽  
New Drugs ◽  
High Grade ◽  
Secondary Resistance ◽  
Orthopedic Surgeons ◽  
Close Cooperation ◽  
High Grade Osteosarcoma ◽  
Effective Drugs

Osteosarcomas (OSs) are a group of neoplasms originating from bone cells, usually presenting in three specific age groups: children, young adults, and the elderly. High-grade OS is an extremely malignant tumor mainly due to evolution into metastatic disease, usually in the lungs. Survival of these patients has improved since the 1980s thanks to close cooperation between oncologists, oncological surgeons and orthopedic surgeons. Unfortunately, no progress has been made in the last 30 years and new, more effective drugs are needed. This article reviews the biological and pharmacological basis of the treatment of OS. Models of clinical pharmacology of the active drugs, toxic effects and reasons for primary and secondary resistance to old and new drugs are discussed.

scholarly journals Survival Analysis of 3 Different Age Groups and Prognostic Factors among 402 Patients with Skeletal High-Grade Osteosarcoma. Real World Data from a Single Tertiary Sarcoma Center

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 486
Author(s):  
Richard E. Evenhuis ◽  
Ibtissam Acem ◽  
Anja J. Rueten-Budde ◽  
Diederik S. A. Karis ◽  
Marta Fiocco ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Medical Center ◽  
Age Groups ◽  
High Grade ◽  
Real World Data ◽  
Poor Overall Survival ◽  
Histopathological Response ◽  
Curative Intent ◽  
Entire Cohort ◽  
High Grade Osteosarcoma

Age is a known prognostic factor for many sarcoma subtypes, however in the literature there are limited data on the different risk profiles of different age groups for osteosarcoma survival. This study aims to provide an overview of survival in patients with high-grade osteosarcoma in different age groups and prognostic variables for survival and local control among the entire cohort. In this single center retrospective cohort study, 402 patients with skeletal high-grade osteosarcoma were diagnosed and treated with curative intent between 1978 and 2017 at the Leiden University Medical Center (LUMC). Prognostic factors for survival were analyzed using a Cox proportional hazard model. In this study poor overall survival (OS) and event-free survival (EFS) were associated with increasing age. Age groups, tumor size, poor histopathological response, distant metastasis (DM) at presentation and local recurrence (LR) were important independent prognostic factors influencing OS and EFS. Differences in outcome among different age groups can be partially explained by patient and treatment characteristics.

Survival in high-grade osteosarcoma: Improvement in a 21-year period at a single institution

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 10515-10515
Author(s):  
P. Picci ◽  
M. Mercuri ◽  
S. Ferrari ◽  
M. Alberghini ◽  
A. Briccoli ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Disease Free Survival ◽  
New Drugs ◽  
Low Grade ◽  
High Grade ◽  
Free Survival ◽  
High Grade Osteosarcoma ◽  
Improvement In Survival ◽  
Lost To Follow Up

10515 Background: After the introduction of pre-operative chemotherapy in the early 1980s, treatment of osteosarcoma had not advantages from new drugs/modalities. Aim of this work is to analyze improvements in overall survival for patients treated over 21 years (1982–2002), with a 5-year minimum follow-up, in the largest series from a single institute ever reported, including all high grade osteosarcomas, despite histology varieties, age, site, and stage. Data are also analyzed in subgroups to define patients who benefited most. Methods: All diagnoses of high grade osteosarcoma were included. Of the 1,656 consecutive cases observed, 198 patients were excluded (41 consultation only, 129 low-grade varieties and 28 lost to follow-up). Within 1,456 included patients, 1,032 had characteristics to be enrolled in conventional clinical trials (classic histology, age < 41, localized and extremity disease). Results: Considering all patients, with a median follow-up of 12 years (5–25 yrs), 754 (51.7%) are alive, 613 continuously disease-free. Survival at 5, 10, and 15 years is 57%, 52%, and 51% respectively. Patients candidates for clinical trials have a survival rate of 68%, 64%, and 61% respectively. Survival for the other patients is 30%, 25%, and 24% respectively. Jointpoint Statistical Analysis at real 5-year follow-up shows a yearly statistically significant improvement in survival of 1.31% (95% CI 0.5–2.1), from 51% for patients treated in 1982 to 68% for those treated in 2002. Within the subgroups, survival statistically improved in patients candidates to protocols, those who relapsed, or presented with metastatic disease at diagnosis, or had axial tumors. Surgery was also analyzed, with a statistical significant increase in the percentage of limb salvage procedures without an increased rate of local recurrences. Conclusions: Despite the lack of new drugs for osteosarcoma, survival has statistically improved, especially for those patients with the worst outcome. Aggressive treatments are therefore recommended for all patients including those with poor prognosis. No significant financial relationships to disclose.

