-
Frontiers in Oncology 2023Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and poorly understood hematopoietic malignancy. This study aimed to investigate the clinical...
BACKGROUND
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and poorly understood hematopoietic malignancy. This study aimed to investigate the clinical characteristics and prognostic factors in patients with primary BPDCN.
METHODS
Patients diagnosed with primary BPDCN from 2001 to 2019 were extracted from the Surveillance, Epidemiology and End Results (SEER) database. Survival outcome was analysed with Kaplan-Meier method. Prognostic factors were evaluated based on the univariate and multivariate accelerated failure time (AFT) regression analysis.
RESULTS
A total of 340 primary BPDCN patients were included in this study. The average age was 53.7 ± 19.4 years, with 71.5% being male. The mostly affected sites were lymph nodes (31.8%). Most patients (82.1%) received chemotherapy, while 14.7% received radiation therapy. For all the patients, the 1-year, 3-year, 5-year, and 10-year overall survival (OS) were 68.7%, 49.8%, 43.9%, and 39.2%, respectively, and the corresponding disease-specific survival (DSS) were 73.6%, 56.0%, 50.2%, and 48.1%, respectively. Univariate AFT analysis showed that older age, marital status of divorced, widowed and separated at diagnosis, primary BPDCN only, treatment delay for 3-6 months and without radiation therapy were significantly associated with poor prognosis of primary BPDCN patients. But multivariate AFT analysis indicated that older age was independently associated with worse survival, while second primary malignancies (SPMs) and radiation therapy were independently associated with extended survival.
CONCLUSIONS
Primary BPDCN is a rare disease with poor prognosis. Advanced age was linked independently to poorer survival, while SPMs and radiation therapy were linked independently to prolonged survival.
PubMed: 37251924
DOI: 10.3389/fonc.2023.1178147 -
European Review For Medical and... Dec 2019It has been reported that for obesity patients, improved problem-solving skills have a positive impact on losing weight and treatment adherence. The aims of our study,...
OBJECTIVE
It has been reported that for obesity patients, improved problem-solving skills have a positive impact on losing weight and treatment adherence. The aims of our study, by describing the problem-solving self-appraisal of obese patients applied to our center, were to provide data in enriching the obesity management, to facilitate weight loss and improve long-term goals for patients.
PATIENTS AND METHODS
The study design was cross-sectional and descriptive. There were no sampling methods, all patients registered to the center program and passed the health screening module were asked to be included. The data collection was performed via "Socio-demographic information form" and "Problem-Solving Inventory" (PSI) forms. Quantitative data were compared by Student's t-test, Mann-Whitney U test, One-way Anova, post-hoc test, and correlation analysis.
RESULTS
The total average of the PSI scores of 87 patients was 122.33±20.25. There was no statistical significance between the inventory scores and gender, marital status, financial state, smoking, and alcohol consumption (p>0.05). Physical activity and education were correlated with the PSI scores (p˂0.05).
CONCLUSIONS
The study showed that participants had low problem-solving self-appraisals. Providing an additional perspective on problem-solving skills may help to promote the psychological and physical well-being of obesity patients.
Topics: Adult; Cognitive Behavioral Therapy; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Obesity; Patient Compliance; Problem Solving; Self-Assessment; Treatment Outcome; Weight Loss; Weight Reduction Programs
PubMed: 31841204
DOI: 10.26355/eurrev_201912_19689 -
International Journal of Environmental... Sep 2022Raising and caring for a child with ASD is a challenge for the parents' marriage relationship. Caring for a disabled child changes the functioning of the family and...
