Differences in treatment and survival of older patients with operable breast cancer between the United Kingdom and the Netherlands – a comparison of two national prospective longitudinal multi-centre cohort studies

Background Previous studies have shown that survival outcomes for older patients with breast cancer vary substantially across Europe, with worse survival reported in the United Kingdom. It has been hypothesised that these differences in survival outcomes could be related to treatment variation. Objectives We aimed to compare patient and tumour characteristics, treatment selection and survival outcomes between two large prospective cohorts of older patients with operable breast cancer from the United Kingdom (UK) and The Netherlands. Methods Women diagnosed with operable breast cancer aged ≥70 years were included. A baseline comprehensive geriatric assessment was performed in both cohorts, with data collected on age, comorbidities, cognition, nutritional and functional status. Baseline tumour characteristics and treatment type were collected. Univariable and multivariable Cox regression models were used to compare overall survival between the cohorts. Results 3262 patients from the UK Age Gap cohort and 618 patients from the Dutch Climb cohort were included, with median ages of 77.0 (IQR: 72.0–81.0) and 75.0 (IQR: 72.0–81.0) years, respectively. The cohorts were generally comparable, with slight differences in rates of comorbidity and frailty. Median follow-up for overall survival was 4.1 years (IQR 2.9–5.4) in Age Gap and 4.3 years (IQR 2.9–5.5) in Climb. In Age Gap, both the rates of primary endocrine therapy and adjuvant hormonal therapy after surgery were approximately twice those in Climb (16.6% versus 7.3%, p < 0.001 for primary endocrine therapy, and 62.2% versus 38.8%, p < 0.001 for adjuvant hormonal therapy). There was no evidence of a difference in overall survival between the cohorts (adjusted HR 0.94, 95% CI 0.74–1.17, p = 0.568). Conclusions In contrast to previous studies, this comparison of two large national prospective longitudinal multi-centre cohort studies demonstrated comparable survival outcomes between older patients with breast cancer treated in the UK and The Netherlands, despite differences in treatment allocation

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Gravity tectonics, gravity field, and palaeomagnetism in Ne-Italy : (with special reference to the Carnian Alps, north of the Val Fella-Val Canale area between Paularo and Tarvisio-Province of Udine-)

In this thesis a geological, gravimetricaL and palaeomagnetical analyses of NE Italy is given, with special reference to the E Carnian Alps north of the Pontebbana-Fella-Canale Valley

Gravity tectonics, gravity field, and palaeomagnetism in NE-Italy : (with special reference to the Carnian Alps, north of the Val Fella-Val Canale area between Paularo and Tarvisio-Province of Udine-)

In this thesis a geological, gravimetricaL and palaeomagnetical analyses of NE Italy is given, with special reference to the E Carnian Alps north of the Pontebbana-Fella-Canale Valley

Transformations of pesticides in the atmosphere: A state of the art

The current knowledge about transformation rates and products of pesticides in the atmosphere is reviewed. Reactive species and their concentrations in the atmosphere are presented. Reactions of pesticides with these species (including photolysis) in the gas and the particulate phase are evaluated from available experimental data. The potential of estimation methods is discussed. Experimental techniques for laboratory and outdoor measurements are reviewed. Finally, an estimation is made of uncertainties in atmospheric lifetimes due to chemical or physical reactions. It is concluded that the most important transformation of pesticides in the atmosphere is due to reaction with OH radicals. Very few experimental data for pesticides are available though. The levels of uncertainty in OH radical concentrations are acceptable, however, for a proper estimation of atmospheric removal rates due to reactions with OH radicals of those pesticides for which experimental transformation rates (of homologues) are available