Research articleBoundaries and e-health implementation in health and social care
BMC Medical Informatics and Decision Making 2012,12:100 doi:10.1186/1472-6947-12-100
Published: 7 September 2012Sent from my iPhone
BREAST ONCOLOGY
Friday, September 07, 2012
BMC Medical Informatics and Decision Making | Abstract | Boundaries and e-health implementation in health and social care
Research articleSent from my iPhone
The struggle for universal health coverage : The Lancet
.....These debates should be informed by the 2010 World Health Report by David Evans and colleagues, one of the most important publications from WHO in a decade, which sets out the how and why of improved health gains and efficiencies from UHC. Efficiencies include better health outcomes, according to Rodrigo Moreno-Serra and Peter Smith, especially for the least advantaged in a society. Debates should also examine the evidence, as has Jeffrey Sachs' Viewpoint, about the obstacle raised by user fees. Regardless of the euphemism chosen to describe shared payments, they are in reality a locked gate that prevents access to health care for many who need it most. They should be scrapped...…
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Thursday, September 06, 2012
Exercise interventions on health-related quality of life for people with cancer during active treatment - The Cochrane Library - Mishra - Wiley Online Library
Intervention Review
Exercise interventions on health-related quality of life for people with cancer during active treatment
Editorial Group: Cochrane Gynaecological Cancer Group
Published Online: 15 AUG 2012
Assessed as up-to-date: 1 JUN 2012
DOI: 10.1002/14651858.CD008465.pub2
Copyright © 2012 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Database Title
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Genetics and Ovarian Cancer: What You Should Know
Genetics and Ovarian Cancer: What You Should Know
Wednesday, September 19, 2012 2:00 PM - 3:00 PM EDT
Webinar Registration
About 10 to 15 percent of women diagnosed with ovarian cancer have a hereditary tendency to develop the disease. Women with mutations in the breast cancer genes (BRCA 1 and 2), as well as HNPCC or Lynch syndrome, are more likely to develop ovarian cancer.
Experts from three groups that work on genetic issues related to cancer will join us for a webinar kicking off National Hereditary Breast and Ovarian Cancer week.
* Rebecca Sutphen, MD, FACMG, of FORCE will talk about family history and how that relates to cancer.
* Amber P. Trivedi, MS, CGC, from Bright Pink will discuss psychosocial issues around hereditary cancer, including fertility issues and prophylactic surgery.
* Shera Dubitsky, MEd, MA, Clinical Supervisor at Sharsheret, will discuss how to talk with your family about hereditary cancer risk.
Whether you know your personal genetic risk, work with women at high risk of developing ovarian cancer or just want to learn more about this topic, we urge you to RSVP today for our free session.
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* Indicates a required field
By clicking the "Register Now" button you submit your information to the Webinar organizer, who will use it to communicate with you regarding this event and their other services.
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Dana-Farber Cancer Institute's Ursula A. Matulonis, MD Article on EntreMed's ENMD-2076 Published in the European Journal of Cancer - MarketWatch
Methods for Identification of CA125 from Ovarian Cancer Ascites by High Resolution Mass Spectrometry.
Methods for Identification of CA125 from Ovarian Cancer Ascites by High Resolution Mass Spectrometry.
Methods for Identification of CA125 from Ovarian Cancer Ascites by High Resolution Mass Spectrometry.
Int J Mol Sci. 2012;13(8):9942-58
Authors: Weiland F, Fritz K, Oehler MK, Hoffmann P
Abstract
CA125 is the most widely used tumour marker in ovarian cancer with unsatisfactory sensitivity and specificity especially at early stage. It is quantified by antibody-based immunoassays; however different molecular weight isoforms have been described in the literature which have never been validated by mass spectrometry, potentially affecting the diagnostic accuracy and clinical reliability of the test. In this study, CA125 was detected by Western blot and its identity confirmed by mass spectrometry. Two-dimensional (2D) gel electrophoresis in combination with mass spectrometry revealed that positive Western blot signals up to 500 kDa are most likely false-positive interactions of M11-like and OC125-like antibodies. Fibronectin, identified as one of these false-positive interaction partners, increased the reading for CA125 in a first generation ELISA significantly (p = 0.02). The existence of low-molecular weight isoforms of CA125 is therefore questionable and is most likely reflecting cross-reactivity of the antibodies with other proteins. This would explain the conflicting reports on the molecular structure of CA125 and also the inconsistency of CA125 levels by different ELISAs. Our results are also the first steps towards a mass spectrometric assay for CA125 quantification, which would improve sensitivity and reliability.
