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Petrova M, Barclay S. From "wading through treacle" to "making haste slowly": A comprehensive yet parsimonious model of drivers and challenges to implementing patient data sharing projects based on an EPaCCS evaluation and four pre-existing literature reviews. PLOS Digit Health 2024; 3:e0000470. [PMID: 38557799 PMCID: PMC10984410 DOI: 10.1371/journal.pdig.0000470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/19/2024] [Indexed: 04/04/2024]
Abstract
Conceptually, this study aimed to 1) identify the challenges and drivers encountered by England's Electronic Palliative Care Coordination System (EPaCCS) projects in the context of challenges and drivers in other projects on data sharing for individual care (also referred to as Health Information Exchange, HIE) and 2) organise them in a comprehensive yet parsimonious framework. The study also had a strong applied goal: to derive specific and non-trivial recommendations for advancing data sharing projects, particularly ones in early stages of development and implementation. Primary data comprised 40 in-depth interviews with 44 healthcare professionals, patients, carers, project team members and decision makers in Cambridgeshire, UK. Secondary data were extracted from four pre-existing literature reviews on Health Information Exchange and Health Information Technology implementation covering 135 studies. Thematic and framework analysis underpinned by "pluralist" coding were the main analytical approaches used. We reduced an initial set of >1,800 parameters into >500 challenges and >300 drivers to implementing EPaCCS and other data sharing projects. Less than a quarter of the 800+ parameters were associated primarily with the IT solution. These challenges and drivers were further condensed into an action-guiding, strategy-informing framework of nine types of "pure challenges", four types of "pure drivers", and nine types of "oppositional or ambivalent forces". The pure challenges draw parallels between patient data sharing and other broad and complex domains of sociotechnical or social practice. The pure drivers differ in how internal or external to the IT solution and project team they are, and thus in the level of control a project team has over them. The oppositional forces comprise pairs of challenges and drivers where the driver is a factor serving to resolve or counteract the challenge. The ambivalent forces are factors perceived simultaneously as a challenge and a driver depending on context, goals and perspective. The framework is distinctive in its emphasis on: 1) the form of challenges and drivers; 2) ambivalence, ambiguity and persistent tensions as fundamental forces in the field of innovation implementation; and 3) the parallels it draws with a variety of non-IT, non-health domains of practice as a source of fruitful learning. Teams working on data sharing projects need to prioritise further the shaping of social interactions and structural and contextual parameters in the midst of which their IT tools are implemented. The high number of "ambivalent forces" speaks of the vital importance for data sharing projects of skills in eliciting stakeholders' assumptions; managing conflict; and navigating multiple needs, interests and worldviews.
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Affiliation(s)
- Mila Petrova
- Palliative and End of Life Care Group in Cambridge (PELiCam), Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, United Kingdom
| | - Stephen Barclay
- Palliative and End of Life Care Group in Cambridge (PELiCam), Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, United Kingdom
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Zhelev K, Mihaylova-Hristov M, Conev N, Cholakova M, Korabova B, Petrov I, Georgieva N, Nedev N, Mihaylova I, Petrova M, Zahariev Z, Donev I. Lower fluorodeoxyglucose positron emission tomography maximum standardized uptake value may show a better response to stereotactic body radiotherapy of adrenals in oligometastatic disease. Contemp Oncol (Pozn) 2024; 27:263-268. [PMID: 38405207 PMCID: PMC10883199 DOI: 10.5114/wo.2023.135288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/02/2024] [Indexed: 02/27/2024] Open
Abstract
Introduction Stereotactic body radiotherapy (SBRT) is well established for oligometastatic disease, and it is increasingly used to treat adrenal metastases. Material and methods In this retrospective study we performed an analysis of 75 metastatic adrenal lesions in 64 patients with oligometastatic disease. According to the fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) maximum standardized uptake value (SUVmax) of adrenal metastases, patients were categorized into three groups: low, intermediate, and high SUVmax. Results For all clinicopathological characteristics we found significant relationships for levels of SUVmax and objective response rate (Kendall Tau-c = 0.290; p = 0.017). Patients who responded to SBRT had a significantly lower SUVmax value than those who did not respond (7.6 ±2.4 vs. 9.7 ±3.8; p = 0.015). At the appropriate SUVmax cut-off values, the biomarker distinguished between patients with and without a response significantly and moderately (area under the curve = 0.670, 95% confidence intervals: 0.540-0.790; p = 0.015). Conclusions Lower SUVmax is associated with a better response to SBRT in patients whose disease progressed mainly in the adrenal glands.
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Affiliation(s)
- Kiril Zhelev
- Department of Radiotherapy, MHAT “Heart and Brain”, Pleven, Bulgaria
| | | | | | - Manoela Cholakova
- Department of Radiotherapy, MHAT “Heart and Brain”, Pleven, Bulgaria
| | - Bilyana Korabova
- Department of Radiotherapy, MHAT “Heart and Brain”, Pleven, Bulgaria
| | - Ivaylo Petrov
- Department of Radiotherapy, MHAT “Heart and Brain”, Pleven, Bulgaria
| | | | - Nikolay Nedev
- Department of Radiotherapy, MHAT “City Clinic”, Sofia, Bulgaria
| | | | - Mila Petrova
- Clinic of Medical Oncology, MHAT “Nadezhda”, Sofia, Bulgaria
| | - Zahari Zahariev
- Department of Radiotherapy, Uni Hospital, Panagyurishte, Bulgaria
| | - Ivan Donev
- Clinic of Medical Oncology, MHAT “Nadezhda”, Sofia, Bulgaria
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Gencheva R, Petrova M, Kraleva P, Hadjidekova S, Radanova M, Conev N, Stoyanov D, Arabadjiev J, Tazimova E, Bachurska S, Eneva M, Tsvetkova M, Zhbantov G, Karanikolova T, Manov D, Ivanova A, Taushanova‐Hadjieva M, Staneva R, Dimitrova E, Donev I. Prevalence and prognosis of PIK3CA mutations in Bulgarian patients with metastatic breast cancer receiving endocrine therapy in first-line setting. Cancer Rep (Hoboken) 2023; 7:e1966. [PMID: 38148576 PMCID: PMC10849999 DOI: 10.1002/cnr2.1966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/30/2023] [Accepted: 12/06/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND AND AIMS In approximately 40% of patients with HER2-negative/HR-positive breast cancer tumors, the PIK3CA gene is mutated. Despite this, clinical outcomes vary between studies in this cohort. We aimed to ascertain the prevalence of PIK3CA mutations in patients with metastatic HR+/HER2- breast in Bulgaria, as well the evaluation and comparison of progression free survival (PFS) between wild-type (WT) and mutation-positive groups in the real-world setting. METHODS Three oncology centers in Bulgaria collected 250 tissue samples between 2016 and 2022 for this multicentric retrospective study. PIK3CA mutations were identified using Real-Time qPCR. The median follow-up period was 35 months. RESULTS The mean age of the mutant cohort was 57.6 ± 11.6 years, compared to 56.5 ± 12.2 years for the WT cohort (p = .52). The percentage of patients with visceral metastasis was 58.8% (n = 147). Approximately 84.3% (n = 210) of the patients had reached postmenopause. 29.2% (n = 73) of the patients had PIK3CA mutations. The predominant mutation was present in exon 20, H1047R (46.5%). We found a significant correlation only between the presence of a mutation and the metastatic diseases at diagnosis (p = .002). As first-line therapy, 67.1% of patients received endocrine therapy (ET) plus cyclin dependent kinase (CDK4/6) inhibitor, while the remainder received ET alone. The median PFS of patients in the group with the mutation was 32 months (95%, CI: 22-40) compared to 24 months in the WT cohort ((95%, CI: 21-36) (p = .45)); HR = 0.86 (95%, CI: 0.5-1.3) (p = .46). We corroborated our conclusion using propensity matching score analysis, (36 months [95% CI: 20-40] vs. 26 months [95% CI: 21-38], [p = .69]). CONCLUSIONS We found that the prevalence of PIK3CA mutations in our patients was comparable to what has been reported in other nations. Our results suggest that PIK3CA mutational status has no bearing to ET efficacy in first-line setting.
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Affiliation(s)
- R. Gencheva
- Clinic of Medical OncologyMHAT “Nadezhda”SofiaBulgaria
| | - M. Petrova
- Clinic of Medical OncologyMHAT “Nadezhda”SofiaBulgaria
| | - P. Kraleva
- Clinic of Medical OncologyMHAT “Nadezhda”SofiaBulgaria
| | - S. Hadjidekova
- Department of Medical Genetics, Medical FacultyMedical University of SofiaSofiaBulgaria
| | - M. Radanova
- Department of Biochemistry, Molecular Medicine and NutrigenomicsMedical University of VarnaVarnaBulgaria
| | - N. Conev
- Clinic of Medical OncologyUniversity Hospital “St. Marina”VarnaBulgaria
| | - D. Stoyanov
- Clinic of Medical OncologyUniversity Hospital “St. Marina”VarnaBulgaria
| | - J. Arabadjiev
- Clinic of Medical OncologyUniversity Hospital Acibadem City Clinic TokudaSofiaBulgaria
| | - E. Tazimova
- Clinic of Medical OncologyUniversity Hospital Acibadem City Clinic TokudaSofiaBulgaria
| | - S. Bachurska
- Department of General and ClinicalpathologyUniversity Specialised Hospital for OncologySofiaBulgaria
| | - M. Eneva
- Department of Hospital Pharmacy “Nadezhda”SofiaBulgaria
| | | | - G. Zhbantov
- Clinic of Medical OncologyMHAT “Nadezhda”SofiaBulgaria
| | | | - D. Manov
- Clinic of Medical OncologyMHAT “Nadezhda”SofiaBulgaria
| | - A. Ivanova
- Clinic of Medical OncologyMHAT “Nadezhda”SofiaBulgaria
| | | | - R. Staneva
- Department of Medical Genetics, Medical FacultyMedical University of SofiaSofiaBulgaria
| | - E. Dimitrova
- Department of Biochemistry, Molecular Medicine and NutrigenomicsMedical University of VarnaVarnaBulgaria
| | - I. Donev
- Clinic of Medical OncologyMHAT “Nadezhda”SofiaBulgaria
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Saikat S, Selbie D, McDarby G, Mustafa S, Petrova M, Seifeldin R, Zhang Y, Jakab Z. Editorial: Health systems recovery in the context of COVID-19 and protracted conflict. Front Public Health 2023; 11:1205286. [PMID: 37293611 PMCID: PMC10246765 DOI: 10.3389/fpubh.2023.1205286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 04/28/2023] [Indexed: 06/10/2023] Open
Affiliation(s)
| | - Duncan Selbie
- International Association of National Public Health Institutes, Paris, France
| | | | | | | | | | - Yu Zhang
- World Health Organization, Geneva, Switzerland
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McDarby G, Seifeldin R, Zhang Y, Mustafa S, Petrova M, Schmets G, Porignon D, Dalil S, Saikat S. A synthesis of concepts of resilience to inform operationalization of health systems resilience in recovery from disruptive public health events including COVID-19. Front Public Health 2023; 11:1105537. [PMID: 37250074 PMCID: PMC10213627 DOI: 10.3389/fpubh.2023.1105537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/27/2023] [Indexed: 05/31/2023] Open
Abstract
This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict' Health systems resilience has become a ubiquitous concept as countries respond to and recover from crises such as the COVID-19 pandemic, war and conflict, natural disasters, and economic stressors inter alia. However, the operational scope and definition of health systems resilience to inform health systems recovery and the building back better agenda have not been elaborated in the literature and discourse to date. When widely used terms and their operational definitions appear nebulous or are not consistently used, it can perpetuate misalignment between stakeholders and investments. This can hinder progress in integrated approaches such as strengthening primary health care (PHC) and the essential public health functions (EPHFs) in health and allied sectors as well as hinder progress toward key global objectives such as recovering and sustaining progress toward universal health coverage (UHC), health security, healthier populations, and the Sustainable Development Goals (SDGs). This paper represents a conceptual synthesis based on 45 documents drawn from peer-reviewed papers and gray literature sources and supplemented by unpublished data drawn from the extensive operational experience of the co-authors in the application of health systems resilience at country level. The results present a synthesis of global understanding of the concept of resilience in the context of health systems. We report on different aspects of health systems resilience and conclude by proposing a clear operational definition of health systems resilience that can be readily applied by different stakeholders to inform current global recovery and beyond.
