To see the other types of publications on this topic, follow the link: Refugee Therapy Centre.
Journal articles on the topic 'Refugee Therapy Centre'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Refugee Therapy Centre.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Alayarian, Aida. "On the Refugee Therapy Centre." Psychoanalysis and History 24, no. 3 (December 2022): 363–67. http://dx.doi.org/10.3366/pah.2022.0443.
Full textAbstract:
This reflection discusses the psychoanalytic work of the Refugee Therapy Centre, London, while highlighting the therapeutic approach of the collective and the challenges encountered in the work with refugees. The author discusses the importance of the idea of ‘healthy dissociation’ and the meaning of ‘resilience’ for dislocated populations.
2
Alayarian, Aida. "The Refugee Therapy Centre." Self & Society 32, no. 5 (December 2004): 5–10. http://dx.doi.org/10.1080/03060497.2004.11083810.
Full text
3
Baker, Felicity, and Carolyn Jones. "Holding a Steady Beat: The Effects of a Music Therapy Program on Stabilising Behaviours of Newly Arrived Refugee Students." British Journal of Music Therapy 19, no. 2 (December 2005): 67–74. http://dx.doi.org/10.1177/135945750501900205.
Full textAbstract:
Vulnerability to crisis in newly arrived refugee youth is common as they try to come to terms with past traumatic experiences and acculturate to the new country in which they have settled. This study examined the effects of a short-term music therapy program on the changes to the Behaviour Symptom Index (BSI, Reynolds and Kamphus, 1998) of 31 new refugee youths attending an English language reception centre in Brisbane. A cross-over design with two five-week intervention periods was employed with group music therapy sessions conducted one-two times per week. Results indicate that changes to BSI scores approached significance indicating trends that music therapy affected a positive change on generalised behaviour. Findings are discussed with reference to stabilizing and preventing crises with this population.
4
DCruz, Jennifer T., and Joanne Joseph. "Narrative Exposure Therapy: An Innovative Short-Term Treatment for Refugees with PTSD – Interview with Dr. Morton Beiser." University of Ottawa Journal of Medicine 6, no. 2 (November 30, 2016): 9–12. http://dx.doi.org/10.18192/uojm.v6i2.1760.
Full textAbstract:
ABSTRACTDr. Morton Beiser is a Professor of Distinction in Psychology at Ryerson University, as well as Founding Director and Senior Scientist at the Centre of Excellence for Research on Immigration and Settlement (CERIS) in Toronto. After obtaining his medical degree from the University of British Columbia in 1960, he interned at the Montreal General Hospital, completed residency in Psychiatry at Duke University Medical Centre and pursued post-doctoral training in Psychiatric Epidemiology at Cornell University. Dr. Beiser was appointed as Associate Professor of Behavioural Sciences at the Harvard School of Public Health from 1967 to 1975, before returning to Toronto to assume a David Crombie Professorship of Cultural Pluralism and Health, and professorship in Psychiatry. Given his extensive research experience on immigration and resettlement work, we interviewed Dr. Beiser to gain further insight into how Narrative Exposure Therapy (NET) can be an innovative short-term option to treat refugee patients with post-traumatic stress disorder (PSTD). Dr. Beiser is currently conducting a randomized trial to assess the effectiveness of NET among refugee children and youth in Toronto. RÉSUMÉDr Morton Beiser est un professeur distingué en psychologie à l’Université Ryerson, ainsi que directeur fondateur et scientifique principal au Centre d’excellence pour la recherche en immigration et en intégration (CEREI) de Toronto. Après avoir obtenu son doctorat en médecine à l’Université de la Colombie-Britannique en 1960, il a fait son internat à l’Hôpital général de Montréal, a complété sa résidence en psychiatrie au centre médical de l’Université Duke et a suivi une formation postdoctorale en épidémiologie psychiatrique à l’Université Cornell. Dr Beiser a été nommé professeur agrégé en sciences du comportement à l’École de santé publique de Harvard de 1967 à 1975, avant de retourner à Toronto pour occuper la Chaire David Crombie sur le pluralisme culturel et la santé, et la chaire de psychiatrie. Compte tenu de sa vaste expérience en recherche sur l’immigration et la réinstallation, nous avons interviewé Dr Beiser pour mieux comprendre comment la thérapie d’exposition descriptive (TED) est une option novatrice à court terme pour traiter les patients réfugiés atteints de trouble de stress post-traumatique. À l’heure actuelle, Dr Beiser mène un essai randomisé pour évaluer l’efficacité de TED chez les enfants et jeunes réfugiés de Toronto.
5
McLeod, Heather, Leah B. Lewis, and Xuemei Li. "Resilience and Hope: Exploring Immigrant and Refugee Youth Experiences through Community-based Arts Practice." Engaged Scholar Journal: Community-Engaged Research, Teaching, and Learning 6, no. 2 (April 15, 2021): 88–104. http://dx.doi.org/10.15402/esj.v6i2.70765.
Full textAbstract:
Community-based arts practice is programming that informs and fosters essential components of well-being and belonging, including resilience, community attachment via interpersonal connection and exchange as preventive to mental health stressors. Our Art Hive is in a centre-city high school with immigrant and refugee youth in St. John’s Newfoundland, where newcomers often face an insider/outsider dynamic of disconnection. The pop-up Art Hive is a publicly accessible and community-located art-making space grounded in Adlerian theory, collaborative community development, feminist thought, and social justice. Through a community-situated arts-based participatory process, we sought emergent themes. An earlier phase of our collaborative project involved visual art-making and exploring experiences of inclusion and belonging. A second phase of the project included some of the same youth and new members, adding local students invited by the immigrant and refugee youth. This phase explored resilience and hope as a feature of well-being and functioning and as having a relationship with immigrant and refugee youth experiences in smaller Canadian centres. The Art Hive, a form of community art therapy practice, is structured along seven social parameters: focus on intentional art-making, no critical commentary (positive or negative), non-evaluative in nature, no forced participation, witnessing, sharing, and participatory involvement of facilitators. The participant-planned and hosted final exhibit contributed to learning, sharing, and group cohesiveness. A focus group generated data on how the Art Hive informs cultural experiences and feelings of hope.
6
Portokaloglou, Thaleia. "Transplanting the Soul-Tree: An Analytical Perspective on how the Sesame Approach and Movement with Touch and Sound Became the Fertile Soil for the Psychological Support and Therapy for Refugee Women." Dramatherapy 39, no. 2 (July 2018): 102–12. http://dx.doi.org/10.1080/02630672.2018.1482937.
Full textAbstract:
This case study explores how the Sesame approach and specifically Marian Lindkvist's ‘Movement with Touch and Sound’ (MTS) became the fertile soil for the psychological support and healing of refugee women in an innovative community centre in Athens. Expression through movement, ritual, imagination and play created the fine line of working obliquely yet deeply with severely traumatised women, most of whom were survivors of gender-based violence (GBV). The archetypal image of the tree, which develops new roots after the so called ‘transplant shock’, is a guiding metaphor that emerged through the therapeutic process and held an enormous significance as a representative unconscious image of the women's inner and outer journey of transformation.
7
Zehetmair, Catharina, Inga Tegeler, Claudia Kaufmann, Anne Klippel, Luise Reddemann, Florian Junne, Sabine C. Herpertz, Hans-Christoph Friederich, and Christoph Nikendei. "Stabilizing Techniques and Guided Imagery for Traumatized Male Refugees in a German State Registration and Reception Center: A Qualitative Study on a Psychotherapeutic Group Intervention." Journal of Clinical Medicine 8, no. 6 (June 22, 2019): 894. http://dx.doi.org/10.3390/jcm8060894.
Full textAbstract:
Refugees have an increased risk of developing mental health problems. Due to the unstable setting in refugee state registration and reception centers, recommended trauma-focused treatment approaches are often not applicable. For this purpose, we devised a suitable therapeutic approach to treat traumatized refugees in a German state registration and reception center: Group therapy, focusing on stabilizing techniques and guided imagery according to Reddemann (2017). From May 2017 to April 2018, we conducted semi-structured interviews with n = 30 traumatized refugees to assess their experiences with the stabilizing techniques and guided imagery in group sessions and self-practice. Participants mainly reported that they had more pleasant feelings, felt increasingly relaxed, and could better handle recurrent thoughts. Additionally, the participants noticed that their psychosocial functioning had improved. The main difficulties that participants encountered were feeling stressed, having difficulties staying focused, or concentrating on the techniques. During self-practice, the participants found it most challenging that they did not have any verbal guidance, were often distracted by the surroundings in the accommodation, and had recurrent thoughts about post-migratory stressors, such as insecurity concerning the future or the application for asylum. Our results show that stabilizing techniques and guided imagery according to Reddemann (2017) are a suitable approach to treat traumatized refugees living in volatile conditions.
8
Magaziotou, Ioanna, Sotirios Tsiodras, Athanasia Xirogianni, Maria Tseroni, Katerina Syrigonaki, Artemis Stoli, Aikaterini Tsekou, et al. "1429. Meningococcal Disease Outbreak in a Refugee Reception Identification Center in Greece and Administration of Mass Antibiotic Prophylaxis." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S720—S721. http://dx.doi.org/10.1093/ofid/ofaa439.1611.
Full textAbstract:
Abstract Background An increased likelihood of transmission of communicable diseases such as invasive meningococcal disease (IMD) exists in refugee camps. Herein, we describe an outbreak investigation of 5 IMD cases among immigrants in Greece. Methods Epidemiological, clinical and laboratory data (culture and molecular identification) as well as the public health management concerning an outbreak of meningococcal disease in a refugee Reception Identification Center (RIC), are described. Results During the period 17th January - 17th February 2020, five cases of IMD in refugees were reported to the National Public Health Organization (NPHO). Four cases were from Afghanistan and resided in the RIC of Lesvos Island; two females aged 2 yo and 21 yo and two males 13 yo and 6 yo. The fifth case, a 4 month old male of Syrian nationality, exhibited symptoms after moving to an inland accommodation center (AC) from Lesvos RIC, on December 2019. Four of the cases presented with meningitis and septicaemia. All cases recovered and had no common exposure other than shared geographic space. Neisseria meningitidis was identified by molecular typing (mPCR, PorA, MLST, WGS) in all cases at the National Meningitis Reference Laboratory; 3/5 cases were identified as MenB, porA 7-2,4, and ST-3129 (new clone) while 2/5 (21 yo female, 13 yo male) as MenY, porA: 5.2, ST-22cc. To prevent secondary cases, antimicrobial chemoprophylaxis via Directly Observed Therapy (DOT) was administered to 4.024 Afgan close contacts (26.7% of the total Afgan population). MenACWY and MenB vaccination was recommended in response to outbreak among persons aged < 20 years old. No new IMD case occurred in the RIC during a follow-up period of 4 months. Conclusion The detection of a new clone in Greece of Chinese and Taiwanese origin through migrants, further underlines the need of enhanced surveillance for early detection, molecular typing, immediate intervention with antibiotic prophylaxis and/or supplemental vaccination in order to prevent IMD in refugee camps. Disclosures All Authors: No reported disclosures
9
Breinlinger, Susanne, Ann-Kathrin Pütz, Natalie R. Stevens, Daniela Mier, Inga Schalinski, and Michael Odenwald. "Narrative Exposure Therapy in challenging and conditions." MALTRATTAMENTO E ABUSO ALL'INFANZIA, no. 3 (January 2021): 37–50. http://dx.doi.org/10.3280/mal2020-003004.
Full textAbstract:
Patients with past exposure to adverse experiences are frequent in clinical services, many of them suffering from co-occurring Posttraumatic Stress Disorder (PTSD). Despite first evi-dence that encourages diagnostics and trauma therapy provision for PTSD, complex cases are often excluded from evidence-based treatments. First, we review the evidence of PTSD treatment for two groups of complex cases: patients with psychotic disorders and pregnant refugee women. Second, we report on how NET is applied to these groups in specialized treatment centres and how the technique is adapted to the specific needs. We encourage cli-nicians to build up concepts of integrated treatment for complex cases including NET as one core component.
