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Klinkhammer-Schalke M Koller M Ehret C Steinger B Ernst B Wyatt JC Hofstädter F Lorenz W;Regensburg QoL Study Group 《British journal of cancer》2008,99(3):415-422
A system for quality-of-life diagnosis and therapy (QoL system) was implemented for breast cancer patients. The system fulfilled the criteria for complex interventions (Medical Research Council). Following theory and modeling, this study contains the exploratory trial as a next step before the randomised clinical trial (RCT) answering three questions: (1) Are there differences between implementation sample and general population? (2) Which amount and type of disagreement exist between patient and coordinating practitioners (CPs) in assessed global QoL? (3) Are there empirical reasons for a cutoff of 50 points discriminating between healthy and diseased QoL? Implementation was successful: 74% of CPs worked along the care pathway. However, CPs showed preferences for selecting patients with lower age and UICC prognostic staging. Patients and CPs disagreed considerably in values of global QoL, despite education in QoL assessment by outreach visits, opinion leaders and CME: Zero values of QoL were only expressed by patients. Finally, the cutoff of 50 points was supported by the relationship between QoL in single items and global QoL: no patients with values above 50 dropped global QoL below 50, but values below 50 and especially at 0 points in single items, induced a dramatic fall of global QoL down to below 50. The exploratory trial was important for defining the complex intervention in the definitive RCT: control for age and prognostic stage grading, support for a QoL unit combining patient''s and CP''s assessment of QoL and support for the 50-point cutoff criterion between healthy and diseased QoL. 相似文献
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Marije E. Hamaker Marthe te Molder Noortje Thielen Barbara C. van Munster Anandi H. Schiphorst Lieke H. van Huis 《Journal of Geriatric Oncology》2018,9(5):430-440
Aim
The aim of this systematic review is to summarise all available data on the effect of a geriatric evaluation on the multidisciplinary treatment of older cancer patients, focussing on oncologic treatment decisions, the implementation of non-oncologic interventions and the impact on treatment outcome.Methods
A systematic search in MEDLINE and EMBASE for studies on the effect of a geriatric evaluation on oncologic and non-oncologic treatment decisions and outcome for older cancer patients.Results
36 publications from 35 studies were included. After a geriatric evaluation, the oncologic treatment plan was altered in a median of 28% of patients (range 8–54%), primarily to a less intensive treatment option. Non-oncologic interventions were recommended in a median of 72% of patients (range 26–100%), most commonly involving social issues (39%), nutritional status (32%) and polypharmacy (31%). Effect on treatment outcome was varying, with a trend towards a positive effect on treatment completion (positive effect in 75% of studies) and treatment-related toxicity/ complications (55% of studies).Conclusion
A geriatric evaluation affects oncologic and non-oncologic treatment and appears to improve treatment tolerance and completion for older cancer patients. Fine-tuning the decision-making process for this growing patient population will require more specific and robust data on the effect of a geriatric evaluation on relevant oncologic and non-oncologic outcomes such as survival and quality of life. 相似文献26.
Nora I. Regensburg H. E. Henkes 《Documenta ophthalmologica. Advances in ophthalmology》1976,40(2):287-300
1. | Measles retinopathy appears to be a specific neuro-retinal disorder caused by the measles virus. |
2. | The prognosis must always be interpreted with due prudence, in view of the fact that the long-term evolution is unknown. |
3. | The frequency of the condition may be higher than has been believed so far, which view is corroborated by the findings in SSPE. |
4. | An agreement concerning uniform nomenclature for the pathological condition measles would help reduce the confusion in the literature (in Anglo-Saxon literature, the term rubeola sometimes wrongly applied to rubella as well as to measles). |
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Jantien A Backer Dirk Eggink Stijn P Andeweg Irene K Veldhuijzen Noortje van Maarseveen Klaas Vermaas Boris Vlaemynck Raf Schepers Susan van den Hof Chantal BEM Reusken Jacco Wallinga 《Euro surveillance : bulletin européen sur les maladies transmissibles = European communicable disease bulletin》2022,27(6)
The SARS-CoV-2 Omicron variant has a growth advantage over the Delta variant because of higher transmissibility, immune evasion or shorter serial interval. Using S gene target failure (SGTF) as indication for Omicron BA.1, we identified 908 SGTF and 1,621 non-SGTF serial intervals in the same period. Within households, the mean serial interval for SGTF cases was 0.2–0.6 days shorter than for non-SGTF cases. This suggests that the growth advantage of Omicron is partly due to a shorter serial interval. 相似文献
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N. Margreth van der Lugt Marije M. Kamphuis Noortje P.M. Paridaans Anouk Figee Dick Oepkes Frans J. Walther Enrico Lopriore 《Trasfusione del sangue》2015,13(1):66-71
Background
Weekly maternal intravenous immunoglobulin (IVIG) is the cornerstone of antenatal treatment of foetal and neonatal alloimmune thrombocytopenia (FNAIT). The aim of this study was to describe the neonatal outcome and management in neonates with FNAIT treated antenatally with IVIG.Materials and methods
All neonates treated antenatally and delivered at our centre between 2006 and 2012 were included in the study. We assessed the neonatal outcome and management, including the occurrence of intracranial haemorrhage, platelet count at birth and need for postnatal platelet transfusions or postnatal IVIG treatment.Results
A total of 22 neonates were included of whom 12 (55%) had severe thrombocytopenia at birth (platelet count ≤50×109/L). Most neonates (67%, 8/12) with severe thrombocytopenia received a platelet transfusion after birth. None of the neonates required postnatal treatment with IVIG. Three neonates had petechiae and haematomas, without clinical consequences. One foetus suffered from intracranial haemorrhage, which was detected just before the planned start of antenatal IVIG at 28 weeks’ gestation.Discussion
Our results suggest that antenatal maternal IVIG and, if necessary, postnatal matched platelet transfusions, are effective and safe for the treatment of FNAIT. 相似文献29.
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Julia Trumpf Jürgen Margraf Noortje Vriends Andrea H. Meyer Eni S. Becker 《Social psychiatry and psychiatric epidemiology》2010,45(12):1161-1166