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Affiliation(s)
- Geraldine McDarby
- Special Programme on Primary Health Care, World Health Organization, Geneva, Switzerland
| | | | | | | | | | | | | | | | - Sohel Saikat
- Special Programme on Primary Health Care, World Health Organization, Geneva, Switzerland
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Petrov D, Petrova M, Mladenova I, Dimitrov N, Mratskova G. A survey of the knowledge, perceptions of and attitudes to digital health of healthcare professionals in 14 Bulgarian hospitals: First large-scale study on digital health in Bulgarian inpatient facilities. Digit Health 2023; 9:20552076231185276. [PMID: 37545631 PMCID: PMC10399259 DOI: 10.1177/20552076231185276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 06/08/2023] [Indexed: 08/08/2023] Open
Abstract
Objective To explore the knowledge, perceptions of and attitudes to digital health of Bulgarian hospital professionals in the first study of digital health in this professional group. Methods A paper-based questionnaire was administered to doctors, trainee doctors, nurses, midwives, and laboratory assistants working in multiprofile or specialized hospitals. Topics included the following: state, objectives, benefits, and future of digital health; data storage, access, security, and sharing; main software used; patient-held Personal Information System (PIS); and telemedicine. A total of 1187 participants from 14 hospitals completed the survey in two phases: September 2013-April 2014 and May 2015-April 2017. Data were analyzed through descriptive statistics and multilevel logistic regression. Results Three-quarters of participants evaluated the state of development of digital health in Bulgaria as subpar (36.0% negative; 38.9% passable; 24.5% positive). 27.2% (323) endorsed patients having unconditional access to their data. In contrast, 89.5% (1062) of participants considered it appropriate to have full access to patient data recorded by colleagues. Doctors were more likely to endorse patients having access to their data than healthcare specialists (OR = 1.79 at facility, OR = 1.77 at location). Conclusion The largely negative or lukewarm attitudes toward the state of development of digital health in Bulgaria are likely to result from the high number of failed projects, unmet expectations, misunderstood benefits, and unforeseen challenges. This study provides a much-needed stimulus and baseline for researching the ways in which the digital health landscape in Bulgaria has matured-or not.
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Affiliation(s)
- Damyan Petrov
- Medical Faculty, Trakia University, Stara Zagora, Bulgaria
| | | | - Irena Mladenova
- Department of Hygiene, Epidemiology, Microbiology, Parasitology and Infectious Diseases, Medical Faculty, Trakia University, Stara Zagora, Bulgaria
| | - Nedko Dimitrov
- Department of Special Surgery, Medical Faculty, Trakia University, Stara Zagora, Bulgaria
| | - Galina Mratskova
- Department of Physical and Rehabilitation Medicine, Medical Faculty, Trakia University, Stara Zagora, Bulgaria
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Okusaka T, Kitano M, Chen MH, Chen JS, Ostwal V, McNamara M, Breder V, Petrova M, Buchschacher G, Rokutanda N, Xiong J, Cohen G, Oh DY. 93P Outcomes by disease status in patients with advanced biliary tract cancer treated with durvalumab or placebo plus gemcitabine and cisplatin in the phase III TOPAZ-1 study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Antonuzzo L, Takahashi H, Park J, Sookprasert A, Gillmore R, Yang SS, Cundom J, Petrova M, Vaccaro G, Holmblad M, Xiong J, Heider K, Rokutanda N, Oh DY. 91P Immune-mediated adverse event (imAE) incidence, timing and association with efficacy in the phase III TOPAZ-1 study of durvalumab (D) or placebo (PBO) plus gemcitabine and cisplatin (+ GC) in advanced biliary tract cancer (BTC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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Antonuzzo L, Takahashi H, Park J, Sookprasert A, Gillmore R, Yang SS, Cundom J, Petrova M, Vaccaro G, Holmblad M, Xiong J, Heider K, Rokutanda N, Oh DY. 57P Immune-mediated adverse event (imAE) incidence, timing and association with efficacy in the phase III TOPAZ-1 study of durvalumab (D) or placebo (PBO) plus gemcitabine and cisplatin (+ GC) in advanced biliary tract cancer (BTC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Rachev NR, Petrova M. How Will the Occupation End? A Real-World Exploration of Hindsight Bias and Retroactive Pessimism Concerning Antigovernment Protests in Bulgaria. The American Journal of Psychology 2022. [DOI: 10.5406/19398298.135.2.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
We explored hindsight bias and retroactive pessimism related to the occupation of Sofia University in 2013–2014, using a memory design. We found partial evidence for hindsight bias for predictions of whether the occupation would achieve its goal (the government's resignation) but not for specific events related to the occupation, which were deemed unlikely from the start and later perceived not to have occurred. We did not find evidence for retroactive pessimism: Hindsight bias indices for the prediction of the government's resignation were not reliably associated with support for the occupation and disappointment with its outcome. We propose using a recall/reconstruct measure as a more rigorous test for retroactive pessimism, which has so far been demonstrated through reassessment.
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Petrova M, Parvanov D, Ganeva R, Metodiev D, Bachurska S, Eneva M, Penkova P, Popov T, Nikolov K, Taushanova M, Kraleva P, Ruseva RK, Zhelev K, Donev I. Tumor neutrophil extracellular traps and pretreatment neutrophils in association with progression-free survival in patients with metastatic non-small cell lung cancer receiving pembrolizumab alone or with chemotherapy. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e21099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e21099 Background: Background: In this multicentric retrospective study, we evaluated the relationship between pre- treatment blood neutrophils and neutrophil extracellular traps (NET) in biopsy samples and their predictive value for progression progression-free survival (PFS) in patients with non-small-cell lung cancer (NSCLC) receiving immunotherapy alone or in combination with chemotherapy as a first-line treatment. Methods: Patients with metastatic NSCLC (n = 100) were retrospectively analyzed between Apr 2018 and Sep 2021; 77.5% of the patients received platinum-containing chemotherapy with Pembrolizumab, and 22.5% – Pembrolizumab only as a first-line treatment. Pre-treatment blood neutrophils were counted. Tissue sections were stained immunohistochemically for Neutrophil elastase (NE) and Histone H3. Both NE and Histone H3 stained tissue areas were calculated manually and determined by Image-J software. We considered the extracellular components that were double-positive for NE and H3 to be NET. Results: In correspondence analysis, patients with low levels (< 33rd percentile) of pre-treatment neutrophils were grouped with low amounts (< 33rd percentile) of NET-positive tumor areas (p = 0.02). The amounts of NET-positive tumor areas were not related to other clinicopathological characteristics of the patients. Patients with an intermediate/high amount of NET-positive areas had significantly shorter mean PFS, 10.7 (95% CI: 9.6–11.8) than those with low NET-positive areas, 14.8 (95% CI: 11.5–18.1) (log-rank test p = 0.003). Moreover, in a multivariate Cox regression model, the presence of an intermediate/high amount of NET-positive areas was an independent predictive factor for shorter PFS, HR 2.1 (95% CI: 1.2–3.7; p = 0.005). Conclusions: Our study suggests that tumor formation of NETs is related to the numbers of pre-treatment neutrophils and may mediate neutrophil-induced antitumor resistance. Excessive NET formation in tumor tissue is a potential negative predictive marker for shorter PFS.
