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Risk of fractures in half a million survivors of 20 cancers: a population-based matched cohort study using linked English electronic health records.

BACKGROUND: A history of multiple myeloma, prostate cancer, and breast cancer has been associated with adverse bone health, but associations across a broader range of cancers are unclear. We aimed to compare the risk of any bone fracture and major osteoporotic fractures in survivors of a wide range of cancers versus cancer-free individuals. METHODS: In this population-based matched cohort study, we used electronic health records from the UK Clinical Practice Research Datalink linked to hospital data. We included adults (aged ≥18 years) eligible for linkage, and we restricted the study start t

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… However, cancer survivors were less likely than controls to be current smokers and more likely to be ex-smokers. 126 021 (21·80%) cancer survivors had a history of fracture compared with 672 188 (20·83%) controls. … 431 (55·94%) | 1 721 534 (53·36%) Ex-drinker | 25 448 (4·40%) | 123 676 (3·83%) Unknown | 174 559 (30·19%) | 1 064 068 (32·98%) Problematic drinking | 16 939 (2·93%) | 89 040 (2·76%) Smoking status Non-smoker | 183 580 (31·75%) | 1 075 246 (33·33%) Current smoker | 80 652 (13·95%) | 574 121 (17·79%) Ex-smoker …

Риск сердечно-сосудистых заболеваний у выживших жертв рака: групповое исследование 446,384 Новозеландские пациенты первичной медико-санитарной помощи.

С учетом успехов, достигнутых в борьбе с раком, все более важное значение приобретает то, чтобы врачи должным образом контролировали риск сердечно-сосудистых заболеваний (КВД) среди выживших жертв рака. Неясно, увеличивается ли риск CVD среди выживших жертв рака в целом, и на сегодняшний день существуют несоответствия в данных о частотности CVD и смертности в разбивке по типам раковых заболеваний. МЕТОДЫ: Пациенты пожилого возраста 30-74 годы, поступившие в открытое когортное исследование на момент первой оценки риска CVD, в период между 2004 и 2018, в системе первичной медико-санитарной помощ

Low serum free light chain is associated with risk of COPD exacerbation.

BackgroundMost exacerbations of chronic obstructive pulmonary disease (COPD) are triggered by respiratory tract infections. Adaptive immunity via antibody production is important in preventing infections. Impaired antibody production is reported to be associated with an increased risk of exacerbations of COPD. In the present study, we elucidated whether reduced free light chains (FLCs), which are excessive amounts of light chains produced during antibody synthesis and can be used to estimate systemic antibody production, may be a promising biomarker to predict the risk of exacerbations of COPD

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… We confirmed that among the study subjects, current smokers with COPD demonstrated a higher proportion of CD19 + CD27 + IgD − class-switched memory B-cells than ex-smokers with COPD (current smoker versus ex-smoker; 30.5±14.4 versus 20.0±11.1, p=0.027). …

Treatment landscape and disease burden of patients with multiple myeloma in Japan: a real-world survey.

AIM: Multiple myeloma (MM) is a hematological malignancy associated with poor health-related quality of life (HRQoL). Safe and effective treatments for MM are limited. There is a need for real-world data to improve understanding of treatment patterns and sequencing in routine clinical practice in Japan. This study evaluated disease burden, treatment patterns, treatment sequencing, and reasons for treatment selection in patients with MM in Japan. METHODS: This analysis used survey data of hematologists or hemato-oncologists and their adult patients with MM who received active treatment in a re

Регулирование сосудистого риска у людей с множественным склерозом во время диагностики в Англии: демографическое исследование.

ВАЖНЕЙШЕЕ УПРАВЛЕНИЕ У ЛЮДЕЙ С Множественным Склерозом (PwMS) имеет важное значение с учетом более высокого сосудистого бремени, чем у населения в целом, связанного с ростом инвалидности и смертности. ЦЕЛИ: Мы провели оценку различий в распространенности видов 2 диабет и гипертония; а также использование антидиабетических, антигипертензионных и липидных лекарств во время диагностирования MS. МЕТОДЫ: Это исследование, основанное на народонаселении, включая PwMS и соответствующий контроль между 1987 и 2018 в Англии. Результаты: Мы определили 12,251 ПВМС и 72,572 Совпадающие с контрольными. У PwM

Dietary supplement use in ambulatory cancer patients: a survey on prevalence, motivation and attitudes.