The Effects of Significant International Sports Events on Hungarian Suicide Rates

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 148-154 ◽  
Author(s):  
Karoly Bozsonyi ◽  
Peter Osvath ◽  
Sandor Fekete ◽  
Lajos Bálint
Keyword(s):  
Significant Relationship ◽  
Olympic Games ◽  
Arima Model ◽  
Age Groups ◽  
The Elderly ◽  
Intervention Analysis ◽  
Middle Aged ◽  
Sports Events ◽  
Sport Events ◽  
The Olympic Games

Abstract. Background: Several studies found a significant relationship between important sport events and suicidal behavior. Aims: We set out to investigate whether there is a significant relationship between the raw suicide rate and the most important international sports events (Olympic Games, FIFA World Cup, UEFA European Championship) in such an achievement-oriented society as the Hungarian one, where these sport events receive great attention. Method: We examined suicide cases occurring over 15,706 days between January 1, 1970, and December 31, 2012 (43 years), separately for each gender. Because of the age-specific characteristics of suicide, the effects of these sport events were analyzed for the middle-aged (30–59 years old) and the elderly (over 60 years old) generations as well as for gender-specific population groups. The role of international sport events was examined with the help of time-series intervention analysis after cyclical and seasonal components were removed. Intervention analysis was based on the ARIMA model. Results: Our results showed that only the Olympic Games had a significant effect in the middle-aged population. Neither in the older male nor in any of the female age groups was a relationship between suicide and Olympic Games detected. Conclusion: The Olympic Games seem to decrease the rate of suicide among middle-aged men, slightly but significantly.

Older workers in the Russian labor market: Trends in employment reallocation

2019 ◽  
pp. 5-34
Author(s):  
Anna L. Lukyanova ◽  
Rostislav I. Kapeliushnikov
Keyword(s):  
Older Workers ◽  
Service Sector ◽  
Age Groups ◽  
The Elderly ◽  
Education And Health ◽  
Job Opportunities ◽  
Intellectual Labor ◽  
Market Trends ◽  
Trade Education ◽  
The One

The paper analyzes changes in job opportunities of older workers in Russia in the period 2005—2017. The study uses the data from the Russian Labor Force Survey conducted by Rosstat. Changes in the occupational and industrial composition of elderly workers follow the trends pursued by other age groups: employment shifts from low- to high-skilled occupations, from physical to intellectual labor, and from material production to the service sector. We find a stronger polarization among older workers as their occupational structure is biased in favor of, on the one hand, the most and, on the other hand, the least qualified types of jobs. Employment of the elderly has fallen sharply in agriculture and manufacturing with a significant increase in trade, education, and health. Although the employment structure of older workers is generally more “traditionalist”, recent decades have witnessed its transformation in “progressive” directions, similarly to other age groups. These findings suggest that the legislated increase in the state retirement age is not likely to give rise to sizeable unemployment among the elderly. Most of them will be able to work in the occupations and industries previously dominated by young and prime-age workers.

ACUTE KIDNEY INJURY IN ELDERLY PATIENTS

2019 ◽  
Vol 72 (8) ◽  
pp. 1466-1472
Author(s):  
Grażyna Kobus ◽  
Jolanta Małyszko ◽  
Hanna Bachórzewska-Gajewska
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Elderly Patients ◽  
Older Patients ◽  
Age Groups ◽  
Kidney Injury ◽  
The Elderly ◽  
Younger Patients ◽  
Common Cause