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Affiliation(s)
- Mila Petrova
- MHAT “Nadezhda”, Sofia, Bulgaria, Sofia, Bulgaria
| | | | - Rumiana Ganeva
- Research Department, MHAT Nadezhda Hospital, Sofia, Bulgaria
| | - Dimiter Metodiev
- Clinical Pathology Laboratory, MHAT Nadezhda Hospital, Sofia, Bulgaria, Sofia, Bulgaria
| | - Svitlana Bachurska
- Department of General and Clinical Pathology, University Specialized Oncology Hospital, Sofia, Bulgaria
| | | | - Polya Penkova
- Clinical Laboratory, MHAT “Nadezhda”, Sofia, Bulgaria
| | - Teodor Popov
- Medical Oncology Dept, Complex Oncology Center, Burgas, Bulgaria, Burgas, Bulgaria
| | - Krasimir Nikolov
- Medical Oncology Dept, Complex Oncology Center, Burgas, Bulgaria, Burgas, Bulgaria
| | | | - Petya Kraleva
- Medical Oncology Dept, MHAT Nadezhda Hospital, Sofia, Bulgaria
| | | | - Kiril Zhelev
- Department of Radiotherapy, MHAT Uni Hospital Panagiurishte, Panagiurishte, Bulgaria
| | - Ivan Donev
- Department of Medical Oncology, Nadezhda Hospital, Sofia, Bulgaria
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Khan SZ, Arecco L, Villarreal-Garza C, Sirohi B, Ponde NF, Habeeb B, Brandão M, Azim HA, Chowdhury AR, Bozovic-Spasojevic I, Kovalenko I, Odhiambo A, Seid FU, Mutombo AB, Petracci F, Vidra R, Altuna SC, Petrova M, Kourie HR, Ozturk MA, Razeti MG, Lengyel CG, Talibova N, Mariamidze E, Sacardo KP, Duma N, Gyawali B, Trapani D, Tagliamento M, Lambertini M. Knowledge, Practice, and Attitudes of Physicians in Low- and Middle-Income Countries on Fertility and Pregnancy-Related Issues in Young Women With Breast Cancer. JCO Glob Oncol 2022; 8:e2100153. [PMID: 35025688 PMCID: PMC8769103 DOI: 10.1200/go.21.00153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Fertility and pregnancy-related issues are highly relevant for young (≤ 40 years) patients with breast cancer. Limited evidence exists on knowledge, practice, and attitudes of physicians from low- and middle-income countries (LMICs) regarding these issues. Online in @ASCO_pubs #JCOGlobOncol large survey by @matteolambe et al. showing suboptimal practice and attitudes of physicians in #LMICs on #fertility and #pregnancy issues in young #BreastCancer patients: increased awareness and education in #oncofertility are needed@OncoAlert![]()
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Affiliation(s)
- Shah Zeb Khan
- Department of Clinical Oncology, BINOR, Bannu, Pakistan
| | - Luca Arecco
- Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Cynthia Villarreal-Garza
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico
| | - Bhawna Sirohi
- Department of Medical Oncology, Apollo Proton Cancer Centre, Chennai, India
| | | | - Baker Habeeb
- Department of Medical Oncology, Shaqlawa Teaching Hospital, Erbil, Iraq
| | - Mariana Brandão
- Department of Medical Oncology, Institut Jules Bordet, Brussels, Belgium
| | - Hatem A Azim
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico
| | - Arman Reza Chowdhury
- Department of Oncology, Evercare Cancer Centre, Evercare Hospital, Dhaka, Bangladesh
| | | | | | - Andrew Odhiambo
- Unit of Medical Oncology, Department of Clinical Medicine, University of Nairobi, Kenya
| | - Fahmi Usman Seid
- Department of Oncology, Hawassa University School of Medicine and Health Sciences, Hawassa, Sidama, Ethiopia.,Department of Oncology, Tikur Anbessa Hospital College of Health Sciences, Addis Ababa University, Ethiopia
| | | | | | - Radu Vidra
- Oncology Department, The Regional Institute of Gastroenterology and Hepatology "Prof Dr Octavian Fodor," Cluj-Napoca, Romania.,Oncology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Mila Petrova
- MHAT Nadezhda Department of Medical Oncology, Sofia, Bulgaria
| | | | - Mehmet Akif Ozturk
- Bahçeşehir University Faculty of Medicine, Department of Internal Medicine, Istanbul, Turkey
| | - Maria Grazia Razeti
- Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | | | - Narmin Talibova
- Department of Medical Oncology, National Oncology Center, Baku, Azerbaijan
| | - Elene Mariamidze
- Department of Oncology and Hematology, Todua Clinic, Tbilisi, Georgia
| | | | - Narjust Duma
- The Cancer Care Equity Program, Lowe Center For Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | | | - Marco Tagliamento
- Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genoa, Genova, Italy
| | - Matteo Lambertini
- Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genoa, Genova, Italy
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Petrova M, Wong G, Kuhn I, Wellwood I, Barclay S. Timely community palliative and end-of-life care: a realist synthesis. BMJ Support Palliat Care 2021:bmjspcare-2021-003066. [PMID: 34887313 DOI: 10.1136/bmjspcare-2021-003066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 09/19/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Community-based and home-based palliative and end-of-life care (PEoLC) services, often underpinned by primary care provision, are becoming increasingly popular. One of the key challenges associated with them is their timely initiation. The latter requires an accurate enough prediction of how close to death a patient is. METHODS Using 'realist synthesis' tools, this review sought to develop explanations of how primary care and community PEoLC programmes generate their outcomes, with the explanations presented as context-mechanism-outcome configurations. Medline, Embase, CINAHL, PsycINFO, Web of Science, ASSIA, Sociological Abstracts and SCIE Social Care Online were originally searched. A multistage process of focusing the review was employed, with timely identification of the EoL stage and timely initiation of associated services representing the final review focus. Synthesised sources included 21 full-text documents and 324 coded abstracts, with 253 'core contents' abstracts generating >800 codes. RESULTS Numerous PEoLC policies and programmes are embedded in a framework of Preparation and Planning for Death and Dying, with identification of the dying stage setting in motion key systems and services. This is challenged by: (1) accumulated evidence demonstrating low accuracy of prognostic judgements; (2) many individuals' orientation towards Living and Hope; (3) expanding grey zones between palliative and curative care; (4) the complexity of referral decisions; (5) the loss of pertinent information in hierarchical relationships and (6) the ambiguous value of having 'more time'. CONCLUSION Prioritising temporal criteria in initiating PEoLC services is not sufficiently supported by current evidence and can have significant unintended consequences. PROSPERO REGISTRATION NUMBER CRD42018097218.
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Affiliation(s)
- Mila Petrova
- Palliative & End of Life Care in Cambridge (PELiCAM) Research Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Geoff Wong
- Nuffied Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Isla Kuhn
- Medical Library, University of Cambridge, Cambridge, UK
| | - Ian Wellwood
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Stephen Barclay
- Palliative & End of Life Care in Cambridge (PELiCAM) Research Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Petrova M, Parvanov D, Ganeva R, Metodiev D, Bachurska S, Stamenov G, Eneva M, Penkova P, Sarbianova I, Popov T, Nikolov K, Radanova M, Taushanova M, Megdanova V, Donev I. 1318P Neutrophil extracellular traps as a potential predictive marker for treatment with pembrolizumab alone or with chemotherapy as a first-line in patients with metastatic non-small cell lung cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Williet N, Petrillo A, Roth G, Ghidini M, Petrova M, Forestier J, Lopez A, Thoor A, Weislinger L, De Vita F, Taieb J, Phelip JM. Gemcitabine/Nab-Paclitaxel versus FOLFIRINOX in Locally Advanced Pancreatic Cancer: A European Multicenter Study. Cancers (Basel) 2021; 13:cancers13112797. [PMID: 34199796 PMCID: PMC8200096 DOI: 10.3390/cancers13112797] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Gemcitabine/nab-paclitaxel (GN) and FOLFIRINOX (FFX) are two standard first-line therapies for metastatic pancreatic cancer (PC) but have rarely been compared, especially in patients with locally advanced PC (LAPC). By carefully selecting patients, it is likely these two regimens lead to similar survival outcomes. Through a multicenter European study, biases regarding practice habits are reduced. Hence, we observed no difference between GN and FFX as first-line treatments in patients with LAPC in terms of either survival, tumor response or tumor resection rate. Further trials are needed to confirm these data. Abstract Background: Gemcitabine/nab-paclitaxel (GN) and FOLFIRINOX (FFX) are two standard first-line therapies for metastatic pancreatic cancer (PC) but have rarely been compared, especially in patients with locally advanced PC (LAPC). Methods: This is a retrospective European multicenter study including patients with LAPC treated with either GN or FFX as the first-line therapy between 2010 and 2019. Coprimary objectives were progression-free survival (PFS) and overall survival (OS), both estimated using the Kaplan–Meier method. Results: A total of 147 patients (GN: n = 60; FFX: n = 87) were included. Tumor resection rates were similar between the two groups (16.7% vs. 16.1%; p = 1), with similar R0 resection rates (88.9%). Median PFS rates were not statistically different: 9 months (95% CI: 8–13.5) vs. 12.1 months (95% CI: 10.1–14.6; p = 0.8), respectively. Median OS rates were 15.7 months (95% CI: 12.6–20.2) and 16.7 months (95% CI: 14.8–20.4; p = 0.7), respectively. Abdominal pain at the baseline (HR = 2.03, p = 0.03), tumors located in the tail of the pancreas (HR = 4.35, p = 0.01), CA19-9 > 200 UI/L (HR = 2.03, p = 0.004) and tumor resection (HR = 0.37, p = 0.007) were independent prognostic factors for PFS, similarly to OS. CA19-9 ≤ 200 UI/L (OR = 2.6, p = 0.047) was predictive of the tumor response. Consolidation chemoradiotherapy, more often used in the FFX group (11.7% vs. 50.6%; p < 0.001), was not predictive. Conclusion: This retrospective study did not show any difference between GN and FFX as the first-line treatment in patients with LAPC.
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Affiliation(s)
- Nicolas Williet
- Department of Hepatogastroenterology, University Hospital of Saint-Etienne, 42000 Saint-Etienne, France;
- Correspondence:
| | - Angelica Petrillo
- Department of Precision Medecine, University of Study of Campania «L. Vanvitelli», 81100 Naples, Italy; (A.P.); (F.D.V.)
| | - Gaël Roth
- Hepato-Gastroenterology Department, University Hospital of Grenoble, 38043 Grenoble, France; (G.R.); (A.T.)
| | - Michele Ghidini
- Department of Medical Oncology, Cancer Center, Hospital of Cremona, 26100 Cremona, Italy;
| | - Mila Petrova
- Department of Medical Oncology, MHAT Nadezhda, 1220 Sofia, Bulgaria;
| | - Julien Forestier
- Department of Medical Oncology, Hôpital Edouard Herriot, 69622 Lyon, France;
| | - Anthony Lopez
- Hepato-Gastroenterology Department, University Hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France; (A.L.); (L.W.)
| | - Audrey Thoor
- Hepato-Gastroenterology Department, University Hospital of Grenoble, 38043 Grenoble, France; (G.R.); (A.T.)
| | - Lucie Weislinger
- Hepato-Gastroenterology Department, University Hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France; (A.L.); (L.W.)
| | - Ferdinando De Vita
- Department of Precision Medecine, University of Study of Campania «L. Vanvitelli», 81100 Naples, Italy; (A.P.); (F.D.V.)