10
Mbamba, Crispin Rakibu, Jennifer Litela Asare, and Clinton Gyimah. "A Preliminary Scoping Review of Trauma Recovery Pathways among Refugees in the United States." Trauma Care 2, no. 4 (November 29, 2022): 579–88. http://dx.doi.org/10.3390/traumacare2040048.
Full textAbstract:
When people move across borders to seek asylum because of violence, conflicts, persecution, or human rights violations, they experience a complex mix of psychological and traumatic downfalls. Often, refugees and asylum seekers’ trauma is compounded by the behaviours of individuals, communities, and the systemic climate of host countries. The United States is host to refugees and asylees from several countries. Evidence shows that several asylum seekers are held up in deplorable conditions in immigration detention centres where they are battling acute trauma. Therefore, consequent to this, coupled with the varying trauma that refugees face, this preliminary scoping review explores the scope and context of available peer-reviewed scholarship on trauma recovery pathways among refugees in the United States to identify gaps for further research. Following the PRISMA-compliant scoping review guidelines, we identified and curated data on the scope and context of peer-reviewed literature on trauma recovery approaches among refugees in the United States. This study identified the following as trauma recovery pathways among refugees: (1) macro-level structural intervention—preventing re-traumatization; (2) culturally sensitive therapeutic intervention; and (3) diagnosis and therapy. This study concludes that little research on the recovery pathways among refugees exists in the United States, hence the need for scholarship in this area.
11
Jeon, Sehyun, Jiyoun Lee, Jin Yong Jun, Young Su Park, Jaehee Cho, Jaeryung Choi, Younsuk Jeon, and Seog Ju Kim. "The Effectiveness of Cognitive Behavioral Therapy on Depressive Symptoms in North Korean Refugees." Psychiatry Investigation 17, no. 7 (July 15, 2020): 681–87. http://dx.doi.org/10.30773/pi.2019.0134.
Full textAbstract:
Objective Despite the growing need for psychological programs for North Korean refugees, most psychological interventions for these people lack a verification study that tests their effectiveness. This study aims to evaluate the effectiveness of cognitive behavioral therapy (CBT) in North Korean refugees.Methods Participants included 38 North Korean refugees, of whom 23 participated in simple relaxation and 15 participated in CBT. The Korean version of the Center for Epidemiologic Studies Depression Scale (CES-D), State-Trait Anxiety Inventory-State (STAI-S), and Impact of Event Scale-Revised were used to evaluate symptoms pre- and post-intervention.Results Participants had a significant decrease in CES-D scores after treatment (p=0.037). The decrease in CES-D was larger in those who participated in the CBT compared to those in simple relaxation (p=0.023). The superior effects that CBT had on depressive symptoms over simple relaxation were particularly more prominent in those with severe depression (p=0.035). Participants with high levels of anxiety also showed significant decreases in STAI-S scores after treatment, regardless of which type of program they participated in (p=0.023).Conclusion This preliminary findings suggests that CBT is an effective psychiatric approach in treating depressive symptoms in North Korean refugees, especially for those with a higher degree of depressive symptom.
12
Vindbjerg, Erik, Christoph Klimpke, and Jessica Carlsson. "Psychotherapy with traumatised refugees – the design of a randomised clinical trial." Torture Journal 24, no. 1 (October 8, 2018): 9. http://dx.doi.org/10.7146/torture.v24i1.109719.
Full textAbstract:
There is little evidence as to which kind of psychotherapy is the most effective in the treatment of traumatised refugees. At the Competence Center for Transcultural Psychiatry, a series of clinical trials have been conducted since 2008. The first results are pending publication. The aim of this paper is to discuss some of the challenges in adapting Cognitive Behavioural Therapy (CBT) to the treatment of traumatised refugees, as well as describe a randomised clinical trial designed to test two such adaptations. In the described trial one group receives CBT with a focus on cognitive restructuring while the other group receives CBT focusing on Stress Management. A main goal of this setup is to test whether some, perhaps even most, of the traumatised refugees referred to treatment, may benefit from a more direct focus on current stress, and its alleviation through simple, repetitive exercises, compared to a focus on analysing and changing thought patterns.
13
Belhan Çelik, Sümeyye, Esma Özkan, and Gonca Bumin. "Effects of Occupational Therapy via Telerehabilitation on Occupational Balance, Well-Being, Intrinsic Motivation and Quality of Life in Syrian Refugee Children in COVID-19 Lockdown: A Randomized Controlled Trial." Children 9, no. 4 (April 1, 2022): 485. http://dx.doi.org/10.3390/children9040485.
Full textAbstract:
We aimed to evaluate the effects of an occupational training program via telerehabilitation on well-being (WB), occupational balance (OB), intrinsic motivation (IM), and quality of life (QoL) in Syrian refugee children resettled in Turkey during the COVID-19 pandemic. This was a single-center, prospective, randomized, non-blinded trial in which children aged 13–15 years and attending a secondary school were recruited. OB, WB, IM, and QoL were evaluated via the OB Questionnaire (OBQ11), the Well-Star Scale (WSS), the IM Scale (IMS), and the Pediatric Quality of Life Inventory (PedsQL). The intervention group attended online occupational therapy classes. Online classes were carried out as five sessions per week, each session lasting 1 h, for 3 weeks. Questionnaires were performed at the outset of the study and following the training program. Overall, 52 refugee children were randomized into the intervention and control groups, each including 26 children. The mean OBQ11, WSS, IMS, and PedsQL scores significantly improved more in the intervention group than in the control group. This was the first study investigating the effects of a customized online training course on OB, WB, IM, and QoL in Syrian refugee children, also affected unfavorably by the COVID-19 lockdown. Our results showed significant improvements in all the study scales that we used to quantify the alterations in the aforementioned traits.
14
Abdel-Razeq, Hikmat, Faris Tamimi, Nayef Abdel-Razeq, Maryam El-Atrash, Baha’ Sharaf, Rawan Mustafa, Razan Mansour, and Rayan Bater. "Late presentation and suboptimal treatment of breast cancer among Syrian refugees: a retrospective study." Journal of International Medical Research 49, no. 5 (May 2021): 030006052110184. http://dx.doi.org/10.1177/03000605211018448.
Full textAbstract:
Objectives The crisis in Syria has had a profound impact on the entire region. In this study, we report the patterns of presentation and management of Syrian patients with breast cancer treated at our institution. Methods We retrospectively collected data on Syrian refugees treated for breast cancer over the past 10 years at our center. Management was compared against our approved clinical practice guidelines. Results A total of 113 patients were eligible and included. The median age (range) at diagnosis was 47 (21–84) years and most women presented with locally advanced or metastatic disease (n = 74, 65.5%). Breast-conserving surgery and breast reconstruction were performed in 27 (33.8%) and 11 (35.4%) patients, respectively. Only a few patients received targeted (35.5%) or advanced endocrine therapy (30.0%). In total, 37 (32.7%) patients had considerable deviations from our institutional treatment guidelines and had worse outcomes. Conclusions Syrian refugees with breast cancer present late, have more advanced-stage disease, and are more likely to receive delayed and suboptimal therapy. An international systematic approach for cancer care among such vulnerable populations is urgently needed.
15
Lukina, Yu V., S. Yu Martsevich, A. V. Zagrebelnyi, S. G. Tripkosh, F. A. Aidu, and A. D. Deev. "THERAPY COMPLIANCE IN AMBULATORY PATIENTS: PROFILE REGISTRY DATA." Cardiovascular Therapy and Prevention 12, no. 5 (October 20, 2013): 56–61. http://dx.doi.org/10.15829/1728-8800-2013-5-56-61.
Full textAbstract:
Aim.Using the data from the PROFILE Registry and the patients’ questionnaire survey, to analyse the patients’ compliance with medical recommendations on lipid-lowering therapy (LLT).Material and methods.Over the period from May 1st 2011 to December 31st 2011, 274 patients were included in the PROFILE Registry: 82 were referred to a specialised medical centre for the first time (control group, CG); 167 were regularly attending the medical centre (main group A, MGA); and 25 last visited the centre >2 years ago (main group B, MGB). 262 patients completed a questionnaire on the therapy compliance, while 12 refused to participate in the questionnaire survey.Results.According to the results of the questionnaire survey, MGA patients were better informed about the LLT goals (65%) than their CG and MGB peers (35% and 48%, respectively; p<0,0001). The percentage of patients who took statins every day was 87% in MGA vs. 41,5% in CG and 64% in MGB (p=0,002). Statin therapy effectiveness was controlled regularly in MGA: cholesterol (CH) levels were measured every 6 months in 37,5% and every 12 months in 28%. For CG, these figures were 17% and 16%, while for MGB, they were 15% and 40%, respectively (p<0,0001). One-third of CG patients, every fourth MGB patient, and only 13% of MGA patients did not control their CH levels (p<0,0001).Conclusion.The MGA patients who were regularly attending the State Research Centre for Preventive Medicine were the most LLT-compliant: they were well-informed about their disease and therapy goals, were regularly taking prescribed medications (statins), and had better treatment control and the highest LLT effectiveness.
16
Sharma, Jyoti, Manish Gupta, and Amit Saini. "Malignant melanoma oral cavity: case report of two patients from sub-Himalayan region." International Journal of Otorhinolaryngology and Head and Neck Surgery 7, no. 5 (April 23, 2021): 896. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20211591.
Full textAbstract:
<p class="abstract">Malignant melanoma of the oral cavity is an exceedingly rare tumor representing 0.2 to 8% of all melanomas. Mucosal melanomas are extremely rare and aggressive neoplasms. Patient reporting to the clinician with a pigmented lesion should raise suspicion in the first visit itself and should be further investigated so as to detect this dreaded malignancy at an earlier stage and thus managed appropriately. We presented two such rare cases who reported at our centre treated with different modalities and had different responses to treatment. In first case report 65 year old male patient diagnosed with malignant melanoma of left upper alveolus underwent multiple modalities of treatment like surgery, chemotherapy, radiation therapy but unfortunately as he defaulted post-surgery and also due to COVID-19 lockdown restrictions he was treated in various centres and finally the result was inoperable residual gigantic mass resistant to chemotherapy and radiation therapy. In second case report, 82 year old male patient reported with malignant melanoma hard palate having good response to initial chemotherapy. He was planned on hypo-fractionated radiotherapy in view of his old age but he refused radiation treatment and is on oral temozolamide and thalidomide with stable disease and good quality of life since past 6 months.</p>
17
Carlsson, Jessica, Kajsa Stade, Signe Skammeritz, and Charlotte Hjortkjær. "“After all the traumas my body has been through, I feel good that it is still working.” – Basic Body Awareness Therapy for traumatised refugees." Torture Journal 25, no. 1 (September 26, 2018): 18. http://dx.doi.org/10.7146/torture.v25i1.109507.
Full textAbstract:
Basic Body Awareness Therapy (BBAT) is a form of physiotherapy that is often used for psychiatric patients in Scandinavian countries. To our knowledge, there have not been any studies investigating BBAT as a treatment for traumatised refugees until now.
Objective: To explore the compliance, acceptability and treatment satisfaction using group BBAT in traumatised refugees. To study changes in psychiatric and somatic symptoms as well as the quality of life, level of functioning and quality of movement during treatment with BBAT.
Method: All Arabic speaking patients that previously had received treatment at the Competence Centre for Transcultural Psychiatry in Copenhagen from April 2008 to June 2009 were invited to participate (N=29). Nine persons were included in a male (N=4) and female (N=5) group. All participants were traumatised refugees. The BBAT treatment consisted of 14 sessions over a period of 14 weeks. Before and after treatment the participants were interviewed using a semi-structured interview guide. The interviews were transcribed and analyzed with a thematic approach. The participants also filled out self-administrated questionnaires and two physiotherapists tested the participants’ movement harmony using the Body Awareness Rating Scale-Movement Harmony (BARS-MH) test. At the end of the study, the participants filled out anonymous questionnaires about treatment satisfaction.
