56 research outputs found
Compliance with recommendations of clinical practice in the management of venous thromboembolism in cancer: the CARMEN study
Cancer is associated with venous thromboembolism in 20% of patients. In such patients, thrombosis is difficult to treat, associated with bleeding, recurrence, and death. Specific treatments for venous thromboembolism in cancer are recommended. Guidelines have been implemented in many countries and international guidelines have been recently developed. We evaluated the adhesion to national French guidelines via a survey of cancer patients treated for venous thromboembolism. METHODS: A national cross-sectional observational study evaluated the adhesion to guidelines in hospitalized patients. Good clinical practice was defined as initial 10-day treatment with injectable molecules followed by long-term treatment with low molecular weight heparin for at least 3 months. Demographic data, cancer type, stage, treatment, risk factors and type of thrombosis, were recorded. RESULTS: Five patients were included in 47 centers. Overall adhesion to guidelines was present in 59% (55-63%) of patients (295/500). During initial treatment, adhesion was high (487/496; 98%) but dropped (296/486; 62%) during the long-term maintenance. In patients with renal insufficiency, only a fourth of them received the adequate treatment. A majority of patients had metastatic disease (64%). Cancer sites were gastro-intestinal (25%), gynecologic (23%), pulmonary (21%), hematological (14%), urologic (10%), or other (8%). Lung and hematological malignancies were significantly associated with the highest and lowest rates of adhesion. CONCLUSION: Adhesion to national guidelines for treatment of venous thromboembolism in cancer is not optimal. Good compliance is observed during initial treatment, but drops after 10 days, underlying the need for further education to achieve a better implementation on a national level
Utilização de leveduras vivas (Saccharomyces cerevisiae) visando à produção de cordeiros Ile de France superprecoces em sistema de creep-feeding
Características morfogênicas e estruturais do capim-xaraés submetido à adubação nitrogenada e desfolhação
Non-AIDS defining cancers in the D:A:D Study-time trends and predictors of survival : a cohort study
BACKGROUND:Non-AIDS defining cancers (NADC) are an important cause of morbidity and mortality in HIV-positive individuals. Using data from a large international cohort of HIV-positive individuals, we described the incidence of NADC from 2004-2010, and described subsequent mortality and predictors of these.METHODS:Individuals were followed from 1st January 2004/enrolment in study, until the earliest of a new NADC, 1st February 2010, death or six months after the patient's last visit. Incidence rates were estimated for each year of follow-up, overall and stratified by gender, age and mode of HIV acquisition. Cumulative risk of mortality following NADC diagnosis was summarised using Kaplan-Meier methods, with follow-up for these analyses from the date of NADC diagnosis until the patient's death, 1st February 2010 or 6 months after the patient's last visit. Factors associated with mortality following NADC diagnosis were identified using multivariable Cox proportional hazards regression.RESULTS:Over 176,775 person-years (PY), 880 (2.1%) patients developed a new NADC (incidence: 4.98/1000PY [95% confidence interval 4.65, 5.31]). Over a third of these patients (327, 37.2%) had died by 1st February 2010. Time trends for lung cancer, anal cancer and Hodgkin's lymphoma were broadly consistent. Kaplan-Meier cumulative mortality estimates at 1, 3 and 5 years after NADC diagnosis were 28.2% [95% CI 25.1-31.2], 42.0% [38.2-45.8] and 47.3% [42.4-52.2], respectively. Significant predictors of poorer survival after diagnosis of NADC were lung cancer (compared to other cancer types), male gender, non-white ethnicity, and smoking status. Later year of diagnosis and higher CD4 count at NADC diagnosis were associated with improved survival. The incidence of NADC remained stable over the period 2004-2010 in this large observational cohort.CONCLUSIONS:The prognosis after diagnosis of NADC, in particular lung cancer and disseminated cancer, is poor but has improved somewhat over time. Modifiable risk factors, such as smoking and low CD4 counts, were associated with mortality following a diagnosis of NADC
Some Chemical Kinetics Issues in Reburning: The Branching Fraction of the HCCO+NO Reaction
Aviation-Related Impacts on Ultrafine Particle Number Concentrations Outside and Inside Residences near an Airport
Jet
engine exhaust is a significant source of ultrafine particles and
aviation-related emissions can adversely impact air quality over large
areas surrounding airports. We investigated outdoor and indoor ultrafine
particle number concentrations (PNC) from 16 residences located in
two study areas in the greater Boston metropolitan area (MA, USA)
for evidence of aviation-related impacts. During winds from the direction
of Logan International Airport, that is, impact-sector winds, an increase
in outdoor and indoor PNC was clearly evident at all seven residences
in the Chelsea study area (∼4–5 km from the airport)
and three out of nine residences in the Boston study area (∼5–6
km from the airport); the median increase during impact-sector winds
compared to other winds was 1.7-fold for both outdoor and indoor PNC.
Across all residences during impact-sector and other winds, median
outdoor PNC were 19 000 and 10 000 particles/cm<sup>3</sup>, respectively, and median indoor PNC were 7000 and 4000 particles/cm<sup>3</sup>, respectively. Overall, our results indicate that aviation-related
outdoor PNC infiltrate indoors and result in significantly higher
indoor PNC. Our study provides compelling evidence for the impact
of aviation-related emissions on residential exposures. Further investigation
is warranted because these impacts are not expected to be unique to
Logan airport
In Silico Application of Quantum Chemical Methods for Relating Toxicity to Chemical Reactivity
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