PMID: 22949840 [PubMed - in process]
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Wednesday, September 05, 2012
New Style and New Content for ClinicalTrials.gov. NLM Technical Bulletin. 2012 Jul–Aug
New Style and New Content for ClinicalTrials.gov. NLM Technical Bulletin. 2012 Jul–Aug
Table of Contents: 2012 JULY–AUGUST No. 387
New Style and New Content for ClinicalTrials.gov
Huston M, Williams RJ, Bergeris A, Fun J, Tse T.
New Style and New Content for ClinicalTrials.gov. NLM Tech Bull. 2012
Jul-Aug;(387):e5.
2012 August 15 [posted]
Etiology of Breast Masses after Autologous Breast Reconstruction
Published in partnership with
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BMC Medical Ethics | Abstract | The ethical decisions UK doctors make regarding advanced cancer patients at the end of life - the perceived (in) appropriateness of anticoagulation for venous thromboembolism: A qualitative study
The ethical decisions UK doctors make regarding advanced cancer patients at the end of life - the perceived (in) appropriateness of anticoagulation for venous thromboembolism: A qualitative study
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Five-year trends in mortality indices a - PubMed Mobile
Five-year trends in mortality indices among gynecological cancer patients in Canada.
Abstract
OBJECTIVE: To estimate and compare the five-year trends in excess mortality rate, net probability of death, and crude probability of death for patients diagnosed with epithelial invasive gynecological cancers in Canada. We compared these trends among ovarian, uterine, and cervical cancers.
METHODS: A flexible parametric model was used to estimate three mortality indices for gynecological cancers. We incorporated age group, type of cancer, and year of diagnosis in the model to estimate these indices over a five-year period after diagnosis.
RESULTS: In total, 39,681 women diagnosed with epithelial invasive gynecological cancers were included in this analysis with a mean age of 57.9 (SD=15.1) years at diagnosis. Approximately 30% of patients were younger than 50years old at diagnosis and 45% were between 50- 69years old. Ovarian cancer had the worst prognosis among the gynecological cancers based on all three mortality indices.
CONCLUSIONS: The three mortality indices provide a clear insight in understanding the elements of mortality in population-based cancer studies where the underlying cause of death is not correctly identified, the accuracy of death certificates varies overtime and among countries, and death tends to be a multi-factorial event.
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A phase I study with an expanded cohort to assess feasibility of intravenous docetaxel, intraperitoneal carboplatin and intraperitoneal paclitaxel in patients with previously untreated ovarian, fallopian tube or primary peritoneal carcinoma: A Gynecologic Oncology Group Study.
A phase I study with an expanded cohort to assess feasibility of intravenous docetaxel, intraperitoneal carboplatin and intraperitoneal paclitaxel in patients with previously untreated ovarian, fallopian tube or primary peritoneal carcinoma: A Gynecologic Oncology Group Study.
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Conservative management of early-stage - PubMed Mobile
Conservative management of early-stage epithelial ovarian cancer: results of a large retrospective series.
Abstract
BackgroundTo assess the long-term oncological outcome and the fertility of young women with early-stage epithelial ovarian cancer (ES/EOC) treated with fertility-sparing surgery (FSS).Patients and methodsAll patients treated with FSS for ES/EOC in two Italian centers were considered for this analysis. Univariate and multivariate analyses were used to test demographic characteristics and clinical features for the association with overall survival (OS), recurrence-free survival (RFS) and fertility.ResultsFrom 1982 to 2010, 240 patients with malignant ES/EOC were treated with FSS in two tertiary centers in Italy. At a median follow-up of 9 years, 27 patients had relapsed (11%) and 11 (5%) had died of progressive disease. Multivariate analysis found only grade 3 negatively affected the prognosis of patients [hazard ratio (HR) for recurrence: 4.2, 95% confidence interval (CI): 1.5-11.7, P = 0.0067; HR for death: 7.6, 95% CI: 2.0-29.3, P = 0.0032]. Grade 3 was also significantly associated with extra-ovarian relapse (P = 0.006). Of the 105 patients (45%) who tried to become pregnant, 84 (80%) were successful.ConclusionsConservative treatment can be proposed to all young patients when tumor is limited to the ovaries, as ovarian recurrences can always be managed successfully. Patients with G3 tumors are more likely to have distant recurrences and should be closely monitored.