Results: The results showed that the participants had a high compliance, acceptability and treatment satisfaction with BBAT. The majority of participants showed improvements in symptoms from baseline to post-intervention on the self-administrated questionnaires and in the BARS-MH test.
Conclusions: Further research is needed to expand the scientific knowledge regarding the use of BBAT in traumatised refugees. If future research can confirm our positive findings it will have a considerable impact on future treatment designs and for the individual patient.
18
Morcillo Marco, Paula. "El vaciamiento del derecho de asilo en el caso de solicitantes procedentes de El Salvador y Honduras / / / \ \ \ The hollowing out of the right to asylum for asylum seekers from El Salvador and Honduras." TERRA: Revista de Desarrollo Local, no. 11 (December 29, 2022): 89. http://dx.doi.org/10.7203/terra.11.25394.
Full textAbstract:
Resumen: La presente investigación se centra en visibilizar la situación de injusticia social y desamparo a la que se ven sometidos miles de solicitantes de protección internacional procedentes de El Salvador y Honduras. Esta denuncia de la desnaturalización del derecho de asilo en España tiene como fin último no solo analizar la violación de las cuestiones jurídicas más fundamentales en materia de protección internacional sino también plasmar recomendaciones que redunden en la mejora de las condiciones de vida de este colectivo vulnerable. La investigación plantea una metodología jurídico-social, proponiéndose interrelacionar la normativa jurídica con la realidad fáctica. De este modo, el análisis legislativo converge con la técnica de investigación cualitativa de la entrevista, capaz de favorecer una aproximación a la realidad objeto de estudio bajo la mirada de los protagonistas. Los resultados revelan una serie de disfuncionalidades alrededor del no reconocimiento por parte del Estado español de la protección internacional por motivo de persecución a manos de las pandillas, siendo el principal argumento la ausencia de elementos probatorios suficientes que acrediten la pasividad de las autoridades salvadoreñas y hondureñas frente a las organizaciones criminales reinantes en el Triángulo Norte Centroamericano.
Palabras clave: refugio; migración; pandillas centroamericanas; agentes de persecución.
Abstract: This research focuses on making visible the situation of social injustice and helplessness to which thousands of applicants for international protection from El Salvador and Honduras are subjected. The ultimate aim of the present denunciation of the denaturalization of the right to asylum in Spain is not only to analyse the violation of the most fundamental legal issues in the field of international protection, but also to make recommendations to improve the living conditions of this vulnerable group. The research proposes a socio-legal methodology, aiming to interrelate the legal regulations with the factual reality. In this way, the legislative analysis converges with the qualitative research technique of the in-depth interview, capable of favoring an approach to the reality under study through the eyes of the protagonists. The results reveal a series of dysfunctions surrounding the non-recognition by the Spanish State of international protection on the grounds of gangs persecution, the main argument being the absence of sufficient evidence to prove the passivity of the Salvadoran and Honduran authorities in the face of the criminal organizations that reign in the Northern Triangle of Central America.
Key words: refugee; migration; Central American gangs; persecution agents.
19
Adachi, Yoshiaki. "LW-6 OKAYAMA ROSAI HOSPITAL GLIOMA SUPPORT CENTER INITIATIVES." Neuro-Oncology Advances 4, Supplement_3 (December 1, 2022): iii27. http://dx.doi.org/10.1093/noajnl/vdac167.107.
Full textAbstract:
Abstract For glioblastoma, which is a rare and intractable disease, it is necessary to speed up the development and verification of new treatment methods through nationwide clinical trials by consolidating cases in the High Volume Center. Okayama University-related facilities have consolidated glioblastoma cases at Okayama University Hospital and are actively conducting high-precision surgery, genetic analysis, and clinical trials. On the other hand, there are cases where it is difficult to continue treatment at university hospitals, such as dissemination cases and poor Performance Status cases. In order to respond to this need with One Stop, we established the Okayama Rosai Hospital Glioma Support Center. We provide seamless support for postoperative radiation chemotherapy, rehabilitation, maintenance chemotherapy, alternating current electric field therapy, best supportive care, and end-of-life support including backward coordination. The goal is not to make glioblastoma patients and their families “cancer refugees” but to provide QOL-oriented treatment until the end within the comprehensive regional care system. We will report on the results of 29 cases of glioblastoma intervention from May 2013 to August 2022 and future issues.
20
Pitruzzella, V., P. Sidoti, A. Frenda, C. Catalano, S. Geraci, and G. Caramanno. "ARRHYTHMIAS, PACING, ABLATIONC1 A DEPENDENT SYNCOPE." European Heart Journal Supplements 22, Supplement_G (August 1, 2020): G1—G56. http://dx.doi.org/10.1093/eurheartj/suaa105.
Full textAbstract:
Abstract A 33-year-old man, ex drug addict on methadone therapy. He arrives to emergency department for syncope, reported by his wife reversion of the eyeballs and fine tremors with subsequent recovery of consciousness. A similar episode had happened a year ago. It was performed ECG: sinus bradycardia , 45 bpm, QT 600 msec, QTc 554 msec . Neurological examination performed: no motor deficits, negative Romberg. At brain CT no parenchymal tomodensitometric changes. Median line structures in axis. At the EEG: slight diffuse slow intercritical changes. Prescribed therapy with levetiracetam 500 mg. Cardiological examination and echocardiogram performed within the limits. Laboratory tests showed Trop HS 80 pg / ml. On the basis of the ECG and the slight increase of the troponin he was hospitalized in Cardiology and monitored. The following day, cardiac arrest due to torsade de pointes degenerated into ventricular fibrillation, DC shock was performed with the restoration of electrical and mechanical activity. Urgent coronary angiography was performed with evidence of coronary artery free from angiographically significant stenosis. SERT has been contacted: the patient had not been treated by them for some time and was using excessive doses of self-procuring methadone. In consideration of cardiac arrest from methadone long QT ventricular arrhythmia, ICD implantation was proposed, refused by the patient because he wanted to start detoxification therapy. During the hospitalization, progressive reduction of QT up to normalization in discharge. After a month new access to emergency department for presynopal episode, ECG showed sinus bradycardia with QTC 552 msec; the patient reports continuing to take excessive methadone doses and refuses treatment at a recovery center; considering that the ICD can be life-saving in this typ77e of patient (intractable addiction), we have re-proposed the ICD implant, rejected by the patient.
21
Ekstrøm, M., C. Sonne, J. Carlsson, P. Bech, and A. Elklit. "The treatment of traumatised refugees with sertraline versus venlafaxine in combination with psychotherapy – a randomised clinical study." European Psychiatry 33, S1 (March 2016): S400. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1438.
Full textAbstract:
Background and aimToday we lack sufficient evidence to conclude which type of treatment approach that is most efficient when it comes to trauma-affected refugees. That is a problem for both patients and doctors as well as for society. Also there is a lack of studies, which examine the relation between psychosocial resources and treatment efficiency, in order to find reliable predictors of treatment outcome. This study therefore aims to produce new evidence within this field in order to optimise treatment for trauma-affected refugees with complex PTSD.MethodsThe study included 207 patients referred to Competence Centre for Transcultural Psychiatry between April 2012 and September 2013. Patients were randomised into one of the two treatment groups: a sertraline group (n = 109) or a venlafaxine group (n = 98). Patients in both groups received the same manual based cognitive behavioural therapy, specially adapted to this group of patients. The trial endpoints were PTSD-and depression symptoms and social functioning, all measured on validated ratings scales. Furthermore the study examined the relation between expected outcome of treatment from a range of predictors and the relation to the treatment results for the individual patient.ResultsData are presently being analysed and results will be ready for the conference.ConclusionThe study is among the largest randomised studies ever conducted on pharmacological treatment among traumatised refugees. It is expected to bring forward new knowledge about clinical evaluation and medical treatment of traumatised refugees.Disclosure of interestThe authors have not supplied their declaration of competing interest.
22
Kim, Hayeon, Hong Wang, Emilia Diego, David Anthony Clump, Kenneth Smith, and Margaret Q. Rosenzweig. "Factors associated with DCIS treatment patterns in a large cancer center network." Journal of Clinical Oncology 40, no. 16_suppl (June 1, 2022): e18589-e18589. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.e18589.
Full textAbstract:
e18589 Background: There remains variability in management of DCIS, particularly with radiation therapy (RT) and hormone therapy (HT). Little is known about DCIS treatment patterns according to patient characteristics. We examined associations between patient characteristics, treating center location and DCIS therapy received. Methods: We performed a retrospective registry review of all patients diagnosed and treated with DCIS from 2018-2019, collected from the UPMC network, an NCI designated cancer center, serving western and central Pennsylvania. Demographics and administered treatments were compiled from cancer registry records. Descriptive statistics and logistic regression were used for analysis. Treatment centers throughout the network were dichotomized to academic (academic practice) or community (non-academic) sites, race was divided into two groups, Black and White/Other. Neighborhood deprivation index (NDI) was dichotomized to median level at > = 59% vs. < 59% and extremes > = 75% vs. < 75%. Results: A total of 941 patients treated for DCIS;29 patients were not eligible for surgery because of trial enrollment randomizing away from surgery. Of the remaining 912 patients, 506 patients were from academic sites and 406 patients from community sites. Median patient age was 63 years old (range: 24-90 years). There were no treatment differences noted for age, race, or NDI. For treatment, 80 patients refused recommended HT; 46 patients refused recommended RT. The likelihood of receiving RT was similar between academic and community sites (64.3% vs. 67.2%; p= 0.47). Of those having surgery, 25% had mastectomy (231 of 912), more likely at academic sites (29% vs. 21%; p= 0.0045). Among patients with lumpectomy, community patents had greater HT utilization than academic patients (82% vs. 68%; p < 0.001), while ER status was not different. Conclusions: Within the UPMC network, variability in the management of DCIS did not differ based on age, race, or NDI. However, academic practice locations had higher levels of mastectomy, while greater HT utilization was observed in community sites. Further qualitative information is under examination from patients and clinicians to better understand how treatment decisions are framed and completed in the context of patient centered care for DCIS.
23
Ekstrøm, M., J. Carlsson, C. Sonne, and E. L. Mortensen. "Stress management versus cognitive restructuring: A randomized clinical study on traumatized refugees." European Psychiatry 33, S1 (March 2016): S399—S340. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1437.
Full textAbstract:
Background and aimThere is a lack of evidence regarding which kind of psychotherapy that is the most effective when treating traumatized refugees. Studies on the effect of psychotherapy among other patient groups with PTSD suggest a good effect using cognitive behavioural therapy (CBT). The competence center for transcultural psychiatry (CTP) has specialized in the treatment of traumatized refugees. The objectives were to study the effect of CBT with a focus on either stress management or cognitive restructuring in a clinical sample of traumatized refugees with PTSD and to identify predictors for the treatment effect.MethodsAll patients (n = 143) referred to CTP from June 2011–March 2012 and fulfilling the inclusion criteria were offered to participate in the study. Participants were offered combined treatment with a psychiatrist (psycho-education and psychopharmacological treatment when needed) and a psychologist (CBT). The duration of the treatment was 6–7 months. The participants were randomized to either CBT with a focus on stress management or cbt with focus on cognitive restructuring. The primary outcome was PTSD measured by the Harvard Trauma Questionnaire.ResultsThe results are presently being analyzed and will be presented at the congress.ConclusionsBoth research results and the clinical experience at CTP suggest, that cognitive restructuring is not always a useful tool and that stress reducing techniques could be more useful. This hypothesis was tested in the present study.Disclosure of interestThe authors have not supplied their declaration of competing interest.
