Association of quality of life with laboratory measurements and lifestyle factors in community dwelling older people in Taiwan

Objectives: Little is known about the influence of routine laboratory measurements and lifestyle factors on generic quality of life (QOL) at older ages. We aimed to study the relationship between generic QOL and laboratory measurements and lifestyle factors in community dwelling older Chinese people.

Methods: We conducted a cross-sectional analysis. Six hundred and ninety nine elders were randomly selected from the examinees of the annual health examination in Taipei City, Taiwan. Blood, urine and stool of the participants were examined and lifestyle data were collected. Participants completed the CASP-19 (control, autonomy, self-realization, pleasure) questionnaire, a 19-item QOL scale. The relationship between QOL and laboratory results and lifestyle factors was explored, using multiple linear regression and profile analysis.

Results: The mean age of the participants was 75.5 years (SD = 6.5), and 49.5% were female. Male gender standardized β coefficients (β = 0.122) and exercise habit (β = 0.170) were associated with a better QOL, whereas advanced age (β = ?0.242), blurred vision (β = ?0.143), depression (β = ?0.125), central obesity (β = ?0.093), anemia (β = ?0.095), rheumatoid arthritis (β = ?0.073), Parkinsonism (β = ?0.079), malignancy (β = ?0.086) and motorcycle riding (β = ?0.086) were associated with a lower QOL. Profile analysis revealed that young–old males, social drinkers, regular exercisers and car drivers had the best QOL (all p < 0.001).

Conclusion: Of the many laboratory measurements, only anemia was associated with the lower QOL. By contrast, several lifestyle factors, such as social drinking, exercise habit and car driving, were associated with better QOL, whereas abdominal obesity and motorcycle riding were associated with lower QOL.     

Atezolizumab in Metastatic Urothelial Carcinoma Outside Clinical Trials: Focus on Efficacy,Safety, and Response to Subsequent Therapies

Background

Little is known about the outcomes, safety, and response to subsequent therapies of patients with metastatic urothelial carcinoma (mUC) treated with atezolizumab outside clinical trials.

Objectives

The objectives of the study include to report the clinical efficacy and safety of atezolizumab, and the response to future therapies in clinical practice outside clinical trials.

Patient and Methods

This is a retrospective, single-center study including consecutive patients with confirmed mUC who received at least one dose of atezolizumab 1200 mg every 3 weeks between May 2016 and April 2017.

Results

Seventy-nine patients, median age 72 years (range 29–93), 71% men and 76% ECOG PS 0–1, were identified. Most patients (79%) had primary cancer in the bladder, 62% had prior surgery, and 75% received at least one prior line of treatment (34 patients had prior cisplatin-based chemotherapy). Best response included 18% partial response, 29% stable disease, and 53% progressive disease. Patients were on atezolizumab for a median of 2.7 months (95%CI, 1.8–3.6) and median PFS was 3.2 months (95%CI, 1.6–4.8). A total of 33 (42%) patients had significant (any cause) AEs, including grade 4 hyperbilirubinemia in two patients; no toxic deaths were reported. At time of data analysis, only 18% of patients received at least one subsequent line of treatment for a median of 1.8 months (95%CI, 0.0–5.0) while 42% were referred to palliative care/hospice or died.

Conclusions

Patients with mUC who progressed on atezolizumab were unlikely to receive subsequent systemic treatments and the benefit of those treatments appeared limited in our cohort. The findings may impact timing and designs of clinical trials in mUC.

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Pegylated Filgrastim Versus Filgrastim for Stem Cell Mobilization in Multiple Myeloma After Novel Agent Induction

Background

The current standard of care for transplant-eligible myeloma patients is novel agent-based induction, followed by high-dose chemotherapy and autologous stem cell rescue. Chemo-mobilization of peripheral blood CD34⁺ stem cells (PBSCs) with pegylated filgrastim (pegfilgrastim), a sustained-duration formulation of filgrastim, has been used as an alternative to filgrastim in several studies involving heterogeneous cohorts of lymphoma and multiple myeloma (MM) patients and shown to be equivalent in PBSC yield and cost-effectiveness. The present study focused on the efficacy of pegfilgrastim in PBSC mobilization compared with filgrastim exclusively after novel agent-based induction in a homogeneous group of MM patients.

