bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cancer outcomes at end-of-life in Michigan
Authors: Finn J. W. , Nelson P. , Yassine M. , Presby K. , Towns J. , Affholter S. 
Published: April 2020

8575 Background: End-of-life care (EOLC) is an important focus of comprehensive cancer control, yet little data is formally collected and no central repository exists across all cancer sites. Collaboration by the MI Department of Community Health, the MI Public Health Institute, and the Institute for Public Policy and Social Responsibility (IPPSR) in 2004 produced an end-of-life module, which was added to a caregiver survey designed to track cancer screening already in use: the Michigan Special Cancer Behavioral Risk Factor Survey (MSCBRFS). Methods: A population-based sample of caregivers, age 40 and older, including minorities, were contacted by trained IPPSR staff (bilingual) using computer-assisted telephone interviews. Results: 761 respondents constituted the sample size of caregivers who reported having cared for a family member or friend who died of cancer in the preceding 5 years, including 196 African Americans, 92 American Indians, 51 Hispanic Americans, 49 Arab Americans and 73 Asian Americans. The average pain level in the final 3 months was severe to excruciating for 44.7%. Pain medications had been prescribed for 93.5%; however, not used as directed for 30.3%. The most frequent reason given for this was fear of addiction/side effects (32.7%). The proportion who died at home was 44.3%. In general terms, Caucasians tended to die outside the hospital, whereas African and Asian Americans tended to die in the hospital and Native and Hispanic Americans at home. 68.2% of cancer decedents died with the support of hospice care (no racial variance). The median length of stay on hospice was short, 17.5 days (2003 MHPCO data). The main reason given why hospice was not chosen was that death occured before hospice enrollment (55.2%). Conclusions: Cancer outcomes data at end-of-life is an important part of state-wide comprehensive cancer control. Specific progress markers are presently established for the Michigan Cancer Consortium. Baselines measurements include the prevalence of severe pain in the final 3 months (44.7%), proportion of those who died at home (44.3%), percent of those who used hospice services (68.2%) and median hospice length of stay (17.5 days). These outcome measures will be trended over the next five years for purposes of cancer care quality improvement, public and professional education and system change. No significant financial relationships to disclose.
The assessment of randomized double blind clinical trial of Shugan-liangxue prescription used for the treatment of hot flashes in breast cancer patients
Authors: Li P. 
Published: April 2020

8584 Background: Hot flashes are a common side effect for breast cancer (BC) pts with TAM treatment. Traditional Chinese medicine (TCM) is typically given to BC pts in China. This trial is to assess the effects of TCM for relieving hot flashes. TCM oral solution is prescribed for clearing heat and cooling blood. The compound was tested and contained no phytoestrogen. A randomized, double blind clinical trial was designed to examine the effects of TCM over a 3-week period. Methods: From October 2004 to October 2005, 49 BC pts undergoing treatment with TAM who having hot flashes at least 3 times a day involved the study. Daily average of hot flashes was recorded by the pts for a week as a baseline. TCM or placebo liquid (100 ml) was administered orally three times a day for 3 weeks by a randomized double-blind method. The number of hot flashes and quantity of sleep disturbance in the two groups were evaluated. Results: 45 pts were evaluated in TCM group (n = 22) and the placebo group (n = 23). The severity of the hot flash symptoms was evaluated according to the Kupperman menopausal index (KI). Pts were distributed approximately equally between the two groups. There were 31% (7/22) and 26% (6/23)pts with mild hot flashes in TCM and placebo groups, and 68% (15/22) and 73% (17/23) with severe hot flashes in TCM and placebo groups. Hot flash relief was described as either symptom disappearing, a decrease from severe to mild symptoms, or no change. In TCM group, 50% showed no change, 27% decrease and 23% symptoms disappearing. In the placebo group, 70% no change, 30% decrease and no pts reporting symptoms disappearing. A statistically significant difference exists between the two groups (P < 0.05). In TCM group, 73% of pts sleep improvement compared to 35% in the placebo group (P < 0.05). No adverse events or any side effects were reported. Conclusion: The oral solution of TCM is effective in alleviating tamoxifen-induced hot flashes and sleep disturbance. The study of the drug’s mechanism and an expanded clinical trial are underway. No significant financial relationships to disclose.
Physical health and depression as predictors of fatigue in women with breast cancer undergoing chemotherapy
Authors: Shimabukuro K. A. , Clark K. L. , Bardwell W. A. , Mortimer J. E. 
Published: April 2020

