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Centralised treatment, entry to trials and survival.

A review was carried out of the published literature on survival rates for cancer in relation to patterns of organisation of medical care, specifically treatment at specialist centres or at hospitals treating larger numbers of patients and treatment by protocol, usually within the context of a clinical trial. Centralised referral or entry to trials was frequently associated with a higher survival rate, particularly for the less common cancers, and was never found to be associated with a lower survival rate. Few studies were identified for any one cancer site and some antedated current methods

Efficacy of expressive helping in adult hematologic cancer patients undergoing stem cell transplant: protocol for the Writing for Insight, Strength, and Ease (WISE) study's two-arm randomized controlled trial.

BackgroundDuring, shortly after, and sometimes for years after hematopoietic stem cell transplant, a large proportion of hematological cancer patients undergoing transplant report significant physical and psychological symptoms and reduced health-related quality of life. To address these survivorship problems, we developed a low-burden, brief psychological intervention called expressive helping that includes two theory- and evidence-based components designed to work together synergistically: emotionally expressive writing and peer support writing. Building on evidence from a prior randomized c

IMPROVE-BMT: a protocol for a pilot randomised controlled trial of prehabilitation exercise for adult haematopoietic stem cell transplant recipients.

IntroductionHaematopoietic stem cell transplant (HSCT) in adults is an intensive medical procedure for a variety of haematological malignancies. Although there is a large body of evidence demonstrating the negative effects of HSCT on physical function and psychosocial parameters, there is limited evidence on the impact of HSCT on body composition and bone health. Further, aerobic and resistance-training exercise interventions aimed at improving physical function and patient-reported outcomes largely take place during the peritransplant and post-transplant period. Prehabilitative exercise, or e

Student Summer Research Awards - SSRAAbstracts of the SSRA September 2022 meeting, UCD School of Medicine.

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… A clinical audit approach was employed with purposive sampling utilised. Predefined data variables were collected retrospectively via Patient Centre and CATO ® software, with explicit coding processes employed. Descriptive analyses were performed, along with appropriate bivariate procedures. …

Pancytopenia and Methemoglobinemia in a Patient With Multiple Myeloma Presenting With Syncope and Dyspnoea: A Diagnostic Challenge.

Methemoglobinaemia is a rare but important cause of hypoxia that may be overlooked, particularly in patients with complex comorbidities. We present a 76-year-old man with Multiple Myeloma undergoing chemotherapy who presented with recurrent syncope and exertional dyspnoea. Initial investigations revealed pancytopenia and hypoxia. Imaging excluded pulmonary embolism and infection. Arterial blood gas analysis demonstrated elevated methemoglobin levels (10.5%), confirming methemoglobinaemia. The patient was managed with supportive therapy, including oxygen, blood transfusion, and filgrastim, resu

Surgical treatment of skeletal metastases in proximal tibia: a multicenter case series of 74 patients.

Background and purpose - The proximal tibia is a rare site for metastatic bone disease and is a challenging anatomical site to manage due to the proximity to the knee joint and poor soft tissue envelope. We investigated implant survival and complications of different surgical strategies in the treatment of proximal tibia pathological fractures.Patients and methods - The study comprised a 4 medical center, retrospective analysis of 74 patients surgically treated for metastases of the proximal tibia. Patient records were reviewed to identify outcome, incidence, and type of complications as well

Prognostic disclosure in cancer care: a systematic literature review.

BackgroundCollusion in cancer care is the diplomatic concealment of information between a triad of the health care professional (HCP), patient, and caregiver. Free and expressive communication is determined by multiple factors, which establishes a healthy balance between 'patient-centric' and 'family-centric' decision making. The lack of a universal approach to prognostic disclosure techniques emphasizes the need for a systematic review of contemporary practice.MethodsA systematic review of the literature was conducted till June 2020 using themes based on cancer, communication, prognostic disc

Продуктирует ли анальгезия в тригеминальной невралгии? Обновленный системный обзор и метаанализ.

Предыстория/цели: Тригеминальная нейронгия (ТН) представляет собой излучающееся состояние, которое в основном регулируется в рамках первичной медико-санитарной помощи, где карбамазепин остается единственной рекомендуемой терапией первой линии. Предварительные метаанализы сообщают о сокращении боли в конце лечения с помощью иглоукалывания, но не приводят к стратифицированным результатам в силу риска предвзятости, проверяют качество отчетности о результатах боли или изучают вопрос о том, сохраняются ли последствия анальгезии после периода лечения. В рамках этого обновленного систематического обз

Stereotactic Body radiotherapy and pedicLE screw fixatioN During one hospital visit for patients with symptomatic unstable spinal metastases: a randomized trial (BLEND RCT) using the Trials within Cohorts (TwiCs) design.