Introduction: In the elderly, impairment of kidney function occurs. Renal diseases overlap with anatomic and functional changes related to age-related involutionary processes. Mortality among patients with acute renal injury is approximately 50%, despite advances in treatment and diagnosis of AKI. The aim: To assess the incidence of acute kidney injury in elderly patients and to analyze the causes of acute renal failure depending on age. Materials and methods: A retrospective analysis included medical documentation of patients hospitalized in the Nephrology Clinic during the 6-month period. During this period 452 patients were hospitalized in the clinic. A group of 77 patients with acute renal failure as a reason for hospitalization was included in the study. Results: The prerenal form was the most common cause of AKI in both age groups. In both age groups, the most common cause was dehydration; in the group of patients up to 65 years of age, dehydration was 29.17%; in the group of people over 65 years - 43.39%. Renal replacement therapy in patients with AKI was used in 14.29% of patients. In the group of patients up to 65 years of age hemodialysis was 16.67% and above 65 years of age. -13.21% of patients. The average creatinine level in the group of younger patients at admission was 5.16 ± 3.71 mg / dl, in the group of older patients 3.14 ± 1.63 mg / dl. The size of glomerular filtration GFR in the group of younger patients at admission was 21.14 ± 19.54 ml / min, in the group of older patients 23.34 ± 13.33 ml / min. Conclusions: The main cause of acute kidney injury regardless of the age group was dehydration. Due to the high percentage of AKI in the elderly, this group requires more preventive action, not only in the hospital but also at home.

Myxofibrosarcoma: clinical and prognostic value of MRI features

2020 ◽  
Vol 16 ◽  
Author(s):  
Paolo Spinnato ◽  
Andrea Sambri ◽  
Tomohiro Fujiwara ◽  
Luca Ceccarelli ◽  
Roberta Clinca ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Local Recurrence ◽  
Contrast Enhancement ◽  
Imaging Modality ◽  
Soft Tissue Sarcomas ◽  
The Elderly ◽  
High Rate ◽  
Imaging Features ◽  
High Grade ◽  
Mri Features

: Myxofibrosarcoma is one of the most common soft tissue sarcomas in the elderly. It is characterized by an extremely high rate of local recurrence, higher than other soft tissue tumors, and a relatively low risk of distant metastases.Magnetic resonance imaging (MRI) is the imaging modality of choice for the assessment of myxofibrosarcoma and plays a key role in the preoperative setting of these patients.MRI features associated with high risk of local recurrence are: high myxoid matrix content (water-like appearance of the lesions), high grade of contrast enhancement, presence of an infiltrative pattern (“tail sign”). On the other hand, MRI features associated with worse sarcoma specific survival are: large size of the lesion, deep location, high grade of contrast enhancement. Recognizing the above-mentioned imaging features of myxofibrosarcoma may be helpful to stratify the risk for local recurrence and disease-specific survival. Moreover, the surgical planning should be adjusted according to the MRI features

A new medical Internet system in healthcare: innovation of Telegeriatrics and healthcare demands of older patients of different age groups (Preprint)

2020 ◽  
Author(s):  
Yu Gong ◽  
Jianyuan Zhou
Keyword(s):  
Cardiovascular Diseases ◽  
General Practitioners ◽  
Older Patients ◽  
Metabolic Diseases ◽  
Treatment Plan ◽  
Age Groups ◽  
The Elderly ◽  
Diagnosis And Treatment ◽  
World Health ◽  
New Model

