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As the number of informal caregivers and their caregiving responsibilities increase, this study aims at evaluating caregiver distress, quality of life (QoL) and their predictors in informal caregivers of cancer patients during active treatment and follow-up.
This cross-sectional descriptive study targeted primary caregivers of patients with different cancer diagnoses. Caregiver-reported outcomes were measured by the Caregiver Risk Screen (CRS), Distress Thermometer (DT) and Caregiver Quality of Life Index-Cancer (CQOLC).
Caregivers (n=1580) experienced a low-to-moderate risk of caregiver distress and a moderate QoL during both treatment and follow-up. About 13% reported a high caregiver risk and 20% reported severe distress. There was a strong and significant correlation between caregiver distress and caregivers' QoL (0.793). Predictive factors for higher distress and poorer QoL were fewer emotional and practical resources, being female, non-spousal relationship or not living together (p<0.05). Caregivers of patients with head-and-neck, skin, lung and brain cancers reported the highest distress and lowest QoL.
Caregiver distress is highly variable, but a minority of caregivers is at high risk for caregiver distress. Professional caregivers play an important role at supporting caregivers and detecting high-risk caregivers.
Caregiver distress is highly variable, but a minority of caregivers is at high risk for caregiver distress. Professional caregivers play an important role at supporting caregivers and detecting high-risk caregivers.The introduction of novel agents over the last decade has rapidly expanded the therapeutic landscape of multiple myeloma (MM) for both transplant-eligible and transplant-ineligible patients. The assessment of minimal residual disease (MRD) by next-generation flow cytometry or next-generation sequencing is established as a powerful predictor of long-term outcomes. The use of MRD in response-adapted clinical trials may provide opportunities to identify candidates for treatment escalation and de-escalation. Agents with proven activity in the relapsed and refractory setting are being studied in the management of high-risk newly diagnosed MM (NDMM). Here, we summarize the most recent clinical trials that have led to the current paradigms in the management of NDMM. We also discuss how novel agents could be incorporated in the newly diagnosed setting and potential clinical trial designs that could leverage MRD information with the goal of treatment optimization.
While bioavailability of oral voriconazole is known to be >90%, several reports have observed much lower oral bioavailability. The aim of the present study was to assess the oral bioavailability of voriconazole in clinical use by evaluating the change in serum voriconazole concentration in patients who received intravenous-to-oral switch therapy with the same dose of voriconazole.
A single-centre, retrospective cohort study was conducted at the 614-bed Gifu University Hospital in Japan. Temsirolimus mTOR inhibitor Patients who received intravenous-to-oral switch therapy with the same dose of voriconazole between 1 January 2011 and 31 December 2018 were enrolled in the present study. We evaluated changes in serum voriconazole concentration before and after switch therapy.
Voriconazole trough concentrations significantly decreased following oral compared to intravenous treatment (2.5±1.5µg/mL vs 3.3±2.0µg/mL, p=0.021). The median change rate of serum concentration by switching the route of administration was 82.7%, with wide inter-individual variability (range 27.2-333.3%). Further, concomitant glucocorticoid administration was a significant protective factor for reducing serum concentration (OR 0.16, 95% CI 0.03-0.79, p=0.025).
Switching from intravenous to oral treatment resulted in a significant decline in voriconazole trough concentrations with wide inter-individual variability. Therefore, measurement of serum concentration for dose adjustment should be performed after switching to the oral form.
Switching from intravenous to oral treatment resulted in a significant decline in voriconazole trough concentrations with wide inter-individual variability. Therefore, measurement of serum concentration for dose adjustment should be performed after switching to the oral form.
To explore the relationships between resilience, empathy, compassion fatigue, work engagement and turnover intention in Chinese haemodialysis nurses.
Although several studies explored nurses' turnover intention in multiple hospital wards, fewer studies focused on turnover intention and its predictors among nurses in dialysis care.
We conducted a cross-sectional study and adopted a two-stage sampling method to recruit 528 Chinese haemodialysis nurses. Multiple regression analysis was performed to explore the effects of resilience, empathy, compassion fatigue and work engagement on turnover intention.
The prevalence of high and exceptionally high levels of turnover intention was 59.1% and 9.0%. Compassion fatigue had the strongest significant effect on turnover intention (β=0.276), followed by work engagement (β=-0.256) and resilience (β=0.193). Haemodialysis nurses in tertiary hospitals reported significant higher levels of turnover intention than those in secondary hospitals (β=0.127).
Higher levels of compassion fatigue and lower levels of resilience and work engagement can result in higher turnover intention in haemodialysis nurses.
Strategies such as resilience training programme, mindfulness-based intervention and establishing a positive work environment may be effective methods to improve resilience, reduce compassion fatigue, promote work engagement and decrease turnover intention.
Strategies such as resilience training programme, mindfulness-based intervention and establishing a positive work environment may be effective methods to improve resilience, reduce compassion fatigue, promote work engagement and decrease turnover intention.Angiosarcoma (AS) is a rare disease with a dismal prognosis. The treatment landscape and prognostic factors for advanced AS, including locally advanced, unresectable, and metastatic disease remain elusive. The Asian Sarcoma Consortium is an international collaborative effort to understand the sarcoma treatment landscape in Asia. We undertook a retrospective chart review of AS patients seen in 8 sarcoma academic centers across Asia. Patients with complete clinical, treatment, and follow-up data were enrolled. Overall, 276 advanced AS patients were included into this study; 84 (30%) of the patients had metachronous metastatic AS. The median age was 67 y; primary sites of AS was cutaneous in 55% and visceral in 45% of patients. In total, 143 (52%) patients received at least 1 line of systemic chemotherapy. The most common first-line chemotherapy regimen used was paclitaxel (47.6%) followed by liposomal doxorubicin (19.6%). The median overall survival (OS) was 7.8 mo. Significant prognostic factors for OS included age > 65 (hazard ratio (HR) 1.
Homepage: https://www.selleckchem.com/products/Temsirolimus.html
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