The prevalence of type 2 diabetes in Oman is high and appears to be rising. Rising rates of diabetes and associated risk factors
have been observed in populations undergoing epidemiological transition and urbanization. A previous study in Oman indicated
that urban-dwellers were not significantly more likely to have diabetes. This study was undertaken to determine if a more
accurate urban and rural categorization would reveal different findings. 相似文献
Adjuvant radiation therapy has been associated with improved local control following breast‐conserving surgery. Traditionally, treatment has been delivered with whole breast irradiation over 3‐6 weeks or partial breast irradiation over 1‐3 weeks. However, intraoperative radiation therapy (IORT) has emerged as a technique that delivers a single dose of radiotherapy at the time of surgery for early‐stage breast cancers. We report initial outcomes and acute toxicities with intraoperative radiation from a single institution. Patients with DCIS or Stage I‐II breast cancer who underwent lumpectomy and sentinel lymph node biopsy (nodal sampling excluded in some cases) were included. All patients in this analysis were treated with IORT as at the time of surgery, 20 Gy in 1 fraction with 50 kV x‐ray. Patients were treated at a single institution between 2011 and 2019. Follow‐up was per standard institutional protocol. Two hundred and one patients were included in the analysis, with a median follow‐up of 23 months (range: 0‐73 months). Median age was 71 years old. Overall, 4 (2.0%) patients had DCIS, 186 (92.5%) patients had Stage 1 disease, and 11 patients had (5.5%) Stage 2 disease. All patients were estrogen receptor‐positive, 175 (87.9%) progesterone receptor‐positive, and 1 (0.5%) HER2 amplified. The crude rate of local recurrence was 2.0% (n = 4) and distant metastasis rate was 0.5% (n = 1). The rate of arm lymphedema was 0.5% (n = 1) and chronic telangiectasia rate was 1.1% (n = 2). Intraoperative radiation therapy, in a cohort of low‐risk patients, demonstrated low rates of recurrence and reproducibility in a multi‐disciplinary setting. Further follow‐up, analysis of patient satisfaction and cosmesis, and comparison to whole breast irradiation and partial breast techniques is necessary in order to further validate these findings. 相似文献
BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has had a huge impact on every facet of life. This directly included the delivery of health care from allied health professionals such as speech–language pathologists (SLPs) in South Africa. Research has shown that there is limited research done locally on the impact of COVID-19 relating to stroke care. Consequently, this results in a lack of research on the provision of speech, language and swallowing intervention using teletherapy after a stroke from an SLP point of view.ObjectivesThe aim of this study was to explore the experiences of SLPs with regard to their use of teletherapy in a COVID-19 context when providing speech, language and swallowing intervention for patients after a stroke.MethodsThis study made use of a qualitative approach. An electronic questionnaire was sent to SLPs inviting them to participate in the study. Purposive sampling was used to recruit participants and thematic content analysis was used to analyse the open-ended qualitative questions.ResultsThe findings show that SLPs experienced a variety of facilitators and barriers to using teletherapy. Additionally, issues of access differ across the private and public sector SLPs for both the clients and the SLPs.ConclusionThe current study provided research in the field of teletherapy, which is relatively new in the South African context. The study, whilst small in scale, provided some insight into the changes experienced from the shift to teletherapy. 相似文献
Horizontal gaze palsy with progressive scoliosis is a rare entity with few cases in the literature. Despite the fact the patient will not present with typical symptoms of this syndrome, clinical suspicion should be raised particularly in terms of imaging findings. Imaging findings are characteristic to flag the possibility of this syndrome. Keeping in mind such congenital abnormalities on magnetic resonance imaging particularly for radiologists might help in the management process. Multidisciplinary teams play a crucial role in terms of communication to find the clinical, radiological and genetic studies to reach the diagnosis.Keywords: Horizontal gaze palsy with progressive scoliosis, ROBO3 gene, Magnetic resonance imaging相似文献
The paper investigates the use of poly(1‐vinylpyrrolidone‐co‐2‐dimethylaminoethylmetacrilate) (PVP‐co‐DMAEMA) as a novel coating agent in the preparation of alginate‐based microcapsule for the supplement delivery of probiotics. Probiotic Lactobacillus plantarum is used to study the viability of the encapsulated bacterium when exposed to conditions simulating the gastrointestinal tract and industrial process. Results demonstrate that the PVP‐co‐DMAEMA polymer constitutes a pH‐responsive coating suitable for probiotic supplement delivery. 相似文献
International Journal of Clinical Pharmacy - Background Uterine leiomyoma is a benign tumour of the uterine smooth muscles associated with an elevated level of inflammatory cytokines. Goserelin, a... 相似文献
We surveyed evidence published by Ireland’s National Centre for Pharmacoeconomics (NCPE) on the cost-effectiveness of cancer drugs approved for funding within the Irish public healthcare system. The purpose is threefold: to assess the completeness and clarity of publicly available cost-effectiveness data of such therapies; to provide summary estimates of that data; to consider the implications of constraints on data availability for accountability regarding healthcare resource allocation.
