Immune-related Thyroid Dysfunction (irTD) in Non-small Cell Lung Cancer (NSCLC) Correlates With Response and Survival

Background: There is no clear information on the proportion of patients who need therapy for immune-related thyroid dysfunction (irTD) or who need to delay, omit, or discontinue immunotherapy. Furthermore, it is not well known whether irTD correlates with better outcomes or not. Patients and Methods: We conducted a retrospective study in patients with metastatic non-small cell lung cancer (NSCLC) treated with anti-PD1 or anti-PD-L1. Results: Our study enrolled 75 patients, 25.3% of them developed immune-related thyroid dysfunction. Three patients delayed a course of immunotherapy due to irTD, 2 patients omitted a course and 1 patient permanently discontinued. In patients with irTD compared with those without irTD the ORR was 42.1% vs. 7.1% (p<0.001), DCR was 78.9% vs. 32.1% (p<0.001); mPFS was 15.7 vs. 3.6 months (p<0.001) and mOS was 18.6 months vs. 5.1 months (p<0.001). Conclusion: Immune-related thyroid dysfunction has a mild impact on the immunotherapy treatment program. The occurrence of irTD correlates with more favorable response and survival.

Risk-Targeted Behavioral Activation for the Management of Work-Disability Associated with Co-Morbid Pain and Depression: A Feasibility Study

Purpose The purpose of the present study was to conduct a preliminary evaluation the feasibility and impact of a risk-targeted behavioral activation intervention for work-disabled individuals with co-morbid pain and depression. Methods The design of the study was a single arm non-randomized trial. The sample consisted of 66 work-disabled individuals with co-morbid pain and depression. The treatment program consisted of a 10-week standardized behavioral activation intervention supplemented by techniques to target two psychosocial risk-factors for delayed recovery, namely, catastrophic thinking and perceptions of injustice. Measures of pain severity, depression, catastrophic thinking, perceived injustice and self-reported disability were completed pre-, mid-, and post-treatment. Satisfaction with treatment was assessed at post-treatment. Return to work was assessed at 6-month follow-up. Results The drop-out rate was 18%. At treatment termination, 91% of participants indicated that they were ‘very’ or ‘completely’ satisfied with their involvement in the treatment program. Significant reductions in pain (d = .71), depression (d = .86), catastrophic thinking (d = 1.1) and perceived injustice (d = 1.0) were observed through the course of treatment. In multivariate analyses, treatment-related reductions in depression, catastrophic thinking, perceived injustice, but not pain, contributed significant unique variance to the prediction of return-to-work outcomes. Conclusions Risk-targeted behavioral activation was found to be an acceptable and effective intervention for work-disabled individuals with co-morbid pain and depression. The findings suggest that interventions targeting psychosocial risk factors for pain and depression might contribute to more positive recovery outcomes in work-disabled individuals with co-morbid pain and depression.

Analysis of Factors Associated with Compliance with Taking Medicines for Pulmonary Tuberculosis Patients at Lut Tawar Health Center, Central Aceh Regency

There is a worldwide epidemic of tuberculosis (TB). As of May 31st, 2021, the Lut Tawar Health Center had recorded 10 instances in 2019, and 17 cases had been recorded as of that date. The purpose of this research is to evaluate the analysis of variables influencing medication adherence in pulmonary TB patients at the Lut Tawar Health Center, Lut Tawar District, Central Aceh Regency. Research is conducted using a cross-sectional design using quantitative analytic techniques. As many as 33 tuberculosis patients are enrolled in the Lut Tawar Health Center's TB treatment program. Total sampling was employed as the sampling strategy. Univariate, bivariate and multivariate analyses were used to analyze the data. There were no statistically significant differences in the p-values for education (0.000), employment (0.000), distance from home (0.000), knowledge (0.00), medication side effects (0.024), or family support (0.024) in the chi square analysis. Multivariate analysis indicated that the pharmacological side effect variable had a value (p=0.000) that was the most significant. Patients and families should be supported by the puskesmas, or health professionals, in charge of running the TB treatment program, so that they can keep tabs on their loved ones' medication compliance and avoid drug withdrawal and resistance. As part of the health education provided by health professionals, they describe the side effects of TB medications and encourage patients to continue taking them until they are well enough to do so.