BACKGROUND Healthcare for older patients is a worldwide challenge for public health system. A new medical Internet system in healthcare which is a new model of telegeriatrics system has been established. The key innovation is the new telegeriatrics system was conducted jointly by general practitioners in the Community Health Service Center and specialists in university teaching hospital. Unlike the typical telemedicine that has been practiced in other countries, the new model provides a solution for the key issues in telemedicine where a doctor is unable to conduct a direct physical examination and the associated potential diagnostic error. OBJECTIVE This study is to introduce the operation mechanism of the new Telegeriatrics system and analyze healthcare demands of older patients in different age groups applying the new Telegeriatrics system. METHODS 472 older patients (aged≥60) were enrolled and divided into the young older group (aged 60 to 74), the old older group (aged 75 to 89) and the very old group (aged≥90) according to the age stratification of World Health Organization. Proportion of the top 10 diseases of older patients of different age groups was analyzed. RESULTS The process of older patients’ diagnosis and treatment made by specialist and general practitioners formed a closed loop. It ensures the timeliness and effectiveness of diagnosis and treatment of older patients. The treatment effect can be observed by general practitioners and specialist can adjust the treatment plan in time. In this study, it was found that older patients in different age groups have different healthcare demands. Coronary heart disease and type 2 diabetes mellitus were found to be the main diseases of the older patients and the young older patients as well as the old older patients applying Telegeriatrics. CONCLUSIONS The new telegeriatrics system can provide convenient and efficient healthcare services for older patients and overcome the disadvantage of currently used models of telegeriatrics. Older patients in different age groups have different medical care demands. Cardiovascular diseases and metabolic diseases have become the main diseases of the elderly applying the new Telegeriatrics system. Healthcare policy makers should invest more medical resources to the prevention of cardiovascular diseases and metabolic diseases in the elderly.

Big Data Driven Clinical Informatics & Surveillance (BDD_CIS) – A Multimodal Database Focused Clinical, Community, and Multi-Omics Surveillance Plan for COVID-19: A study Protocol (Preprint)

2020 ◽  
Author(s):  
Bankole Olatosi ◽  
Jiajia Zhang ◽  
Sharon Weissman ◽  
Zhenlong Li ◽  
Jianjun Hu ◽  
...  
Keyword(s):  
Big Data ◽  
South Carolina ◽  
Data Science ◽  
Age Groups ◽  
The Elderly ◽  
The United States ◽  
Data Sources ◽  
Patient Registries ◽  
Multiple Partner ◽  
Multimodal Data

BACKGROUND The Coronavirus Disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2) remains a serious global pandemic. Currently, all age groups are at risk for infection but the elderly and persons with underlying health conditions are at higher risk of severe complications. In the United States (US), the pandemic curve is rapidly changing with over 6,786,352 cases and 199,024 deaths reported. South Carolina (SC) as of 9/21/2020 reported 138,624 cases and 3,212 deaths across the state. OBJECTIVE The growing availability of COVID-19 data provides a basis for deploying Big Data science to leverage multitudinal and multimodal data sources for incremental learning. Doing this requires the acquisition and collation of multiple data sources at the individual and county level. METHODS The population for the comprehensive database comes from statewide COVID-19 testing surveillance data (March 2020- till present) for all SC COVID-19 patients (N≈140,000). This project will 1) connect multiple partner data sources for prediction and intelligence gathering, 2) build a REDCap database that links de-identified multitudinal and multimodal data sources useful for machine learning and deep learning algorithms to enable further studies. Additional data will include hospital based COVID-19 patient registries, Health Sciences South Carolina (HSSC) data, data from the office of Revenue and Fiscal Affairs (RFA), and Area Health Resource Files (AHRF). RESULTS The project was funded as of June 2020 by the National Institutes for Health. CONCLUSIONS The development of such a linked and integrated database will allow for the identification of important predictors of short- and long-term clinical outcomes for SC COVID-19 patients using data science.

France

2018 ◽  
Author(s):  
Philippe Askenazy ◽  
Bruno Palier
Keyword(s):  
Income Inequality ◽  
Labour Market ◽  
Rapid Growth ◽  
Household Income ◽  
General Trend ◽  
Age Groups ◽  
Wage Growth ◽  
The Elderly ◽  
Wage Setting ◽  
Rich Countries

This chapter describes France as apparently one of the few rich countries to have avoided a significant increase in income inequality in recent decades. However, stable average inequalities mask an asymmetric trend of income between age groups, the elderly improving their situation while the young see theirs worsening. Furthermore, it shows that behind this relatively still surface, a general trend of precarization of more and more ordinary workers is occurring. The importance of wage-setting processes and of regulation of the labour market is brought out, together with the way the tax and transfer systems have operated, in restraining the forces driving inequality upwards. Wage growth, while limited, has thus been reasonably uniform across the distribution and together with the redistributive system have kept household income inequality within bounds. However, in response to high unemployment both regulatory and tax–transfer systems have served to underpin the very rapid growth in precarious working over the last decade, representing a very serious challenge for policy.

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