Raising and caring for a child with ASD is a challenge for the parents' marriage relationship. Caring for a disabled child changes the functioning of the family and requires greater involvement in care and specialist therapy. The respondents' answers show that such parents experience higher levels of stress related to the upbringing and future of the child. However, parenting challenges need not be a negative experience if the parents support each other. The process of bringing up children in the family are related, inter alia, to the quality of their parents 'marriage, which is influenced by the partners' personal resources. The resilience of the partners and coping with this situation contribute to marital satisfaction. The aim of the study is to find out about the relationship between spouses' resilience and coping styles and their assessment of marriage satisfaction. In total, 50 married couples participated in the study-50 mothers of children with ASD and 50 fathers, the partners of these mothers (N = 100). The following tools were used: the Resilience Scale (SPP-25), the Coping Inventory for Stressful Situations (CISS) and the Well-Matched Marriage Questionnaire (KDM-2), as well as a survey questionnaire (data on respondents). The results show that the gender of the parent of a child with ASD does not differentiate the overall assessment of the quality of marriage (the overall score on the scale indicates a low level of satisfaction with the relationship). When analyzing in detail the dimensions of individual scales of satisfaction with the relationship, one statistically significant difference was noted for the sex of the respondents in the disappointment dimension, showing that the level of disappointment in the quality of the relationship is higher in wives than in husbands. In the other dimensions of satisfaction with marriage: intimacy, personal fulfillment, similarity, there were no statistically significant differences in terms of gender of the respondents. The resilience of the spouses positively correlates with their assessment of marriage satisfaction, and in particular, openness, perseverance and determination to act increase the level of Task-oriented coping (SSZ) with difficult situations. All resilience factors negatively correlate with the emotional coping style (SSE). In both the studied groups, openness is a significant predictor of intimacy, and persistence is a predictor of self-fulfilment in a relationship. A predictor of disappointment in women is managing using substitute activities (ACZ), while in men it is the Emotion-oriented coping (SSE) style. The results indicate the need to support married couples raising a child with ASD during the pandemic.
Topics: Adaptation, Psychological; Autism Spectrum Disorder; COVID-19; Child; Female; Humans; Male; Marriage; Pandemics; Parenting; Personal Satisfaction; Spouses
PubMed: 36231674
DOI: 10.3390/ijerph191912372 -
Clinical Journal of the American... Jul 2020Although some patients regret the decision to start dialysis, modifiable factors associated with regret have rarely been studied. We aimed to identify factors associated...
BACKGROUND AND OBJECTIVES
Although some patients regret the decision to start dialysis, modifiable factors associated with regret have rarely been studied. We aimed to identify factors associated with patients' regret to initiate dialysis.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS
A 41-item questionnaire was administered to adult patients receiving maintenance dialysis in seven dialysis units located in Cleveland, Ohio, and its suburbs. Of the 450 patients asked to participate in the study, 423 agreed and 397 provided data on decisional regret. We used multivariable logistic regression to identify predictors of regret, which was assessed using a single item, "Do you regret your decision to start dialysis?" We report adjusted odd ratios (ORs) and 95% confidence intervals (95% CIs) for the following candidate predictors: knowledge of CKD, attitudes toward CKD treatment, and preference for end-of-life care.
RESULTS
Eighty-two of 397 respondents (21%) reported decisional regret. There were no significant demographic correlates of regret. Regret was more common when patients reported choosing dialysis to please doctors or family members (OR, 2.34; 95% CI, 1.27 to 4.31; <0.001). Patients who reported having a prognostic discussion about life expectancy with their doctors (OR, 0.42; 95% CI, 0.18 to 0.98; =0.03) and those who had completed a living will (OR, 0.48; 95% CI, 0.25 to 0.95; =0.03) were less likely to report regret with dialysis initiation.
CONCLUSIONS
Dialysis regret was common in this sample. Demographic factors (age, sex, marital status, race, or educational attainment) were not significantly associated with regret, but modifiable care processes were.
PODCAST
This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2020_06_09_CJN13781119.mp3.
Topics: Adult; Aged; Aged, 80 and over; Conservative Treatment; Decision Making; Emotions; Family Relations; Female; Health Knowledge, Attitudes, Practice; Humans; Living Wills; Male; Middle Aged; Patient Preference; Physician-Patient Relations; Prognosis; Renal Dialysis; Renal Insufficiency, Chronic; Surveys and Questionnaires; Terminal Care; Young Adult
PubMed: 32499230
DOI: 10.2215/CJN.13781119 -
Preventive Medicine Reports Sep 2021Breast cancer screening guidelines serve as crucial evidence-based recommendations in deciding when to begin regular screenings. However, due to developments in breast...