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Healthcare Workers View Hand Hygiene Reminders Unfavorably (mobile format)
From Medscape Medical News
Healthcare Workers View Hand Hygiene Reminders Unfavorably
September 4, 2012 — Healthcare workers do not appear to support being reminded to wash their hands by patients, according to the findings of a cross-sectional study.
Yves Longtin, MD, from Centre Hospitalier Universitaire de Quebec in Quebec City, Canada, and colleagues presented their findings in an article published online September 3 in theArchives of Internal Medicine.
The authors mention that the concept of having patients remind healthcare workers about the importance of hand hygiene has been promoted. "This strategy has been recommended by a large number of organizations and authorities worldwide, including the World Health Organization and the US Centers for Disease Control and Prevention," the authors write. "However, very little is known about [healthcare workers'] views of such programs."
The authors sent anonymous, confidential surveys to the home addresses of 700 healthcare workers in a single institution in 2009 and assessed the views and opinions of the respondents by using a 5-point Likert scale (from 1, strongly agree, to 5, strongly disagree). Of the 277 respondents (41.1% response rate), 29% did not wish to be reminded by patients to wash their hands, 27% believed that this request was beyond the bounds of the patient's role, and 37% did not wish to wear a name badge that prompted patients to remind them about hand hygiene.
Multivariate analysis revealed that the endorsement of patient inquiry was positively associated with the belief that patients could help prevent medical errors (adjusted odds ratio [AOR], 8.4; 95% confidence interval [CI], 3.2 - 22.1; P < .001) and improve healthcare worker hand hygiene compliance (AOR, 6.4; 95% CI, 2.4 - 16.8; P < .001).
Conversely, support for patient inquiry was negatively associated with the concepts that neglecting hand hygiene was inconsequential (AOR, 0.1; 95% CI, 0.02 - 0.5; P = .006), that patient inquiry would be embarrassing (AOR, 0.3; 95% CI, 0.1 0.8; P = .02), and that patient inquiry would question their competency (AOR, 0.4; 95% CI, 0.2 - 1.0; P = .05).
This study was limited by its low response rate, its single-institution nature, and the possibilities of participation and desirability biases...
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Tuesday, September 04, 2012
NCI Cancer Bulletin for September 4, 2012New Website Highlights NCI-Designated Cancer Centers
Cancer.gov Update
New Website Highlights NCI-Designated Cancer Centers
Sixty-seven U.S. cancer centers have earned recognition as NCI-designated cancer centers, indicating that they have met rigorous criteria for world-class programs in multidisciplinary cancer research. These centers develop research programs, faculty, and facilities that are focused on developing better approaches to cancer prevention, diagnosis, and treatment.
One section of the updated site focuses on the development of one of the first targeted cancer therapies, imatinib (Gleevec), and describes how researchers at several NCI-designated cancer centers were involved in the initial research and, later, clinical trials for the drug. After the first clinical study was reported in 1999, imatinib moved quickly toward Food and Drug Administration approval for chronic myelogenous leukemia. By 2011, it had been tested and approved to treat several other cancers.
Another feature of the new website is an interactive map of NCI-designated cancer centers across the United States, with links to detailed profiles for each center. There is also a list of top scientific and medical awards for cancer center scientists, including 45 Nobel Prize winners, and a section describing what it takes for an institution to become an NCI-designated cancer center.
2011/2012 Cancer Trends Progress Report Available
NCI released its 2011/2012 Cancer Trends Progress Reportlast week. The report summarizes the nation's progress against cancer in relation to the Healthy People 2020 targets developed by the U.S. Department of Health and Human Services. The revised report, published every other year, is intended for policy makers, researchers, clinicians, and public health service providers. It offers updated national trends data in a user-friendly format that is fully accessible to people with disabilities.