8591 Background: Fatigue is common in breast cancer patients undergoing systemic chemotherapy and is also linked with depression. We evaluated the importance of physical health and depression in the fatigue reported by women with early-stage breast cancer undergoing adjuvant chemotherapy. Methodology: 75 women treated for Stage I-II breast cancer were assessed within 1mo after initiating chemotherapy (‘baseline‘) and at 2, 6 and 12mo. Scales included the Profile of Mood States (POMS) & SF36 quality of life (QOL) survey. The POMS contains fatigue and depression subscales (higher scores, worse mood symptoms). The SF36 is comprised of 4 physical and 4 mental health subscales (higher scores, better QOL). Results: 26 Stage I (46.4%) and 30 (53.6%) Stage II breast cancer patients provided baseline data (median age 53yrs; range 28–82 yrs). Fatigue decreased significantly from baseline to 12mo (p<0.01). Using Pearson correlations, worse physical health summary scores (r= −0.55, p<0.01) and higher depression scores (r=0.55, p<0.01) were independently linked with fatigue at baseline. In partial correlations controlling for depression, the relationship between physical health and fatigue remained significant (p<0.01), but was reduced in strength by 27%, although, the influence of depression on fatigue diminished over time. Similar patterns were observed for 3 of the SF36 physical health subscales. However, the relationship between fatigue and bodily pain was unchanged when controlling for depression (p<0.01), suggesting a strong independent relationship. In linear regression models, depression predicted fatigue at all time points and was the strongest predictor at baseline and 2mo; however physical health subscales assumed increasing importance in accounting for fatigue at 6 and 12mo. Conclusion: Depression is the strongest predictor of fatigue during chemotherapy, however, over time physical health variables become increasingly important at predicting fatigue in women with early stage breast cancer. Conducted at Washington University, supported by NIH CA72554–02 No significant financial relationships to disclose.
Palonosetron (PALO) + dexamethasone (DEX) for prevention of chemotherapy (CT)-induced nausea and vomiting (CINV) in patients receiving multiple-day cisplatin CT for germ cell cancer
Authors: Brames M. J. , Roth B. J. , Dreicer R. , Bubalo J. , Nichols C. , Cullen M. T. , Degroot T. , Einhorn L. H. 
Published: April 2020

8607 Background: Fractionated cisplatin is highly emetogenic; despite 5HT3 receptor antagonists + DEX, patients still experience acute and delayed CINV. PALO, a novel 5HT3 antagonist, is superior to conventional 5HT3 antagonists in protecting patients from emesis with a 0.25-mg IV dose prior to single-day CT. To assess the efficacy and safety of PALO in 40 patients with germ cell tumors receiving multiple-day cisplatin-based CT, a phase II multicenter study is being conducted. Methods: Adult men receiving 5-day cisplatin-based (20 mg/m2/d) CT received PALO 0.25 mg IV 30 min before CT on days 1, 3, and 5 and DEX 20 mg qd (po or IV 30 min before CT) on days 1–2; 8 mg po bid on days 6–7; and 4 mg po bid on day 8. Rescue medication was allowed at investigator discretion. Endpoints included emetic episodes (EE), nausea intensity, and rescue use, recorded in diaries for 9 consecutive 24-h periods. Interference with functioning due to nausea on a 4-point scale (none, a little bit, quite a bit, very much) was assessed with the validated Osoba nausea module on days 1, 5, and 10; safety was assessed at all follow-up encounters. Results: To date, 32 patients are evaluated, median age 35 years, 81% CT-naïve. Prior to CT, 97% of patients reported no more than a little interference with functioning from nausea. Most patients reported no significant interference with functioning due to nausea on days 1–4 of cisplatin (73% reported none/a little bit) and days 5–9 (87% none/a little bit). PALO + DEX was well tolerated; treatment-related adverse events were mild-moderate headache (18.8%), constipation (6.3%), and abdominal pain (3.1%), none serious. Conclusions: Three doses of PALO + 5 doses of DEX over an 8-day period effectively prevented both emesis and significant nausea in the majority of patients with germ cell tumors receiving multiple-day cisplatin-based CT. This regimen appears to be an improvement over historical CINV control. [Table: see text] [Table: see text]
A phase II trial of olanzapine and palonosetron for the prevention of chemotherapy induced nausea and vomiting (CINV)
Authors: Navari R. M. , Einhorn L. H. , Loehrer P. J. , Passik S. D. , Vinson J. , McClean J. , Chowhan N. , Hanna N. , Calley C. , Yu M. 
Published: April 2020