PurposePatients with cancer often believe dietary supplements (DS) such as micronutrients and botanical products to be health supporting and non-toxic despite growing concerns regarding potential pharmacological interactions. Studies on the prevalence of DS use among patients with cancer are heterogeneous and mainly conducted at university-based cancer centers. This survey focused on a particular cancer patient group treated in an ambulatory setting without regular access to professional nutritional counselling.MethodsPatients with a history of cancer or hematological malignancy were included

Long Term Therapeutic Plan for Patients with Non-Small Cell Lung Cancer Harboring EGFR Mutation.

Non-small cell lung cancer harboring epidermal growth factor receptor (EGFR) sensitizing mutations has a distinct disease entity. Patients with this cancer have better prognosis, and frequently achieve long-term survival. EGFR-tyrosine kinase inhibitor (TKI) is the drug of choice for this cancer; but the disease inevitably progresses, after durable response. The tumor is a mixture of EGFR-TKI sensitive clones and resistant clones, regardless of their molecular mechanisms. EGFR-TKI sensitive clones are very susceptible to this drug, but rarely eradicated; so, withdrawal of the drug permits rapi

Prognostic impact of malignant diseases in idiopathic pulmonary fibrosis.

No studies on idiopathic pulmonary fibrosis (IPF) have investigated the prognostic impact of extrapulmonary cancers in patients with IPF. We aimed to determine the prognostic impact of malignancies in patients with IPF. We retrospectively reviewed the medical records of patients diagnosed with IPF between 2001 and 2015. Patients were divided into three groups: IPF without cancer (n = 440), IPF with lung cancer (n = 69), and IPF with extrapulmonary cancer (n = 70). Of the 579 patients with IPF, 139 (24%) had cancer; the three most common types were lung (11.9%), gastric (2.4%), and colorectal (

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… Smokers were defined as current and ex-smokers who had smoked more than 100 cigarettes in their lifetime. …

Associations of body mass index and waist circumference with incidence of overall and of 27 site-specific cancers: a population-based retrospective cohort study.

BackgroundOverweight and obesity are known risk factors for cancer. The aim of this study was to investigate associations of body mass index (BMI) and waist circumference (WC) with incidence of 27 site-specific cancers stratified by sex and menopausal status accounting for non-linearity.MethodsWe performed a population-based retrospective cohort study using the Korean National Health Insurance Service (KNHIS 2009-2020) database. We included 3,986,155 participants (aged ≥ 20 years), and the mean follow-up duration was 9.0 ± 1.6 years. The primary outcome was the incidence of cancer.ResultsThere

Траектории и управление сосудистым риском после диагностирования множественных склерозов: 1987 и 2018 в Англии.

У людей с множественным склерозом (PwMS) увеличивается нагрузка на сердечно-сосудистые и цереброваскулярные заболевания, но это может быть компенсировано за счет регулирования сосудистых факторов риска. ЦЕЛИ: Мы сравнили траектории сосудистых факторов риска, сосудистых коморбидов и клинического управления в PwMS с общим диагнозом населения после MPS, контролируя при этом слабость. МЕТОДЫ: Ретроспективный продольный анализ с использованием данных на английском языке, полученных в рамках программы исследований клинической практики 1987 и 2018 в том числе PwMS six :: контроль без НР в разбивке по

Polymorphisms in the promoter region of the CRBN gene as a predictive factor for the first-line CTD therapy in multiple myeloma patients.

