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Author Roh, T.H.; Park, H.H.; Kang, S.-G.; Moon, J.H.; Kim, E.H.; Hong, C.-K.; Ahn, S.S.; Choi, H.J.; Cho, J.; Kim, S.H.; Lee, S.K.; Kim, D.S.; Kim, S.H.; Suh, C.-O.; Lee, K.S.; Chang, J.H. url  doi
openurl 
  Title Long-term outcomes of concomitant chemoradiotherapy with temozolomide for newly diagnosed glioblastoma patients: A single-center analysis Type Journal Article
  Year 2017 Publication Medicine Abbreviated Journal Medicine (Baltimore)  
  Volume 96 Issue 27 Pages e7422  
  Keywords Adult; Aged; Aged, 80 and over; Antineoplastic Agents, Alkylating/*therapeutic use; Brain Neoplasms/diagnosis/genetics/metabolism/*therapy; *Chemoradiotherapy; DNA Methylation; DNA Modification Methylases/genetics/metabolism; DNA Repair Enzymes/genetics/metabolism; Dacarbazine/*analogs & derivatives/therapeutic use; Disease-Free Survival; Female; Follow-Up Studies; Glioblastoma/diagnosis/genetics/metabolism/*therapy; Humans; Male; Middle Aged; Prognosis; Promoter Regions, Genetic; Retrospective Studies; Treatment Outcome; Tumor Suppressor Proteins/genetics/metabolism; Young Adult  
  Abstract The present study analyzed outcomes of surgery followed by concomitant chemoradiotherapy (CCRT) with temozolomide (TMZ) in patients with newly diagnosed glioblastoma (GBM) at a single institution. Outcomes were retrospectively reviewed in 252 consecutive patients with newly diagnosed GBM who underwent surgery followed by CCRT with TMZ at the authors' institution between 2005 and 2013. At initial operation, 126 (50.0%), 55 (21.8%), 45 (17.9%), and 26 (10.3%) patients underwent gross total resection (GTR), subtotal resection, partial resection (PR), and biopsy, respectively. Their median overall survival (OS) was 20.8 months (95% confidence interval [CI] 17.7-23.9 months) and their median progression-free survival was 12.7 months (95% CI 11.2-14.2 months). The O-methylguanine-DNA methyltransferase (MGMT) promoter was methylated in 78 (34.1%) of the 229 patients assayed, and an isocitrate dehydrogenase 1 mutation was detected in 7 (6.6%) of the 106 patients analyzed. Univariate analyses showed that patient age, involvement of eloquent areas, involvement of the subventricular zone, presence of leptomeningeal seeding, Karnofsky Performance Status, extent of resection (EOR), MGMT promoter methylation, and presence of an oligodendroglioma component were prognostic of OS. Multivariate analysis showed that age, involvement of eloquent areas, presence of leptomeningeal seeding, EOR, and MGMT promoter methylation were significantly predictive of survival. OS in patients with GBM who undergo surgery followed by CCRT with TMZ is enhanced by complete resection. Other factors significantly prognostic of OS include that age, involvement of eloquent areas, presence of leptomeningeal seeding, and MGMT promoter methylation.  
  Address aYonsei University Graduate School, Seoul bDepartment of Neurosurgery, Ajou University Hospital, Ajou University School of Medicine, Suwon cDepartment of Neurosurgery dDepartment of Radiology eDepartment of Medical Oncology fDepartment of Radiation Oncology gDepartment of Pathology, Yonsei University College of Medicine hBrain Tumor Center, Severance Hospital, Yonsei University Health System iBrain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN (up) 0025-7974 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28682902 Approved no  
  Call Number ref @ user @ Serial 96578  
Permanent link to this record
 

 
Author Liu, Y.; Shen, Y.; Sun, T.; Yang, W. url  doi
openurl 
  Title Mechanisms regulating radiosensitivity of glioma stem cells Type Journal Article
  Year 2017 Publication Neoplasma Abbreviated Journal Neoplasma  
  Volume 64 Issue 5 Pages 655-665  
  Keywords glioma stem cells; radiosensitivity signaling pathways.  
  Abstract Malignant glioblastoma (GBM) has become a very common and difficult brain tumor given its low cure rate and high recurrence rate. GBMs are resistant to treatments because glioma stem cells (GSCs)/glioma-initiating cells (GICs), a specific subpopulation of GBM, possess properties of tumor stem cells, such as unlimited proficiency, self-renewal, differentiation and resistance to chemotherapy and radiotherapy, and exhibit a very strong DNA repair capability. Radiotherapy has become a preponderant treatment, and researchers have found many significant tumor microenvironmental factors and valuable signaling pathways regulating the GSC radioresistance, including NOTCH, Wnt/beta-catenin, Hedgehog, STAT3, and PI3K/AKT/mTOR. Therefore, we seek to boost GSC radiosensitivity through activating or inactivating pathways alone or together to eliminate the likely source of glioma and prolong survival of patients.  