24
Astuti, Lestari Puji, Zuliah Zuliah, and Tri Ismu Pujiyanto. "EFEKTIVITAS MASSAGE EFFLEURAGE DAN TERAPI MUSIK TERHADAP PENURUNAN TEKANAN DARAH PADA IBU BERSALIN DENGAN PRE EKLAMSI." Jurnal Ilmu Keperawatan dan Kebidanan 11, no. 1 (January 3, 2020): 43. http://dx.doi.org/10.26751/jikk.v11i1.782.
Full textAbstract:
ABSTRACTBackground: According to the Indonesian Health Demographic Survey (IDHS) in 2017, the direct cause of the maternal mortality rate (MMR) of 30% was preeclampsia. Preeclampsia can be treated pharmacologically and non pharmacologically. Non-pharmacological treatment is a natural treatment including effluerage massage and music therapy.Objective: To identify and analyze differences in blood pressure reduction in pre-eclampsia mothers before and after massage effleurage and music therapy in the Kragan II Puskesmas maternity room.Methods: The study design used the Two Group Post Test With Control Design. Sampling by accidental sampling. Sampling in this study were 40 women with preeclampsia. Test results using the Mann-Whitney test.Results: With effluarge massage the average blood pressure value was 22.0 while in music therapy 19.00 and obtained ρ was 0.002 (<0.05). So Ho refused Ha accepted, which means there are differences in the effectiveness of massage effleurage and music therapy to reduce blood pressure in mothers giving birth with pre-eclampsia in health center II.Conclusion: Massage effleurage is more effective when compared to music therapy in reducing maternal blood pressure. It is expected that health workers to implement an effleurage massage program in women with preeclampsia. Keywords: Massage effleurage, Music Therapy, Preeclampsia
25
Zalutskaya, N. M., I. A. Beltceva, and N. G. Neznanov. "Tolerability of antidementive therapy: results of observational research." V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY, no. 2 (November 11, 2018): 117–24. http://dx.doi.org/10.31363/2313-7053-2018-2-117-124.
Full textAbstract:
Tere are 44 patients (5 males and 39 females), aged 56 to 90 years were included in the study. To assess the tolerability and safety of the drug, undesirable events were recorded, associated and not associated with taking the drugwith taking the drug, a physical examination of patients was performed, an ECG was recorded and a biochemical blood test was performed at each visit of the patient to the center. During the observation period, two undesirable events chronologically associated with taking the drug were recorded During the study, none of the patients was excluded from the program due to the development of side effects and none of the patients refused to take the drug. We did not fnd any statistically signifcant increase in the incidence of cardiac pathology in patients taking the study drug, nor worsening of the already existing symptoms on the background of taking the drug for six months. Te observed growth trends in the level of blood creatinine a give grounds to recommend monitoring of kidney function in the patients taking the drug. In general, noogerone showed good tolerability, despite the elderly age of its patients and the high prevalence of concomitant somatic diseases in the sample.
26
Elfimova, E. M., O. O. Mikhailova, N. T. Khachatryan, A. Y. Litvin, I. E. Chazova, L. Y. Laiovich, T. A. Malkina, A. V. Pevzner, and S. P. Golitsyn. "Adherence and efficacy of long-term PAP therapy in patients with sleep-related breathing disorders associated with cardiac conduction disorders." Terapevticheskii arkhiv 92, no. 9 (October 14, 2020): 39–43. http://dx.doi.org/10.26442/00403660.2020.09.000730.
Full textAbstract:
Aim.To study the effectiveness of prolonged use of PAP therapy (positive airway pressure therapy) in eliminating sleep respiratory disorders and associated cardiac conduction disturbances.
Materials and methods.We included 21 patients who were examined at the Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology, regarding cardiac rhythm and conduction disturbances, as well as obstructive sleep apnea and who have been on PAP therapy for more than 12 months. The average age was 66.5 [63.5; 73.2] years, body mass index 33.0 [30.2; 38.5] kg/m2, apnea-hypopnea index 65.0 [59.0; 86.3]/h. At the time of analysis, 15 patients continued to use PAP therapy (mean time of use: 6.0 years [4.7; 9.2]) and 6 patients refused long-term use of PAP therapy, mean time to use PAP therapy until failure amounted to 2.82.1 years.
Results.PAP therapy lead to a persistent decrease in apnea-hypopnea index of 63.6/h to 3.7/h was (p=0.0002). 86% of patients met the criteria for adherence to PAP therapy (use 4 hours/night, more than 70% of nights). Initially, before the use of PAP therapy, all cardiac conduction disorders were during sleep and exceeded 3 seconds, with fluctuations from 3.1 to 10.6 seconds. PAP therapy appeared to be effective in all patients: no asystoles, duration of more than 3 seconds, were detected.
Conclusion.In obstructive sleep apnea patients with concomitant nighttime cardiac conduction disturbances, the long-term use of PAP therapy is effective and with good adherence.
27
Kornevs, Egils. "Diagnostics and Treatment Strategies of Early (T1) Lower Lip Cancer." Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences. 74, no. 1 (February 1, 2020): 48–52. http://dx.doi.org/10.2478/prolas-2020-0007.
Full textAbstract:
AbstractData from 35 patients were analysed to identify the main factors that may have predisposed the unfavourable clinical course in early diagnosed lower lip cancer. Of 35 patients who were sent to the Oncology Centre of Latvia, Rīga East University Hospital, with the diagnosis of early lower lip cancer, histologically diagnosis was confirmed for 22 patients. Sizes of the primary tumours were less than 2 cm (T1 size tumour). Vermilionectomy was carried out for 17 patients, wedge- or V-shaped resection was performed for 13 patients, and in five cases patients refused to receive surgical treatment and received radiation therapy instead. Review of the reports of the histological criteria for patients with aggressive course of the illness with relapses, regional metastases and also in cases of death, showed that vermilionectomy can be considered an effective diagnostic and therapeutic operation.
28
Kolar, Martin, Kristyna Kastylova, Martin Lukas, Dana Duricova, Veronika Hruba, Nadezda Machkova, Karin Cerna, et al. "EFFICIENCY OF DUAL THERAPY WITH VEDOLIZUMAB AND TOFACITINIB IN REFRACTORY ULCERATIVE COLITIS PATIENTS – SINGLE CENTRE EXPERIENCE." Inflammatory Bowel Diseases 29, Supplement_1 (January 26, 2023): S78. http://dx.doi.org/10.1093/ibd/izac247.150.
Full textAbstract:
Abstract INTRODUCTION Despite significant impact biological treatment had on prospects of patients with ulcerative colitis, there is still a substantial proportion of patients with either secondary loss of response or primary non-response to multiple drugs. Beside dose optimization and selection of drugs with different mechanism of action, combination of two different targeted molecules has been proposed in cases where inflammatory activity cannot get under control. This case series provide promising results of vedolizumab in combination with tofacitinib in treatment resistent UC patients. METHODS Patients with complicated refractory or acute severe colitis, in whom combined treatment with vedolizumab and tofacitinib based on shared clinical decision was started, were included. Data on demographics, treatment details, persistence and disease activity including laboratory markers, clinical activity index (partial Mayo score) during regular visits every 2 months up to one year after treatment initiation were collected. Currently available data were analyzed at 6 months of treatment. Endoscopic disease activity before and 2-6 months after dual therapy start was evaluated. RESULTS In total, 21 ulcerative colitis patients who were started on vedolizumab and tofacitinib dual therapy between October 2020 and September 2022 were included. Tofacitinib dose was 10mg bid in all patients and all patients on vedolizumab maintenance treatment had intensified dosing regimen. Mean patients age was 36.4±8.1 years, 47.6% were males and 52.4% females. Mean disease duration at baseline was 7.5±5.8 years. All patients had advanced disease including 61.9% with extensive colitis and 38.1% with left-sided colitis. At least 2 previous biologics in monotherapy were used in 85.7% of patients. Mean pMayo score at baseline was 5.6±1.9 and decreased to 0.5±0.9 at 6 months (p=0.0020). Initial fecal calprotectin in the cohort was 1829±2520µg/g vs. 225±257µg/g at 6 months (p=0.0068) and mean CRP changed from 11.4±17.1 to 5.4±7.2mg/l (p=ns). Endoscopic Mayo score before dual treatment initiation averaged 2.8±0.5 indicating mostly severe disease activity and decreased to 1.4±1.2 during follow-up endoscopy (p=0.0005) with half of the patients having only no to mild activity (eMayo 0-1). Up to now, dual therapy had to be terminated in 7 patients – 4 patients failed on the treatment, 1 refused to continue with dual therapy, 1 patient experienced adverse event (liver lesion) and 1 was discontinued for reimbursement reasons. CONCLUSION In the presented small cohort of patients, however, with refractory and complicated ulcerative colitis in whom other modalities were depleted or colectomy was considered, combined vedolizumab and tofacitinib treatment has proven to be very efficient with half of the patients reaching mucosal healing after 6 months and without raising significant safety concerns.
29
Oxnard, G. R., P. Fidias, and L. V. Sequist. "Treatment patterns of very elderly patients with non-small cell lung cancer." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 18110. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.18110.
Full textAbstract:
18110 Background: Among patients with non-small cell lung cancer (NSCLC), patients aged 80 or older, termed the ‘very elderly‘, have inferior survival. Treatment patterns within this patient population are poorly described. Methods: A retrospective chart review was performed of 111 outpatients with NSCLC presenting at age 80 or older to an academic referral center over 5.3 years. Based upon available literature regarding elderly patients with NSCLC, a guideline recommended therapy (GRT) was determined for each tumor stage. Each patient’s treatment regimen was evaluated for consistency with the GRT. Particular attention was paid to how patient characteristics and attitudes influenced therapy decisions. Results: Patients characteristics included: median age 82.6 (range 80–92); 50% male; 55% adenocarcinoma, 19% squamous cell; 30% stage I-II, 28% stage III, 39% stage IV; and 59% performance status (PS) 0–1, 25% PS = 2 (PS not available for 15%). 89% of patients received some form of anti-neoplastic therapy and 11% were treated with best supportive care alone. Of 34 patients with localized disease, 53% underwent tumor resection and 38% received definitive radiation. Of 74 patients with stage III or IV disease, 34% received cytotoxic chemotherapy. Radiotherapy (47%) and oral targeted therapy (35%) were the most common treatment modalities overall. 32% of patients received the stage-specific GRT. Multivariable analysis demonstrated that independent predictors for failing to receive GRT included PS = 2 (odds ratio [OR] 17.1, 95% confidence interval [CI] 2.2–135) and age =85 (OR 4.8, 95% CI 1.0–23.4) Of the patients who failed to receive GRT, 19% electively refused GRT that was offered (13% specifically refused chemotherapy), and 76% were not offered GRT (44% due to PS or comorbidities, 32% due to age or unstated reasons). Conclusions: The vast majority of NSCLC patients age 80 or above receive some form of anti-neoplastic therapy, but only one-third of this population receives the stage-specific GRT. The strongest predictor of treatment with GRT is PS 0–1; those with poor PS are 17-fold less likely to receive GRT. A small but clinically significant portion of patients elect against the offered GRT; more data is needed about the attitudes of these patients toward therapy. No significant financial relationships to disclose.
30
Valiev, T. T., and E. S. Belyaeva. "Results of longstanding, single-center trial for pediatric Hodgkin lymphoma treatment." Oncohematology 16, no. 3 (September 10, 2021): 95–104. http://dx.doi.org/10.17650/1818-8346-2021-16-3-95-104.
