Patient preferences and predicted relative uptake for targeted therapies in metastatic colorectal cancer: a discrete choice experiment

Abstract

Objective

Ras wild-type metastatic colorectal cancers (mCRC) may be treated with anti-vascular endothelial growth factor (VEGF) or anti-epidermal growth factor receptor (EGFR) agents. We aim to estimate patients’ preferences for mCRC treatment and relative importance of cost, efficacy improvement, avoidance of side effects and therapy convenience, and relative uptake between profiles that resemble Bevacizumab (anti-VEGF) and Cetuximab (anti-EGFR), two commonly prescribed mCRC targeted therapies.     

A guide to upwardly mobile spermatozoa

Morphological comparison of sperm in raw ejaculates and swim-ups showed that the swim-up process does not simply increase the proportion of 'normal' sperm. Rather, sperm of specific morphologies have characteristic grades of upward motility.     

Management of hip dislocations in children with arthrogryposis

From a review of 131 children with arthrogryposis, we studied 18 patients with hip dislocations. Fourteen patients (10 unilateral, four bilateral) were treated by open reduction. Mean age at surgery was 9.7 months, and follow-up ranged from 9 to 245 months. Range of motion of patients treated by open reduction following the medial approach was greater than in those treated by anterolateral incision and greater than in bilateral cases treated by closed reduction. Acetabular development was satisfactory following the medial approach and there were no re-dislocations, but one hip developed avascular necrosis.     

Temporomandibular joint arthrography following surgical treatment of internal derangements

Arthrograms of the temporomandibular joint were obtained in 20 symptomatic joints that had previous reconstructive arthroplasty with disk repositioning because of internal derangements. Preoperative arthrograms were available for comparison in 18 joints. Symptoms resulting in a postoperative arthrogram included pain, limited ability to open the mouth, and clicking of the joints. Postoperative arthrographic findings included limited anterior translation of the condyle (90%), irregularity in outline of the intraarticular contrast agent (60%), a conical configuration of the posterior recess (25%), decreased size of the joint (28%), anterior displacement of the meniscus (25%), and perforated meniscus (15%). Many of these findings may have resulted from fibrosis and scarring, which may be a response to intraarticular bleeding. The mechanism by which the fibrosis causes the postsurgical arthrographic features is discussed.     

Investigation and treatment of female urinary incontinence

There are four main types of urinary incontinence in the female namely stress incontinence, urge incontinence, overflow incontinence due to retention of urine and total incontinence. It is important to differentiate them to institute proper treatment. It is the aim of this paper to present a simple clinical evaluation of an incontinent woman. The different methods of surgical correction of stress incontinence are discussed. The latest trend is the paraurethral suspension of the bladder neck. 39 cases of Grade II stress incontinence were treated by paraurethral suspension of the bladder neck at "A" Unit, Kandang Kerbau Hospital and Dept. of Urology, SGH. 33 cases were cured. 4 improved with occasional stress incontinence, frequency and urgency. Of these, 3 were cured with imipramine. One failed because of a fixed, "lead pipe" rigid urethra from previous multiple operations to the bladder neck.     

Detection of diacetyl (caramel odor) in presumptive identification of the "Streptococcus milleri" group.

The caramel odor associated with the "Streptococcus milleri" group was shown to be attributable to the formation of the metabolite diacetyl. Levels of diacetyl in the 22- to 200-mg/liter range were produced by 68 strains of the "S. milleri" group; apart from one strain of Streptococcus mutans, all 92 other strains of streptococci belonging to 12 species produced < 13 mg of diacetyl per liter. Quantitation of diacetyl levels from cultures of streptococci is suggested as a rapid presumptive test for the "S. milleri" group.