BackgroundSpinal metastases can lead to unremitting pain and neurological deficits, which substantially impair daily functioning and quality of life. Patients with unstable spinal metastases receive surgical stabilization followed by palliative radiotherapy as soon as wound healing allows. The time between surgery and radiotherapy delays improvement of mobility, radiotherapy-induced pain relief, local tumor control, and restart of systemic oncological therapy. Stereotactic body radiotherapy (SBRT) enables delivery of preoperative high-dose radiotherapy while dose-sparing the surgical field, al

Validation of the Medicare-Enhanced Laboratory and Demographics (MELD™) Dataset: A Comprehensive Psychometric, Epidemiologic, and Predictive-Utility Assessment of a 60-Million-Patient Real-World Evidence Resource.

BackgroundReal-world evidence studies increasingly rely on integrated data resources that combine Medicare fee-for-service claims with electronic medical records (EMRs), laboratory results, and patient-reported outcomes. The Medicare-Enhanced Laboratory and Demographics (MELD™) dataset, developed by Columbia Data Analytics, spans 2020 through 2024 and contains 60 million unique patients, roughly 1 billion visits, and more than 241 000 clinicians. Its data-quality properties must be characterized before regulatory-grade use.ObjectiveTo provide a preregistered, multidomain validation of MELD, qu

It is time to consider the climate crisis in haematology.

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Полнота и общедоступность шведского регистра MS.

Шведский реестр множественных склерозов (MS) является общенациональным клиническим инструментом и исследовательской базой данных. До этого не проводилась оценка ее общего охвата более широкой популяцией НР. Мы стремились дать количественную оценку полноты регистра и потенциальным различиям между теми, кто был включен в него, и теми, кто этого не сделал. Используя взаимосвязанные национальные регистры, мы идентифицировали лиц с НР до декабря 2020 как у тех, ≥ 3 Диагноз MS в Национальном регистре пациентов. Мы провели оценку полноты регистра MS и сопоставимых характеристик включенных и не включе

Cost per patient and potential budget implications of denosumab compared with zoledronic acid in adults with bone metastases from solid tumours who are at risk of skeletal-related events: an analysis for Austria, Sweden and Switzerland.

ObjectivesTo assess cost implications per patient, per year, and to predict the potential annual budget impact when patients with bone metastases secondary to solid tumours at risk of skeletal-related events (SREs) transition from zoledronic acid (ZA; 4 mg every 3-4 weeks) to denosumab (120 mg every 4 weeks) in Austria, Sweden and Switzerland.MethodsCountry specific costs for medication and administration, patient management and SREs (defined as pathologic fracture, radiation to bone, surgery to bone and spinal cord compression) were assessed over a 1-year time horizon. Drug administration and

Machine learning and multi-omics technologies for precision cardiovascular medicine: advancing diagnosis, risk prediction, and therapeutic guidance.

Cardiovascular disease remains a major global health burden. Owing to its complex pathogenesis and marked clinical heterogeneity, conventional one-size-fits-all strategies often yield limited benefit for a substantial proportion of patients. Precision medicine advocates individualized management based on patients' clinical and molecular characteristics to improve outcomes. In this context, multi-omics and machine learning provide critical technical support for precision medicine: multi-omics can capture the full spectrum of cardiovascular disease from molecular alterations to phenotypic manife

37th International Symposium on Intensive Care and Emergency Medicine (part 2 of 3) : Brussels, Belgium. 21-24 March 2017

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Patient-reported symptoms and performance status before palliative radiotherapy in geriatric cancer patients (octogenarians).

PurposeTo evaluate differences in baseline parameters including performance status and self-reported symptom burden between geriatric and non-geriatric cancer patients, and to assess the hypothesis that these factors might predispose older patients to incomplete radiotherapy and short survival.Patients and methodsRetrospective comparison of geriatric and non-geriatric patients treated with palliative radiotherapy (age ⩾80 years and ResultsMost patients received radiotherapy for bone metastases, commonly 5-10 fractions. Geriatric patients had significantly less pain at rest and depression. No s

Резюме ESPR 2013Европейское общество педиатрической радиологии 50th Ежегодное совещание и 36th Курсы для аспирантов. Июнь 3–7 2013. Будапешт, Венгрия.

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Алгоритмический подход к поиску людей с множественным склерозом с использованием обычных медицинских данных в Уэльсе.

Идентификация многочисленных случаев склероза (МС) в обычных хранилищах данных о здравоохранении по-прежнему сопряжена с трудностями. СС может иметь затяжной диагностический процесс и редко определяется в качестве основной причины для поступления в больницу. Трудности с идентификацией усугубляются в системах, которые не включают информацию о страховании или плательщике, касающуюся лечения наркотиков или не поддающихся уведомлению заболеваний. Проверка чувствительности и специфичности проводилась с использованием two существующие независимые наборы данных по MS, one Клинически подтвержденная и

Patent pooling to increase access to essential medicines.

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Interventions for preventing falls in older people in care facilities and hospitals.

BackgroundFalls in care facilities and hospitals are common events that cause considerable morbidity and mortality for older people. This is an update of a review first published in 2010 and updated in 2012.ObjectivesTo assess the effects of interventions designed to reduce the incidence of falls in older people in care facilities and hospitals.Search methodsWe searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (August 2017); Cochrane Central Register of Controlled Trials (2017, Issue 8); and MEDLINE, Embase, CINAHL and trial registers to August 2017.Selection crite