Prospective observational cohort study of oesophagogastric cancer patients (POCOP): A Dutch nationwide cohort

Experimentele farmacotherapi

Prognostic value of patient-reported quality of life for survival in oesophagogastric cancer: analysis from the population-based POCOP study

Background Accumulating evidence of trials demonstrates that patient-reported health-related quality of life (HRQoL) at diagnosis is prognostic for overall survival (OS) in oesophagogastric cancer. However, real-world data are lacking. Moreover, differences in disease stages and tumour-specific symptoms are usually not taken into consideration. The aim of this population-based study was to assess the prognostic value of HRQoL, including tumour-specific scales, on OS in patients with potentially curable and advanced oesophagogastric cancer. Methods Data were derived from the Netherlands Cancer Registry and the patient reported outcome registry (POCOP). Patients included in POCOP between 2016 and 2018 were stratified for potentially curable (cT1-4aNallM0) or advanced (cT4b or cM1) disease. HRQoL was measured with the EORTC QLQ-C30 and the tumour-specific OG25 module. Cox proportional hazards models assessed the impact of HRQoL, sociodemographic and clinical factors (including treatment) on OS. Results In total, 924 patients were included. Median OS was 38.9 months in potentially curable patients (n = 795) and 10.6 months in patients with advanced disease (n = 129). Global Health Status was independently associated with OS in potentially curable patients (HR 0.89, 99%CI 0.82-0.97), together with several other HRQoL items: appetite loss, dysphagia, eating restrictions, odynophagia, and body image. In advanced disease, the Summary Score was the strongest independent prognostic factor (HR 0.75, 99%CI 0.59-0.94), followed by fatigue, pain, insomnia and role functioning. Conclusion In a real-world setting, HRQoL was prognostic for OS in patients with potentially curable and advanced oesophagogastric cancer. Several HRQoL domains, including the Summary Score and several OG25 items, could be used to develop or update prognostic models.Biological, physical and clinical aspects of cancer treatment with ionising radiatio

Nationwide comprehensive gastro-intestinal cancer cohorts: the 3P initiative

Background: The increasing sub-classification of cancer patients due to more detailed molecular classification of tumors, and limitations of current trial designs, require innovative research designs. We present the design, governance and current standing of three comprehensive nationwide cohorts including pancreatic, esophageal/gastric, and colorectal cancer patients (NCT02070146). Multidisciplinary collection of clinical data, tumor tissue, blood samples, and patient-reported outcome (PRO) measures with a nationwide coverage, provides the infrastructure for future and novel trial designs and facilitates research to improve outcomes of gastrointestinal cancer patients. Material and methods: All patients aged ≥18 years with pancreatic, esophageal/gastric or colorectal cancer are eligible. Patients provide informed consent for: (1) reuse of clinical data; (2) biobanking of primary tumor tissue; (3) collection of blood samples; (4) to be informed about relevant newly identified genomic aberrations; (5) collection of longitudinal PROs; and (6) to receive information on new interventional studies and possible participation in cohort multiple randomized controlled trials (cmRCT) in the future. Results: In 2015, clinical data of 21,758 newly diagnosed patients were collected in the Netherlands Cancer Registry. Additional clinical data on the surgical procedures were registered in surgical audits for 13,845 patients. Within the first two years, tumor tissue and blood samples were obtained from 1507 patients; during this period, 1180 patients were included in the PRO registry. Response rate for PROs was 90%. The consent rate to receive information on new interventional studies and possible participation in cmRCTs in the future was >85%. The number of hospitals participating in the cohorts is steadily increasing. Conclusion: A comprehensive nationwide multidisciplinary gastrointestinal cancer cohort is feasible and surpasses the limitations of classical study designs. With this initiative, novel and innovative studies can be performed in an efficient, safe, and comprehensive setting

Nationwide comprehensive gastro-intestinal cancer cohorts: the 3P initiative

Background: The increasing sub-classification of cancer patients due to more detailed molecular classification of tumors, and limitations of current trial designs, require innovative research designs. We present the design, governance and current standing of three comprehensive nationwide cohorts including pancreatic, esophageal/gastric, and colorectal cancer patients (NCT02070146). Multidisciplinary collection of clinical data, tumor tissue, blood samples, and patient-reported outcome (PRO) measures with a nationwide coverage, provides the infrastructure for future and novel trial designs and facilitates research to improve outcomes of gastrointestinal cancer patients. Material and methods: All patients aged ≥18 years with pancreatic, esophageal/gastric or colorectal cancer are eligible. Patients provide informed consent for: (1) reuse of clinical data; (2) biobanking of primary tumor tissue; (3) collection of blood samples; (4) to be informed about relevant newly identified genomic aberrations; (5) collection of longitudinal PROs; and (6) to receive information on new interventional studies and possible participation in cohort multiple randomized controlled trials (cmRCT) in the future. Results: In 2015, clinical data of 21,758 newly diagnosed patients were collected in the Netherlands Cancer Registry. Additional clinical data on the surgical procedures were registered in surgical audits for 13,845 patients. Within the first two years, tumor tissue and blood samples were obtained from 1507 patients; during this period, 1180 patients were included in the PRO registry. Response rate for PROs was 90%. The consent rate to receive information on new interventional studies and possible participation in cmRCTs in the future was >85%. The number of hospitals participating in the cohorts is steadily increasing. Conclusion: A comprehensive nationwide multidisciplinary gastrointestinal cancer cohort is feasible and surpasses the limitations of classical study designs. With this initiative, novel and innovative studies can be performed in an efficient, safe, and comprehensive setting

Een omstreden uitspraak.