Breast cancer screening guidelines serve as crucial evidence-based recommendations in deciding when to begin regular screenings. However, due to developments in breast cancer research and differences in research interpretation, screening guidelines can vary between organizations and within organizations over time. This leads to significant lapses in adopting updated guidelines, variable decision making between physicians, and unnecessary screening for low to moderate risk patients (Jacobson and Kadiyala, 2017; Corbelli et al., 2014). For analysis, risk factors were assessed for patient screening behaviors and results. The outcome variable for the first analysis was whether the patient had undergone screening. The risk factors considered were age, marital status, education level, rural versus urban residence, and family history of breast cancer. The outcome variable for the second analysis was whether patients who had undergone breast cancer screening presented abnormal results. The risk factors considered were age, Body Mass Index, family history, smoking and alcohol status, hormonal contraceptive use, Hormone Replacement Therapy use, age of first pregnancy, number of pregnancies (parity), age of first menses, rural versus urban residence, and whether or not patients had at least one child. Logistic regression analysis displayed strong associations for both outcome variables. Risk of screening nonattendance was negatively associated with age as a continuous variable, age as a dichotomous variable, being married, any college education, and family history. Risk of one or more abnormal mammogram findings was positively associated with family history, and hormonal contraceptive use. This procedure will be further developed to incorporate additional risk factors and refine the analysis of currently implemented risk factors.
PubMed: 34168953
DOI: 10.1016/j.pmedr.2021.101446 -
Neuropsychiatric Disease and Treatment 2023Ectopic pregnancy is a leading cause of death for child-bearing aged women. Most patients with ectopic pregnancy experience suffer psychological distress which seriously... (Review)
Review
Ectopic pregnancy is a leading cause of death for child-bearing aged women. Most patients with ectopic pregnancy experience suffer psychological distress which seriously affects their physical and mental health. The psychological distress, influencing factors, measurement tools, and nursing interventions in patients with ectopic pregnancy in China are reviewed in this article. The results showed that the main psychological distress of patients with ectopic pregnancy is anxiety, depression, uncertainty sense of disease, and low self-esteem. The main factors affecting the psychological distress of ectopic pregnancy patients included life-threatening disease, different marital status, and reproductive needs. The main intervention methods for psychological distress in pregnant patients included: cognitive behavioral therapy, emotional therapy of traditional Chinese medicine, and family support. The majority of cross-sectional surveys in China focused on psychological conditions of the patients with ectopic pregnancy, and there are very few longitudinal studies. Large-sample, multi-center longitudinal studies should be conducted in the future to monitor the development of ectopic pregnancy. Qualitative research should be conducted on patient experience, to provide guidance and basis for the implementation of targeted nursing interventions and to further explore standardized, continuous, and generalizable psychological care protocols for distress interventions for patients with ectopic pregnancy, thereby minimizing psychological distress such as anxiety, depression, and uncertainty in patients with ectopic pregnancy.
PubMed: 37497307
DOI: 10.2147/NDT.S410320 -
Heliyon Jul 2020Having sexual relations plays a very important role in the success and scope of procreation. Understanding sexual function can lead to sexual satisfaction and ultimately...
BACKGROUND
Having sexual relations plays a very important role in the success and scope of procreation. Understanding sexual function can lead to sexual satisfaction and ultimately to marital satisfaction and reconciliation of spouses.
OBJECTIVE
The aim of this study was to evaluate the effectiveness of a psychoeducational programme on sexual function and marital satisfaction of Iranian couples.
MATERIALS AND METHODS
This is a semi-experimental pre-test and post-test study with control group. The statistical population included all couples diagnosed with sexual dysfunction referred to Bahar Consulting Center in Mashhad in 2019. A total of 40 individuals were randomly assigned to the two treatment conditions which were experimental (n = 20) and control (n = 20) forming two groups. The individuals assigned to experimental condition experienced a 10 session psychoeducational program and the control condition comprised of Treatment As Usual (TAU) which was based on medical and general counseling regime. The data collection tool was marital satisfaction and sexual function questionnaire. Data was analyzed using SPSS version 22 software.
RESULTS
there is a significant difference between the amount of sexual function and marital satisfaction before and after the test in experimental group (p < 0.01). The results of this study showed that Psychoeducational Group Therapy improved the sexual performance and improved marital satisfaction.
CONCLUSION
Psychoeducational Group Therapy helps to increase marital satisfaction and sexual functioning of married couples. Therefore, this intervention is recommended as an effective program for improving marital satisfaction and sexual performance of couples. It can help to strengthen the foundation of the family.
PubMed: 32775734
DOI: 10.1016/j.heliyon.2020.e04586 -
Current Cancer Reports Jun 2021Breast cancer survivors may experience worse social, physical, and emotional function compared to the general population, although symptoms often improve over time. Data...