The report features
- A quick tutorial to ease navigating and downloading materials within the report;
- Updated "Trends-at-a-Glance" snapshot;
- Links to NCI's State Cancer Profiles' state- and county-level data;
- Data, graphs, and slides that are easy to download;
- Links to Healthy People 2020 materials;
- Links to colorectal cancer mortality projections; and
- Custom print reports.
The Cancer Trends Progress Report: 2011/2012 Update can be viewed online. General questions about the report may be directed to progressreporthelp@mail.nih.gov.
Website for NCI's Geographic Information Systems & Science Updated
The recently updated website for NCI's Geographic Information Systems (GIS) & Science for cancer prevention and control boasts a streamlined design to help users more easily navigate the site.
GIS systems capture, manage, analyze, and visualize geographic information, including cancer data, making it easier for researchers to observe and interpret relationships, patterns, and trends in complicated data sets.
The redesigned website features a "Why Spatial Context Matters" screen with rotating images that depict geographic and environmental factors that affect cancer risk, as well as four entry routes to the main elements of the GIS site.
Please visit the GIS website to
- Learn about GIS initiatives and research at NCI;
- Explore the tools and data used in GIS research; and
- Find out about NCI and NIH funding and training opportunities.
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Making progress against radiotherapy-induced side effects
From The Globe and Mail: Making progress against radiotherapy-induced side effects - http://www.theglobeandmail.com/life/health-and-fitness/advsunnybrook/sunnybrookfeatures/making-progress-against-radiotherapy-induced-side-effects/article4517565/?utm_source=Shared+Article+Sent+to+User&utm_medium=E-mail:+Newsletters+/+E-Blasts+/+etc.&utm_campaign=Shared+Web+Article+Links
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Intake of omega-3 and omega-6 fatty acids and risk of ovarian cancer.
Intake of omega-3 and omega-6 fatty acids and risk of ovarian cancer.
Intake of omega-3 and omega-6 fatty acids and risk of ovarian cancer.
Cancer Causes Control. 2012 Aug 30;
Authors: Ibiebele TI, Nagle CM, Bain CJ, Webb PM
Abstract
OBJECTIVES: Limited experimental evidence suggests that omega-3 polyunsaturated (n-3) fatty acids inhibit the proliferation of ovarian cancer cells in vitro, whereas omega-6 polyunsaturated (n-6) fatty acids have been shown to promote carcinogenesis, but epidemiological studies to date have been inconclusive. Our aim was to evaluate the role of polyunsaturated fatty acids in ovarian carcinogenesis. METHODS: Participants in the Australian Ovarian Cancer Study (1,366 cases and 1,414 population controls) self-completed risk factor and food frequency questionnaires. Logistic regression models were used to calculate adjusted odds ratio (OR) and 95 % confidence intervals (CI). RESULTS: We found no association between intake of total n-3 fatty acids from foods, or the individual n-3 fatty acids-alpha-linolenic, eicosapentaenoic, docosapentaenoic, docosahexaenoic acids-and ovarian cancer risk. High intake of total n-6 fatty acids was inversely associated with risk (OR for highest vs. lowest category 0.78, 95 % CI 0.60-1.00, p-trend 0.04); however, the association was restricted to n-6 fatty acids from avocado, vegetables, and nuts. Neither higher intake of the individual n-6 fatty acids nor the ratio of n-3 to n-6 fatty acids was associated with ovarian cancer risk. We found no evidence that risk varied by supplement use. CONCLUSIONS: Our data provide no evidence of a protective role for n-3 fatty acids in ovarian carcinogenesis. The benefit, if any, of higher intake of n-6 fatty acids is due to general properties of the food sources, rather than due to the n-6 fatty acids per se.
PMID: 22933054 [PubMed - as supplied by publisher]
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Changes in supportive care needs after first-line treatment for ovarian cancer: identifying care priorities and risk factors for future unmet needs.
Changes in supportive care needs after first-line treatment for ovarian cancer: identifying care priorities and risk factors for future unmet needs.
Changes in supportive care needs after first-line treatment for ovarian cancer: identifying care priorities and risk factors for future unmet needs.