Cereblon is a primary molecular target for immunomodulatory drugs. The aim of this study was to evaluate the influence of selected clinical and molecular factors including single nucleotide polymorphisms (SNPs) in CRBN gene on the efficacy of first line CTD (cyclophosphamide, thalidomide, dexamethasone) chemotherapy in patients with multiple myeloma. Study group consisted of 68 patients. Analysis of CRBN gene SNPs (rs6768972, rs1672753) was performed using Real-Time PCR genotyping technique. Median progression free survival (PFS) was 15 months and overall survival (OS) 79 months. Factors assoc

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… 32,6) | 27 (58,7) | 0,7104 ≥65 | 9 (40,9) | 11 (50) | 2 (9,1) | 0,1250 | 1 (4,5) | 9 (40,9) | 12 (54,5) | 0,0998 Smoking Non-smokers | 23 (50) | 19 (41,3) | 4 (8,7) | 0,6368 | 5 (10,9) | 15 (32,6) | 26 (56,5) | 0,6082 Active smokers | 5 (41,7) | 7 (58,3) | - | 0,190 | - | 5 (41,7) | 7 (58,3) | 0,196 Ex-smokers … months) | p HR (95% CI) | Median (months) | p HR (95% CI) 15 | 79 Sex Men | 12 | 0,6938 | 50 | 0,0585 Women | 15 | 0,89 (0,50-1,61) | 79 | 2,45 (1,06-5,63) Age <65 | 15 | 0,5942 | 82 | 0,2853 ≥65 | 17 | 0,85 (0,44-1,64) | 38 | 0,63 (0,23-1,70) Smoking Non-smokers | 12 | 0,8644 | 79 | 0,6341 Active and ex-smokers …

Obesity-Independent Association between Glycemic Status and the Risk of Hematologic Malignancy: A Nationwide Population-Based Longitudinal Cohort Study.

There have been conflicting results regarding the association between diabetes and the risk of hematologic malignancies, and its interaction with obesity is unknown. This study determined the risk of hematologic malignancies according to the glycemic status in a population-based study involving health screening 9,774,625 participants. The baseline glycemic status of the participants was categorized into no diabetes, impaired fasting glucose (IFG), newly detected diabetes, diabetes duration <5 years, and diabetes duration ≥5 year groups. The risks of overall and specific hematologic malignancie

Cardiotoxicity after cancer treatment: a process map of the patient treatment journey.

Background/aimCardiotoxicity is a potential complication of anticancer therapy. While guidelines have been developed to assist practitioners, an effective, evidence based clinical pathway for the treatment of cardiotoxicity has not yet been developed. The aim of this study was to describe the journey of patients who developed cardiotoxicity through the healthcare system in order to establish baseline data to inform the development and implementation of a patient-centred, evidence-based clinical pathway.MethodsMixed-methods design with quantitative and qualitative components using process mappi

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… Almost 40% were overweight or obese; 24% had a family history of CVD, 41% were current or ex-smokers, 24% were regular consumers of alcohol, 48% had hypertension and 26% diabetes. A quarter of patients presenting for cancer treatment (24%) had more than four cardiovascular risk factors. … clinical characteristics (pre-existing risk factors) ≥ 1 risk factor | 41 (90) ≥ 4 risk factors | 11 (24) Diabetes (type 1 or 2) | 12 (26) Hypertension | 22 (48) Hypercholesterolemia | 14 (30) Stroke | 1 (2) Angina | 5 (11) Arrhythmia (atrial fibrillation) | 6 (13) Valvular disease | 1 (2) Current−/ex-smoker …

A confusing case report of pulmonary langerhans cell histiocytosis and literature review.

Pulmonary Langerhans Cell Histiocytosis (PLCH) is a rare disease. From the insidious onset and nonspecific manifestations, it is difficult to diagnose PLCH. To help improve the diagnosis and therapy options of adult PLCH, we present this case report and literature review about a confusing case of PLCH. In this report, we present a 37-year-old male PLCH case that was negative for CD1a and S100 expression. Smoking cessation and use of prescribed Spiriva appeared to improve the patient's symptoms. To the best of our knowledge, this is the first reported case of PLCH in which improved symptoms wer

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… PLCH has a close relationship with smoking, both in current smokers and ex-smokers. Complete remission of PLCH may occur after smoking cessation. Clinical manifestation of PLCH generally does not have presentation of specific symptoms. …

(Поли) фенолы и множественный склероз: результаты межсекционного исследования наблюдений.

