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Patel posted an update 9 months, 1 week ago
RATIONALE Adherence to endocrine therapy provides substantial reduction in breast cancer (BC) relapses and improve survival. Hence, non-adherence remains an under reported issue mainly in developing countries. AIMS AND OBJECTIVES The aim of this study is to evaluate the adherence to endocrine therapy (tamoxifen [TAM] and aromatase inhibitors [AIs]) among BC patients visiting an out-patient clinic (2015-2016) in Khartoum Oncology Hospital, Sudan. METHODS Adherence was assessed using pills count and self-reporting methods. A total of 172 patients were interviewed. Also, records were reviewed for demographic and other cancer characteristics. RESULTS The patients’ mean age at diagnosis was 53 years, with the highest frequency at (41-60) years. Invasive ductal carcinoma 69.2% formed the main pathological diagnosis. T2 tumour size (51.2%) and lymph node involvement (N1) (31.4%) were most evident. Also, the majority of patients were stage III (45.9%) and grade II (48%). The studied women were postmenopausal (49.4%) ere significantly correlated (P less then .000). © 2020 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.BACKGROUND To the authors’ knowledge, there are limited data regarding the epidemiology of malignant appendiceal tumors. It remains unknown whether the previously reported trends are occurring in different countries and/or continuing in recent years and/or whether they are possibly due to increasing rates of appendectomies. In the current study, the authors investigated the patterns and time trends of malignant appendiceal tumor diagnosis by age group, sex, stage of disease, and histology in Canada and the United States and concomitant rates of appendectomies in Canada. METHODS The Canadian Cancer Registry and the US Surveillance, Epidemiology, and End Results incidence databases were used to identify incident patients of malignant appendiceal tumors in the 2 countries between 1992 and 2016. The Canadian national hospitals Discharge Abstract Database was used to identify appendectomies performed between 2004 and 2015. Joinpoint regression analyses were performed to determine time trends. RESULTS There was an overall increase in the incidence of malignant appendiceal tumors of 232% in the United States and 292% in Canada between 2000 and 2016. The increase was noted for malignant adenocarcinomas and neuroendocrine appendiceal tumors in both countries. The increase occurred across all age groups, sexes, and stages of disease. The highest rate of increase was noted for appendiceal neuroendocrine malignant tumors diagnosed among the youngest age groups. The rate of appendectomies was stable in the recent time periods, resulting in a decreasing rate of appendectomies per malignant appendiceal tumor diagnosis. CONCLUSIONS The incidence of malignant appendiceal tumor is continuing to increase, which is not likely due to the increasing diagnosis of asymptomatic tumors at the time of appendectomies. © 2020 American Cancer Society.RATIONALE, AIMS, AND OBJECTIVE A group of organizations and individuals in the Netherlands collaborated to attempt to improve access to health care and health education for deaf and hard of hearing (DHH) patients in the country. this website The outcome was the start of a specialized outpatient clinic named PoliDOSH. An independent research group was set up to evaluate the effect of this specialized clinic. Even though the initiative did not succeed and was closed after 2 years, an extensive analysis of the start-up and functioning of the whole process was made. METHODS Structured and nonstructured questionnaires and structured interviews. RESULTS Only a small group of DHH patients indicated that they felt a need for consultations at the PoliDOSH. It became clear that to ensure successful functioning of a specialized facility the team members should include a representative group of DHH members. All key functions should be filled by top experts in the relevant fields as well as an expert in communication and needs of the target group. CONCLUSIONS There is a great need for facilities to collect and disseminate information to and about DHH patients. The information should be aimed at providing psycho-education for the DHH persons themselves and health care professionals, concerning the specific needs and problems of this patient group. If a similar facility is set up in the future, thorough market research prior to start up is needed to enable the facility to connect with the needs of patients. The start-up period should allow sufficient time for the project to become known and for patients to become familiar with it and trust it. © 2020 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.Pharmacoinformatics research has experienced a great deal of successes in detecting drug-induced adverse events (AEs) using large-scale health record databases. In the era of polypharmacy, pharmacoinformatics faces many new challenges, and two significant challenges are to detect high-order drug interactions and to handle strongly correlated drugs. In this article, we propose a super-combo-drug test (SupCD-T) to address the aforementioned two challenges. SupCD-T detects drug interactions by identifying optimal drug combinations with increased AE risks. In addition, SupCD-T increases the statistical powers to detect single-drug effects by combining strongly correlated drugs. Although SupCD-T does not distinguish single-drug effects from their combination effects, it is noticeably more powerful in selecting an individual drug effect in the multiple regression analysis, where confounding justification between two correlated drugs reduces the power in testing the individual drug effects on AEs. Our simulation studies demonstrate that SupCD-T has generally better power comparing with the multiple regression analysis. In addition, SupCD-T is able to select meaningful drug combinations (eg, highly coprescribed drugs). Using electronic health record database, we illustrate the utility of SupCD-T and discover a number of drug combinations that have increased risk in myopathy. Some novel drug combinations have not yet been investigated and reported in the pharmacology research. © 2020 John Wiley & Sons, Ltd.