Full textAbstract:
Background. Actually, treatment results of Hodgkin lymphoma (HL) are the most dramatic oncohematology achievements, therefore modern treatment protocols designed to toxicity reduction with the same high level of patients’ survival. Time of complete response occupies a central position in the prognostic factors for HL and helps to find a group of patients whose treatment could be de-escalated.Objective: to evaluate the efficacy of original domestic risk-adopted protocol RDC POG-HL 2003 with treatment de-escalation and refused radiation therapy (RT) for early-responded patients.Materials and methods. 192 patients were enrolled in prospective RDC POG-HL 2003 protocol from February 2003 to November 2020. Median age was 12.8 years (from 3 to 17). Local stages (IA–IIA) were diagnosed in 48 (25 %) patients, disseminated (IIB–IVB) – in 144 (75 %) cases. For local (IA–IIA) stages by RCD POG-HL 2003 treatment included DBVE + RT, for disseminated (IIB–IVB) – BEACOPP escalated (esc.) + RT. In case of 70 % and more tumor reduction after 4 induction courses of BEACOPP-esc., the following treatment included less intensive schemes (ABVD, COPP/ABV). Because of high risk of breast cancer in girls after mediastinal RT, it was possible to omit a RT in case of early response.Results. All patients with local stages are alive by the time of study end. Event- and relapse-free survivals in this group were 97.8 ± 2.5 % (median follow up 181.9 ± 4.8 months). Event-free survival for disseminated stages patients was 90.3 ± 3.3 % (median follow up 179.1 ± 4.2 months), relapse-free survival – 93.5 ± 2.1 % (median follow up 191.7 ± 2.3 months) and overall survival – 97.9 ± 1.2 % (median follow up 196.3 ± 2.6 months). In 48 (25 %) patients it was possible to omit RT without reducing survival rates.Conclusion. Differentiated HL treatment with respect to disease stage and time of complete response is a key to success of treatment. Such approach permits us to reduce cumulative therapy toxicity by its de-escalation and, in some cases, to omit RT.
31
Hughes, Luke D., Jamal Khudr, Edward Gee, and Anand Pillai. "Pitfalls preventing bone union with EXOGEN Low-Intensity Pulsed Ultrasound." SICOT-J 8 (2022): 15. http://dx.doi.org/10.1051/sicotj/2022012.
Full textAbstract:
Objectives: To evaluate the efficacy of EXOGEN in achieving union and common pitfalls in its use within the Manchester Foundation Trust (MFT) and Salford Royal Foundation Trust (SRFT). Method: Patients receiving EXOGEN therapy between 01/01/2017 and 31/12/2019 at hospitals within MFT and SRFT were identified using EXOGEN logbooks and hospital IT systems. An equal number of patients were included from both sites. Data were retrospectively collected from clinical documents detailing clinical presentation comorbidities, and radiographic images, determining the radiological union post EXOGEN therapy. In addition, local practices were observed and compared to EXOGEN’s standardized guidance for clinicians. Results: Fifty-eight patients were included in the primary review, with 9 subsequently excluded based on insufficient clinical data. 47% of patients achieved radiological union following completion of EXOGEN therapy. Outcomes of the 23 patients with persistent non-union were as follows – 18 were referred for revision surgery, 5 were prescribed further EXOGEN therapy, 2 refused or were unfit for further intervention, and 1 did not have a plan documented. No significant baseline differences were present in both outcome groups. However, at MFT and SRFT, rates of union with EXOGEN are below that previously published in the literature. Conclusion: EXOGEN has proven successful in facilitating union in established cases of non-union without the risk and cost associated with revision surgery. Centre outcome differences may be explained by failure to educate clinicians and patients on the correct use of the EXOGEN device, failure to standardize follow-up or monitor compliance, and must be addressed to improve current services.
32
Rossi, Serena, Carla Pietrangelo, Sante Donato Pierdomenico, and Livio Giuliani. "Upfront triple oral combination therapy including selexipag in a high-risk patient with idiopathic pulmonary arterial hypertension: a case report." European Heart Journal - Case Reports 4, no. 5 (August 30, 2020): 1–5. http://dx.doi.org/10.1093/ehjcr/ytaa190.
Full textAbstract:
Abstract Background Selexipag is an oral selective prostacyclin IP receptor agonist approved in patients with low- and intermediate-risk pulmonary hypertension (PH); evidence in patients at high risk is lacking. Case summary A 42-year-old woman with worsening dyspnoea (World Health Organization functional class III–IV) and suspected PH at echocardiographic examination was evaluated in our Pulmonary Hypertension Centre. Right heart catheterization showed pre-capillary PH with reduced cardiac index and increased pulmonary vascular resistance. High-resolution computed tomography excluded parenchymal lung disease and ventilation/perfusion (V/Q) lung scan was negative for mismatched perfusion defects so the conclusive diagnosis was high-risk idiopathic pulmonary arterial hypertension (PAH). The patient refused an initial combination therapy including a parenteral prostacyclin analogue (PCA) in accordance with the ESC/ERS guidelines, so an off-label triple oral combination therapy including a phosphodiesterase-5 inhibitor, an endothelin receptor antagonist, and selexipag was started. At 3- and 6-month follow-up we found a clinical and haemodynamic improvement, so the patient was reclassified as low risk. Her clinical condition is currently stable. Discussion Despite the benefit of parenteral PCAs in high-risk PAH, low adherence to treatment may be explained by adverse side effects related to the intravenous route of administration. Given the potential effect seen in our patient, upfront triple oral combination therapy in PAH high-risk patients should be further evaluated in a controlled clinical trial.
33
Chen, Lu chuan. "Efficacy and safety of conversion therapy using chemotherapy plus anti-angiogenic therapy in unresectable gastric cancer." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): e15510-e15510. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e15510.
Full textAbstract:
e15510 Background: Conversion therapy has been a promising option for patients with unresectable gastric cancer (GC) (including Phase IV gastric cancer, N3, lymph node fusion and local progression patients). We aimed to investigate the efficacy and safety of S1/oxaliplatin chemotherapy plus apatinib, a novel inhibitor of VEGFR-2, in the conversion therapy for unresectable GC. Methods: This was a single-center, single-arm, open-label study. unresectable GC patients with unresectable factors were eligible for this study. Apatinib (500mg, qd) was administrated continuously, oxaliplatin (130mg/m2) on day 1, and S1 (<1.25m2, 40mg*2/d; 1.25-1.5m2, 50mg*2/d; >1.5m2, 60mg*2/d) on day 1-14 every 3 weeks. Treatment was given for 4-6 cycles preoperatively, but the last cycle did not include apatinib. The primary objective included R0 resection rate and safety profile of preoperative treatment. Results: Total 17 patients were enrolled, the median age was 57 (55.12±10.08) years old. The histological types were mainly signet ring cell carcinoma 10 (58.82%), poorly differentiated adenocarcinoma 5 (29.41%), and moderately differentiated adenocarcinoma 2 (11.76%). Among the 17 patients eligible for preoperative efficacy evaluation, 13 achieved partial response (PR), 3 achieved stable disease (SD), and 1 had progressive disease (PD), the overall response rate (ORR) was 76.5% and disease control rate was 94.1%. Of the 13 pts with PR, 1 refused consents for surgery, 12 patients underwent surgery and 9(75%) achieved R0 resection. During preoperative treatment, the incidence of adverse events (AEs) was 76.5%. The common hematologic AEs were neutropenia (64.7%), leukopenia (64.7%) and hemoglobin decrease (11.8%), and nonhematologic AEs included hyperbilirubinemia (11.8%), hand-foot syndrome (17.6%), oral mucositis (29.4%), fatigue (70.6%), proteinuria (5.9%). Conclusions: Combination of apatinib with S1/oxaliplatin chemotherapy could induce a sufficient conversion rate and achieve a relative high R0 resection rate for initially unresectable GC, with tolerable safety profile. Clinical trial information: ChiCTR-ONC-17010430 trial.
34
Wissgott, Christian, Christopher W. Lüdtke, Hendryk Vieweg, Fabian Scheer, Michael Lichtenberg, Erik Schlöricke, and Reimer Andresen. "Endovascular Treatment of Aneurysms of the Popliteal Artery by a Covered Endoprosthesis." Clinical Medicine Insights: Cardiology 8s2 (January 2014): CMC.S15232. http://dx.doi.org/10.4137/cmc.s15232.
Full textAbstract:
Purpose The current gold standard of popliteal artery aneurysm (PAA) treatment is saphenous vein bypass grafting. The aim of this retrospective single-center study is to investigate the safety and efficacy in the treatment of PAA by an endovascular implanted covered endoprosthesis. Materials and Methods Ten patients, mean age 64.6 (range, 52-78) years, with PAA were treated with an expanded Polytetrafluoroethylen (ePTFE)-covered stent graft (Viabahn®, W.L. Gore and Associates Inc, Flagstaff, AZ, USA). In median, 1.4 prostheses were implanted with a median length of 180 mm. Follow-up visits included determination of ankle-brachial index (ABI) and color-coded duplex sonography. Results The technical success rate was 100% (10/10). Clinically, there was an increase in ABI from 0.62 ± 0.17 to 0.91 ± 0.15 postinterventionally and to 0.89 ± 0.16 after an average follow-up of 24.7 months. During the follow-up period, 2 (20%) stent occlusions occurred; both of them were treated with a bypass graft. Conclusion The treatment of PAA with covered endoprosthesis is a safe and effective alternative to open surgical therapy, where open surgical therapy is contraindicated or patient refused open surgery.
35
Chen, Sile, Yanzhe Xia, Shaohua Yang, Yan Qian, Ertao Zhai, Shaoqing Huang, Yihang Shi, Yulong He, Shirong Cai, and Xinhua Zhang. "Regorafenib third-lined therapy in advanced GISTs: A single center analysis based on different genotypes." Journal of Clinical Oncology 40, no. 16_suppl (June 1, 2022): 11537. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.11537.
Full textAbstract:
11537 Background: The relationship between primary and secondary mutational status and efficacy of regorafenib in third-line therapy on GISTs is yet clear. Methods: From Jun 2017 to Dec 2021, a total of 62 patients with advanced GIST refractory to imatinib and/or sunitinib were enrolled in this study from the First Affiliated Hospital, Sun Yat-sen University. Results: Primary mutational was most common in KIT exon 11(40/62, 64.5%), followed by exon 9 (19.4%), exon 17 (4.8%). Six cases (9.7%) belonged to SDH deficiency and one case (1.6%) was NF1-associated GISTs. Before receiving treatment of regorafenib, specimens obtaining for secondary mutations were as follows: 39 cases from surgery，12 from core-needle biopsy; ctDNA alone was performed in 9 cases and 2 patients refused to secondary mutational test. Excluding 6 patients with SDH deficiency, 14 patients (25.8%) had mutations in exon 11+13, 15 (27.7%) in exon 11+17, 7 (13.0%) in exon 9+17, 4 (7.4%) in exon 11+13+17. Exon 11 + 18, exon 11 + 13 + 18, exon 11 + 13 + 17 + 18, exon 9 + 16, exon 11 + 17 + 18 and NF-1 were found in 1 case, respectively (1.9%). Eight (14.7%) patients with primary KIT mutation were not detected any secondary mutation（2nd-not-detected）. There was no complete response, 4 of partial response (4/54, 7.4%), 27 of stable disease (50.0%). Progression disease was seen in 23 patients (42.6%) and 8 were not applicable (no assessable lesion) to imaging response assessment due to R0/1 surgery before using regorafenib. The median follow-up time was 19.0 months. The median progression-free survival (mPFS) was 5.4 months (0.2-29.1 months) and the median overall survival (mOS) was 20.3 months (0.2-37.0 months). For primary mutation analysis, it was found that SDH-deficient patients had longer mPFS (29.1 months) than those with mutations in exon 9 or exon 11 (5.4 and 4.8 months, respectively; P= 0.013). In terms of secondary mutations, patients with activation loop mutations (exon 17+18) showed both longer mPFS (7.3 months vs 1.9 months, P= 0.001) and longer mOS (20.3 months vs 7.7 months, P= 0.059) than those patients with non-activation loop mutations. Not any specific or new adverse reaction was found in all patients. By Cox-regression analysis, response to regorafenib and mutational status were independent predictors of PFS，response to regorafenib was also an independent predictor of OS. Conclusions: Regorafenib seems to have better treatment efficacy in GIST patients with SDH deficiency compared to those with primary KIT mutations, and better with secondary mutations in activation loop than those with non-activation loop mutations. It is necessary to carry out clinical research for later-line treatment choice based on different genotypes for imatinib-resistant GISTs.