8608 Background: Olanzapine has been shown to be a safe and effective agent for the prevention of CINV in chemotherapy naïve cancer patients. Palonosetron has been approved for the prevention of acute CINV and for the prevention of delayed CINV in patients receiving moderately emetogenic chemotherapy (MEC). Methods: A phase II trial was performed for the prevention of CINV in chemotherapy naïve patients using the combination of olanzapine and palonosetron. The regimen was 10 mg of oral olanzapine, 0.25 mg of intravenous palonosetron, and dexamethasone (20 mg for highly emetogenic and 8 mg for moderately emetogenic chemotherapy) on the day of chemotherapy, day 1, and 10 mg/day of oral olanzapine alone on days 2–4 after chemotherapy. Forty patients (median age 60 yrs, range 38–84; 22 females; ECOG PS 0,1) consented to the protocol and all were evaluable. Results: The percentage of patients with a complete response (CR) (no emesis, no rescue) was 100% for the acute period (24 h post chemotherapy), 75% for the delayed period (days 2–5 post chemotherapy), and 75% for the overall period (0–120 h) for eight patients receiving highly emetogenic chemotherapy (HEC) (cisplatin > 70 mg/m2). CR was 97% for the acute period, 75% for the delayed period, and 72% for the overall period in 32 patients receiving MEC (doxorubicin, >50mg/m2). In the patients receiving HEC, the percentage of patients without nausea (0, scale 0–10, M. D. Anderson Symptom Inventory) was 100% in the acute period, 50% in the delayed period, and 50% in the overall period. In patients receiving MEC, the percentage without nausea was 100% in the acute period, 78% in the delayed period, and 78% in the overall period. There were no Grade 3 or 4 toxicities and no significant pain, fatigue, disturbed sleep, memory changes, dyspnea, lack of appetite, drowsiness, dry mouth, mood changes or restlessness experienced by the patients. CR and control of nausea in subsequent cycles of chemotherapy (35 patients, cycle 2; 31 patients cycle 3; 23 patients, cycle 4) were equal to or greater than cycle one. Conclusions: The combination of olanzapine and palonosetron with dexamethasone given only on the day of chemotherapy was safe and highly effective in controlling acute and delayed CINV in patients receiving HEC and MEC. No significant financial relationships to disclose.
Effect of wheat grass juice in supportive care of terminally ill cancer patients— A tertiary cancer centre experience from India
Authors: Dey S. , Sarkar R. , Ghosh P. , Khatun R. , Ghorai K. , Choudhury R. , Ahmed R. , Gupta P. , Mukhopadhyay S. , Mukhopadhyay A. 
Published: April 2020