| | - Julien Taieb
- Department of Gastroenterology and Gastro-Intestinal Oncology, Hôpital Européen Georges-Pompidou, APHP, Paris Descartes University, Sorbonne Paris Cité, 75004 Paris, France;
| | - Jean Marc Phelip
- Department of Hepatogastroenterology, University Hospital of Saint-Etienne, 42000 Saint-Etienne, France;
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Abstract
Background:Uric acid (UA) is well-known biomarker of cardiovascular risk and inflammation. However, the data about interrelations between asymptomatic hyperuricemia (AHU) and rheumatic diseases (RD) are limited and contradictory [1].Objectives:to identify the occurrence of AHU in pts with different RD and to evaluate the interrelations between the AHU and clinical features of the RD.Methods:The study included data from 822 pts with AHU and RD involved in the Saint-Petersburg Register of Pts with AHU in period from the 01jan2000 to the 01apr2020. The AHU was defined as the serum level of uric acid (UA) that exceeded 360 μmol/l without signs of gouty arthritis. Pts with the secondary reasons of AHU (an oncologic diseases, late stages of chronic kidney disease, ets), and inflammatory diseases another than RD were excluded from the study.Patient’s demographical characteristics, duration of AHU, level of UA, activity of RD, ESR, CRP, urate-lowering therapy (ULT) were analyzed. The study was approved by local ethic committee. Statistics was performed with SPSS17.Results:Characteristics of the Patients with the RD and AHU are present in Table 1. The duration of AHU in pts with the RD was 3.4±3.4 [0.08-18] years, mean duration of follow-up 2.7±4.0 years, mean number of visits during the period of follow-up was 3,2 [min 1; max 7], ESR 26.0±14.1 mm / h, CRP 19.6±21.0 mg/l.Table 1.Characteristics of the Patients with the Rheumatic diseases and asymptomatic hyperuricemia.Age, years(Mean±SD)Male, %**Serum UA, μmol/l(Mean±SD)Normalization of UA during the follow-up, n (%)RD, n=82256.7±14.540.27493.3±98.5242 (29.44) ##RA, n=32964.2±12.13.74504.8±107.5#99 (30.09) ##PsA, n= 14956.6±12.953.69531.5±94.9#32 (21.48) ##SpA, n= 10745.6±15.1*33.43520.8±86.5#18 (16.82)##SLE, n=13750.3±14.1*20.44451.6±91.457 (41.61)SSc, n= 5761.0±12.422.81456.2±99.520 (35.09)SD, n= 4362.0±10.716.28442.4±107.516 (37.21)RD – rheumatic disease; RA –– rheumatoid arthritis; PsA –– psoriatic arthritis; SpA –– spondyloarthritis; SLE –– systemic lupus erythematosus; SSc –– systemic sclerosis; SD –– Sjogren’s disease; * –– p<0.001 for the differences with RD, RA, PsA, SSc, SD; ** –– p < 0.01 for all intergroup differences; # –– p < 0.01 for the differences with RD, RA, SSc, SD; ##–– p < 0.01 for the differences with RA, SSc, SD.Were revealed the interrelations between the level of UA and ESR (Spearmen’s R=0.1, p=0.01), and UA and CRP (Spearmen’s R =0.12, p=0.001).The level of UA in male pts was 507.0 [361-940], in female pts 450.0 [361-1010] μmol /l (p<0.0001), in SLE pts with elevated anti-nuclear factor (ANF) UA was 429 [361-940] and with normal 494 [361-973] (p<0.0001). In pts with high and low RD activity UA was 490 [361-940] and 454 [363-1010]) μmol /l respectively, (p<0.0001). The higher UA level was found in any RD as compared with UA in low activity of the same RD (p<0.0001 for all the differences).Normalization of UA was found in 243 (29.6 %) pts, lack of normalization of UA in 434 (52.8 %) of cases, n = 677, Table 1. ULT received 219 (26.6 %) pts. Normalization of UA without ULT was registered in 16 (1.9 %) of the pts.Conclusion:UA level is higher and normalize less often in patients with SpA and PsA as compered with RA, SLA, SSc and SD pts. In any of analyzed rheumatic diseases the level of UA is higher in male pts and in pts with high disease activity.References:[1]K.Bosmansky, M. Ondrasik. Ter Arkh.1987;59(4):22-5.Disclosure of Interests:None declared.
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Bagasha P, Namukwaya E, Leng M, Kalyesubula R, Mutebi E, Naitala R, Katabira E, Petrova M. Comparison of the health-related quality of life of end stage kidney disease patients on hemodialysis and non-hemodialysis management in Uganda. BMC Palliat Care 2021; 20:52. [PMID: 33794849 PMCID: PMC8017791 DOI: 10.1186/s12904-021-00743-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 03/15/2021] [Indexed: 11/04/2022] Open
Abstract
Background Health-related quality of life is recognized as a key outcome in chronic disease management, including kidney disease. With no national healthcare coverage for hemodialysis, Ugandan patients struggle to pay for their care, driving families and communities into poverty. Studies in developed countries show that patients on hemodialysis may prioritize quality of life over survival time, but there is a dearth of information on this in developing countries. We therefore measured the quality of life (QOL) and associated factors in end stage renal disease (ESRD) patients in a major tertiary care hospital in Uganda. Methods Baseline QOL measurement in a longitudinal cohort study was undertaken using the Kidney Disease Quality of Life Short Form Ver 1.3. Patients were recruited from the adult nephrology unit if aged > 18 years with an estimated glomerular filtration rate ≤ 15mls/min/1,73m2. Clinical, demographic and micro-financial information was collected to determine factors associated with QOL scores. Results Three hundred sixty-four patients (364) were recruited, of whom 124 were on hemodialysis (HD) and 240 on non-hemodialysis (non-HD) management. Overall, 94.3% of participants scored less than 50 (maximum 100). Mean QOL scores were low across all three principal domains: physical health (HD: 33.14, non-HD: 34.23), mental health (HD: 38.01, non-HD: 38.02), and kidney disease (HD: 35.16, non-HD: 34.00). No statistically significant difference was found between the overall quality of life scores of the two management groups. Breadwinner status (p < 0.001), source of income (p0.026) and hemodialysis management type (p0.032) were the only factors significantly associated with QOL scores, and this was observed in the physical health and kidney disease principal domains only. No factors were significantly associated with scores for the mental health principal domain and/or overall QOL score. Conclusion The quality of life of Ugandan patients with ESRD has been found to be lower across all three domains of the Kidney Disease Quality of Life Short Form than reported anywhere in the world, with no difference observed between the non-HD and HD management groups. Interventions targeting all domains of QOL are needed among patients with ESRD in Uganda and, potentially, in other resource limited settings.
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Affiliation(s)
- Peace Bagasha
- School of Medicine, Department of Internal medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda. .,Makerere-Mulago Palliative Care Unit, Clinical Research Building, Mulago hospital site, P.O. Box 7072, Kampala, Uganda.
| | - Elizabeth Namukwaya
- School of Medicine, Department of Internal medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.,Makerere-Mulago Palliative Care Unit, Clinical Research Building, Mulago hospital site, P.O. Box 7072, Kampala, Uganda
| | - Mhoira Leng
- School of Medicine, Department of Internal medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.,Makerere-Mulago Palliative Care Unit, Clinical Research Building, Mulago hospital site, P.O. Box 7072, Kampala, Uganda
| | - Robert Kalyesubula
- School of Medicine, Department of Internal medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Edrisa Mutebi
- School of Medicine, Department of Internal medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Ronald Naitala
- School of Medicine, Department of Internal medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.,Baylor College of Medicine Children's Foundation Uganda, P. O Box 72052, New Mulago Road, Kampala, Uganda
| | - Elly Katabira
- School of Medicine, Department of Internal medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Mila Petrova
- Cambridge Palliative and End of Life Care Research Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.,Cambridge Institute of Public Health, Forvie Site, Cambridge, CB2 0SR, UK
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Bagasha P, Leng M, Katabira E, Petrova M. Health-related quality of life, palliative care needs and 12-month survival among patients with end stage renal disease in Uganda: protocol for a mixed methods longitudinal study. BMC Nephrol 2020; 21:531. [PMID: 33287725 PMCID: PMC7720495 DOI: 10.1186/s12882-020-02197-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 11/29/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The prevalence of chronic kidney disease is on the rise globally and in sub-Saharan Africa. Due to its "silent" nature, many patients often present with advanced disease. At this point options for care are often limited to renal replacement therapies such as hemodialysis and kidney transplantation. In resource limited settings, these options are associated with catastrophic expenditures and increased household poverty levels. Early palliative care interventions, if shown to ensure comparable quality of life (QoL), can significantly mitigate this by focusing care on comfort, symptom control and QoL rather than primarily on prolonging survival. METHODS A mixed methods longitudinal study, recruiting patients with End Stage Renal Disease (ESRD) on hemodialysis or conservative management and following them up over 12 months. The study aims are to: 1) measure and compare the health-related quality of life (HRQoL) scores of patients with ESRD receiving hemodialysis with those receiving conservative management, 2) measure and compare the palliative care needs and outcomes of patients in the two groups, 3) explore the impact of treatment modality and demographic, socio-economic and financial factors on QoL and palliative care needs and outcomes, 4) review patient survival over 12 months and 5) explore the patients' lived experiences. The Kidney Disease Quality Of Life Short Form version 1.3 (KDQOL-SF) will be used to measure HRQoL; the African Palliative Care Association Palliative care Outcome Score (APCA POS) and the Palliative care Outcome Score for renal symptoms (POS-S Renal) will be used to assess palliative care needs and outcomes; and semi-structured in-depth interviews to explore the patients' experiences of living with ESRD. Data collection will be carried out at 0, 3, 6, 9 and 12 months. DISCUSSION To the best of our knowledge, no similar study has been conducted in sub-Saharan Africa. This will be an important step towards raising awareness of patients' need and preferences and the strengths and limitations of available health care services for ESRD in resource limited settings.
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Affiliation(s)
- Peace Bagasha
- Department of Internal medicine, Makerere University College of Health Sciences, School of Medicine, P.O. Box 7072, Kampala, Uganda. .,Makerere-Mulago Palliative Care Unit, Clinical Research Building, Mulago hospital site, P.O.Box 7072, Kampala, Uganda.
| | - Mhoira Leng
- Department of Internal medicine, Makerere University College of Health Sciences, School of Medicine, P.O. Box 7072, Kampala, Uganda.,Makerere-Mulago Palliative Care Unit, Clinical Research Building, Mulago hospital site, P.O.Box 7072, Kampala, Uganda
| | - Elly Katabira
- Department of Internal medicine, Makerere University College of Health Sciences, School of Medicine, P.O. Box 7072, Kampala, Uganda
| | - Mila Petrova
- Cambridge Palliative and End of Life Care Research Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge; Cambridge Institute of Public Health, Forvie Site, Cambridge, CB2 0SR, UK
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Goloubev A, Petrova M, Grechko A, Zakharchenko V, Kuzovlev A. Molecular markers of ischemic stroke associated with atherosclerosis. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abrams R, Park S, Wong G, Rastogi J, Boylan AM, Tierney S, Petrova M, Dawson S, Roberts N. Lost in reviews: Looking for the involvement of stakeholders, patients, public and other non-researcher contributors in realist reviews. Res Synth Methods 2020; 12:239-247. [PMID: 32985074 DOI: 10.1002/jrsm.1459] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 09/07/2020] [Accepted: 09/24/2020] [Indexed: 12/31/2022]
Abstract
The involvement of non-researcher contributors (eg, stakeholders, patients and the public, decision and policy makers, experts, lay contributors) has taken a variety of forms within evidence syntheses. Realist reviews are a form of evidence synthesis that involves non-researcher contributors yet this practice has received little attention. In particular, the role of patient and public involvement (PPI) has not been clearly documented. This review of reviews describes the ways in which contributor involvement, including PPI, is documented within healthcare realist reviews published over the last five years. A total of 448 papers published between 2014 and 2019 were screened, yielding 71 full-text papers included in this review. Statements about contributor involvement were synthesized across each review using framework analysis. Three themes are described in this article including nomenclature, nature of involvement, and reporting impact. Papers indicate that contributor involvement in realist reviews refers to stakeholders, experts, or advisory groups (ie, professionals, clinicians, or academics). Patients and the public are occasionally subsumed into these groups and in doing so, the nature and impact of their involvement become challenging to identify and at times, is lost completely. Our review findings indicate a need for the realist review community to develop guidance to support researchers in their future collaboration with contributors, including patients and the public.