36
Kalantri, Siddhesh Arun, Saikat Datta, Vijaykumar Shirure, Subham Bhattacharya, and Maitreyee Bhattacharyya. "Azacytidine in Juvenile Myelomonocytic Leukaemia: A Single Centre Experience." Blood 132, Supplement 1 (November 29, 2018): 5524. http://dx.doi.org/10.1182/blood-2018-99-112033.
Full textAbstract:
Abstract Background Juvenile myelomonocytic leukemia (JMML) is very rare and aggressive disease of infancy and childhood. This disorder is characterized by features of both myeloproliferative and myelodysplastic disorders. Allogeneic stem cell transplant is the only curative option available for this disease. The median survival time of children who do not receive an allograft can be as short as 10 to 12 months. Recent studies have highlighted the importance of epigenetic aberrations (aberrant DNA methylation) in JMML. Hence, azacytidine an epigenetic modifier can be good potential therapeutic option in these group of patients. There are very few cases reported in literature. Rarity of this disease makes prospective randomized trials with this agent difficult. Here we report favorable outcome for three patients diagnosed with this fatal condition. Case Series Three patients diagnosed JMML as per WHO 2016 Criteria since March 2017 were enrolled in this study after obtaining informed consent. Details of baseline patient characteristics are shown in table 1. All the patients received azacytidine at 75mg/m2/ day for seven consecutive days every 28 days. All the patients have refused option of allogenic stem cell transplant and hence they are planned to be kept on same protocol till progression. Two children are continuing treatment. First patient enrolled in this study has completed 13 cycles. Second patient discontinued treatment after completion of 5 cycles of azacytidine (parental preference). Third patient in this study has completed 9 cycles. Bone marrow aspiration and cytogenetic evaluation was planned after 6 cycles of azacytidine. Results All the children enrolled in this study are maintaining stable course and are free from transfusion requirement. The second patient who discontinued therapy after 5 cycles of azacytidine is also doing well as per telephonic confirmation with parents and is free from any transfusion requirement at 14 months since he was enrolled in study. At a median follow up of 13 months since the date of diagnosis, all three children are surviving (Range 10-16 months) which is already higher than median overall survival reported for patients not receiving stem cell transplant. No patient has shown evidence of clinical progressive disease as per response criteria of JMML International Symposium (December 2013). As per these criteria one patient had clinical complete remission, another patient had clinical partial remission with progressive genetic disease and the patient who lost to follow up is considered to have clinically stable disease (since we could not complete assessment for this patient). Table 2 summarizes response to treatment for different parameters assessed. We documented a new cytogenetic abnormality (appearance of 20 q deletion) in one patient which was not documented at baseline. Therapy was well tolerated and no major toxicities (grade III-IV) were documented except episode of febrile neutropenia in one patient requiring hospitalization. Other adverse events included thrombocytopenia in between cycles but none were grade III-IV after initial platelet response. Discussion and conclusion Though the sample size is small, results are encouraging. To note all patients in our study had platelet count less than 33 thousand and two patients had haemoglobin F percentage higher than that for age which are poor prognostic clinical variable as reported by EWOG-MDS study group. Our results are similar to those reported by EWOG MDS study group which comprised of nine treatment naive patients. Azacytidine was used for bridge to transplant in this group. However, in resource poor setting like India where most families cannot afford transplant it would be prudent to evaluate if azacytidine can prolong survival or alter the natural history of this fatal disease. Long term study with more number of patients are required to know whether azacytidine can be a suitable alternative in patients where stem cell transplant is not an option. Disclosures No relevant conflicts of interest to declare.
37
Rizzo, M., N. Reisman, S. G. Gabram, H. L. Bumpers, J. Okoli, O. W. Brawley, and M. Lund. "Differences in treatment in stage III breast cancer in African American women." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 504. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.504.
Full textAbstract:
504 Background: Stage III breast carcinomas account for about 6–7% of all invasive breast cancers diagnosed annually in the US. Locally advanced breast cancer (Stage IIIA) and inflammatory breast cancer (Stage IIIB T4d) are now recognized as two distinct clinical pathologic entities, characterized by different prognostic factors profiles. The aim of this study was to compare differences in treatment in women with Stage III breast cancer in an inner city Cancer Center serving a large African American population. Methods: Retrospective review was performed on all Stage III primary breast cancers diagnosed and or treated from 2000 to 2005. Results: Of the 684 primary invasive breast cancers, 96 (14%) were Stage III (45 were Stage IIIA, 33 were Stage IIIB and 12 were inflammatory breast cancer) and 83 of the 96 (86%) were among African American women. The 6 Stage IIIC cases were excluded from analyses. To all patients was offered a combination of chemotherapy, surgery and radiation therapy. All patients with primary or residual tumors ≥ 5 cm or ≥ 3 positive axillary nodes were considered for chest wall and axillary radiation therapy; 48 of 74 received radiotherapy. Stage IIIA patients were less likely to receive neoadjuvant chemotherapy and were more likely to have ≥ 3 positive axillary nodes. Nineteen patients refused chemotherapy. The table summarizes our findings. Conclusions: In this predominantly African American female population, Stage III breast cancers were about twice as prevalent as observed nationally and a high number of these Stage III patients refused adjuvant and neoadjuvant chemotherapy. The benefit of chemotherapy and radiotherapy in improving prognosis for Stage III breast cancers is well established. Thus, reasons for refusal of chemotherapy and lack of radiotherapy need further investigation. [Table: see text] No significant financial relationships to disclose.
38
Kienitz, Tina, Marcus Quinkler, Christian J. Strasburger, and Manfred Ventz. "Long-term management in five cases of TSH-secreting pituitary adenomas: a single center study and review of the literature." European Journal of Endocrinology 157, no. 1 (July 2007): 39–46. http://dx.doi.org/10.1530/eje-07-0098.
Full textAbstract:
Objective: TSH-secreting pituitary tumors (TSH-omas) are a rare cause of hyperthyroidism and account for <1% of all pituitary adenomas. Failure to recognize the presence of a TSH-oma may result in dramatic consequences such as thyroid ablation that may cause further growth in pituitary tumor. The primary goal of the treatment of TSH-omas is to remove the pituitary tumor. Medical treatment includes dopaminergic agonists or somatostatin analogs. Methods and results: We report five cases of TSH-oma diagnosed between 1997 and 2006 and review the literature. All the patients are females with an age range from 54 to 65 years at diagnosis. Four of the five patients had at least one event of thyroid surgery due to goiter or nodule of unknown dignity. Three of the five patients had a stroke before the diagnosis of TSH-oma, probably due to hypertension, or smoking and contraceptive treatment. One patient with invasive tumor growth received stereotactic radiotherapy (and developed panhypopituitarism after operation), another patient received somatostatin analogs preoperatively and successfully underwent transsphenoidal operation. Three of the five patients received dopaminergic agonists (bromocriptine 5 mg daily or cabergoline 0.5–0.75 mg per week), because they refused surgical therapy or the tumor was stable under dopaminergic therapy. All patients have been followed-up for 2.5–8 years. A normalization of circulating thyroid hormone levels was achieved in all patients. The patient who underwent operation shows no recurrence of the disease. The other patients have a stable pituitary mass without signs of growth. Conclusion: We report the successful long-term treatment of TSH-omas with different therapies.
39
Seth, Tulika, Vandana Sharma, Sanjeev Sharma, Manoranjan Mahapatra, Pravas Mishra, Rajat Kumar, and Hara prasad Pati. "Dasatinib As a Late Second Line Therapy in Chronic Myeloid Leukemia Patients: A Retrospective Study From a Tertiary Care Centre in India." Blood 118, no. 21 (November 18, 2011): 4438. http://dx.doi.org/10.1182/blood.v118.21.4438.4438.
Full textAbstract:
Abstract Abstract 4438 Introduction- Chronic myeloid leukemia in Indian patients manifests a decade earlier than reported in the West. However, patients present later to the hospital, with advanced disease as evinced by large spleen size, fever and other symptoms and a high Sokal score. The cost of medicines and lack of health insurance means that most will receive Imatinib mesylate (Glivec) from the GIPAP program only, or locally produced Imatinib. The usual option for imatinib failure is to increase the dose to 600 or 800mg. Switching patients to second line therapy is difficult due to financial constraints; patients who fail Imatinib are offered allogeneic stem cell transplantation. Methods- We present a single-institution retrospective data of Dasatinib as second line therapy in CML patients resistant to imatinib. In a total of 1200 CML patients followed in our clinic, 24 patients were treated with dasatinib over a period of 4 years. 17 of whom were in chronic phase (switched after failure of Interferon and Imatinib -2, not in CHR at time of switch- 4), accelerated phase-5 and blast crisis-2 patients, at the time of starting dasatinib. They either refused transplant, did not have donor or had co-morbid factors (3-diabetes mellitus and CVD, 1- chronic renal disease along with diabetes) which made transplant difficult. Results- The median age of patients was 45 years (26–65 years) with 12 males and 12 females. They had received imatinib for a median of 50 months (20–98 months) before starting dasatinib. After a median follow up of 12 months (6.6 – 39.6 months), there was 2 deaths (CML-BC-1, CML-AP-1). Non-hematologic toxicity was generally mild to moderate (grades 1 or 2); dyspnea, gastrointestinal disorders (diarrhea, nausea) and fluid retention were seen. Pleural effusion occurred in two patients. Conclusions- Toxicities with Dasatinib were generally reversible and could be managed effectively with dose adjustments. Our limited experience showed this to be effective and well tolerated even in late failure patients with high disease burden. Disclosures: No relevant conflicts of interest to declare.
40
Hédi-Katalin, Sárközi, Mara Andreea Vultur, Mioara Szathmáry, Corina Budin, Monica Chiș, and Gabriela Jimborean. "Therapeutic challenges in a case of sarcoidosis." Pneumologia 70, no. 2 (September 1, 2021): 91–96. http://dx.doi.org/10.2478/pneum-2022-0020.
Full textAbstract:
Abstract Sarcoidosis is a chronic systemic inflammatory disease with unknown etiology, whose diagnosis is based on suggestive symptoms/imaging, histopathological examination with non-caseous granuloma, and exclusion of other etiologies. Corticosteroid therapy is the treatment of choice for moderate/severe forms, but medication intolerance or unfavorable evolution may require immunomodulatory therapy. A 40-year-old patient known with poly-allergy was hospitalized for resting dyspnoea, dry cough, night sweats, and itching. Objective examination identifies roughened breathing, wheezing and SpO2 = 98%. Spirometry shows a medium mixed ventilatory dysfunction. Computed tomography (CT) describes multiple mediastinal lymphadenopathies and inhomogeneous hepatomegaly. Osteomedullary biopsy refutes the suspicion of lymphoma. Bronchoscopy detects bronchial hypervascularization. Due to the suggestive imaging context, a transbronchial biopsy was performed (EBUS-TBNA) from the mediastinal lymphadenopathy. Histopathological examination suggested sarcoidosis: granulomas with epithelioid histiocytes, without caseous necrosis, associated with Langerhans cells and lymphocytes. We initiated corticosteroid therapy, but the patient had an allergic reaction that required the interruption of treatment and administration of methotrexate. After eight months, the clinical and imaging aspect worsened, and we replaced the treatment with cyclophosphamide. However, side effects occurred after a few months, it was replaced with azathioprine. The patient’s condition deteriorates significantly with desaturation. We requested a consultation with the ‘Sarcoidosis Center’ in Rotterdam, which recommended treatment with anti-TNF-α or human immunoglobulin. The patient shows a slightly favorable evolution under human immunoglobulin. The poly-allergy and drug intolerance, including corticosteroid therapy, led to the initiation of immunomodulatory therapy for a young patient with moderate/severe sarcoidosis. The choice of medication was difficult due to the side effects.
