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Neutropenic sepsis and septic shock in ICU patients: A single-center experience over the last decade.

PURPOSE: Sepsis and septic shock in patients with neutropenia are associated with high mortality. We investigated the features and outcome predictors of neutropenic sepsis in the last decade. METHODS: Consecutive patients who were admitted to the intensive care unit (ICU) of a French university-affiliated hospital in 2012-2022, met criteria for sepsis or septic shock, and had neutropenia were included retrospectively. Patient features were collected and compared for 2012-2017 and 2018-2022. Factors associated with hospital mortality were sought by univariate and multivariate analyses. RESULT

Socioeconomic and physical health status changes after visual impairment in Korea using difference-in-difference estimations.

This study analyzed the impact of visual impairment on socioeconomic and physical health status and its heterogeneity by severity of visual impairment. We used nationally representative cohort data based on Korean national health insurance claims (2002-2013), which were extracted for 11,030 persons (2206 visually impaired, 8824 control). This was restructured as monthly data for each person (person-month). Multivariate and ordered logistic regressions were conducted, and the pre-impairment status between the visually impaired and non-visually impaired people was adjusted by difference-in-diffe

Последствия применения обеспеченных предписаний для амбулаторного использования прегабалина во Франции: региональная оценка во Французском Нувеле-Аквитане.

AIM: Французские власти разрешили использовать в мае безопасные рецепты на догабалин. 2021. Цель этого исследования заключалась в оценке воздействия этой меры на использование и неправильное использование догабалинов в Нувеле-Акитане, юго-западном французском регионе, расположенном вокруг six million Жители. МЕТОДЫ: Это исследование было проведено на основе региональных баз данных французской системы медицинского страхования " Нувел-Аквитейн " . В нее входят все лица, которые получают по крайней мере one Возмещение расходов на догабалин между 24 Май 2020 и 24 Май 2022. Мы проанализир

Patient-reported pain severity and health-related quality of life in patients with multiple myeloma in real world clinical practice.

BACKGROUND: The association between patient self-reported pain severity and health-related quality-of-life (HRQoL) is poorly understood. AIMS: This real-world study of symptomatic multiple myeloma (MM) patients sought to determine how pain severity from a single question asked during routine clinical consultation was associated with HRQoL. METHODS AND RESULTS: Point-in-time data on HRQoL of 330 patients with MM (median age 70 years) receiving anti-myeloma therapy in Germany and Italy from November 2017 through February 2018 were analyzed. HRQoL was assessed using validated questionnaires (Wo

The organization, weaknesses, and challenges of the control of thalidomide in Brazil: A review.

The drug thalidomide has resurged in the world market under restrictive conditions for marketing and use. In Brazil, there are still cases of pregnant women using thalidomide even after the implementation of laws that regulate the control of use (Law No. 10.651/2003 and Collegiate Board Resolution No. 11/2011). The objective of this study was to discuss the control of thalidomide use in Brazil, based on a scoping review of the scientific literature, documents, and data from the Ministry of Health. A total of 51 studies and documents related to the following subthemes were selected: (1) organiz

The health and economic impact and cost effectiveness of interventions for the prevention and control of overweight and obesity in Kenya: a stakeholder engaged modelling study.

BackgroundThe global increase in mean body mass index has resulted in a substantial increase of non-communicable diseases (NCDs), including in many low- and middle-income countries such as Kenya. This paper assesses four interventions for the prevention and control of overweight and obesity in Kenya to determine their potential health and economic impact and cost effectiveness.MethodsWe reviewed the literature to identify evidence of effect, determine the intervention costs, disease costs and total healthcare costs. We used a proportional multistate life table model to quantify the potential i

Депрессивные и удручающие симптомы при первоначальной психиатрической экспертизе пациентов, вступающих в протоколы трансплантации ячеек гематопоэтического ствола: перекрестное исследование с использованием PHQ-9 и GAD-7.

Объективная депрессия и беспокойство широко распространены в ходе трансплантации стволовых клеток (ГХЦТ) и предсказывают более низкий уровень сопричастности и худшие результаты, однако их бремя при проведении первоначальной психиатрической экспертизы не было задокументировано у мексиканских пациентов. Подтвержденные краткие обзоры, такие, как " Здоровье пациентов " Questionnaire-9 (В тыс.PHQ-9) и Всеобщая тревога Disorder-7 (В тыс.GAD-7) может обнаружить эти симптомы на этом раннем, доступном окне до начала кондиционирования. Мы стремились описать частотность и остроту депрессивных и

A review of big data and medical research.