8634 Background: The solid content of juice made from wheat grass is 70% chlorophyll. Chlorophyll is often referred to as “The blood of plant life” and has almost the same chemical structure as haemoglobin. Chlorophyll cleanses the blood by improving the supply of oxygen to the circulatory system. Wheat grass is also a complete protein with about 30 enzymes, vitamins & minerals. Wheat grass juice has been proven over many years to benefit people in numerous ways, building the blood, restoring balance in the body, removing toxic metals from the cells, nourishing the liver & kidneys and restoring vitality. The aim of our study was to see the effect of wheat grass juice in terminally ill cancer patients to improve the quality of life. Methods: During period from January 2003 to December 2005 we selected 400 solid organ cancer patients in our palliative care unit of Netaji Subhash Chandra Bose Cancer Research Institute to see the effect of wheat grass on improvement of haemoglobin level, serum protein & performance status on terminally ill cancer patients. The age range of the patients was 22 year to 87 year (median age 42 years). The different types of cancers were Lung (25%), Breast (20%), Oesophagaus (11%), Colon (9%), Ovary (8%), Hepatocellular carcinoma (6%), Stomach (6%) and others (15%) respectively. We cultivated wheat grass in our campus. When the grasses were 5 days old we took the fresh leaves including roots and made fresh juice out of that and had given 30ml of juice to all our 400 cancer patients for continuous 6 months. Result: The mean levels of haemoglobin, Serum total protein, albumin and performance status were 8gm%, 5.4gm%, 2.2gm% and 50%. Fifty patients required transfusion support & those patients were excluded from the study. Other 348 patients are evaluated 6 months after giving wheat grass juice. The mean values for haemoglobin, total protein & albumin were improved significantly (pvalue < .005) and were observed mean of 9.6gm%, 7.4gm% and 3.1gm%. White blood cell & platelet count were same in both the cases. The performance status was improved from 50% to 70% (Karnofsky) after wheat grass treatment. Conclusion: We concluded that wheat grass juice is an effective alternative of blood transfusion. Its use in terminally ill cancer patients should be encouraged. No significant financial relationships to disclose.
Mobile Technologies and Cervical Cancer Screening in Low- and Middle-Income Countries: A Systematic Review
Authors: Zhang Dongyu , Advani Shailesh , Waller Jo , Cupertino Ana-Paula , Hurtado-de-Mendoza Alejandra , Chicaiza Anthony , Rohloff Peter J. , Akinyemiju Tomi F. , Gharzouzi Eduardo , Huchko Megan J. , Barnoya Joaquin , Braithwaite Dejana 
Published: April 2020

PURPOSE Cervical cancer screening is not well implemented in many low- and middle-income countries (LMICs). Mobile health (mHealth) refers to utilization of mobile technologies in health promotion and disease management. We aimed to qualitatively synthesize published articles reporting the impact of mHealth on cervical cancer screening–related health behaviors. METHODS Three reviewers independently reviewed articles with the following criteria: the exposure or intervention of interest was mHealth, including messages or educational information sent via mobile telephone or e-mail; the comparison was people not using mHealth technology to receive screening-related information, and studies comparing multiple different mHealth interventional strategies were also eligible; the primary outcome was cervical cancer screening uptake, and secondary outcomes included awareness, intention, and knowledge of screening; appropriate research designs included randomized controlled trials and quasi-experimental or observational research; and the study was conducted in an LMIC. RESULTS Of the 8 selected studies, 5 treated mobile telephone or message reminders as the exposure or intervention, and 3 compared the effects of different messages on screening uptake. The outcomes were diverse, including screening uptake (n = 4); health beliefs regarding the Papanicolaou (Pap) test (n = 1); knowledge of, attitude toward, and adherence to colpocytologic examination (n = 1); interest in receiving messages about Pap test results or appointment (n = 1); and return for Pap test reports (n = 1). CONCLUSION Overall, our systematic review suggests that mobile technologies, particularly telephone reminders or messages, lead to increased Pap test uptake; additional work is needed to unequivocally verify whether mhealth interventions can improve knowledge regarding cervical cancer. Our study will inform mHealth-based interventions for cervical cancer screening promotion in LMICs.
Contributions of Prenatal Exposures and Child Lifestyle to Insulin Sensitivity
Authors: Alves Jasmin M , Zink Jennifer , Chow Ting , Luo Shan , Belcher Britni R , Xiang Anny H , Page Kathleen A 
Published: April 2020

Abstract

Context
Prenatal exposures and lifestyle factors are important for metabolic health.

Objective
Determine how prenatal exposures to maternal obesity and/or gestational diabetes mellitus (GDM) and childhood lifestyle factors independently contribute to child insulin sensitivity.

Design and Participants
Ninety children aged 7 to 11 years (56% girls, 60% exposed to GDM), born at Kaiser-Permanente Southern California, completed an oral glucose tolerance test (OGTT) as part of the BrainChild Study. Matsuda insulin sensitivity index (ISI) was used to estimate insulin sensitivity. Participants completed two 24-hour dietary recalls, and daily energy intake (EI), dietary added sugar, and total sugar were calculated. The 3-day physical activity recall determined the average minutes per day of moderate to vigorous physical activity (MVPA) and the average minutes per day spent sedentary. Maternal prepregnancy body mass index (BMI) and GDM status were extracted from electronic medical records.

Main Outcome Measure
Matsuda-ISI.