41
Jasra, Sakshi, Vipra Sharma, Alice J. Cohen, and Nicole Jabel. "Breast cancer in the elderly: An area for improvement." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e16565-e16565. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e16565.
Full textAbstract:
e16565 Background: Treatment (TX) of breast cancer (BC) in elderly (E) patients (pt) can be problematic due to the increased co-morbidities (CM), multiple medications, and cognitive dysfunction related to age. Due to this many E pt are less likely to have standardized treatment (TX). This study was undertaken to assess if pt over the age of 70 diagnosed with BC received TX based on NCCN guidelines and what CM led to selection of therapies. Methods: A retrospective review at a tertiary care medical center identified 108 pt over the age of 70 with BC from 2001-2011. Clinical data was obtained regarding race, age, stage (ST) at diagnosis, TX, CM, estrogen receptor (ER), progesterone receptor (PR), and HER2neu receptor (H2N) status. Results: Of the 108 pts, 22% were Caucasians, 66% were African-American, 3% Asian, 6% Hispanic, and 2% other. The age range was 70 to 96 years, mean of 75. Staging was as follows: 23% DCIS, 24% ST I, 28% ST II, 9% ST III, and 7% ST IV. 66% were ER positive (+), 60% PR+, and 87% H2N negative. H2N status was not available on 9% of the pts. In 92% of the pt surgical intervention (SI), either lumpectomy (L) with radiation therapy (RT), or mastectomy (M) was done (see table below). 8% of pt either refused SI or were lost to follow-up. ER/PR+ pt hormone therapy (HT) was started in 95% of pt. 3% of ER/PR+ pt refused HT. In stage II and III 60% of pt had adjuvant chemotherapy (CT), only 5% refused CT. In ST IV 30% had HT alone, 50% with CT and HT, and 25% with RT to chest wall for local recurrence. Only 23% of H2N positive pt received Herceptin. 52% of the CT used in stage II and III was cyclophosphamide, methotrexate, fluorouracil (CMF). CM in the CMF pts were as follows 90% cardiovascular disease (CAD), 53% arthritis (AR), 13% history malignancy, and 13% pulmonary disease. In the pt who refused SI, and/or CT the most common CM were 70% CAD, 50% AR, and 25% dementia. Conclusions: The majority of the E BC pt in this cohort had significant CM that made TX challenging. Some pt were not offered appropriate CT (i.e., trastuzumab) due to CM. Age impacts BC TX, but should not hinder the pt receiving optimal tx. Further studies with women over the age of 70 with BC is required to determine the most appropriate TX in this subset of pts. [Table: see text]
42
Djukanović, L., M. Radović, J. Baković, I. Budošan, D. Bukvić, A. Cvetičanin, S. Davinić, et al. "Epidemiology of End-Stage Renal Disease and Current Status of Hemodialysis in Yugoslavia." International Journal of Artificial Organs 25, no. 9 (September 2002): 852–59. http://dx.doi.org/10.1177/039139880202500907.
Full textAbstract:
Maintenance hemodialysis (HD) in Yugoslavia started in the sixties and followed the dialysis trends in the Western Europe. However, in the last decade the development of renal replacement therapy (RRT) slowed down. In this report the epidemiology of ESRD from 1997–1999 and the survey of the status of HD treatment in Yugoslavia in 1999 are presented. Epidemiological data are obtained by the annual center questionnaires (response rate: 92.6 −94.2%). The survey of HD status is based on a specific questionnaire and covered 2108 patients (65%). At the end of 1999 there were 56 RRT centers in Yugoslavia treating 3939 patients: 3232 (82%) patients by HD, 248 (6.3%) by peritoneal dialysis, and 459 (11.7%) living with transplanted kidney. In a three year period, incidence of ESRD ranged from 108–128 pmp, point prevalence from 435–463 pmp and mortality rate from 20.7–17.9. Numerous refugee patients were treated over the last 10 years. Main causes of ESRD were glomerulonephritis (30%); Balkan nephropathy represented 11% and diabetic nephropathy 7% of all primary renal diseases. Cardiovascular and cerebrovascular diseases were the most common causes of death of RRT patients. Most centers are overcrowded and HD machines are worn out. Mean Kt/V was 1.19±0.08, mean URR% 58.8±7.4. The shortage of drugs prevented adequate management: 83% of HD patients had hemoglobin level less than 100 g/L but only 10.3 −17.8% were treated with rHuEpo; 64.5% of patients had phosphate levels higher than 1.7 mmol/L but only 33.5% used phosphate binders; 47% of patients had hypertension despite the antihypertensive therapy. The prevalence of hepatitis B remained unchanged (about 14%) in HD population during the last three years, but the prevalence of anti-HCV positive patients decreased (31–23%). In conclusion, there is a well developed dialysis service in Yugoslavia but insufficient conditions for adequate treatment.
43
Park, Jaehyeon, Ji Woon Yea, Se An Oh, Min Kyoung Kim, Jun Hyuk Son, and Jae Won Park. "Prospective Study of 4 Gy Radiotherapy for Orbital Mucosa-Associated Lymphoid Tissue Lymphoma (FORMAL)." Cancers 14, no. 17 (September 1, 2022): 4274. http://dx.doi.org/10.3390/cancers14174274.
Full textAbstract:
External beam radiotherapy is effective for stage I orbital mucosa-associated lymphoid tissue lymphoma (MALToma). Hence, very-low-dose radiotherapy is increasingly being investigated. We conducted a single-center prospective phase II trial to evaluate the effectiveness of very-low-dose radiotherapy of 4 Gy (2 Gy × 2 fractions) in pathologically confirmed stage I orbital MALToma. In this first prospective trial, patients with complete response were observed after 3–6 months of follow-up. For patients without complete remission, a radiation dose of 24 Gy/12 fractions was additionally delivered. The primary endpoint was complete response rate; secondary endpoints were overall survival, local control, and progression-free survival. Seventeen patients were screened and three patients refused enrollment during October 2018–October 2021. Thus, 14 patients (17 eyes) were analyzed (median follow-up, 28.2 months). The overall response rate was 100% (complete remission: 11 lesions; partial remission: six lesions). In all lesions with residual disease, additional radiation therapy (dose: 24 Gy) was performed. One local failure was observed. Therefore, 4 Gy ultralow-dose radiation therapy for orbital MALToma was safely performed with a planned second-line treatment in patients without complete remission. This is the first prospective study to report the effectiveness of ultralow-dose radiotherapy of 4 Gy for stage I orbital MALToma treatment.
44
Mandelson, Margaret T., and Vincent J. Picozzi. "Resected pancreatic cancer (PC): Impact of adjuvant therapy (Rx) at a high-volume center (HVC) on overall survival (OS)." Journal of Clinical Oncology 34, no. 4_suppl (February 1, 2016): 191. http://dx.doi.org/10.1200/jco.2016.34.4_suppl.191.
Full textAbstract:
191 Background: Surgical outcomes for resected PC are known to be superior at HVCs. However, the impact of adjuvant (Rx) performed at HVCs is less studied. We examined the impact of site of adjuvant Rx administration on our resected patients (pts). Methods: Eligible pts were diagnosed 2003-2014 and resected at HVC. Pts were excluded for neoadjuvant Rx, synchronous cancer, death/lost to follow-up within 3 months or contraindications (e.g. morbidity) to adjuvant Rx.. Pts were also excluded if they refused adjuvant treatment or if a community oncologist (CC) was not identified in the medical record or in the western Washington population-based cancer registry. Pt and tumor characteristics were compared in univariate analysis and survival was calculated from date of diagnosis to death or last follow-up. Five year OS was estimated by the Kaplan Meier method and compared using Cox proportional hazards modeling to evaluate the impact of HVC adjuvant Rx on OS while adjusting for potential confounding factors. Results: 245 pts were eligible for study: 139 (57%) treated at HVC, 106 (43%) treated at CC. HVC and CC pts were similar with respect to stage and tumor size, nodal status, resection margins and average distance travelled to HVC. They differed by age (HVC: 63.1, CC: 68.2 p < 0.01). Median and 5-yr OS was 36 mos and 33%. Median OS for HVC vs CC was 44 mos vs. 28 mos (p < 0.01), and 5yr OS was 38.6% vs. 24.8% (p < 0.01), adjustment for age did not alter our findings. Conclusions: 1) With respect to adjuvant Rx for resected PC, HVC and CC pts differed with respect to age only. 2) Both median and 5- yr OS was statistically superior at HVC vs CC. 3) Our study supports the use of HVCs for all Rx components for PC treated with curative intent. 4) Ongoing investigation of patterns of care and their impact on OS in PC is warranted.
45
Bähr, Oliver, Ghazaleh Tabatabai, Rainer Fietkau, Roland Goldbrunner, and Martin Glas. "QOLP-31. QUALITY OF LIFE OF PATIENTS WITH NEWLY DIAGNOSED GLIOBLASTOMA DURING TTFIELDS THERAPY IN ROUTINE CLINICAL CARE: FIRST RESULTS OF THE TIGER STUDY." Neuro-Oncology 23, Supplement_6 (November 2, 2021): vi189—vi190. http://dx.doi.org/10.1093/neuonc/noab196.751.
Full textAbstract:
Abstract OBJECTIVE Current interdisciplinary treatment strategies for glioblastoma (GBM) outside clinical trials include maximally safe resection, followed by radiation and chemotherapy. The results of the positive phase III trial EF-14, adding Tumor Treating Fields (TTFields) to temozolomide (TMZ) maintenance therapy, brought an additional treatment method to clinical routine. The TIGER (TTFields In GErmany in Routine Clinical Care) study documents the use of TTFields in routine clinical care with a focus on health-related quality of life (HRQoL) within 4 months after starting therapy, treatment compliance and duration. METHODS This multi-center, prospective, non-interventional study in Germany (NCT03258021) included ndGBM patients eligible for TTFields therapy. Following their consent, patients received a comprehensive introduction to the therapy and baseline demographic data were collected. Information on TTFields therapy decision was evaluated based on a dedicated TTFields questionnaire at baseline in both arms; follow-up information on how patients handle the therapy was collected two months after TTFields treatment start. HRQoL was assessed in patients deciding for TTFields therapy at baseline and at 2 and 4 months using the EORTC-QLQ-C30/BN-20 questionnaires. RESULTS Between August 2017 and November 2019, 710 patients (259 female/451 male) were enrolled at 81 participating centers. The mean age was 58.5 years (range: 19.0-85.0; Cut-off: August 31, 2020). The overall baseline characteristics of the study group reflects a typical GBM population. Of these, 582 (82%) decided to start TTFields; 128 (18%) refused TTFields treatment. HRQoL did not decline during TTFields therapy except for itchy skin, comparable to the EF-14 trial. A detailed analysis of the cohort as well as their reported QoL will be presented. CONCLUSION The TIGER study is the largest non-interventional trial on the use of TTFields in routine clinical care. The use of TTFields in patients with ndGBM did not impair HRQoL during the follow-up period, except for more itchy skin.
46
Prichard, Sarah S. "Treatment Modality Selection in 150 Consecutive Patients Starting Esrd Therapy." Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 16, no. 1 (January 1996): 69–72. http://dx.doi.org/10.1177/089686089601600116.