PURPOSE
Breast cancer survivors may experience worse social, physical, and emotional function compared to the general population, although symptoms often improve over time. Data on problems in living can help to improve interventions and supportive care for breast cancer survivors. Symptoms such as fatigue, pain, difficulties with sleep, and sexual problems may have an adverse effect on the quality of life of breast cancer survivors.
METHODS
We examined problems in living using data from a survey of 164 breast cancer survivors who had completed primary therapy for the disease.
RESULTS
A total of 164 women completed the study questions (response rate 16.4%). The mean age of the women was 67 years. Among all participants, 66.7% were white, 29.5% were African-American, and the remainder were of other races. Almost all of the symptoms were more likely to be reported by participants who were < 55 years of age. Other important correlates of symptoms included non-white race, marital status, and having a household income of less than $50,000 per year.
CONCLUSION
The results of this study highlight the need for caregivers to emphasize screening for and discussion of symptoms, including sleep difficulties, fatigue, loss of strength, aches and pains, and muscle or joint stiffness. Of particular concern are younger survivors and those who are African American or low-income.
PubMed: 33937867
DOI: 10.25082/CCR.2021.01.005 -
Emergency Medicine International 2023Urinary tract infections (UTIs) and sexually transmitted infections (STIs) can have overlapping signs, symptoms, and findings on urinalysis. Our objective was to...
INTRODUCTION
Urinary tract infections (UTIs) and sexually transmitted infections (STIs) can have overlapping signs, symptoms, and findings on urinalysis. Our objective was to determine if patient or provider demographics are associated with differences in the diagnosis and management of UTIs and STIs in the emergency department (ED).
METHODS
We analyzed 38,062 ED patient encounters from a single healthcare system between April 18, 2014, and March 7, 2017. All encounters were women ≥18 years of age and not admitted to the hospital. We performed logistic regression using patient and provider demographics, laboratory testing results, ED triage data, and ED diagnoses.
RESULTS
The patient's age, race, and marital status were not associated with having an ED UTI diagnosis with a urine culture ≥10,000 colony forming units (CFUs)/mL (vs. <10,000 CFUs/mL). Patient race and the sex of the ED provider were not associated with differences in empiric antibiotic treatment for gonorrhea and chlamydia during the ED encounter. Patient's race and the sex of the ED provider were also not associated with discordance between empiric antibiotic therapy given in the ED and the results of gonorrhea and chlamydia tests that resulted following the ED encounter.
CONCLUSION
In our multivariate analyses, we did not observe that the patient's race resulted in significant differences in the diagnosis of UTIs with bacteriuria ≥10,000 CFU/mL or differences in the empiric treatment of gonorrhea and chlamydia infections among those tested for the infection in the ED. The patient's age and marital status, but not the provider's sex, were significantly associated with differences in the management of gonorrhea and chlamydia.
PubMed: 37727654
DOI: 10.1155/2023/1522347 -
Life (Basel, Switzerland) Sep 2023Choroid plexus carcinomas (CPC) are rare aggressive tumours that primarily affect very young children. Treatment for CPC typically involves a combination of surgery,... (Review)
Review
Choroid plexus carcinomas (CPC) are rare aggressive tumours that primarily affect very young children. Treatment for CPC typically involves a combination of surgery, chemotherapy, and radiation therapy. Whilst considered necessary for a cure, these therapies have significant neurocognitive consequences for patients, negatively impacting cognitive function including memory, attention, executive functioning, and full-scale intelligence quotients (FSIQ). These challenges significantly impact the quality of life and ultimately socioeconomic parameters such as the level of educational attainment, marital status, and socioeconomic status. This review looks at the tumour- and treatment-related causes of neurocognitive damage in CPC patients and the progress made in finding strategies to reduce these. Opportunities to mitigate the neurodevelopmental consequences of surgery, chemotherapy, and radiation therapy are explored in the context of CPC treatment. Evaluation of the pathological and biological mechanisms of injury has identified innovative approaches to neurocognitive protection and neurorehabilitation, which aim to limit the neurocognitive damage. This review aims to highlight multiple approaches physicians can use when treating young children with CPC, to focus on neurocognitive outcomes as a measure of success.
PubMed: 37763259
DOI: 10.3390/life13091855