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Healthcare ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 91
Author(s):  
Emmie Cohen ◽  
Allison A. Bay ◽  
Liang Ni ◽  
Madeleine E. Hackney

Background: Apathy, often-unrecognized in Parkinson’s Disease (PD), adversely impacts quality-of-life (QOL) and may increase with disease severity. Identifying apathy early can aid treatment and enhance prognoses. Whether feelings related to apathy (e.g., loss of pleasure) are present in mild PD and how apathy and related feelings increase with disease severity is unknown. Methods: 120 individuals (M age: 69.0 ± 8.2 y) with mild (stages 1–2, n = 71) and moderate (stages 2.5–4; n = 49) PD were assessed for apathy and apathy-related constructs including loss of pleasure, energy, interest in people or activities, and sex. Correlations were used to determine the association of apathy with apathy-related constructs. Regression models, adjusted for age, cognitive status, and transportation, compared groups for prevalence of apathy and apathy-related feelings. Results: Apathy-related constructs and apathy were significantly correlated. Apathy was present in one in five participants with mild PD and doubled in participants with moderate PD. Except for loss of energy, apathy-related constructs were observed in mild PD at a prevalence of 41% or greater. Strong associations were noted between all apathy-related constructs and greater disease severity. After adjustment for transportation status serving as a proxy for independence, stage of disease remained significant only for loss of pleasure and loss of energy. Conclusion: People with mild PD showed signs of apathy and apathy-related feelings. Loss of pleasure and energy are apathy-related feelings impacted by disease severity. Clinicians should consider evaluating for feelings related to apathy to enhance early diagnosis in individuals who might otherwise not exhibit psychopathology.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Line Hjøllund Pedersen ◽  
Friederike Erdmann ◽  
Gitte Lerche Aalborg ◽  
Lisa Lyngsie Hjalgrim ◽  
Hanne Bækgaard Larsen ◽  
...  

Abstract Background While underlying mechanisms and pathways of social inequalities in cancer survival have been extensively examined in adults, this is less so for children with cancer. Hypothesized mechanisms include prediagnostic utilization of and navigation through the health care system, which may differ by socioeconomic resources of the families. In this nationwide register-based study we investigated the association between measures of family socioeconomic position in relation to prediagnostic health care contacts and stage of disease at diagnosis in children with cancer in Denmark. Methods We identified all children diagnosed with a cancer at ages 0–15 years in 1998–2016 (N = 3043) from the Danish Childhood Cancer Registry. We obtained comprehensive information on measures of socioeconomic position, parental health and prediagnostic contacts to both general practitioners and hospitals 24 months prior to diagnosis from various national registries. We fitted multivariable conditional logistic regression models for the association of family socioeconomic and health-related variables with firstly, frequent health care contacts and secondly, advanced stage. Results We found higher odds ratios (OR) of frequent both overall and emergency health care contacts in the last 3 months before diagnosis in children from households with short parental education and mixed affiliation to work market, when compared to children with high family socioeconomic position. Further, children of parents with depression or of non-Western origin, respectively, had higher OR for frequent overall and emergency contacts. We found no association between socioeconomic position, parental health and stage of disease. Conclusion Families with socioeconomic disadvantage, non-Western origin or depression more frequently utilize prediagnostic health care services, both generally and in the acute setting, indicating that some disadvantaged families may struggle to navigate the health care system when their child is sick. Reassuringly, this was not reflected in disparities in stage at diagnosis. In order to improve the diagnostic process and potentially reduce health care contacts, attention and support should be given to families with a high number of health care contacts over a short period of time.


AYUSHDHARA ◽  
2021 ◽  
pp. 3466-3472
Author(s):  
Varinder Kaur ◽  
Janu Manohar ◽  
Sakshi

Today in the era of information and technology the whole scenario has been changed. Women have a multidimensional attitude and enjoy special place in the society by reaching all kinds of heights by their spectacular physical and mental performance in almost all possible fields. Problems of different age group of women are still present and the most suffering age group is forty plus due to change in reproductive life by cessation of menstruation causing untoward physical and mental agonies called menopause. Every woman faces various physiological and psychological changes during this change as part of hormonal de arrangement. The presence of regular menstruation indicates the starting of reproductive life of women and menopause indicates the declining fertility rate of female. Rajonivritti word is made up of two different words viz., ‘Rajah and Nivritti Rajah denoted as Aartava (menstrual blood) Nivritti as Uprama (cessation). In Ayurveda this phenomenon taken in different way not as a serious health problem. As Sushruta mentioned that menopause deals with Jarapakvya avastha of the body. Sometimes such disturbances attain the stage of disease or syndrome called Menopausal Syndromes accompanied by various vasomotor, psychological, genital, locomoter and G.I.T related symptoms.


