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1.
Emile Gogineni Zaker Rana Michael Wotman Jessie Karten Adam Riegel Mihaela Marrero Luis Maduro Dev Kamdar Douglas Frank Doru Paul Nagashree Seetharamu Maged Ghaly 《Journal of Geriatric Oncology》2021,12(1):122-127
PurposeManagement of head and neck cancers (HNC) in older adults is a common but challenging clinical scenario. We assess the impact of Stereotactic Body Radiation Therapy (SBRT) on survival utilizing the Geriatric-8 (G8) questionnaire.Materials and methods171 HNC patients, deemed medically unfit for definitive treatment, were treated with SBRT ± systemic therapy. G8 questionnaires were collected at baseline, at 4–6 weeks, and at 2–3 months post-treatment. Patients were stratified according to their baseline G8 score: <11 as ‘vulnerable’, 11–14 as ‘intermediate’, and >14 as ‘fit’. Overall survival (OS) was assessed through univariate Kaplan Meier analysis. Repeated measures ANOVA was used to determine if baseline characteristics affected G8 score changes.ResultsMedian follow-up was seventeen months. 60% of patients presented with recurrent HNC, 30% with untreated HNC primaries, and 10% with metastatic non-HNC primaries. Median age was 75 years. Median Charlson Comorbidity Index score was 2. 51% of patients were ‘vulnerable’, 37% were ‘intermediate’, and 12% were ‘fit' at baseline, with median survival of 13.2, 24.3, and 41.0 months, respectively (p = .004). Patients who saw a decrease in their follow-up G8 score (n = 69) had significantly lower survival than patients who had stable or increased follow-up G8 scores (n = 102), with median survival of 8.6 vs 36.0 months (p < .001).ConclusionThe G8 questionnaire may be a useful tool in upfront treatment decision-making to predict prognosis and prevent older patients from receiving inappropriate anti-cancer treatment. Decline in follow-up G8 scores may also predict worse survival and aid in goals of care following treatment. 相似文献
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Phantana-angkool April Voci Amy E. Warren Yancey E. Livasy Chad A. Beasley Lakesha M. Robinson Myra M. Hadzikadic-Gusic Lejla Sarantou Terry Forster Meghan R. Sarma Deba White Richard L. 《Annals of surgical oncology》2019,26(12):3874-3882
Annals of Surgical Oncology - The role of sentinel lymph node biopsy (SLNB) when ductal carcinoma in situ with microinvasion (DCISM) is identified on core biopsy is unclear. Our aim was to assess... 相似文献
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In contrast with cross-sectional designs used in previous studies, this exploratory study compared survey data from 127 matched pairs of clinical pharmacists and physicians working together. Physicians' perceptions of the importance of clinical pharmacy activities for patient care and the competence of pharmacists performing the activities were examined for their influence on prescribing behavior in an institutional setting. Data from a national survey showed that physicians rated pharmacists higher regarding recommendations based on drug use evaluations (p = 0.004) and competency to provide all clinical pharmacy services. Scores for pharmacokinetics ratings were similar between pharmacists and physicians (p = 0.168). Pharmacists rated the importance of recommendations based on cost-effectiveness higher than physicians (p = 0.012). Overall, physicians' perceptions of activity importance for patient care and pharmacist competency appear to dictate pharmacists' influence on physician prescribing behavior (R = 0.723). 相似文献
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We examined seven 1-d diet records kept during 1 y by 272 men and women instructed to follow a lipid-lowering diet while participating in a clinical trial of pravastatin, a new 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor. The mean percentage of calories from total fat and saturated, unsaturated, and monounsaturated fatty acids was similar throughout the year even though the patients knew they were taking an effective lipid-lowering agent. However, the diets of greater than 40% of women included less than two-thirds of the recommended dietary allowance (RDA) of folic acid, vitamins B-6 and D, and calcium and zinc; in men, folic acid and zinc intakes were low. We conclude that patients comply with lipid-lowering diets even when they know that they are receiving an effective serum lipid-lowering agent. However, for both men and women special attention should be given to the intake of several nutrients. 相似文献
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Effect of Glass Transition Temperature on the Stability of Lyophilized Formulations Containing a Chimeric Therapeutic Monoclonal Antibody 总被引:3,自引:0,他引:3
Purpose. The purpose of this study is to highlight the importance of knowing the glass transition temperature, Tg, of a lyophilized amorphous solid composed primarily of a sugar and a protein in the interpretation of accelerated stability data.
Methods. Glass transition temperatures were measured using DSC and dielectric relaxation spectroscopy. Aggregation of protein in the solid state was monitored using size-exclusion chromatography.
Results. Sucrose formulation (Tg ~ 59°C) when stored at 60°C was found to undergo significant aggregation, while the trehalose formulation (Tg ~ 80°C) was stable at 60°C. The instability observed with sucrose formulation at 60°C can be attributed to its Tg (~59°C) being close to the testing temperature. Increase in the protein/sugar ratio was found to increase the Tgs of the formulations containing sucrose or trehalose, but to different degrees.
Conclusions. Since the formulations exist in glassy state during their shelf-life, accelerated stability data generated in the glassy state (40°C) is perhaps a better predictor of the relative stability of formulations than the data generated at a higher temperature (60°C) where one formulation is in the glassy state while the other is near or above its Tg. 相似文献
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D. N. K. Sarma R. L. Khosa J. P. N. Chansauria M. Sahai 《Phytotherapy research : PTR》1995,9(8):589-590
The ethanol extracts of the roots of T. cordifolia Miers and C. asiatica Linn were observed to induce a marked protective action against an 8 h restraint stress induced ulcerization, the activity being comparable to that of diazepam. 相似文献
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We report a case of malakoplakia in association with colonic adenocarcinoma. Tumour-associated malakoplakia in the gastrointestinal tract is a rare finding, generally confined to the colon. It may be locally aggressive, with invasion of pericolic tissues, but is always located adjacent to the tumour. This contrasts with the often more diffuse, multifocal distribution of colonic malakoplakia in association with other pathologies. 相似文献
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Laipcarpine (LC), a pyorrolizidine alkaloid, is able to inducea series of chronic and progressive lesions in rat liver, includingalong-lasting block in the cell cycle, the appearance of enlargedhepatocytes (megalocytosis), fibrosis, cirrhosis and malignantneoplasms. In this study the effect of transplantation of normalhepatocytes on the development of LC (80 µmol/kg i.p.).Four weeks later all animals were subjected to 2/3 paroticlhepatectomy (PH). In addition, at the time of PH one group ofrats were transplanted with normal hepatocytes isolated froma syngeneic donor (106 cells/rat via the portal vein), whilethe other group received only the culture medium. All rats werekilled 14 weeks after the operation. Grossly, the liver of ratsexposed to LC followed by PH with no transplantation of normalhepatocytes was small in size (% liver wt/body wt 1.66 ±0.08) and exhibited a few whitish nodules. Histologically, 相似文献