Methods
The National Cancer Control Programme lists 91 drug-indication pairs approved between June 2012 and July 2020. Records were retrieved from the NCPE website for each drug-indication pair, including, where available, health technology assessment (HTA) summary reports. We assessed what cost-effectiveness data regarding approved interventions is available, aggregated it and considered the consequences of reporting constraints.
Results
Among the 91 drug-indication pairs 61 were reimbursed following full HTA, 22 after a rapid review process and 8 have no corresponding NCPE record. Of the 61 where an HTA report was available, 41 presented costs and quality-adjusted life-year (QALY) estimates of the interventions compared. Cost estimates and corresponding incremental cost-effectiveness ratios (ICERs) are based on prices on application for reimbursement. Reimbursed prices are not published. Aggregating over the drug-indication pairs for which data is available, we find a mean incremental health gain of 0.85 QALY and an aggregate ICER of €100,295/QALY, which exceeds Ireland’s cost-effectiveness threshold of €45,000/QALY.
Conclusion
Reimbursement applications by pharmaceutical manufacturers for cancer drugs typically exceed Ireland’s cost-effectiveness threshold, often by a considerable margin. On aggregate, the additional total net cost of new drugs relative to current treatments needs to be more than halved for the prices sought on application to be justified for reimbursement. Commercial confidentiality regarding prices and cost-effectiveness upon reimbursement compromises accountability regarding the fair and efficient allocation of scarce healthcare resources.
Despite advances in diagnosis and treatment of prostate cancer, development of metastases remains a major clinical challenge. Research efforts are dedicated to overcome this problem by understanding the molecular basis of the transition from benign cells to prostatic intraepithelial neoplasia (PIN), localized carcinoma, and metastatic cancer. Identification of proteins that inhibit dissemination of cancer cells will provide new perspectives to define novel therapeutics. Development of antimetastatic drugs that trigger or mimic the effect of metastasis suppressors represents new therapeutic approaches to improve patient survival. This review focuses on different biochemical and cellular functions of metastasis suppressors known to play a role in prostate carcinogenesis and progression. Ten putative metastasis suppressors implicated in prostate cancer are discussed. CD44s is decreased in both PIN and cancer; Drg-1, E-cadherin, KAI-1, RKIP, and SSeCKS show similar expression between benign epithelia and PIN, but are downregulated in invasive cancer; whereas, maspin, MKK4, Nm23 and PTEN are upregulated in PIN and downregulated in cancer. Moreover, the potential role of microRNA in prostate cancer progression, the understanding of the cellular distribution and localization of metastasis suppressors, their mechanism of action, their effect on prostate invasion and metastasis, and their potential use as therapeutics are addressed. 相似文献
Hyponatremia is a frequent complication following subarachnoid hemorrhage (SAH), and is commonly attributed either to the
syndrome of inappropriate antidiuretic hormone secretion (SIADH) or cerebral salt wasting syndrome (CSW). The object of this
study is to elucidate the clinical demographics and sequelae of hyponatremia due to CSW in subjects with aneurysmal SAH. Retrospective
chart review of patients >18 years with aneurysmal SAH admitted between January 2004 and July 2007 was performed. Subjects
with moderate to severe hyponatremia (serum sodium <130 mmol l−1) were divided into groups consistent with CSW and SIADH based on urine output, fluid balance, natriuresis, and response to
saline infusion. Clinical demographics were compared. Of 316 subjects identified, hyponatremia (serum sodium <135 mmol l−1) was detected in 187 (59.2%) subjects and moderate to severe hyponatremia in 48 (15.2%). Of the latter group, 35.4% were
categorized with SIADH and 22.9% with CSW. Compared to eunatremic subjects, hyponatremia was associated with significantly
longer hospital stay (15.7 ± 1.9 vs. 9.6 ± 1.1 days, p < 0.001). Subjects with CSW had similar mortality and duration of hospital stay vs. those with SIADH. Though less common
than SIADH, CSW was detected in approximately 23% of patients with history of aneurysmal SAH and was not clearly associated
with enhanced morbidity and mortality compared to subjects with SIADH. Further studies regarding the pathogenesis and management,
along with the medical consequences, of CSW are important. 相似文献