(Поли) фенолы представляют собой широкий и разнородный класс веществ с рядом потенциальных преимуществ для здоровья. Их роль в нейрозащите и когниции по-прежнему вызывает сомнения. Цель этого исследования заключается в изучении возможной взаимосвязи между общим и индивидуальным (поли)поглощением фенола, основными источниками питания и остротой множественного склероза (МС) в группе пациентов, страдающих НР. Были собраны демографические данные, данные о физической активности участников, данные о курении и рационе питания наряду с клиническими параметрами, включая Расширенный цикл оценки инвалидн

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… Smoking habits were arranged as (i) non-smokers, (ii) smokers, and (iii) ex-smokers. The International Physical Activity Questionnaire (IPAQ) [ 44 ] was used to assess physical activity habits. It comprises a set of 4 questionnaires (5 activity domains asked independently). …

Исследование реальных наблюдений за инфекциями у лиц, проходящих лечение острелизумабами, в связи с множественным склерозом.

ИСТОРИЯ ВОПРОСА: Anti-CD20 Моноклональные антитела в настоящее время являются обычным средством лечения склероза (MS). Rituximab, ocrelizumab и outatumumumab были связаны с зависящим от дозы риском гипогаммаглобулинамии, однако ее актуальность в клинической практике остается неопределенной. ЦЕЛИ: Изучение показателей инфицирования с течением времени в реальной когорте людей, которые лечатся окролизумабами, и их связи с сывороткой иммуноглобулин. DESIGN: Исследование по наблюдению 152 :: лица, получающие ocrelizumab для MS 5.6 Годы (среднее 2.7 США).Результаты: Среднегодовые (SD) изменения в им

The concept of exceptionality: a legal farce?

How do we decide which treatments should be offered by the National Health Service (NHS) when we cannot afford to fund them all? In the absence of a positive appraisal by the National Institute for Health and Clinical Excellence (NICE), which mandates the provision of a treatment by the NHS, Primary Care Trusts (PCTs) are free to decide whether to provide a particular drug to some, or all, of their population. However, as public bodies, it is a well-established principle of Administrative Law that PCTs are not at liberty to fetter the exercise of their own discretion. They must recognise the p

Exploring participant perceptions of a virtually supported home exercise program for people with multiple myeloma using a novel eHealth application: a qualitative study.

IntroductionSupervision, tailoring, and flexibility have been proposed as key program elements for delivering successful exercise programs for people with multiple myeloma (MM). However, no studies to date have evaluated the acceptability of an intervention employing these components. The aim of this study was to determine the acceptability of a virtually supported exercise program and eHealth application for people with MM.MethodsA qualitative description approach was used. One-on-one interviews were conducted with participants who completed the exercise program. Content analysis was used to

Baseline Characteristics of Participants in the Alberta Cancer Exercise Hybrid Effectiveness-Implementation Study: A Wake-Up Call for Action.

Background: Alberta Cancer Exercise (ACE) is a hybrid effectiveness-implementation study evaluating a cancer-specific community-based exercise program across urban sites in Alberta, Canada. The purpose of this paper is to describe the baseline characteristics of participants. Methods: Adults with any type and stage of cancer, who were undergoing cancer treatment or up to three years post treatment completion, were eligible. ACE was delivered in person at 18 sites across 7 cities in Alberta, with video conferencing introduced during the COVID-19 pandemic. Participants took part in 60 min of mil

Association between Cholesterol Level and the Risk of Hematologic Malignancy According to Menopausal Status: A Korean Nationwide Cohort Study.

Recent studies have revealed the possible association between serum cholesterol levels and hematologic malignancy (HM). However, limited information is available about how reproductive factors interact with this association. Therefore, we investigated the roles of serum cholesterol in the risk of HM according to the menopausal status. We finally identified 1,189,806 premenopausal and 1,621,604 postmenopausal women who underwent a national health screening program in 2009 using data from the Korean National Health Insurance Service database. Overall, 5449 (0.19%) developed HM. Among postmenopau