  Address  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN (up) 0028-2685 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28592117 Approved no  
  Call Number ref @ user @ Serial 96582  
Permanent link to this record
 

 
Author Hudgins, J.D.; Goldberg, V.; Fell, G.L.; Puder, M.; Eisenberg, M.A. url  doi
openurl 
  Title Reducing Time to Antibiotics in Children With Intestinal Failure, Central Venous Line, and Fever Type Journal Article
  Year 2017 Publication Pediatrics Abbreviated Journal Pediatrics  
  Volume 140 Issue 5 Pages  
  Keywords Anti-Bacterial Agents/*administration & dosage; Bacteremia/diagnosis/drug therapy/epidemiology; Central Venous Catheters/microbiology; Child, Preschool; Cohort Studies; Female; Fever/diagnosis/*drug therapy/*epidemiology; Humans; Intestinal Diseases/diagnosis/drug therapy/epidemiology; Length of Stay/*trends; Male; Short Bowel Syndrome/diagnosis/*drug therapy/*epidemiology; Time-to-Treatment  
  Abstract BACKGROUND: Children with intestinal failure (IF) on parenteral nutrition (PN) are at high risk for bacteremia, and delays in antibiotic administration have been associated with increased morbidity and mortality. We designed an emergency department (ED) quality improvement (QI) initiative to reduce time to administration of intravenous antibiotics in febrile children with IF on PN. METHODS: Our aim was to decrease the mean time for febrile children with IF on PN to receive intravenous antibiotics by 50% to <60 minutes over a 12-month period. Secondary outcome measures were ED, hospital, and ICU length of stay (LOS). Our process measure was the rate of ordering recommended antibiotics, and our balancing measure was the rate of hypoglycemia. Interventions included increasing provider knowledge of IF, streamlining order entry, providing individualized feedback, and standardizing the triage process. Results were analyzed by using statistical process control methodology and time series analysis. RESULTS: We identified 149 eligible ED patients, of which 62 (41.6%) had bacteremia. The mean time to antibiotics decreased after the onset of the QI initiative from 112 to 39 minutes, and the ED LOS decreased from 286 to 247 minutes, but the total length of hospital and ICU stays were unchanged. The rate of hypoglycemia was also unchanged. CONCLUSIONS: Our QI intervention for febrile children with IF on PN shortened the time to receive antibiotics. Larger studies are needed to demonstrate the impact on overall LOS and mortality.  
  Address Division of Emergency Medicine and  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN (up) 0031-4005 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:29066581 Approved no  
  Call Number ref @ user @ Serial 98935  
Permanent link to this record
 

 
Author Hudgins, J.D.; Goldberg, V.; Fell, G.L.; Puder, M.; Eisenberg, M.A. url  doi
openurl 
  Title Reducing Time to Antibiotics in Children With Intestinal Failure, Central Venous Line, and Fever Type Journal Article
  Year 2017 Publication Pediatrics Abbreviated Journal Pediatrics  
  Volume 140 Issue 5 Pages  
  Keywords Anti-Bacterial Agents/*administration & dosage; Bacteremia/diagnosis/drug therapy/epidemiology; Central Venous Catheters/microbiology; Child, Preschool; Cohort Studies; Female; Fever/diagnosis/*drug therapy/*epidemiology; Humans; Intestinal Diseases/diagnosis/drug therapy/epidemiology; Length of Stay/*trends; Male; Short Bowel Syndrome/diagnosis/*drug therapy/*epidemiology; Time-to-Treatment  
  Abstract BACKGROUND: Children with intestinal failure (IF) on parenteral nutrition (PN) are at high risk for bacteremia, and delays in antibiotic administration have been associated with increased morbidity and mortality. We designed an emergency department (ED) quality improvement (QI) initiative to reduce time to administration of intravenous antibiotics in febrile children with IF on PN. METHODS: Our aim was to decrease the mean time for febrile children with IF on PN to receive intravenous antibiotics by 50% to <60 minutes over a 12-month period. Secondary outcome measures were ED, hospital, and ICU length of stay (LOS). Our process measure was the rate of ordering recommended antibiotics, and our balancing measure was the rate of hypoglycemia. Interventions included increasing provider knowledge of IF, streamlining order entry, providing individualized feedback, and standardizing the triage process. Results were analyzed by using statistical process control methodology and time series analysis. RESULTS: We identified 149 eligible ED patients, of which 62 (41.6%) had bacteremia. The mean time to antibiotics decreased after the onset of the QI initiative from 112 to 39 minutes, and the ED LOS decreased from 286 to 247 minutes, but the total length of hospital and ICU stays were unchanged. The rate of hypoglycemia was also unchanged. CONCLUSIONS: Our QI intervention for febrile children with IF on PN shortened the time to receive antibiotics. Larger studies are needed to demonstrate the impact on overall LOS and mortality.  
