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1.
Barriers and Facilitators to Participation in Health Screening: an Umbrella Review Across Conditions
Le Bonniec Alice Sun Sophie Andrin Amandine Dima Alexandra L. Letrilliart Laurent 《Prevention science》2022,23(7):1115-1142
Prevention Science - Screening is an essential prevention practice for a number of health conditions. However, screening coverage remains generally low. Studies that investigate determinants of... 相似文献
2.
Rachel L. Harrington Dima M. Qato James W. Antoon Rachel N. Caskey Glen T. Schumock Todd A. Lee 《Pediatric blood & cancer》2019,66(6)
Early survivors of pediatric cancer are at increased risk of experiencing chronic conditions; however, little is known about the morbidity burden in this population. In this observational cohort study of commercially insured pediatric cancer survivors in the United States (2009–2014), we find that 22.5% of survivors had one chronic condition, and 36.3% had multiple. Compared with survivors without chronic conditions, the presence of multiple conditions significantly increased the odds of an emergency department visit by 70% (odds ratios [OR], 1.7; 95% confidence interval [CI], 1.4–2.1) and of a hospitalization almost four‐fold (OR, 3.8; 95% CI], 2.5–5.5). Findings are important for informing pediatric survivorship care plans in the years following completion of therapy. 相似文献
3.
Rao G Suki D Chakrabarti I Feiz-Erfan I Mody MG McCutcheon IE Gokaslan Z Patel S Rhines LD 《Journal of neurosurgery. Spine》2008,9(2):120-128
OBJECT: Sarcomas of the spine are a challenging problem due to their frequent and extensive involvement of multiple spinal segments and high recurrence rates. Gross-total resection to negative margins, with preservation of neurological function and palliation of pain, is the surgical goal and may be achieved using either intralesional resection or en bloc excision. The authors report outcomes of surgery for primary and metastatic sarcomas of the mobile spine in a large patient series. METHODS: A retrospective review of patients undergoing resection for sarcomas of the mobile spine between 1993 and 2005 was undertaken. Sarcomas were classified by histology study results and as either primary or metastatic. Details of the surgical approach, levels of involvement, and operative complications were recorded. Outcome measures included neurological function, palliation of pain, local recurrence, and overall survival. RESULTS: Eighty patients underwent 110 resections of either primary or metastatic sarcomas of the mobile spine. Twenty-nine lesions were primary sarcomas (36%) and 51 were metastatic sarcomas (64%). Intralesional resections were performed in 98 surgeries (89%) and en bloc resections were performed in 12 (11%). Median survival from surgery for all patients was 20.6 months. Median survival for patients with a primary sarcoma of the spine was 40.2 months and was 17.3 months for patients with a metastatic sarcoma. Predictors of improved survival included a chondrosarcoma histological type and a better preoperative functional status, whereas osteosarcoma and a high-grade tumor were negative influences on survival. Multivariate analysis showed that only a high-grade tumor was an independent predictor of shorter overall survival. American Spinal Injury Association scale grades were maintained or improved in 97% of patients postoperatively, and there was a significant decrease in pain scores postoperatively. No significant differences in survival or local recurrence rates between intralesional or en bloc resections for either primary or metastatic spine sarcomas were found. CONCLUSIONS: Surgery for primary or metastatic sarcoma of the spine is associated with an improvement in neurological function and palliation of pain. The results of this study show a significant difference in patient survival for primary versus metastatic spine sarcomas. The results do not show a statistically significant benefit in survival or local recurrence rates for en bloc versus intralesional resections for either metastatic or primary sarcomas of the spine, but this may be due to the small number of patients undergoing en bloc resections. 相似文献
4.