Universally, the volume of data has increased, with the collection rate doubling every 40 months, since the 1980s. "Big data" is a term that was introduced in the 1990s to include data sets too large to be used with common software. Medicine is a major field predicted to increase the use of big data in 2025. Big data in medicine may be used by commercial, academic, government, and public sectors. It includes biologic, biometric, and electronic health data. Examples of biologic data include biobanks; biometric data may have individual wellness data from devices; electronic health data include t

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… His discarded DNA was matched to his relative’s DNA, which has been sold to a third party, and which was accessed by law enforcement legally without a court order. 54 , 55 Rushed preemptive release of drugs | The results of the interim phase 3 BELLINI trial, which had a greater risk of death in the treatment …

The impact of COVID-19 on autologous stem cell transplantation in multiple myeloma: A single-centre, qualitative evaluation study.

Autologous stem cell transplantation (ASCT) is standard of care in biologically fit, newly diagnosed multiple myeloma (MM) patients, offering better therapeutic outcomes and improved quality of life (QoL). However, with the UK's 1st national lockdown on 23/03/2020, several guidelines recommended deferring ASCT due to risks of infection, with resource limitations forcing some units to suspend ASCT entirely. Such changes to patients' treatment plans inevitably altered their lived experience during these uncertain times with expected impact on QoL. We conducted a qualitative study using semi-stru

Impact of renal impairment on outcomes after autologous stem cell transplantation in multiple myeloma: a multi-center, retrospective cohort study.

BackgroundRenal impairment (RI) is a negative prognostic factor in Multiple Myeloma (MM) and affected patients are often excluded from autologous stem cell transplantation (ASCT). However, it remains unclear whether historically inferior outcome data still hold true.MethodsFrom a total of 475 eligible MM patients who had undergone ASCT between 1998 and 2016, 374 were included in this multi-centric retrospective cohort study. Renal function was determined both at the time of MM diagnosis and ASCT by estimated glomerular filtration rate (eGFR according to the MDRD formula, RI defined as eGFR 2).

Cell Therapy: Types, Regulation, and Clinical Benefits.

Cell therapy practices date back to the 19th century and continue to expand on investigational and investment grounds. Cell therapy includes stem cell- and non-stem cell-based, unicellular and multicellular therapies, with different immunophenotypic profiles, isolation techniques, mechanisms of action, and regulatory levels. Following the steps of their predecessor cell therapies that have become established or commercialized, investigational and premarket approval-exempt cell therapies continue to provide patients with promising therapeutic benefits in different disease areas. In this review

The Challenges of Outcomes-Based Contract Implementation for Medicines in Europe.

ObjectivesThe aim was to outline the challenges of implementing outcomes-based contracts (OBCs) in Europe.MethodsA scoping review was conducted, building on the searches of a previous systematic review and updating them for December 2017 until May 2021. The combined results were screened, based on inclusion and exclusion criteria. All identified studies published in the English language that described specific OBC schemes for medicines in European countries were included. Insights into the challenges of OBCs were extracted and analysed to develop a conceptual framework.ResultsTen articles from

Using Genomic Data in Personalized Oncology Medicine: An Exploratory Expert-Elicitation Study with Narrative Regulatory Mapping of Regulations, Implementations, and Challenges in Saudi Arabia.

BACKGROUND/OBJECTIVES: Personalized medicine represents a transformative approach to healthcare in Saudi Arabia. However, a significant research gap exists regarding the specific regulatory, implementation, and practical challenges of integrating genomic data into personalized oncology care in the Saudi context. We aimed to conduct an exploratory assessment of the current regulatory landscape, practices, and challenges related to genomic data use in personalized oncology in Saudi Arabia and to identify regulatory and practical gaps, propose actionable solutions, and outline future directions f

Comparing Perceptions, Determinants, and Needs of Patients, Family Members, Nurses, and Physicians When Making Life-Sustaining Treatment Decisions for Patients with Hematologic Malignancies.