  Address Division of Emergency Medicine and  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN (up) 0031-4005 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:29066581 Approved no  
  Call Number ref @ user @ Serial 99965  
Permanent link to this record
 

 
Author Nunes, B.P.; Soares, M.U.; Wachs, L.S.; Volz, P.M.; Saes, M. de O.; Duro, S.M.S.; Thume, E.; Facchini, L.A. url  doi
openurl 
  Title Hospitalization in older adults: association with multimorbidity, primary health care and private health plan Type Journal Article
  Year 2017 Publication Revista de Saude Publica Abbreviated Journal Rev Saude Publica  
  Volume 51 Issue Pages 43  
  Keywords Aged; Brazil; *Comorbidity; Cross-Sectional Studies; Female; Hospitalization/*statistics & numerical data; Humans; Male; Middle Aged; Prepaid Health Plans/*statistics & numerical data; Primary Health Care/*standards/statistics & numerical data; Socioeconomic Factors; Urban Population  
  Abstract OBJECTIVE: Evaluate the association of multimorbidity, primary health care model and possession of a private health plan with hospitalization. METHODS: A population-based cross-sectional study with 1,593 elderly individuals (60 years old or older) living in the urban area of the city of Bage, State of Rio Grande do Sul, Brazil. The outcome was hospitalization in the year preceding the interview. The multimorbidity was evaluated through two cut-off points (>/= 2 and >/= 3). The primary health care model was defined by residence in areas covered by traditional care or by Family Health Strategy. The older adults mentioned the possession of a private health plan. We performed a gross and adjusted analysis by Poisson regression using a hierarchical model. The adjustment included demographic, socioeconomic, functional capacity disability and health services variables. RESULTS: The occurrence of overall and non-surgical hospitalization was 17.7% (95%CI 15.8-19.6) and 10.6% (95%CI 9.1-12.1), respectively. Older adults with multimorbidity were admitted to hospitals more often when to older adults without multimorbidity, regardless of the exhibition' form of operation. Having a private health plan increased the hospitalization by 1.71 (95%CI 1.09-2.69) times among residents in the areas of the Family Health Strategy when compared to elderly residents in traditional areas without a private health plan. CONCLUSIONS: The multimorbidity increased the occurrence of hospitalizations, especially non-surgical ones. Hospitalization was more frequent in older adults with private health plan and those living in Family Health Strategy areas, regardless of the presence of multiple diseases. OBJETIVO: Avaliar a associacao da multimorbidade, modelo de atencao basica e posse de plano de saude com hospitalizacao. METODOS: Estudo transversal de base populacional com 1.593 idosos (60 anos ou mais) residentes na zona urbana do municipio de Bage, Rio Grande do Sul. O desfecho foi a hospitalizacao no ano anterior a entrevista. A multimorbidade foi avaliada por meio de dois pontos de corte (>/= 2 e >/= 3). O modelo de atencao basica foi definido pela residencia em areas cobertas pela atencao tradicional ou da Estrategia Saude da Familia. A posse de plano de saude foi referida pelos idosos. Realizou-se analise bruta e ajustada por regressao de Poisson utilizando modelo hierarquizado. O ajuste incluiu variaveis demograficas, socioeconomicas, capacidades funcionais e de servicos de saude. RESULTADOS: A ocorrencia de hospitalizacao geral e nao cirurgica foi de 17,7% (IC95% 15,8-19,6) e 10,6% (IC95% 9,1-12,1), respectivamente. Idosos com multimorbidade hospitalizaram mais em comparacao com os idosos sem multimorbidade, independentemente da forma de operacionalizacao da exposicao. O plano de saude aumentou em 1,71 (IC95% 1,09-2,69) vezes a internacao hospitalar entre residentes nas areas da Estrategia Saude da Familia em comparacao aos idosos residentes nas areas tradicionais sem plano de saude. CONCLUSOES: A multimorbidade aumentou a ocorrencia de hospitalizacoes, principalmente aquelas nao cirurgicas. Idosos com plano de saude e residentes em areas de Estrategia Saude da Familia internaram mais, independentemente da presenca de multiplas doencas.  
  Address Departamento de Medicina Social. Faculdade de Medicina. Universidade Federal de Pelotas. Pelotas, RS, Brasil  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language Portuguese Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN (up) 0034-8910 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28492761 Approved no  
  Call Number ref @ user @ Serial 97638  
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