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Affiliation(s)
- Ruth Abrams
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, England
| | - Sophie Park
- Department of Primary care and population health, UCL, London, UK
| | - Geoff Wong
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Juhi Rastogi
- Department of Primary care and population health, UCL, London, UK
| | - Anne-Marie Boylan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Stephanie Tierney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Mila Petrova
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Shoba Dawson
- Centre for Academic Primary Care, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
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Wynne KJ, Petrova M, Coghlan R. Dying individuals and suffering populations: applying a population-level bioethics lens to palliative care in humanitarian contexts: before, during and after the COVID-19 pandemic. J Med Ethics 2020; 46:514-525. [PMID: 32561660 PMCID: PMC7418598 DOI: 10.1136/medethics-2019-105943] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 05/13/2020] [Accepted: 05/16/2020] [Indexed: 05/26/2023]
Abstract
BACKGROUND Humanitarian crises and emergencies, events often marked by high mortality, have until recently excluded palliative care-a specialty focusing on supporting people with serious or terminal illness or those nearing death. In the COVID-19 pandemic, palliative care has received unprecedented levels of societal attention. Unfortunately, this has not been enough to prevent patients dying alone, relatives not being able to say goodbye and palliative care being used instead of intensive care due to resource limitations. Yet global guidance was available. In 2018, the WHO released a guide on 'Integrating palliative care and symptom relief into the response to humanitarian emergencies and crises'-the first guidance on the topic by an international body. AIMS This paper argues that while a landmark document, the WHO guide took a narrowly clinical bioethics perspective and missed crucial moral dilemmas. We argue for adding a population-level bioethics lens, which draws forth complex moral dilemmas arising from the fact that groups having differential innate and acquired resources in the context of social and historical determinants of health. We discuss dilemmas concerning: limitations of material and human resources; patient prioritisation; euthanasia; and legacy inequalities, discrimination and power imbalances. IMPLICATIONS In parts of the world where opportunity for preparation still exists, and as countries emerge from COVID-19, planners must consider care for the dying. Immediate steps to support better resolutions to ethical dilemmas of the provision of palliative care in humanitarian and emergency contexts will require honest debate; concerted research effort; and international, national and local ethical guidance.
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Affiliation(s)
- Keona Jeane Wynne
- Social and Behavioral Sciences, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
- Center for Bioethics, Harvard Medical School, Boston, Massachusetts, USA
| | - Mila Petrova
- Cambridge Palliative and End of Life Care Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Rachel Coghlan
- Centre for Humanitarian Leadership, Deakin University, Burwood, Victoria, Australia
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Penkova M, Stoyanov D, Panayotova T, Donev I, Petrova M, Conev N. P-33 Regorafenib and trifluridine/tipiracil efficacy and safety in chemorefractory metastatic colorectal cancer patients: A single Bulgarian centre retrospective study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Doherty M, Power L, Petrova M, Gunn S, Powell R, Coghlan R, Grant L, Sutton B, Khan F. Illness-related suffering and need for palliative care in Rohingya refugees and caregivers in Bangladesh: A cross-sectional study. PLoS Med 2020; 17:e1003011. [PMID: 32126076 PMCID: PMC7053708 DOI: 10.1371/journal.pmed.1003011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 01/24/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Despite recognition that palliative care is an essential component of any humanitarian response, serious illness-related suffering continues to be pervasive in these settings. There is very limited evidence about the need for palliative care and symptom relief to guide the implementation of programs to alleviate the burden of serious illness-related suffering in these settings. A basic package of essential medications and supplies can provide pain relief and palliative care; however, the practical availability of these items has not been assessed. This study aimed to describe the illness-related suffering and need for palliative care in Rohingya refugees and caregivers in Bangladesh. METHODS AND FINDINGS Between November 20 and 24, 2017, we conducted a cross-sectional study of individuals with serious health problems (n = 156, 53% male) and caregivers (n = 155, 69% female) living in Rohingya refugee camps in Bangladesh, using convenience sampling to recruit participants at the community level (i.e., going house to house to identify eligible individuals). The serious health problems, recent healthcare experiences, need for medications and medical supplies, and basic needs of participants were explored through interviews with trained Rohingya community members, using an interview guide that had been piloted with Rohingya individuals to ensure it reflected the specificities of their refugee experience and culture. The most common diagnoses were significant physical disabilities (n = 100, 64.1%), treatment-resistant tuberculosis (TB) (n = 32, 20.5%), cancer (n = 15, 9.6%), and HIV infection (n = 3, 1.9%). Many individuals with serious health problems were experiencing significant pain (62%, n = 96), and pain treatments were largely ineffective (70%, n = 58). The average age was 44.8 years (range 2-100 years) for those with serious health problems and 34.9 years (range 8-75 years) for caregivers. Caregivers reported providing an average of 13.8 hours of care per day. Sleep difficulties (87.1%, n = 108), lack of appetite (58.1%, n = 72), and lack of pleasure in life (53.2%, n = 66) were the most commonly reported problems related to the caregiving role. The main limitations of this study were the use of convenience sampling and closed-ended interview questioning. CONCLUSIONS In this study we found that many individuals with serious health problems experienced significant physical, emotional, and social suffering due to a lack of access to pain and symptom relief and other essential components of palliative care. Humanitarian responses should develop and incorporate palliative care and symptom relief strategies that address the needs of all people with serious illness-related suffering and their caregivers.
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Affiliation(s)
- Megan Doherty
- Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- World Child Cancer, London, United Kingdom
- * E-mail:
| | - Liam Power
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Mila Petrova
- Cambridge Palliative and End of Life Care Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Scott Gunn
- Faculty of Medicine, Queens University, Kingston, Ontario, Canada
| | | | - Rachel Coghlan
- Centre for Humanitarian Leadership, Faculty of Arts and Education, Deakin University, Burwood, Victoria, Australia
| | - Liz Grant
- Usher Institute of Population Health Sciences and Informatics, Global Health Academy, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Brett Sutton
- Health Protection and Emergency Management, Department of Health and Human Services, Melbourne, Victoria, Australia
| | - Farzana Khan
- Fasiuddin Khan Research Foundation, Dhaka, Bangladesh
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Krastev B, Timcheva C, Valev S, Zhbantov G, Petrova M, Karanikolova T, Gencheva R, Ivanova A, Stoykov I, Stamenov G. Abstract OT1-03-03: Investigating circulating lncRNAs in breast cancer patients on neoadjuvant systemic therapy. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-ot1-03-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background. In cells long non-coding RNAs (lncRNAs) control gene expression through various mechanisms, acting on different biological levels: chromatin remodeling, regulation of transcription, posttranscriptional modification. LncRNAs could also be transported via systemic circulation, encapsulated in extracellular vesicles called “exosomes” or in vesicle-free form, bounded to proteins or lipoproteins. Knowing the intracellular function of lncRNAs, it is reasonably speculated that in cancer patients their existence in bloodstream is more than just an extracellular release. It is thought to be a kind of an epigenetic mechanism, rendered by tumor cells, so the last could influence gene expression programs of normal cells in distance, creating tumor-friendly environment in other body compartments - a sine qua non for metastatic spread. Few studies have investigated in vivo circulating lncRNAs in breast cancer and even less have done it in the neoadjuvant setting.
Goals and objectives. We decided to conduct a small exploratory study in patients with locally advanced breast cancer, focusing on changes in plasma lncRNAs during neoadjuvant therapy. The two main goals of the study are: 1. Assessing the effect of systemic anticancer treatment on epigenetic regulators such as circulating lncRNAs; 2. Testing the technical feasibility of using lncRNAs as plasma biomarkers. Our objectives include lncRNA profiling in circulation before onset as well as in the course of systemic therapy, followed by correlation analysis between distinct lncRNA signatures and clinicopathological features. Differential lncRNA expression will be assessed between patients and normal controls as well as among patient subgroups according to time of sampling, age, intrinsic breast cancer phenotype and response to therapy. LncRNAs of interest will be further examined in larger cohorts of patients and healthy controls.
Design/materials/methods. This is a prospective, interventional, case-control clinical trial in two parts - exploration and validation. Patients eligibility criteria: age ≥ 18 years; females; histologically confirmed locally advanced breast cancer; multidisciplinary tumor board decision for neoadjuvant chemotherapy or chemotherapy plus targeted therapy; radiologically excluded distant dissemination; no concomitant malignancy; signed informed consent form (ICF). Healthy controls eligibility criteria: age ≥ 18 years; females; no oncologic history; signed ICF. For part I ten patients and two controls have already been recruited. Blood samples were taken from each patient twice - before onset of neoadjuvant therapy and before 4th cycle (in one patient the second sample was taken before 6th cycle), from control subjects blood was taken once. Plasma was immediately separated and frozen until RNA extraction. Next-generation RNA sequencing was performed with subsequent bioinformatics analysis on lncRNAs. Clinical and pathology information was obtained from each patient’s hospital file. In part II plasma will be collected in the same manner as in part I. Preselected lncRNAs from part I will be measured by real-time polymerase chain reaction.
Statistics. This is an exploratory study with no empirical data and no formal planning for sample size. The correlation between lncRNAs and clinicopathological characteristics and the significance of the differences among groups will be assessed by parametric tests (Pearson correlation, Student’s t-test) and/or multivariate such (ANCOVA).
Present and target accrual. Part I accrual has completed and bioinformatics data are expected. Part II accrual is ongoing with 15 patients already recruited. Target accrual for part II is 50 patients and 20 controls.