Surgical treatment strategies and outcome in patients with breast cancer metastatic to the spine: a review of 87 patients 总被引:3,自引:0,他引:3
Joseph A. Shehadi Daniel M. Sciubba Ian Suk Dima Suki Marcos V. C. Maldaun Ian E. McCutcheon Remi Nader Richard Theriault Laurence D. Rhines Ziya L. Gokaslan 《European spine journal》2007,16(8):1179-1192
Aggressive surgical management of spinal metastatic disease can provide improvement of neurological function and significant
pain relief. However, there is limited literature analyzing such management as is pertains to individual histopathology of
the primary tumor, which may be linked to overall prognosis for the patient. In this study, clinical outcomes were reviewed
for patients undergoing spinal surgery for metastatic breast cancer. Respective review was done to identify all patients with
breast cancer over an eight-year period at a major cancer center and then to select those with symptomatic spinal metastatic
disease who underwent spinal surgery. Pre- and postoperative pain levels (visual analog scale [VAS]), analgesic medication
usage, and modifed Frankel grade scores were compared on all patients who underwent surgery. Univariate and multivariate analyses
were used to assess risks for complications. A total of 16,977 patients were diagnosed with breast cancer, and 479 patients
(2.8%) were diagnosed with spinal metastases from breast cancer. Of these patients, 87 patients (18%) underwent 125 spinal
surgeries. Of the 76 patients (87%) who were ambulatory preoperatively, the majority (98%) were still ambulatory. Of the 11
patients (13%) who were nonambulatory preoperatively, four patients were alive at 3 months postoperatively, three of which
(75%) regained ambulation. The preoperative median VAS of six was significantly reduced to a median score of two at the time
of discharge and at 3, 6, and 12 months postoperatively (P < 0.001 for all time points). A total of 39% of patients experienced complications; 87% were early (within 30 days of surgery),
and 13% were late. Early major surgical complications were significantly greater when five or more levels were instrumented.
In patients with spinal metastases specifically from breast cancer, aggressive surgical management provides significant pain
relief and preservation or improvement of neurological function with an acceptably low rate of complications. 相似文献
5.
Spinal cord ependymoma: radical surgical resection and outcome 总被引:22,自引:0,他引:22
Hanbali F Fourney DR Marmor E Suki D Rhines LD Weinberg JS McCutcheon IE Suk I Gokaslan ZL 《Neurosurgery》2002,51(5):1162-72; discussion 1172-4
OBJECTIVE: Several authors have noted increased neurological deficits and worsening dysesthesia in the postoperative period in patients with spinal cord ependymoma. We describe the neurological progression and pain evolution of these patients over the 1-year period after surgery. In addition, our favored method of en bloc tumor resection is illustrated, and the rate of complications, recurrence, and survival in this group of patients is addressed. METHODS: We operated on 26 patients (12 male and 14 female) with low-grade spinal cord ependymomas between 1975 and 2001. The median age at diagnosis was 42 years. Tumors extended into the cervical cord in 13 patients, the thoracic cord in 7 patients, and the conus medullaris in 6 patients. Eleven patients had previous surgery and/or radiation therapy. RESULTS: We achieved a gross total resection in 88% of patients, whereas 8% had a subtotal resection and 4% had a biopsy. Only 1 patient developed a recurrence over a mean follow-up period of 31 months. CONCLUSION: We conclude that radical surgical resection of spinal cord ependymomas can be safely achieved in the majority of patients. A trend toward neurological improvement from a postoperative deficit can be expected between 1 and 3 months after surgery and continues up to 1 year. Postoperative dysesthesias begin to improve within 1 month of surgery and are significantly better by 1 year after surgery. The best predictor of outcome is the preoperative neurological status. 相似文献
6.
Staci Martin Pamela Wolters Nia Billings Mary Anne Toledo-Tamula Dima A. Hammoud Pamela Welch Dirk Darnell Steven M. Holland Alexandra F. Freeman 《Journal of clinical immunology》2013,33(7):1175-1184
Purpose
Individuals with hyperimmunoglobulin E Syndrome (HIES) have central nervous system abnormalities, including focal white matter hyperintensities (WMH), or unidentified bright objects. This cross-sectional study aimed to describe the cognitive and emotional functioning and quality of life of people with HIES. We also sought to explore the relationship between cognitive functioning and WMHs in this population.Methods
Twenty-nine individuals (13 males) with autosomal-dominant HIES (mean age?=?35.1 years, range 16–55) were administered a comprehensive psychological assessment as part of a natural history protocol. The assessment included measures of global cognitive functioning (Wechsler Adult Intelligence Scale-III), memory (California Verbal Learning Test-II, Wechsler Memory Scale-III), executive skills (Delis Kaplan Executive Function System), and attention (Test of Everyday Attention). Emotional symptoms and quality of life also were assessed.Results
All mean cognitive scores were within normal limits. Mean scores on memory and executive functioning measures were significantly lower than Full Scale IQ scores (ps?<?.05). Substantial percentages of patients self-reported executive skills to be in the clinical range. Patients with fewer (1–20) versus more (21+) WMHs scored significantly better on measures of global cognitive skills, visual-perceptual skills, and working memory. Mean scores on emotional symptom and quality of life measures were in the average range and unrelated to WMHs.Conclusions
Global cognitive functioning was average to high average in our sample of individuals with HIES. However, focal brain lesions were associated with lower scores in specific domains. Emotional functioning and quality of life are within normal limits in this sample. 相似文献7.
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