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Reducing nutrient availability and enhancing biotic resistance limits settlement and growth of the invasive Australian swamp stonecrop (Crassula helmsii)

The Australian swamp stonecrop is invasive due to its efficient colonization of empty niches. The establishment of dense C. helmsii growth is threatening native biodiversity and functioning of freshwater ecosystems. In this study we’ve tested the competitive strength of C. helmsii in a greenhouse experiment with two native competitor species of the same habitat type, Pilularia globulifera and Littorella uniflora. After the collection of native vernation and bare soil sods we manually infested these with 60 propagules of C. helmsii. The settlement and growth of C. helmsii was assessed (by counting) after five weeks. In addition, the effect of nutrient enrichment by water bird feces on competition was studied by adding waterfowl droppings. Additionally we’ve measured nutrients in soil and water samples (by AA- and ICP analysis) collected from the sods. This gives insights in the establishment success and invasiveness of C. helmsii in absence of native competitors and eutrophication. *The data appropriate to this article may contain Dutch notes. For an English explanation, please contact the author of the data Abstract of the paper: The invasive Australian swamp stonecrop, Crassula helmsii, is a perennial amphibious herb originating from Australia and New Zealand. In freshwater wetlands of North-western Europe, this alien plant species is invasive due to its efficient colonization of empty niches. The establishment of dense C. helmsii growth is threatening native biodiversity and functioning of freshwater ecosystems, especially oligotrophic wetlands with high disturbance and nutrient enrichments. As the effects of these potential drivers of ecosystem degradation are generally difficult to determine in the field, we tested the competitive strength of C. helmsii in a greenhouse experiment with two native competitor species of the same habitat type, Pilularia globulifera and Littorella uniflora. Sods dominated by either of the native species, as well as bare soils, were collected from the field and manually infested with propagules of C. helmsii. Settlement and growth of C. helmsii was assessed after five weeks. In addition, the effect of nutrient enrichment by water bird feces on competition was studied by adding waterfowl droppings. C. helmsii was able to settle successfully in all treatments, but P. globulifera and L. uniflora dominance reduced settlement success and growth of C. helmsii. On vegetated sods, the addition of waterfowl droppings had a low effect on the performance of C. helmsii, however, this treatment significantly increased biomass production on bare soils with low nutrient availability. We conclude that both absence of native competitors and eutrophication, including guanotrophication by waterfowl, explain the establishment success and invasiveness of C. helmsii. Given the fact that eradication of C. helmsii is very challenging, our results imply that management should focus on a combination of increasing local species densities and abating eutrophication. This will strongly limit the window of opportunity for invasion of C. helmsii and enhance resistance by native plant communities

Health-related quality of life in 975 patients with complex regional pain syndrome type 1

Perioperative Medicine: Efficacy, Safety and OutcomeAnesthesiolog

Reactions of Ca and Sr with CH₃X and CF₃X (X=Br, I). A laser-induced fluorescence study on nascent CaBr, SrBr, and SrI.

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Reactions of Ca and Sr with CH(3)X and CF(3)X (X=Br,I). A laser-induced fluorescence study on nascent CaBr, SrBr, and SrI (vol 207, pg 261, 1996)

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Distribution of signs and symptoms of complex regional pain syndrome type 1 in patients meeting the diagnostic criteria of the international association of the study of pain

The aim of the present study was to describe the occurrence of signs and symptoms in CRPS I patients meeting the IASP (Orlando) criteria, assess the occurrence of signs and symptoms in relation to disease duration and compare these to historical data based on a different diagnostic criteria set. Six hundred and ninety-two ambulatory patients meeting the IASP criteria for CRPS I referred to the outpatient clinics of five participating centers were included in this cross-sectional study. Characteristics were recorded in a standardized fashion and categorized according to the factor structure proposed by Bruehl/Harden. Subgroups were classified according to the duration of complaints and compared to historical data as described by Veldman et al. The Chi-square test corrected for multiple comparisons was used for statistical analysis. The prevalence of sensory signs was higher in patients with longer disease duration, especially for the allodynia's and hyperalgesia (all p 6 months). Prevalences of signs in the motor subgroup were all higher (p <0.0001) in patients with longer disease duration, except for limited range of motion. Occurrence of signs was significantly lower (<0.001) than those reported by Veldman et al., except for hyperesthesia and dystonia. Occurrence rates may vary at different time points after onset of CRPS, which may be of influence for diagnosing patients with novel derived diagnostic criteria. We argue for a mechanism based description of CRPS I based on one set of uniform generally accepted diagnostic criteria in future studies