Results
Linear regression showed that children who spent more time in MVPA had better ISI (β = 0.33; P = 0.001), and results remained after adjustment for maternal prepregnancy BMI, GDM exposure, child age, sex, daily EI, dietary added sugar (β = 0.34; P = 0.001), and further adjustment for child adiposity (β = 0.29; P = 0.001). Time spent sedentary, maternal prepregnancy BMI, GDM exposure, dietary added sugar, total sugar, and EI were not associated with ISI.

Conclusions
Physical activity was the only predictor of ISI at this age, suggesting that engaging in physical activity during childhood is beneficial for insulin sensitivity and may ameliorate future risk for metabolic disease.
qSOFA score for prediction of sepsis outcome in emergency department
Authors: Shahsavarinia Kavous , Moharramzadeh Payman , Arvanagi Reza Jamal , Mahmoodpoor Ata 
Published: April 2020

Objective: The third international consensus definition for sepsis and septic shock (sepsis 3) task force recently introduced qSOFA (quick sequential organ failure assessment) as a score for detection of patients at risk of sepsis outside of intensive care units. We performed this study to evaluate the validity of qSOFA for early detection and risk stratification of septic patients in emergency department.
Methods: We conducted this study in an emergency department of the largest university affiliated hospital in northwest of Iran from Sept 2015 to Sept 2016. One hundred and forty patients who were SIRS positive with a suspected infection without alternative diagnosis and a microbiological proven infection were enrolled in this study. qSOFA was calculated for each patient and correlated with sepsis grades and mortality.
Results: From 140 patients 84 (60%) had positive qSOFA score and 56 (40%) patients had negative qSOFA score. Our results showed that near half of patients with positive qSOFA expired during their stay in hospital while this was about 5% for patients with negative qSOFA. ROC curve of study regarding prediction of outcome with qSOFA showed an area under curve of 0.59. (P value: 0.04). Time spent to sepsis detection was 16 minutes shorter with qSOFA score compared to SIRS criteria in this study.
Conclusion: In patients with suspected sepsis, qSOFA has acceptable value for risk stratification of severity, multi organ failure and mortality. It seems that education of medical staff and frequent screening of patients for warning signs can help to increase the value of qSOFA in prediction of mortality in critically ill septic patients.
doi: https://doi.org/10.12669/pjms.36.4.2031
How to cite this:Shahsavarinia K, Moharramzadeh P, Arvanagi RJ, Mahmoodpoor A. qSOFA score for prediction of sepsis outcome in emergency department. Pak J Med Sci. 2020;36(4):668-672. doi: https://doi.org/10.12669/pjms.36.4.2031
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Where is the patient’s chair? Differences in general practitioner consultation room layouts - an exploratory questionnaire
Authors: Floss Mayara , Hoedebecke Kyle , Vidal-Alaball Josep 
Published: April 2020

Background: Consultation room design varies from country to country. The layout of a general practitioner’s (GP’s) consulting room may influence the physician’s or patient’s experience. The aim of this study is to explore and investigate the layout of GP’s consulting rooms around the world and to describe any significant differences. Methods: Between 3rd July and 2nd August 2018, an internet-based questionnaire on Google Docs was distributed by email, social media and WhatsApp platforms to several worldwide rural medicine groups. Analysis of an internet-based questionnaire to explore possible layouts of consultation rooms within practices was performed. The questionnaire was designed with three distinct sections: first, a GP demographic profile including gender, year of graduation from medical school, country of graduation, and type of practice (private or public); second, questions relating to the office layout; third, a section for questionnaire feedback. Results: 502 responses to the questionnaire were received; 65.3% women and 34.7% men. The most common layout in Europe and America was where the physician and the patient were separated by a desk. The layout where the physician and the patient had a 90º angle facing each other was the most commonly used layout in Asia-Pacific and Africa. For GPs who graduated before 1990 and between 1990-2010, the layout where the table was between the patient and physician was preferred. However, physicians graduating after 2010 preferred a layout with the physician and the patient with a 90º angle facing each other. Conclusion: The position of the GP’s desk differs between and within countries as well as the gender of the physician and year of graduation. Next steps should focus on gathering an even greater breadth of GP input, as well as comparing and contrasting those to the preferences of our patients and communities.