Evaluation of Job Strain of Family Physicians in COVID-19 Pandemic Period- An Example from Turkey

Journal of Community Health - The purpose of this study was to evaluate family physicians’ job strain during the Covid-19 pandemic and determine the effective factors. The study was carried...     

松质骨中两种纵波的传播特性分析

基于松质骨的层状模型，利用Schoenberg理论分析了松质骨中两种纵波(快纵波和慢纵波)的传播特性；并在理论和实验上详细分析了骨小梁方向与传播方向间的夹角对松质骨中快纵波和慢纵波传播特性的影响。分析结果表明，当超声波平行于骨小梁入射时，松质骨中两种纵波都传播，入射角度在60度附近时，松质骨中两种纵波的相速度曲线有一个转折点，入射角度在60度以上，角度越大时，骨髓和骨小梁耦合得越紧，因此阻止了慢纵波的传播，而只有快纵波传播。     

Reliability of Katz's Activities of Daily Living Scale when used in telephone interviews

The reliability of a five-item Katz's Activities of Daily Living (ADL) scale collected by self-report telephone interview is presented. A random sample of 6,472 South Carolina residents over 55 years of age selected from a statewide population is used. Factor structure, Guttman properties, internal consistency reliability, Mokken's index of test homogeneity, and Spearman's coefficient of rank-order correlation are used to show that ADL data gathered by telephone interview are reliable. Because telephone interviewing methods are faster, cheaper, and safer they are recommended as a viable way for researchers, policymakers, and practitioners to gather ADL information.     

The role of the Medical Care Advisory Committee in the administration of state Medicaid programs. A twenty-year perspective

Every state Medicaid program has a Medical Care Advisory Committee (MCAC). MCACs are required by federal regulations to have representation from state human service agencies, health care providers, and Medicaid consumers. Survey data presented in this study show the make-up of MCACs by representative group. Other data presented show meeting frequencies, subcommittee structure, and information about MCAC activities. Comparisons are made from historical MCAC data showing long-term trends of their composition and structure. It is argued that MCACs can be useful to state Medicaid agencies in policy development but have not been structured to do so. Recommendations are given to make MCACs more useful.     

Phase II study of denileukin diftitox for relapsed/refractory B-Cell non-Hodgkin's lymphoma.

PURPOSE: Denileukin diftitox is a fusion protein combining diphtheria toxin and interleukin-2 (IL-2) that targets tumor cells expressing the IL-2 receptor. Its efficacy has been shown in CD25+ cutaneous T-cell lymphoma, but not in B-cell non-Hodgkin's lymphoma (NHL). A phase II study was performed to evaluate the efficacy and tolerability of denileukin diftitox for relapsed or refractory B-cell NHL. PATIENTS AND METHODS: Patients with relapsed or refractory B-cell NHL were eligible. Tumor CD25 expression was determined by immunohistochemistry or flow cytometry. Denileukin diftitox was administered intravenously at a dose of 18 microg/kg once daily for 5 days every 3 weeks, up to eight cycles. RESULTS: Of the 45 patients assessable for response, 32 (71%) were refractory to the last chemotherapy treatment, and all were previously treated with rituximab. Three complete responses (6.7%) and eight partial responses (17.8%) were observed, for an overall response rate of 24.5%. Nine patients (20%) had stable disease. Objective response rates were similar in CD25+ (22%) and CD25- histologies (29%), as were stable disease rates (22% and 18%, respectively). For responding patients, the median time to treatment failure was 7 months, with a median follow-up in survivors of 18 months (range, 9 to 28 months), and the projected progression-free survival at 20 months was 24% (95% CI, 0% to 60%). Most toxicities were low-grade and transient. CONCLUSION: Denileukin diftitox seems to be effective in relapsed or refractory, CD25+ and CD25- B-cell NHL and is well-tolerated at the dosage evaluated. Evaluation of denileukin diftitox in combination with other agents may be warranted.     

Pursuit of the perfect mother: an unusual case of stalking

OBJECTIVE: To highlight issues of adoption and twinship in an unusual case of stalking. CLINICAL PICTURE: An ususual case of same gender, serial stalking which began at an early age in a young woman who was one of a set of twins adopted at birth. TREATMENT: Insight orientated psychotherapy. OUTCOME: Beneficial outcome in context of clear boundaries, therapist selection and emphasis upon legal consequences of behaviour. CONCLUSIONS: Early disruptions to attachments including adoption and twinship may have relevance in some patterns of adult stalking behaviour.     

Phase II study of proteasome inhibitor bortezomib in relapsed or refractory B-cell non-Hodgkin's lymphoma.

PURPOSE: Evaluate efficacy and toxicity of bortezomib in patients with relapsed or refractory B-cell non-Hodgkin's lymphoma. PATIENTS AND METHODS: Patients were stratified, based on preclinical data, into arm A (mantle-cell lymphoma) or arm B (other B-cell lymphomas) without limitation in number of prior therapies. Bortezomib was administered as an intravenous push (1.5 mg/m2) on days 1, 4, 8, and 11 every 21 days for a maximum of six cycles. RESULTS: Sixty patients with a median number of prior therapies of 3.5 (range, one to 12 therapies) were enrolled; 33 patients were in arm A and 27 were in arm B, including 12 diffuse large B-cell lymphomas, five follicular lymphomas (FL), three transformed FLs, four small lymphocytic lymphomas (SLL), two Waldenstrom's macroglobulinemias (WM), and one marginal zone lymphoma. In arm A, 12 of 29 assessable patients responded (six complete responses [CR] and six partial responses [PR]) for an overall response rate (ORR) of 41% (95% CI, 24% to 61%), and a median time to progression not reached yet, with a median follow-up of 9.3 months (range, 1.7 to 24 months). In arm B, four of 21 assessable patients responded (one SLL patient had a CR, one FL patient had a CR unconfirmed, one diffuse large B-cell lymphoma patient had a PR, and one WM patient had a PR) for an ORR of 19% (95% CI, 5% to 42%). Grade 3 toxicity included thrombocytopenia (47%), gastrointestinal (20%), fatigue (13%), neutropenia (10%), and peripheral neuropathy (5%). Grade 4 toxicity occurred in nine patients (15%), and three deaths from progression of disease occurred within 30 days of withdrawal from study. CONCLUSION: Bortezomib showed promising activity in relapsed mantle-cell lymphoma and encouraging results in other B-cell lymphomas. Future studies will explore bortezomib in combination with other cytotoxic or biologic agents.