Citation Format: Boris Krastev, Constanta Timcheva, Spartak Valev, Georgi Zhbantov, Mila Petrova, Teodora Karanikolova, Radostina Gencheva, Anika Ivanova, Ivaylo Stoykov, Georgi Stamenov. Investigating circulating lncRNAs in breast cancer patients on neoadjuvant systemic therapy [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr OT1-03-03.
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Kust D, Murgic J, Vukovic P, Kruljac I, Prpic M, Zilic A, Lengyel C, Wdowiak K, Simaskaite L, Mutlu Gunaydin U, Tica Sedlar I, Fountzilas E, Janzic U, Coroian I, Durutovic I, Pellegrino B, Petrova M, Huti E, Napolskaia E, Seruga B, Balenovic A, Frobe A, Luetic K. Oncologist Burnout Syndrome in Eastern Europe: Results of the Multinational Survey. JCO Oncol Pract 2020; 16:e366-e376. [PMID: 32048930 DOI: 10.1200/jop.19.00470] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Burnout is defined as a three-dimensional syndrome-emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA)-caused by chronic occupational stress. The aim of the current study was to investigate the prevalence of burnout among oncologists in Eastern Europe and to identify the contributing factors. METHODS The study was conducted as an online survey between October 2017 and March 2018. Oncologists (including medical, radiation, clinical, and surgical oncologists) from 19 countries were invited to participate. The survey consisted of 30 questions, including the standardized burnout instrument, Maslach Burnout Inventory, and eight demographic questions. Burnout risk was scored according to the scoring manual for health care workers. RESULTS The study included 637 oncologists. Overall, 28% were at low or intermediate risk and 72% were at high risk for burnout. Forty-four percent of participants were at high risk for EE, 28.7% for DP, and 47.3% for PA. EE risk was associated with female sex. DP risk was highest among clinical and radiation oncologists, whereas PA risk was positively correlated with years of service, percentage of cancer deaths, and availability of the number of oncologists. In multivariate logistic regression analysis, burnout was significantly associated with standardized cancer mortality and fewer years of practice. CONCLUSION Burnout among oncologists in Eastern Europe is high, and younger oncologists are the most vulnerable group. Preventive measures should be taken to address this issue, which negatively affects optimal care delivery and poses a threat to oncologists' health and well-being.
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Affiliation(s)
- Davor Kust
- Department of Oncology and Nuclear Medicine, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
| | - Jure Murgic
- Department of Oncology and Nuclear Medicine, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
| | - Petra Vukovic
- Department of Medical Oncology, University Hospital for Tumors, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
| | - Ivan Kruljac
- Department of Internal Medicine, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
| | - Marin Prpic
- Department of Oncology and Nuclear Medicine, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia.,School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Ana Zilic
- Intensive Oncology and Supportive Care Department, Clinic For Medical Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | | | - Kamil Wdowiak
- Department of Internal Medicine and Oncological Chemotherapy, Medical University of Silesia, Katowice, Poland
| | - Lina Simaskaite
- Department of Oncology and Hematology, Hospital of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ulug Mutlu Gunaydin
- Department of Medical Oncology, Istanbul Medeniyet University, Istanbul, Turkey
| | - Ivana Tica Sedlar
- Clinic of Oncology, University Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Elena Fountzilas
- Department of Medical Oncology, Euromedica General Clinic, Thessaloniki, Greece
| | - Urska Janzic
- Medical Oncology Unit, University Clinic Golnik, Golnik, Slovenia
| | - Iulia Coroian
- Medical Oncology Department, Oncology Institute Prof. Dr. I. Chiricuta, Cluj-Napoca, Romania
| | - Ivana Durutovic
- Clinic for Oncology and Radiotherapy, Clinical Center of Montenegro, Podgorica, Montenegro
| | | | - Mila Petrova
- Department of Medical Oncology, Multi Profile Hospital for Active Treatment Nadezhda, Sofia, Bulgaria
| | - Emiljana Huti
- Department of Oncology, American Hospital Tirana II, Tirana, Albania
| | - Elena Napolskaia
- Outpatient Department, Clinical Scientifical Practical Center of Specialized Kinds of Medical Care (Oncology), Saint Petersburg, Russia
| | - Bostjan Seruga
- Division of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | | | - Ana Frobe
- Department of Oncology and Nuclear Medicine, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia.,School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Kresimir Luetic
- Department of Gastroenterology and Hepatology, Clinical Hospital "Sveti Duh," Zagreb, Croatia
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Petrova M, Barclay S. Response to Correspondence from Kolstoe and colleagues concerning our paper entitled, Research approvals iceberg: How a 'low-key' study in England needed 89 professionals to approve it and how we can do better. BMC Med Ethics 2019; 20:101. [PMID: 31870356 PMCID: PMC6929303 DOI: 10.1186/s12910-019-0433-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/28/2019] [Indexed: 11/25/2022] Open
Abstract
In their letter to the Editor in this issue, Kolstoe and Carpenter challenge a core aspect of our recently published case study of research approvals [BMC Medical Ethics 20:7] by arguing that we conflate research ethics with governance and funding processes. Amongst the key concerns of the authors are: 1) that our paper exemplifies a typical conflation of concepts such as governance, integrity and ethics, with significant consequences for claims around the responsibility and accountability of the organisations involved; 2) that, as a consequence of this conflation, we misrepresent the ethics review process, including in fundamental aspects such as the ethics approval-opinion distinction; 3) that it is difficult to see scope for greater integration of processes such as applying for funding, research approvals, Patient and Public Involvement, etc., as suggested by us. Here we present an alternative point of view towards the concerns raised.
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Affiliation(s)
- Mila Petrova
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Institute of Public Health, Forvie Site, Robinson Way, Cambridge, CB2 0SR UK
| | - Stephen Barclay
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Institute of Public Health, Forvie Site, Robinson Way, Cambridge, CB2 0SR UK
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Abstract
BACKGROUND Drug usage in pregnant women is associated with a problem of possible negative influence on prenatal development. It is always necessary to judge the need for drug administration during pregnancy. OBJECTIVE The aim of presented study was to analyse data about pregnant women hospitalized in the postpartum period. METHODS The study was designed as a retrospective observational study including 300 women hospitalized at the 2nd Department of Gynaecology and Obstetrics, University Hospital, Bratislava. Data were obtained through questionnaires in form of an interview. RESULTS The average age of women was 30.79 ± 4.40 years. Risk pregnancy occured in 20.59 % of women. Chronic disorders before pregnancy required regular pharmacotherapy in 29.24 %. Drug usage analysis: I. trimester, 31 % used at least one drug, 52 % nutritional supplements, 63.3 % drug and/or nutritional supplement; II. trimester, 23 % used at least one drug, 45 % nutritional supplements, 58.3 % drug and/or nutritional supplement; III. trimester, 32 % used at least one drug, 67 % nutritional supplements, 75.3 % drug and/or nutritional supplement. CONCLUSION Drug usage during pregnancy requires great precaution at choosing pharmacotherapy. The benefit of pharmacotherapy should always outweight the potential risk of administered drug (Tab. 3, Fig. 3, Ref. 37).