Three-Year Outcomes of Wet Age-Related Macular Degeneration Treatment in Polish Therapeutic Programs

Background and Objectives: Wet age-related macular degeneration (wAMD) is a chronic, progressive disease of the central part of the retina. Standard treatment for wAMD consists of multiple intravitreal injections of anti-vascular endothelial growth factor drugs. The study goal was to evaluate the three-year effectiveness of wAMD treatment with aflibercept and ranibizumab as part of the therapeutic program in routine clinical practice. Materials and Methods: 1430 patients (possessing 1430 wAMD eyes) with median age of 78.0 years (71.0, 83.0) were enrolled in a non-randomized, retrospective, observational, multicenter study; 804 (56.2%) eyes were treatment-naïve. Therapy was carried out in accordance with the guidelines of the treatment program (the fixed or pro re nata regimen). Results: After the first year of treatment, there was a gain of 2.03 (12.15) letters; after the second, 0.94 (13.72) (p ˂ 0.001); and after the third, 0.17 (14.05) (p ˂ 0.001). There was a significant reduction in the central retinal thickness. In the first year, the patients received 7.00 (5.00, 8.00) injections. In the following years, a significantly lower number of injections (4.00 (2.00, 5.00)) was administered. After the first year, there was a significant difference in the distribution of the best corrected visual acuity according to the Early Treatment Diabetic Retinopathy Study protocol, with more frequent values in the ranges > 35 ≤ 70 for this parameter and > 70 letters in the treatment naïve eye subgroup. After the first year, central retinal thickness in treatment-naïve eyes was significantly reduced. Conclusions: Regular treatment of wet age-related macular degeneration as part of the treatment program achieves functional stabilization and significant morphological improvement over a long-term, three-year follow-up, with significantly fewer injections needed after the first year of treatment.

A Pilot Study of the Swedish Sexual Offender Treatment Program

Purpose: The aim was to test whether dynamic criminogenic risk factors change after participation in a new cognitive-behavioral treatment program adhering to the Risk-Need-Responsivity (RNR) model, within a group of adult men convicted of a sexual offense in Sweden. Methods: Three psychometric tests from approximately 26 participants were completed. Therapists rated 46 participants using the Therapist Rating Scale-2 (TRS-2). Results: Participants reported a significant decrease in hypersexuality, small to medium effect size, a non-significant, increased, internal locus of control, but no change regarding attachment styles, posttreatment. Therapists rated significant decrease in all treatment needs posttreatment, medium to large effect size. Conclusions: The significant reduction of several criminogenic risk factors posttreatment indicates the treatment program may reduce problems related to increased risk of recidivism, especially hypersexuality. Moreover, treatment did not appear to have negative effects, motivating further implementation. However, to evaluate the effectiveness, more research is necessary.

Yoga in Psychiatry: feasibility of a yoga-intervention for severely affected children and young adults with non-internalizing psychiatric disorders

Yoga-based interventions are increasingly being introduced to improve the lives of individuals with widely varying psychiatric diagnoses and symptoms. We developed a yoga-program for two severely affected populations at our psychiatric department: young adults with psychosis from our inpatient clinic, and children with severe developmental disorders and/or behavioral problems from our inpatient clinic or outpatient treatment program. The participants, clinic staff and yoga-instructors assessed the feasibility of our yoga program. They participated in evaluation meetings and gave feedback. Participants also filled in an evaluation form before and after every session. Results showed that our yoga-program is feasible for severely affected populations. The program can and should be tailored to meet the differing needs of individuals. Participants benefitted from and enjoyed sessions and reported feeling calmer, more goal-oriented and more relaxed after the sessions.