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Bogina G Bortesi L Marconi M Venturini M Lunardi G Coati F Massocco A Manfrin E Pegoraro C Zamboni G 《Virchows Archiv : an international journal of pathology》2011,459(1):1-10
Differences in hormone receptor and HER-2 status between primary tumour and corresponding relapse could have a substantial
impact on clinical management of patients. The aim of this study was to evaluate change in expression of hormone receptors
and HER-2 status between primary tumour and corresponding local recurrence or distant metastasis. We analysed 140 primary
tumours and related recurrent or metastatic samples. Hormone receptors status was evaluated by immunohistochemistry, while
HER-2 status by immunohistochemistry and silver in situ hybridisation. A change in HER-2 was rare; 3.7% of cases by immunohistochemistry
and only 0.7% by silver in situ hybridisation analysis. A change in estrogen and progesterone receptors was seen in 6.4% and
21.4% of cases, respectively. Estrogen receptor change was not affected by adjuvant therapy, whereas progesterone receptor
was influenced by adjuvant chemotherapy associated to hormone therapy (P = 0.0005). A change in progesterone receptor was more frequent in distant metastases than in local recurrences (P = 0.03). In the setting of estrogen receptor positive tumours, patients with progesterone receptor loss in local recurrence
had a statistically significant lower median metastasis free survival compared to others patients; progesterone receptor positive,
112 months; progesterone receptor negative, 24 months (P = 0.005). A change between primary tumour and corresponding relapse is frequent for progesterone receptor, infrequent for
estrogen receptor and rare for HER-2. In cases with changes in HER-2, it is worthwhile reassessing HER-2 status with both
immunohistochemistry and in situ hybridisation analysis. Progesterone receptor loss seems to be influenced by therapy and
to correlate with a worse prognosis. 相似文献
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Andrea Manfrin PhD MBA HPS PharmD MPharm CFSM PGCHE 《Journal of evaluation in clinical practice》2023,29(5):825-835
Rationale, Aims and Objectives
This study aimed to investigate the relationship between the pharmacist's role, patient understanding and satisfaction during the provision of a cost-effective pharmacist-led intervention using structural equation modelling (SEM). SEM is a group of statistical techniques used in different disciplines to model latent variables and evaluate theories.Methods
A validated questionnaire was used to gather patient views on a pharmacist-led intervention. A conceptual model was developed to test the statistical significance of the relationship between patient understanding and satisfaction, the pharmacist's role and patient understanding, the pharmacist's role and patient satisfaction. In addition, the study evaluated the model's in-sample and out-of-sample predictive power. The analysis tested fours hypotheses (H): 1) There was no significant relationship between patient understanding and patient satisfaction; 2) There was no significant relationship between the pharmacist's role and patient understanding; 3) There was no significant relationship between the pharmacist's role and patient satisfaction; 4) The in-sample and out-of-sample predictive power of the model. Data were analysed using Smart-PLS software version 3.2.8.Results
Two hundred and forty-six patients returned the questionnaire. Construct reliability, validity (Cronbach's alpha〉0.70, ⍴A>0.70, ⍴C>0.70), average extracted variance (AVE〉0.50) and discriminant validity (HTMT<0.85) were confirmed. The structural model and hypothesis testing results showed that all hypotheses were supported in this study. Path coefficients and effect sizes suggested that the pharmacist's role played a significant part in patient understanding (H2, β=0.650, f2=0.730, p<0.001), which then influenced patient satisfaction (H1, β=0.474, f2=0.222, p<0.001). The in-sample and out-of-sample predictive powers were moderate.Conclusions
Patient satisfaction is becoming an integral component in healthcare provision and evaluation of healthcare quality. The results support using structural equation modelling to assess the link between the pharmacist's role and patient understanding and satisfaction when delivering cost-effective pharmacist-led interventions. 相似文献317.
Emanuele Bertaglia MD PhD Saverio Iacopino MD Roberto Verlato MD Giuseppe Arena MD Paolo Pieragnoli MD Claudio Tondo MD PhD Giulio Molon MD Massimiliano Manfrin MD Giovanni B. Perego MD Giovanni Rovaris MD Francesco Rivezzi MD Massimo Mantica MD Umberto Startari MD Luigi Sciarra MD PhD 《Clinical cardiology》2023,46(2):142-150