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Zeymer U, Ludman P, Danchin N, Kala P, Maggioni AP, Weidinger F, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy VK, Nedoshivin A, Petronio AS, Roos-Hesselink J, Wallentin L, Zeymer U, Weidinger F, Zeymer U, Danchin N, Ludman P, Sinnaeve P, Kala P, Ferrari R, Maggioni AP, Goda A, Zelveian P, Weidinger F, Karamfilov K, Motovska Z, Zeymer U, Raungaard B, Marandi T, Shaheen SM, Lidon RM, Karjalainen PP, Kereselidze Z, Alexopoulos D, Becker D, Quinn M, Iakobishvili Z, Al-Farhan H, Sadeghi M, Caporale R, Romeo F, Mirrakhimov E, Serpytis P, Erglis A, Kedev S, Balbi MM, Moore AM, Dudek D, Legutko J, Mimoso J, Tatu-Chitoiu G, Stojkovic S, Shlyakhto E, AlHabib KF, Bunc M, Studencan M, Mourali MS, Bajraktari G, Konte M, Larras F, Lefrancq EF, Mekhaldi S, Laroche C, Maggioni AP, Goda A, Shuka N, Pavli E, Tafaj E, Gishto T, Dibra A, Duka A, Gjana A, Kristo A, Knuti G, Demiraj A, Dado E, Hasimi E, Simoni L, Siqeca M, Sisakian H, Hayrapetyan H, Markosyan S, Galustyan L, Arustamyan N, Kzhdryan H, Pepoyan S, Zirkik A, Von Lewinski D, Paetzold S, Kienzl I, Matyas K, Neunteufl T, Nikfardjam M, Neuhold U, Mihalcz A, Glaser F, Steinwender C, Reiter C, Grund M, Hrncic D, Hoppe U, Hammerer M, Hinterbuchner L, Hengstenberg C, Delle Karth G, Lang I, Weidinger F, Winkler W, Hasun M, Kastner J, Havel C, Derntl M, Oberegger G, Hajos J, Adlbrecht C, Publig T, Leitgeb MC, Wilfing R, Jirak P, Ho CY, Puskas L, Schrutka L, Spinar J, Parenica J, Hlinomaz O, Fendrychova V, Semenka J, Sikora J, Sitar J, Groch L, Rezek M, Novak M, Kramarikova P, Stasek J, Dusek J, Zdrahal P, Polasek R, Karasek J, Seiner J, Sukova N, Varvarovsky I, Lazarák T, Novotny V, Matejka J, Rokyta R, Volovar S, Belohlavek J, Motovska Z, Siranec M, Kamenik M, Kralik R, Raungaard B, Ravkilde J, Jensen SE, Villadsen A, Villefrance K, Schmidt Skov C, Maeng M, Moeller K, Hasan-Ali H, Ahmed TA, Hassan M, ElGuindy A, Farouk Ismail M, Ibrahim Abd El-Aal A, El-sayed Gaafar A, Magdy Hassan H, Ahmed Shafie M, Nabil El-khouly M, Bendary A, Darwish M, Ahmed Y, Amin O, AbdElHakim A, Abosaif K, Kandil H, Galal MAG, El Hefny EE, El Sayed M, Aly K, Mokarrab M, Osman M, Abdelhamid M, Mantawy S, Ali MR, Kaky SD, Khalil VA, Saraya MEA, Talaat A, Nabil M, Mounir WM, Mahmoud K, Aransa A, Kazamel G, Anwar S, Al-Habbaa A, Abd el Monem M, Ismael A, Amin Abu-Sheaishaa M, Abd Rabou MM, Hammouda TMA, Moaaz M, Elkhashab K, Ragab T, Rashwan A, Rmdan A, AbdelRazek G, Ebeid H, Soliman Ghareeb H, Farag N, Zaki M, Seleem M, Torki A, Youssef M, AlLah Nasser NA, Rafaat A, Selim H, Makram MM, Khayyal M, Malasi K, Madkour A, Kolib M, Alkady H, Nagah H, Yossef M, Wafa A, Mahfouz E, Faheem G, Magdy Moris M, Ragab A, Ghazal M, Mabrouk A, Hassan M, El-Masry M, Naseem M, Samir S, Marandi T, Reinmets J, Allvee M, Saar A, Ainla T, Vaide A, Kisseljova M, Pakosta U, Eha J, Lotamois K, Sia J, Myllymaki J, Pinola T, Karjalainen PP, Paana T, Mikkelsson J, Ampio M, Tsivilasvili J, Zurab P, Kereselidze Z, Agladze R, Melia A, Gogoberidze D, Khubua N, Totladze L, Metreveli I, Chikovani A, Eitel I, Pöss J, Werner M, Constantz A, Ahrens C, Zeymer U, Tolksdorf H, Klinger S, Sack S, Heer T, Lekakis J, Kanakakis I, Xenogiannis I, Ermidou K, Makris N, Ntalianis A, Katsaros F, Revi E, Kafkala K, Mihelakis E, Diakakis G, Grammatikopoulos K, Voutsinos D, Alexopoulos D, Xanthopoulou I, Mplani V, Foussas S, Papakonstantinou N, Patsourakos N, Dimopoulos A, Derventzis A, Athanasiou K, Vassilikos VP, Papadopoulos C, Tzikas S, Vogiatzis I, Datsios A, Galitsianos I, Koutsampasopoulos K, Grigoriadis S, Douras A, Baka N, Spathis S, Kyrlidis T, Hatzinikolaou H, Kiss RG, Becker D, Nowotta F, Tóth K, Szabó S, Lakatos C, Jambrik Z, Ruzsa J, Ruzsa Z, Róna S, Toth J, Vargane Kosik A, Toth KSB, Nagy GG, Ondrejkó Z, Körömi Z, Botos B, Pourmoghadas M, Salehi A, Massoumi G, Sadeghi M, Soleimani A, Sarrafzadegan N, Roohafza H, Azarm M, Mirmohammadsadeghi A, Rajabi D, Rahmani Y, Siabani S, Najafi F, Hamzeh B, Karim H, Siabani H, Saleh N, Charehjoo H, Zamzam L, Al-Temimi G, Al-Farhan H, Al-Yassin A, Mohammad A, Ridha A, Al-Saedi G, Atabi N, Sabbar O, Mahmood S, Dakhil Z, Yaseen IF, Almyahi M, Alkenzawi H, Alkinani T, Alyacopy A, Kearney P, Twomey K, Iakobishvili Z, Shlomo N, Beigel R, Caldarola P, Rutigliano D, Sublimi Saponetti L, Locuratolo N, Palumbo V, Scherillo M, Formigli D, Canova P, Musumeci G, Roncali F, Metra M, Lombardi C, Visco E, Rossi L, Meloni L, Montisci R, Pippia V, Marchetti MF, Congia M, Cacace C, Luca G, Boscarelli G, Indolfi C, Ambrosio G, Mongiardo A, Spaccarotella C, De Rosa S, Canino G, Critelli C, Caporale R, Chiappetta D, Battista F, Gabrielli D, Marziali A, Bernabò P, Navazio A, Guerri E, Manca F, Gobbi M, Oreto G, Andò G, Carerj S, Saporito F, Cimmino M, Rigo F, Zuin G, Tuccillo B, Scotto di Uccio F, Irace L, Lorenzoni G, Meloni I, Merella P, Polizzi GM, Pino R, Marzilli M, Morrone D, Caravelli P, Orsini E, Mosa S, Piovaccari G, Santarelli A, Cavazza C, Romeo F, Fedele F, Mancone M, Straito M, Salvi N, Scarparo P, Severino P, Razzini C, Massaro G, Cinque A, Gaudio C, Barillà F, Torromeo C, Porco L, Mei M, Iorio R, Nassiacos D, Barco B, Sinagra G, Falco L, Priolo L, Perkan A, Strana M, Bajraktari G, Percuku L, Berisha G, Mziu B, Beishenkulov M, Abdurashidova T, Toktosunova A, Kaliev K, Serpytis P, Serpytis R, Butkute E, Lizaitis M, Broslavskyte M, Xuereb RG, Moore AM, Mercieca Balbi M, Paris E, Buttigieg L, Musial W, Dobrzycki S, Dubicki A, Kazimierczyk E, Tycinska A, Wojakowski W, Kalanska-Lukasik B, Ochala A, Wanha W, Dworowy S, Sielski J, Janion M, Janion-Sadowska A, Dudek D, Wojtasik-Bakalarz J, Bryniarski L, Peruga JZ, Jonczyk M, Jankowski L, Klecha A, Legutko J, Michalowska J, Brzezinski M, Kozmik T, Kowalczyk T, Adamczuk J, Maliszewski M, Kuziemka P, Plaza P, Jaros A, Pawelec A, Sledz J, Bartus S, Zmuda W, Bogusz M, Wisnicki M, Szastak G, Adamczyk M, Suska M, Czunko P, Opolski G, Kochman J, Tomaniak M, Miernik S, Paczwa K, Witkowski A, Opolski MP, Staruch AD, Kalarus Z, Honisz G, Mencel G, Swierad M, Podolecki T, Marques J, Azevedo P, Pereira MA, Gaspar A, Monteiro S, Goncalves F, Leite L, Mimoso J, Manuel Lopes dos Santos W, Amado J, Pereira D, Silva B, Caires G, Neto M, Rodrigues R, Correia A, Freitas D, Lourenco A, Ferreira F, Sousa F, Portugues J, Calvo L, Almeida F, Alves M, Silva A, Caria R, Seixo F, Militaru C, Ionica E, Tatu-Chitoiu G, Istratoaie O, Florescu M, Lipnitckaia E, Osipova O, Konstantinov S, Bukatov V, Vinokur T, Egorova E, Nefedova E, Levashov S, Gorbunova A, Redkina M, Karaulovskaya N, Bijieva F, Babich N, Smirnova O, Filyanin R, Eseva S, Kutluev A, Chlopenova A, Shtanko A, Kuppar E, Shaekhmurzina E, Ibragimova M, Mullahmetova M, Chepisova M, Kuzminykh M, Betkaraeva M, Namitokov A, Khasanov N, Baleeva L, Galeeva Z, Magamedkerimova F, Ivantsov E, Tavlueva E, Kochergina A, Sedykh D, Kosmachova E, Skibitskiy V, Porodenko N, Namitokov A, Litovka K, Ulbasheva E, Niculina S, Petrova M, Harkov E, Tsybulskaya N, Lobanova A, Chernova A, Kuskaeva A, Kuskaev A, Ruda M, Zateyshchikov D, Gilarov M, Konstantinova E, Koroleva O, Averkova A, Zhukova N, Kalimullin D, Borovkova N, Tokareva A, Buyanova M, Khaisheva L, Pirozhenko A, Novikova T, Yakovlev A, Tyurina T, Lapshin K, Moroshkina N, Kiseleva M, Fedorova S, Krylova L, Duplyakov D, Semenova Y, Rusina A, Ryabov V, Syrkina A, Demianov S, Reitblat O, Artemchuk A, Efremova E, Makeeva E, Menzorov M, Shutov A, Klimova N, Shevchenko I, Elistratova O, Kostyuckova O, Islamov R, Budyak V, Ponomareva E, Ullah Jan U, Alshehri AM, Sedky E, Alsihati Z, Mimish L, Selem A, Malik A, Majeed O, Altnji I, AlShehri M, Aref A, AlHabib K, AlDosary M, Tayel S, Abd AlRahman M, Asfina KN, Abdin Hussein G, Butt M, Markovic Nikolic N, Obradovic S, Djenic N, Brajovic M, Davidovic A, Romanovic R, Novakovic V, Dekleva M, Spasic M, Dzudovic B, Jovic Z, Cvijanovic D, Veljkovic S, Ivanov I, Cankovic M, Jarakovic M, Kovacevic M, Trajkovic M, Mitov V, Jovic A, Hudec M, Gombasky M, Sumbal J, Bohm A, Baranova E, Kovar F, Samos M, Podoba J, Kurray P, Obona T, Remenarikova A, Kollarik B, Verebova D, Kardosova G, Studencan M, Alusik D, Macakova J, Kozlej M, Bayes-Genis A, Sionis A, Garcia Garcia C, Lidon RM, Duran Cambra A, Labata Salvador C, Rueda Sobella F, Sans Rosello J, Vila Perales M, Oliveras Vila T, Ferrer Massot M, Bañeras J, Lekuona I, Zugazabeitia G, Fernandez-Ortiz A, Viana Tejedor A, Ferrera C, Alvarez V, Diaz-Castro O, Agra-Bermejo RM, Gonzalez-Cambeiro C, Gonzalez-Babarro E, Domingo-Del Valle J, Royuela N, Burgos V, Canteli A, Castrillo C, Cobo M, Ruiz M, Abu-Assi E, Garcia Acuna JM. The ESC ACCA EAPCI EORP acute coronary syndrome ST-elevation myocardial infarction registry. European Heart Journal - Quality of Care and Clinical Outcomes 2019; 6:100-104. [DOI: 10.1093/ehjqcco/qcz042] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 07/24/2019] [Indexed: 12/20/2022]
Abstract
Abstract
Aims
The Acute Cardiac Care Association (ACCA)–European Association of Percutaneous Coronary Intervention (EAPCI) Registry on ST-elevation myocardial infarction (STEMI) of the EurObservational programme (EORP) of the European Society of Cardiology (ESC) registry aimed to determine the current state of the use of reperfusion therapy in ESC member and ESC affiliated countries and the adherence to ESC STEMI guidelines in patients with STEMI.
Methods and results
Between 1 January 2015 and 31 March 2018, a total of 11 462 patients admitted with an initial diagnosis of STEMI according to the 2012 ESC STEMI guidelines were enrolled. Individual patient data were collected across 196 centres and 29 countries. Among the centres, there were 136 percutaneous coronary intervention centres and 91 with cardiac surgery on-site. The majority of centres (129/196) were part of a STEMI network. The main objective of this study was to describe the demographic, clinical, and angiographic characteristics of patients with STEMI. Other objectives include to assess management patterns and in particular the current use of reperfusion therapies and to evaluate how recommendations of most recent STEMI European guidelines regarding reperfusion therapies and adjunctive pharmacological and non-pharmacological treatments are adopted in clinical practice and how their application can impact on patients’ outcomes. Patients will be followed for 1 year after admission.