Comparison between DVH-based doses and ICRU point-based doses to the rectum and the bladder using CT-based high-dose rate brachytherapy to the cervix

Traditionally, doses to the bladder and the rectum were quantified using the bladder and rectal reference points defined by the International Commission on Radiation Units and Measurements (ICRU) in Report No. 38. In this study, we compared the 0.1-, 1.0-, 2.0-cc doses to the bladder and the rectum with the corresponding ICRU point doses using computed tomography (CT)-based planning in the intracavitary brachytherapy of carcinoma of the cervix. CT datasets of 136 consecutive intracavitary brachytherapy insertions between January and May 2015 were analyzed. The bladder and the rectum were contoured on consecutive CT slices as per Groupe Europeen de Curietherapie and the European Socie Ty for Radiotherapy and Oncology recommendations. Dose volume histograms were generated and doses of 0.1, 1.0, and 2.0?cc to the bladder and the rectum were recorded. ICRU bladder and rectal points were identified in the treatment plan. Mean doses of 0.1, 1.0, and 2.0?cc to the bladder was found to be 2.02, 1.57, and 1.35 times the ICRU point dose, respectively. The maximum dose received by the bladder was found to be 5.83 times the average ICRU point dose. Mean doses of 0.1, 1.0, and 2.0?cc to the rectum were found to be 1.12, 0.90, and 0.78 times the ICRU rectal point dose, respectively. The maximum dose received by the rectum was 4.79 times the average ICRU point dose. The Pearson correlation coefficient value (r) was found to be 0.639 for D2cc and ICRU bladder point values. The Pearson correlation coefficient value was found to be 0.752 for D2cc and ICRU rectal point values. Our results show that the ICRU bladder points underestimated the dose to the bladder, which is in agreement with other studies. ICRU rectal point doses were higher than the corresponding D2cc doses. However, there was a good correlation between D2cc and ICRU point doses for both the bladder and the rectum.     

Toxicity of copper on marine diatoms,Chaetoceros calcitrans and Nitzchia closterium from Cochin estuary,India

The effects of copper (Cu) toxicity on the growth, pigments, protein, carbohydrate, lipid and antioxidant enzyme activities of two endemic microalgae, Chaetoceros calcitrans and Nitzchia closterium from Cochin estuary were studied and compared. The 96?h median inhibition concentration (IC₅₀) of Cu for C. calcitrans was 143.8?µg?L^?1 and that for N. closterium was 204.5?µg?L^?1. No observable effect concentration (NOEC), lowest observable effect concentration (LOEC) and chronic value of Cu on C. calcitrans were 17.93?µg?L^?1, 31.91?µg?L^?1and 24.92?µg?L^?1 respectively, whereas that for N. closterium were 18.35?µg?L^?1, 36.04?µg?L^?1 and 27.2?µg?L^?1 respectively. Chlorophyll a and c showed significant variation from the control at NOEC in both species. Carotenoid content showed significant increase at LOEC. The chlorophyll a/c ratio significantly decreased at NOEC and LOEC of N. closterium. In N. closterium catalase (CAT) activity showed significant increase at NOEC and LOEC, but in C. calcitrans it varied significantly above LOEC. Protein content showed a significant decrease at NOEC of C. calcitrans. No significant variation was observed for N. closterium. Carbohydrate showed significant variation between the species at NOEC. Lipid content varied significantly at NOEC of C. calcitrans. Chaetoceros calcitrans was observed to be more sensitive to copper toxicity than N. closterium. The metal stress tolerance mechanism of N. closterium and its bioremediation capacity can be established in further studies. This study also provides an insight on the biochemical changes that happened at NOEC.

     

Aortic root surgery with circulatory arrest: Predictors of prolonged postoperative hospital stay

Objective

Little is known about the outcomes of aortic root operations that involve inducing hypothermic circulatory arrest for relatively extensive proximal aortic surgery. We attempted to identify predictors of postoperative hospital length of stay (LOS) and factors that affect postoperative recovery.