2021 ◽  
Vol 13 (2) ◽  
pp. 91-96
Author(s):  
Bishnu Dev Pant ◽  
Sharad Chand ◽  
Sophia M George ◽  
Nandakumar UP ◽  
Pukar Khanal ◽  
...  

Author(s):  
Kumari B. Lata ◽  
Surya K. Nirala

Background: Breast carcinoma is the most common malignant tumor and the leading cause of cancer death in women, with more than 10,00,000 cases occurring worldwide annually. Its incidence varies from one geographical area to the other.Methods: Cases of all breast conservative surgeries and modified radical mastectomy specimen received for routine histopathological evaluation from the department of onco Surgery, Mahavir Cancer Sansthan, Patna, Bihar, form the source of data for the study.Results: Infiltrating duct cell carcinoma (NOS) type was the commonest type of carcinoma breast in our institute with significant group occurring in more than 45 years of age. ER and PR positive expression was seen in grade 2 tumors and negative expression was seen with tumor size more than 2cm, positive lymph nodes and higher stage of disease. HER2/neu negative expression was seen in the post-menopausal age group, tumor size more than 2 cm, positive lymph nodes and higher stage of disease indicating bad prognosis. HER2/neu expression was inversely related to ER and PR expression. HER2/neu expression was seen in 50% of medullary carcinoma which is rare. Triple negative cases were seen in 22.08% cases of infiltrating duct cell carcinoma indicating bad prognosis.Conclusions: A beforehand knowledge of these immunohistochemical markers can help oncotherapists to initiate a correct form of treatment and improve the survival rate in breast carcinoma patients.


2021 ◽  
pp. 13-15
Author(s):  
Nidhi Singh ◽  
Hiru Navaney ◽  
Yogesh Goel

Background: Early diagnosis and treatment is important in reducing mortality and morbidity. The aim of the study was to describe clinical characteristic, neuroimaging and neurological outcome of TBM in pediatric age group. Methods: A total of 72 patients were included in the study based on inclusion and exclusion criteria. Detailed history and neurological examination, CSF analysis, EEG and CT scan studies done in all patients. Mean age of patient was 59 months (range 6month- 18 year). The majority of these patients were in stage II and III. Results: Among 72 patients included in the study tuberculous meningitis was common in children under 5 years of age (70%). Out of 72 patients 50 patients (70%) were in advanced stage of disease. Most common symptom were fever (90%), altered sensorium (83%), convulsion (80%), th vomiting (75%).7 nerve palsy was most commonly involved (25%), hemiplegia in 15 patients (21%) and papilledema in (14%). CSF culture was positive in 61 patients (85%) with Pleocytosis, lymphocytosis and elevated CSF protein as dominant ndings. Abnormal chest X ray present in 11 patients (50%) in stage I, 9 patients (38) in stage II, and 6 patients (23%) in stage III of disease.: In our study Leptomeningeal enhancement was present in 17 patients (77.27%) in stage I, 16 patients (66.6%) in stage II, 18 patients (69.2%) in stage III of disease. Hydrocephalus was presents in 14 patients (63.63%) in stage I, 15 patients (62.5%) in stage II, 17 patients (65.38%) in stage III of disease. Survival with neurological decit is more in younger age and advanced stage of disease. Conclusion: TBM is an important cause of mortality and morbidity in pediatric patients especially under 5 years of age in countries where tuberculosis is an endemic disease. In our study we found younger the child and more advanced the stage of disease, higher CSF protein value, the greater was mortality and morbidity.


2021 ◽  
Vol 10 (Supplement_2) ◽  
pp. S22-S22
Author(s):  
Kamalakshi G Bhat ◽  
Zahabiya Nalwalla ◽  
Nitin Joseph