Psychooncology. 2012 Aug 31;
Authors: Beesley VL, Price MA, Webb PM, O'Rourke P, Marquart L, Australian Ovarian Cancer Study Group, Australian Ovarian Cancer Study-Quality of Life Study Investigators, Butow PN
Abstract
OBJECTIVE: The objective of this paper is to determine changes in supportive care needs after first-line treatment for ovarian cancer and identify risk factors for future unmet needs. METHODS: Two hundred and nineteen women with ovarian cancer were asked to complete a baseline survey 6-12 months after diagnosis then follow-up surveys every 6 months for up to 2 years. The validated Supportive Care Needs Survey-Short Form measured 34 needs across five domains. Logistic regression identified baseline variables associated with future needs. RESULTS: At baseline, standardized median scores (possible range 0-100, least-to-greatest need) within the psychological, system/information, physical, patient care and sexuality need domains were 25, 20, 15, 15 and 8, respectively. The most frequently reported moderate-to-high unmet needs at baseline were needing help with fear about cancer spreading (25%), concerns about worries of those close (20%), being informed about things to help get well (20%), uncertainty about future (19%) and lack of energy (18%). All except the item about being informed were still reported as unmet needs by ≥15% of women 2 years later. Median health system/information, patient care and sexuality need scores decreased over 2 years (p < 0.05), whereas psychological and physical scores remained constant. Risk factors for having ≥1 moderate-to-high unmet overall, psychological or physical need 1-2 years after baseline included older age, advanced disease, unmet need, anxiety, depression, insomnia and less social support at baseline. CONCLUSION: Women with ovarian cancer report needing ongoing assistance to deal with psychological and physical needs over the first 2 years after first-line treatment. Targeting individuals at risk of future unmet needs should be prioritized. Copyright © 2012 John Wiley & Sons, Ltd.
PMID: 22936668 [PubMed - as supplied by publisher]
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Type 2 Diabetes Mellitus and the Incidence of Epithelial Ovarian Cancer in the Cancer Prevention Study-II Nutrition Cohort.
Type 2 Diabetes Mellitus and the Incidence of Epithelial Ovarian Cancer in the Cancer Prevention Study-II Nutrition Cohort.
Type 2 Diabetes Mellitus and the Incidence of Epithelial Ovarian Cancer in the Cancer Prevention Study-II Nutrition Cohort.
Cancer Epidemiol Biomarkers Prev. 2012 Aug 31;
Authors: Gapstur SM, Patel AV, Diver WR, Hildebrand JS, Gaudet MM, Jacobs EJ, Campbell PT
Abstract
BACKGROUND: Despite consistent associations of type 2 diabetes mellitus (DM) with hormonally-related cancers such as breast and endometrium, the relation between type 2 DM and ovarian cancer risk is unclear. METHODS: Associations of type 2 DM status, duration and insulin use with epithelial ovarian cancer overall, and with serous and non-serous histologic subtypes were examined in the Cancer Prevention Study-II Nutrition Cohort, a prospective study of U.S. men and women predominantly aged 50 years and older. Between 1992 and 2007, 524 incident epithelial ovarian cancer cases were identified among 63,440 post-menopausal women. Multivariable-adjusted relative risks (RRs) and 95% confidence intervals (CIs) were computed using extended Cox regression to updated diabetes status and bilateral oophorectomy status during follow-up. RESULTS: Type 2 DM status (RR=1.05, 95% CI 0.75-1.46) and duration were not associated with epithelial ovarian cancer risk. Although not statistically significantly different (Pdifference=0.39), the RR was higher for type 2 DM with insulin use (RR=1.28, 95% CI 0.74, 2.24) than for type 2 DM without insulin use (RR=0.96, 95%: CI 0.64, 1.43). Diabetes appeared to be more strongly associated with non-serous (RR=1.41, 95%: CI 0.70, 2.85) than serous (RR=0.71, 95%: CI 0.41, 1.23) histologic subtypes. CONCLUSIONS: Type 2 DM was not associated with risk of epithelial ovarian cancer, although higher risks with non-serous subtypes and among insulin users cannot be ruled out. Impact: Larger studies are needed to clarify associations of type 2 DM with or without insulin use with risk of ovarian cancer overall and by histologic subtypes.
PMID: 22941335 [PubMed - as supplied by publisher]
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