Efficacy and safety of nivolumab in patients with non-small cell lung cancer: a retrospective study in clinical practice

Nivolumab, a fully human immunoglobulin monoclonal antibody inhibiting the programmed cell death protein‐1 receptor, demonstrated robust efficacy and a manageable safety profile across multiple tumor types in clinical trials. The aim of the present study was to investigate the efficacy and safety of nivolumab for pretreated patients with non-small cell lung cancers in clinical practice. In this observational monocentric retrospective study, 98 patients were enrolled between February 2015 and February 2016. The global median overall survival was 6.34 months (95% confidence interval (CI) : 4.11–10.88) and the global median progression free survival was 1.84 months (95% CI: 1.68–2.73). In the univariate analysis, clinical performance status score was the only factor significantly correlated with overall survival. The safety profile of nivolumab is consistent with that described in prior studies, with only 7% undesirable effects requiring the discontinuation of treatment. The results of the present study demonstrate that nivolumab affords clinical efficacy and manageable tolerability in patients with non-small cell lung cancers.     

Selection of an immunoassay screening cutoff concentration for opioids in oral fluid

A retrospective analysis of data from oral fluid specimens was conducted in order to identify a relevant cutoff concentration for opiates and/or synthetic opiates in oral fluid. Previously proposed regulations from the Substance Abuse and Mental Health Services Administration (SAMHSA) have recommended 40 μg/L as a cutoff concentration. In this study, data from oral fluid specimens collected using the Quantisal? device and screened with enzyme linked immunosorbent assays (ELISA) for both opiates and oxycodone were retrospectively assessed for screen positives > 20 μg/L and those between negative and 20 μg/L. Specimens identified at these concentrations were then analyzed using liquid chromatography with tandem mass spectral detection using a fully validated procedure. Overall, 156 positive specimens were identified using 40 μg/L; 191 specimens using 20 μg/L; and 241 specimens between negative and 20 μg/L. Specifically, the number of 6-acetylmorphine (6-AM) positives increased from 10 to 16; morphine 4 to 9; codeine from 11 to 19; oxycodone from 56 to 74; hydrocodone from 73 to 119; and hydromorphone from 2 to 4 when specimens with enzyme inhibition between negative and 20 μg/L were analyzed. For workplace testing where only codeine, morphine, and 6-AM are considered, the use of a lowered cutoff concentration produced significant increases in the positive rate.     

Asian American Women and Alcohol-Related Problems: The Role of Multidimensional Feminine Norms

Increasing rates of heavy episodic drinking (HED; four or more drinks in one sitting) and alcohol use disorders among young adult Asian American women signify the need to identify the risk and protective factors for HED and alcohol-related problems in this demographic. Multidimensional feminine norms, or the beliefs and expectations of what it means to be a woman, are theoretically relevant factors that may help elucidate within-group variability in HED and alcohol-related problems. The present study examined associations between nine salient feminine norms, HED, and alcohol-related problems among 398 second-generation Asian American college women. Our findings reveal that certain feminine norms are protective of HED and alcohol-related problems, while others are risk factors, even when controlling for well-established correlates of HED and alcohol-related problems, such as perceived peer drinking norms. The results elucidate the importance of multidimensional feminine norms and their relationship to HED and alcohol-related problems among the increasingly at-risk group, Asian American college women.     

The psychosocial impact of inpatient management of monoamniotic twin gestations

Objective: Monoamniotic twins require unique considerations in clinical management that challenge both clinicians and patients. The aim of this study was to assess the psychosocial impact of inpatient antepartum versus outpatient management for these patients.

Methods: Women with a history of a monoamniotic twin pregnancy between 2002 and 2012 were identified through a social media group and invited to participate in an original survey regarding their clinical management and psychological well-being during gestation. Results between patients managed with inpatient versus outpatient protocols were compared using the Fisher exact test.

Results: Participants (n?=?197) were multinational. Planned inpatient management after 23 weeks gestation was reported in 76.2% of respondents. Participants in both groups endorsed persistent feelings of hopelessness or despair related to their pregnancies (42.4% of inpatients versus 24.1% of outpatients, p?=?0.089). Relationship strain between participants and their partners was similar in both the groups. Participants in the outpatient group were more likely to report feelings of guilt related to their infrequent monitoring (p?=?0.01). Patient satisfaction with care was higher in the inpatient group.

Conclusions: Inpatient management did not significantly increase measures of psychosocial stress as compared to outpatient management. Participants in the outpatient group reported feelings of guilt about their infrequent monitoring. Our findings provide increased understanding of the patient experience in these rare and challenging clinical circumstances.     

Link Between Carbapenemase-Producing Enterobacteria Carriage and Cross-Border Exchanges: Eight-Year Surveillance in a Large French Multihospitals Institution

Assistance Publique-H?pitaux de Paris launched a specific strategy to survey and control the spread of emerging multidrug-resistant bacteria such as carbapenemase-producing Enterobacteria (CPE). Among the 63 CPE events that occurred between 2004 and 2011, 87% involved patients with a link with cross-border exchanges, justifying the recommendation to screen and isolate such patients.     

Risk models for predicting the health-related quality of life of caregivers of youth with gastrointestinal concerns

Quality of Life Research - To determine the usefulness of cumulative and additive risk models in predicting the healthy-related quality of life (HRQOL) of caregivers of youth with chronic...     

Fertility in males after childhood,adolescent, and adult inguinal operations

Background/purpose

Inguinal hernia repair and orchidopexy are among the most common operations in boys. The impact on future fertility has not been conclusively defined. This study evaluates sperm quality after previous inguinal surgery.