Abstract Introduction Perinatally HIV infected neonates are surviving into adulthood with an impact on mental and emotional health. Attention deficit hyperactive disorder (ADHD) and Oppositional Defiant disorder (ODD) are few of the common behavioral disorders, which have been found to have a higher prevalence amongst HIV infected children. Objectives The objectives were to assess the proportion of ADHD and ODD in adolescents living with HIV/AIDS and to find its association with various factors. Materials and Methods 88 adolescents aged 10–19 years living with HIV/AIDS were included in the study. The Swanson, Nolan Pelham (SNAP-IV) scale was administered to the caretakers and children were assessed for the proportion of ADHD/ODD. Association between those who scored positive with duration of treatment, CD4 counts, stage of disease and socio-demographic variables were done using statistical tests. Results Our study included 88 participants, of whom 9 scored positive in the inattention subset resulting in a proportion of 10.2%. 5 participants had symptoms of hyperactivity/impulsivity resulting in a proportion of 5.6% and 1 had combined symptoms with a proportion of 1.1%. 13 scored positive in the opposition/defiant subset resulting in a proportion of 14.7%. No statistical significance was found between duration of treatment, CD4 count, stage of disease, socio-demographic variables and ADHD/ODD. Conclusion The proportion of ADHD and ODD in this study was found to be comparable to the general population. A holistic approach to improve the long-term health of these youth is needed to ensure that our success in achieving survival of HIV-infected children from infancy is maintained into adulthood.


Author(s):  
Massimiliano Copetti ◽  
Edoardo Biancalana ◽  
Andrea Fontana ◽  
Federico Parolini ◽  
Monia Garofolo ◽  
...  

2021 ◽  
pp. 1-6
Author(s):  
Agung Sindu Pranoto ◽  
Haryasena Haryasena ◽  
Prihantono Prihantono ◽  
Septiman Rahman ◽  
Daniel Sampepajung ◽  
...  

INTRODUCTION: Programmed death ligand 1 (PD-L1) plays a role in tumor escape and progression by inactivating T lymphocytes. The aim of the study reported here was to determine the relationship between the expression of PD-L1 and histopathological grade, stage of disease, and the occurrence of metastasis in breast cancer. METHODS: The observational cross-sectional study involved analyzing the expression of PD-L1 by immunohistochemistry. RESULTS: PD-LI was expressed in 43 of 60 patients with breast cancer (71.6%), mostly with a moderate histopathological grade (58.3%) and at an advanced stage (50%). Associations between the expression of PD-L1 and histopathological grade (p = 0.011), stage of disease (p = 0.009), and the occurrence of metastasis (p = 0.01) were significant, with an odds ratio of 5. CONCLUSION: The associations between the expression of PD-L1 and histopathological grade, disease stage, and occurrence of metastasis were all significant in cases of breast cancer in the sample. Those findings suggest that the expression of PD-L1 increases the progression of breast cancer.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13620-e13620
Author(s):  
Rakesh Shankar Goud ◽  
Amit Kumar Jotwani ◽  
Thirtha Poovaiah ◽  
Rejil Rajan ◽  
Rama Waghmare ◽  
...  

e13620 Background: As we see rising cancer incidence in India, there is a parallelly increasing trend in patient-driven second medical opinions (SMO) in oncology. We analysed different attributes of patients seeking online second opinions through onco.com to help us understand the driving factors for patients. Here we present the patient and disease attributes to understand the reasons and perceived value of SMOs in oncology through an online platform. Methods: We did a retrospective analysis of 1,142 patients who availed online tumor board opinion through Onco.com between August 2018 & December 2020. Patient characteristics like age, gender, city of residence (metro or non-metro) & disease characteristics like cancer type and stage were recorded. Tumors included both solid and hematological malignancies. Results: Of the 1,142 patients, 87% (991) cases were solid tumors and the rest 13% (151) were hematological malignancies. Top 6 cancer types for which patients sought SMOs- Breast- 13%, Head & neck- 8.7%, Lung- 7.5%, Leukaemia- 5.8%, Lymphoma- 5.4%, & Ovarian- 5% cancers. Of the 991 solid tumour cases, 13% had early (stage I & II) disease, 24% had locally advanced (stage III) disease, 52% had metastatic disease & and 11% had recurrent disease. The mean age of patients was 50 years with equivalent gender distribution. 23% of patients seeking SMOs were young adults (17-44 years), 59% were older adults (45-70 years), and 9% patients were from elderly (>70 years) age group. City of residence- 39% patients were residents of metro (tier 1) cities and 61% were residents of non-metro (tier 2/3) cities. Conclusions: Advanced stage of disease (metastatic + recurrent) and non-metro city of residence were found to be the commonest attributes for majority of patients. Desperate nature of the situation in advanced stage of disease and lack of access to specialised oncology care in non-metro cities respectively appear to be the reasons for higher SMOs in these groups. Higher number of SMOs for younger age patients was disproportionate to the incidence of cancer in this age-group. A larger analysis of the contrarian opinions, compliance and clinical impact of second opinions in terms of better survival outcomes is warranted to see if patients get true value out of this exercise.


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