PurposeThis descriptive study compared the perceptions, determinants, and needs of patients, family members, nurses, and physicians regarding life-sustaining treatment decisions for patients with hematologic malignancies in the hematology-oncology department of a tertiary hospital in Seoul, Korea.MethodsIn total, 147 subjects were recruited, gave written consent, and provided data by completing a structured questionnaire. Data were analyzed using analysis of variance, the chi-square test, and the Fisher exact test.ResultsNurses (F=3.35) and physicians (F=3.57) showed significantly greater fami

Interpretability and fairness evaluation of deep learning models on MIMIC-IV dataset.

The recent release of large-scale healthcare datasets has greatly propelled the research of data-driven deep learning models for healthcare applications. However, due to the nature of such deep black-boxed models, concerns about interpretability, fairness, and biases in healthcare scenarios where human lives are at stake call for a careful and thorough examination of both datasets and models. In this work, we focus on MIMIC-IV (Medical Information Mart for Intensive Care, version IV), the largest publicly available healthcare dataset, and conduct comprehensive analyses of interpretability as w

Patients' and caregivers' perspectives on preparedness for and experience with chimeric antigen receptor T-cell therapy.

BackgroundChimeric antigen receptor-T (CAR-T) cell therapy has improved survival, yet its toxic profile may impact on survivors' well-being. We examined patients' and caregivers' perspectives on the most common, severe, and distressing side effects across recovery (ie, first 60 days) and survivorship (ie, 60 days and onwards) and explored their perspectives on the education received to prepare for CAR-T.Materials and methodsWe conducted semi-structured interviews with patients and caregivers addressing (1) how they prepared for CAR-T, (2) the side effects experienced during the first-year post

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… I was in law enforcement for 35 years and I’ve never seen anybody that was eyes open and didn’t know where they were. Nothing” (caregiver) 3. Following discharge, patients experience a myriad of ongoing symptoms, some of which are severe and negatively impact on patientś recovery. …

Множественная миелома у людей трудоспособного возраста в Германии, Польше и Чехии: результаты качественного исследования.

ЦЕЛЬ: Цель исследования состояла в том, чтобы понять опыт взрослых трудоспособного возраста с миеломой и их партнерами/членами семьи, проживающими в Германии, Чешской Республике и Польше. МЕТОДЫ: КОНСУЛЬТАТИВНЫЕ СООБРАЖЕНИЯ 36 взрослых трудоспособного возраста, живущих с миеломой, и three Члены семьи. Данные были собраны в период с мая по октябрь 2022. К данным был применен тематический анализ. Результаты: Описано медицинское обслуживание и государственная поддержка в каждой стране. Степень участия в трудовой деятельности зависит от бремени симптомов пациентов, потребностей в лечении, государс

Regulatory insights on gene therapies, adeno-associated virus-based gene therapies, cell/tissue-based products, and medical care/practice in cell and gene therapies: Report from the 7th Asia partnership conference - April 25, 2024.

The 7th Asia Partnership Conference of Regenerative Medicine (APACRM) was held both in person and online on April 25, 2024, to promote the regulatory harmonization of regenerative medicine products across Asia. Recognizing domestic regulatory guidelines and their underlying rationales within each country and region is an important initial step toward achieving harmonious regulation. The 7th APACRM featured open dialogues on the non-clinical evaluations of adeno-associated virus gene therapy products, regulation of gene therapies, considerations for conducting clinical trials, and provision of

Gabapentinoids and unexplained death in general practice: Case series and feasibility study arising from a critical incident.

BACKGROUND: Prescribing epidemiology in general practice shows gabapentinoid drugs to be independently associated with unexpected, drug-related death. There is an increasing trend of gabapentinoid deaths throughout Europe and North America. OBJECTIVES: The overall aim of this study was to assess how patient, practice and health system factors might be associated with gabapentinoid prescribing in primary care. METHODS: Case series following a critical incident of an unexpected death in a patient prescribed a gabapentinoid drug in a single general practice. Unexpected and expected deaths in pa

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… Gabapentinoids in Ireland 2010 to 2020: an observational study of trends in gabapentinoid prescribing, law enforcement drug seizures and postmortem toxicology . Br J Clin Pharmacol . 2024 ; 90 ( 4 ): 987 – 995 . doi: 10.1111/bcp.15984 . 38072974 9 Administration UFaD . …

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