Full textAbstract:
Objective The purpose of this study was to assess the reasons for treatment modality selection between hemodialysis (HD) and peritoneal dialysis (PD) in 150 consecutive patients in a single center. Design This study is a retrospective study using chart review as the data collection method. Setting A single tertiary care university teaching hospital. Patients One hundred and fifty consecutive patients starting end-stage renal disease (ESRD) therapy at the Royal Victoria Hospital in Montreal were assessed. Their treatment modality at 6 weeks after starting dialysis was recorded as their treatment modality. Patients transplanted or who died prior to that 6 week period were excluded. Main Outcome Measures The treatment modality, that is, either HD or PD, at 6 weeks after the initiation of ESRD was the modality assigned to the patient. Results One hundred and fifty patients started ESRD therapy of whom 83 went to HD and 67 to PD. Thirty-one patients were directed to HD, including 20 for social reasons, 3 with ostomies, and 6 with unsuitable abdomens. Fourteen patients were directed to PD, including 10 with severe cardiovascular disease, 3 with no vascular access, and one for geographical reasons. Of 31 diabetics who were encouraged to do PD, 17 went to PD and 14 to HD (10 for social reasons, 3 refused PD, and one with an inappropriate abdomen). Seventy-four patients were initially eligible for either PD or HD. Fifty percent (37) went to PD and 50% to HD. Of those going to HD, 15 went to self-care HD, of whom 7 had prior exposure to HD. Eleven were not informed regarding PD. There was no gender preference for PD versus HD. Conclusion We conclude that among informed patients, if given a choice of treatment modality, the majority will choose self-care dialysis including continuous ambulatory peritoneal dialysis (CAPD) or selfcare HD.
47
Piliotis, Eugenia, Panayiota Govas, Kevin R. Imrie, Matthew C. Cheung, Neil Shear, Scott Walsh, Cathy Fairlie, and David Barth. "Sezary Syndrome and Combination Immunomodulatory Therapy: Improving Clinical Outcomes." Blood 112, no. 11 (November 16, 2008): 4957. http://dx.doi.org/10.1182/blood.v112.11.4957.4957.
Full textAbstract:
Abstract Introduction: Sezary syndrome is a rare, aggressive and advanced stage of cutaneous T cell lymphoma where patients exhibit total body erythroderma and peripheral blood involvement. Patients can progress from preexisting mycoses fungoides or present de-novo. Historically median survival has been less than two years however with current combinations of skin directed and immunomodulatory therapy median survival has been documented up to 3–4 years, however randomized trials are lacking given the rarity of this disorder. We describe the outcomes 23 patients followed in our centre diagnosed with sezary syndrome based on peripheral blood involvement and erythroderma who have been treated primarily with combination skin and immunomodulatory therapy. Methods: A review of all patients diagnosed with sezary syndrome in our centre was conducted. Base line characteristics, survival, number and type of therapies as well as responses to treatments were recorded Results: 23 patients were identified. 11 male, 12 female, average age at diagnosis 64.7 yrs (range 47–85). Therapies included total skin electron beam (TSEB), PUVA, Interferon, oral retinoids, and extracorporeal photophoresis (ECP). 5 patients had received prior traditional chemotherapy including CHOP, chlorambucil and purine analogues with either no or transient responses. 19 patients received a combination of all 5 therapies. 19 patients received IFN, 13 TSEB, 21 PUVA, 18 ECP and 16 oral retinoids. 7 patients received 3 or fewer therapies (3 in process of escalating therapy, 1 CR to TSEB, 3 pts refused multiagent therapy as elderly and stable on PUVA +/− retinoids). 6 patients achieved a durable complete remission while on therapy (4 received IFN/TSEB/PUVA/ECP, 1 IFN/PUVA/ECP, 1 TSEB alone), 3 patients had progressive disease, and the remainder either had partial responses or stable disease. Median follow-up was 44 months (range 9–127). Median survival of the entire cohort was 37 months (mean 52 months, range 6–108 months, 5 patients have been diagnosed in the last 12 months). There have been 5 deaths to date, median 43 months (range 33–101) from the time of diagnosis. Cause of death included 2 cardiac, 1 renal, 1 infection, and 1 progressive disease. There was no correlation between survival and LDH at presentation, sezary cell count or number of therapies. There was a modest correlation between survival and age at diagnosis (R2=0.1263). Patients who received TSEB had an average of 57 months survival vs. 33.5 months than those who did not, however this was not statistically significant. Reasons not to receive TSEB included 5 patient refusal, 3 still escalating therapy, 2 had adequate response to other therapies. Patients who achieved a CR to therapy had a median survival of 63 months (average 65 months) vs. those who did not achieve a CR had a median survival of 22 months (average 65 months). Conclusions: Patients receiving combination immunotherapy and skin based treatments for sezary syndrome appear to be living longer than historical series. Given the small number of this cohort it was not possible to statistically determine variables predictive of prolonged survival, however patients who received TSEB and or achieved a CR to treatment had median survival of approximately 5 years. The majority of patients received maintenance immunotherapy to sustain disease control.
48
Gowhari, Michel, Taimur Abbasi, Roberto F. Machado, and Victor R. Gordeuk. "Use Of Hydroxyurea For Sickle Cell Disease In An Academic Center." Blood 122, no. 21 (November 15, 2013): 4697. http://dx.doi.org/10.1182/blood.v122.21.4697.4697.
Full textAbstract:
Introduction The sole disease-modifying agent approved by the FDA for sickle cell disease (SCD) is hydroxyurea (HU), but it may be underutilized in the management of this condition. Not all patients respond to or can tolerate treatment with HU and it is not clear a priori who will respond. We evaluated the utilization of HU in a cross-sectional study of adults with SCD at the University of Illinois at Chicago (UIC) to determine how often HU has been attempted in all individuals who fulfill the criteria for the use of this disease modifying agent. Methods HU status was noted at the time of blood draw for enrollment in the UIC registry of SCD. Those not on HU were assessed as to whether or not they met criteria for being on HU in particular three or more vaso-occlusive episodes requiring presentation to a health care facility during the preceding 12 months or a lifetime history of one or more episodes of acute chest syndrome. The subjects who met these criteria for HU treatment were then divided into two groups, those who had been treated with HU in the past and those who had never received treatment. Those previously treated with HU were further assessed as to whether or not treatment was discontinued due to an adverse drug reaction, development of a contraindication, non-response, refusal to continue treatment, or noncompliance with treatment and/or clinic visits. Those who had never been on HU were categorized into whether or not treatment was not provided because of a contraindication, patient refusal of treatment, or noncompliance with clinic visits. Results Of 290 subjects enrolled in the study, 171 (59%) were either on HU (N=124, 43%), did not meet criteria for HU (N=35, 12%), or were on a chronic transfusion program (N=12, 4%). The remaining 119 (41%) were not on HU although they met the criteria. Among these 119 subjects HU had been attempted in almost half (N=58) but 37 were no longer on HU because of an adverse drug reaction, development of a contraindication, or non-response and 18 were noncompliant or refused to continue treatment. For those subjects in whom HU had never been attempted (N=61), almost half (N=30) had refused treatment or had been noncompliant with clinic visits. It was not possible to establish a valid reason for non-treatment in only 25 of 119 subjects not receiving HU (4 subjects in the group in which HU had been attempted in the past and 21 in the group in which HU had never been prescribed). Conclusion A cross-sectional survey at our sickle cell center clarified the picture for utilization of HU in individuals with SCD at UIC. Among those fulfilling criteria for HU therapy, 75% were currently receiving the medication or had received it in the past. A valid reason for non-treatment could be established in the majority of patients not receiving HU. However, 25 individuals (8% of all subjects included in the study) fulfilled criteria for treatment with HU but were not receiving the agent and the reason for non-treatment could not be established. Disclosures: No relevant conflicts of interest to declare.
49
Huemer, Josef, Julius Hienert, Cornelia Hirn, Christoph Hackl, Stephan M. Radda, and Oliver Findl. "Remodelling intravitreal therapy pathways for macular disease during the COVID-19 pandemic and an Austrian national lockdown." BMJ Open Ophthalmology 5, no. 1 (September 2020): e000560. http://dx.doi.org/10.1136/bmjophth-2020-000560.
Full textAbstract:
ObjectiveTo analyse the remodelling and recovery of a relocated intravitreal injection (IVI) service with an adapted treatment regimen in a tertiary referral centre during a nationwide lockdown with initial cancellation of all non-emergency treatments caused by the COVID-19 pandemic.Methods and analysisFor this retrospective observational study at Hanusch Hospital, Vienna, between 16 March 2020 and 5 May 2020, we conducted an analysis of an appointment booking system based on prioritisation incorporating disease class, severity and fellow eye status by evidence-based impact on irreversible structural impairment and survey data from telephone interviews. Recapture time was defined as the time-to-discard the backlog of patients in need for treatment. Non-attendance was stratified as treatment refusal for personal reasons and non-attendance due to lockdown-related restrictions.ResultsOf the 1109 patients, 241 (21.7%) were considered as highly urgent, 269 (24.3%) as urgent, 402 (36.2%) as semiurgent and 197 (17.8%) as non-urgent. Recapture time was 15 days for highly urgent patients, 22 days for urgent patients, 43 days for semiurgent patients and 46 days for non-urgent patients. The proportion of patients who refused treatment due to personal reasons was 5.2%, with a mean age of 82.4 years; 29 patients (2.6%) could not attend due to lockdown-related restrictions.ConclusionBy streamlining treatment based on urgency as well as increasing the number of bilateral IVI, recapture time was fast. We could provide a safe treatment environment for healthcare professionals and patients after resetting the injection service outside of the hospital with increased levels of protection.
50
Grimm, Donata, Katharina Prieske, Sabrina Mathey, Sascha Kuerti, Eike Burandt, Barbara Schmalfeldt, and Linn Woelber. "Superficially invasive stage IA vulvar squamous cell carcinoma—therapy and prognosis." International Journal of Gynecologic Cancer 29, no. 3 (January 4, 2019): 466–73. http://dx.doi.org/10.1136/ijgc-2018-000046.
Full textAbstract:
ObjectivesSuperficially invasive stage IA squamous vulvar cancer (VSCC) is defined as a single lesion measuring ≤2 cm with a depth of invasion of ≤1.0 mm (FIGO stage IA). This article examines the natural course and prognosis of superficially invasive VSCC.MethodsThis is a retrospective case series of 46 patients (median age 58 years) with superficially invasive stage IA VSCC receiving wide local excision between January 1996 and November 2014 in the University Medical Center Hamburg-Eppendorf.ResultsMedian tumor size was 4 mm. In 39/46 (84.8%) patients peri-tumoral high-grade intraepithelial neoplasia (HSIL) and/or lichen sclerosus (LS) of the vulva were histologically detected: 34 (74.0%) usual type high-grade vulvar intraepithelial neoplasia (uVIN, HSIL), 4 (8.7%) LS with simultaneous VIN (3 uVIN, 1 differentiated VIN (dVIN)), 1 (2.2%) with LS only. 37/46 (80.4%) patients had a R0 resection; in 2 (4.3%) a high-grade VIN was detected in the margin and in 7 (15.2%) the resection status was unknown. The mean follow-up was 58 (range 10–185) months. Four patients (8.7%) suffered from an invasive recurrence after 4, 17, 40, and 54 months, three in the vulva and one in the groin. All local recurrences occurred in women with LS in a combination with high-grade VIN (3 uVIN, 1 dVIN). Two were treated surgically again including inguino-femoral lymphadenectomy (ifLAE) (no regional lymph node metastasis histologically) as invasion depth exceeded 1 mm. The third patient refused treatment. Inguinal recurrence was treated with a bilateral ifLAE, revealing one positive lymph node, followed by adjuvant radiotherapy (groins, pelvis). None of these patients had experienced further recurrences at last follow-up.ConclusionsSuperficially invasive VSCC is characterized by having a very good prognosis. Sole surgical therapy is highly effective. Patients with LS might benefit additionally from intensified surveillance and adequate maintenance therapy in specialized centers.