Conclusion
The ESC ACCA-EAPCI EORP ACS STEMI registry is an international registry of care and outcomes of patients hospitalized with STEMI. It will provide insights into the contemporary patient profile, management patterns, and 1-year outcome of patients with STEMI.
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Affiliation(s)
- Uwe Zeymer
- Hospital of the City of Ludwigshafen, Medical Clinic B and Institute of Heart Attack Research, Ludwigshafen on the Rhine, Germany
| | - Peter Ludman
- Institute of Cardiovascular Sciences, Birmingham University, Birmingham, UK
| | - Nicolas Danchin
- Cardiology Department, Georges Pompidou European Hospital, Paris, France
| | - Petr Kala
- Internal Cardiology Department, University Hospital Brno, Czech Republic
| | - Aldo P Maggioni
- EURObservational Research Programme, ESC, Sophia Antipolis, France
- ANMCO Research Center, Florence, Italy
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Trneny M, Polgarova K, Janikova A, Belada D, Prochazka V, Duras J, Mocikova H, Steinerova K, Campr V, Blahovcova P, Petrova M, Zogala D, Ptacnik V. IS IT RADIOTHERAPY NECESSARY FOR PRIMARY MEDIASTINAL B-CELL LYMPHOMA (PMBL) PATIENTS ACHIEVING PET NEGATIVITY AFTER IMMUNOCHEMOTHERAPY? Hematol Oncol 2019. [DOI: 10.1002/hon.77_2630] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- M. Trneny
- Ist Dept Med; Charles University General Hospital; Praha Czech Republic
| | - K. Polgarova
- Ist Dept Med; Charles University General Hospital; Praha Czech Republic
| | - A. Janikova
- Dept Hemato-Oncology; University Hospital Brno; Brno Czech Republic
| | - D. Belada
- Dept Hematology; University Hospital; Hradec Kralove Czech Republic
| | - V. Prochazka
- Dept Hematology; University Hospital; Olomouc Czech Republic
| | - J. Duras
- Dept Hematology; University Hospital; Ostrava Czech Republic
| | - H. Mocikova
- Dept Hematology; University Hospital Kralovske Vinohrady; Praha Czech Republic
| | - K. Steinerova
- Dept Hematology; University Hospital; Plzen Czech Republic
| | - V. Campr
- Dept Pathology; University Hospital Motol; Praha Czech Republic
| | - P. Blahovcova
- Data Center; Czech Lymphoma Study Group; Praha Czech Republic
| | - M. Petrova
- Data Center; Czech Lymphoma Study Group; Praha Czech Republic
| | - D. Zogala
- Dept Nuclear Medicine; Charles University General Hospital; Praha Czech Republic
| | - V. Ptacnik
- Dept Nuclear Medicine; Charles University General Hospital; Praha Czech Republic
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Manolov V, Hadjidekova S, Emilova R, Petrova I, Tzatchev K, Vasilev V, Bogov B, Vazelov E, Angov G, Tzankova M, Zlatina G, Karadjova M, Petrova M, Nikolova M, Petrova-Ivanova I, Kunchev T, Ovcharov D, Jeliazkov P, Traykov L. Impaired cognitive function in chronic kidney disease patients and serum hepcidin quantification. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Petrova M, Barclay S. Research approvals iceberg: how a 'low-key' study in England needed 89 professionals to approve it and how we can do better. BMC Med Ethics 2019; 20:7. [PMID: 30678668 PMCID: PMC6346542 DOI: 10.1186/s12910-018-0339-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 12/25/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The red tape and delays around research ethics and governance approvals frequently frustrate researchers yet, as the lesser of two evils, are largely accepted as unavoidable. Here we quantify aspects of the research ethics and governance approvals for one interview- and questionnaire-based study conducted in England which used the National Health Service (NHS) procedures and the electronic Integrated Research Application System (IRAS). We demonstrate the enormous impact of existing approvals processes on costs of studies, including opportunity costs to focus on the substantive research, and suggest directions for radical system change. MAIN TEXT We have recorded 491 exchanges with 89 individuals involved in research ethics and governance approvals, generating 193 pages of email text excluding attachments. These are conservative estimates (e.g. only records of the research associate were used). The exchanges were conducted outside IRAS, expected to be the platform where all necessary documents are provided and questions addressed. Importantly, the figures exclude the actual work of preparing the ethics documentation (such as the ethics application, information sheets and consent forms). We propose six areas of work to enable system change: 1. Support the development of a broad range of customised research ethics and governance templates to complement generic, typically clinical trials orientated, ones; 2. Develop more sophisticated and flexible frameworks for study classification; 3. Link with associated processes for assessment, feedback, monitoring and reporting, such as ones involving funders and patient and public involvement groups; 4. Invest in a new generation IT infrastructure; 5. Enhance system capacity through increasing online reviewer participation and training; and 6. Encourage researchers to quantify the approvals processes for their studies. CONCLUSION Ethics and governance approvals are burdensome for historical reasons and not because of the nature of the task. There are many opportunities to improve their efficiency and analytic depth in an age of innovation, increased connectivity and distributed working. If we continue to work under current systems, we are perpetuating, paradoxically, an unethical system of research approvals by virtue of its wastefulness and impoverished ethical debate.
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Affiliation(s)
- Mila Petrova
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Institute of Public Health, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK.
| | - Stephen Barclay
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Institute of Public Health, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK
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Petrova M, Riley J, Abel J, Barclay S. Crash course in EPaCCS (Electronic Palliative Care Coordination Systems): 8 years of successes and failures in patient data sharing to learn from. BMJ Support Palliat Care 2018; 8:447-455. [PMID: 27638631 PMCID: PMC6287568 DOI: 10.1136/bmjspcare-2015-001059] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 06/08/2016] [Accepted: 07/14/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Electronic Palliative Care Coordination Systems (EPaCCS) are England's pre-eminent initiative in enabling advance care planning and improved communication and coordination at the end of life. EPaCCS have been under development for 8 years after being proposed, as Locality Registers, in the 2008 End of Life Care Strategy for England. EPaCCS are electronic registers or tools and processes for sharing data which aim to enable access to information about dying patients. Striking outcomes have been reported around EPaCCS, such as 77.8% of 'Coordinate My Care' patients dying in their preferred place. EPaCCS have, however, been extremely challenging to develop and implement, with many projects remaining continuously 'under development' or folding. They also continue to be suboptimally integrated with other data sharing initiatives. Rigorous research is non-existent. DISCUSSION POINTS We discuss the current EPaCCS landscape and way forward. We summarise key facts concerning the availability, uptake, outcomes and costs of EPaCCS. We outline 5 key challenges (scope of projects, unrealistic expectations set by existing guidance, the discrepancy between IT realities in healthcare and our broader lives, information governance and 'death register' associations) and 6 key drivers (robust concept, striking outcomes, national support and strong clinical leadership, clinician commitment, education and funding). CONCLUSIONS The priorities for advancing EPaCCS we propose include linking to other work streams and reframing the concept, potentially making it less 'end of life', overview of current EPaCCS and lessons learnt, continuing work on information standards, rethinking of national funding and new levels of individual and community involvement.
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Affiliation(s)
- Mila Petrova
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge—Institute of Public Health, Cambridge, UK
| | - Julia Riley
- The Royal Marsden & Royal Brompton Palliative Care Service, London, UK
- Institute of Global Health Innovation, Imperial College, London, UK
| | - Julian Abel
- Weston Hospicecare and Weston Area Health Trust, Weston-super-Mare, UK
| | - Stephen Barclay
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge—Institute of Public Health, Cambridge, UK
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Petrova M, Muhamadejev R, Vigante B, Duburs G, Liepinsh E. Correction to 'Intramolecular hydrogen bonds in 1,4-dihydropyridine derivatives'. R Soc Open Sci 2018; 5:180990. [PMID: 30109869 PMCID: PMC6083734 DOI: 10.1098/rsos.180990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
[This corrects the article DOI: 10.1098/rsos.180088.].
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Petrova M, Muhamadejev R, Vigante B, Duburs G, Liepinsh E. Intramolecular hydrogen bonds in 1,4-dihydropyridine derivatives. R Soc Open Sci 2018; 5:180088. [PMID: 30110409 PMCID: PMC6030305 DOI: 10.1098/rsos.180088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 05/02/2018] [Indexed: 05/24/2023]
Abstract
1,4-Dihydropyridine (1,4-DHP) derivatives have been synthesized and characterized by 1H, 13C, 15N nuclear magnetic resonance (NMR) spectroscopy, secondary proton/deuterium 13C isotope shifts, variable temperature 1H NMR experiments and quantum-chemical calculation. The intramolecular hydrogen bonds NH⋯O=C and CH⋯O=C in these compounds were established by NMR and quantum-chemical studies The downfield shift of the NH proton, accompanied by the upfield shift of the 15N nuclear magnetic resonance signals, the shift to the higher wavenumbers of the NH stretching vibration in the infrared spectra and the increase of the 1J(15N,1H) values may indicate the shortening of the N-H bond length upon intramolecular NH⋯O=C hydrogen bond formation.
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Affiliation(s)
- M. Petrova
- Latvian Institute of Organic Synthesis, Aizkraukles 21 Street, Riga 1006, Latvia
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Affiliation(s)
- Mila Petrova
- Primary Care Unit, Palliative and End of Life Care Research Group, University of Cambridge, Cambridge. E-mail:
| | - Stephen Barclay
- University Senior Lecturer in General Practice and Palliative Care; GP and Honorary Consultant Physician in Palliative Care, University of Cambridge, Cambridge
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Banerjee S, Califano R, Corral J, de Azambuja E, De Mattos-Arruda L, Guarneri V, Hutka M, Jordan K, Martinelli E, Mountzios G, Ozturk MA, Petrova M, Postel-Vinay S, Preusser M, Qvortrup C, Volkov MNM, Tabernero J, Olmos D, Strijbos MH. Professional burnout in European young oncologists: results of the European Society for Medical Oncology (ESMO) Young Oncologists Committee Burnout Survey. Ann Oncol 2018; 28:1590-1596. [PMID: 28449049 DOI: 10.1093/annonc/mdx196] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Indexed: 02/05/2023] Open
Abstract
Background Burnout in health care professionals could have serious negative consequences on quality of patient care, professional satisfaction and personal life. Our aim was to investigate the burnout prevalence, work and lifestyle factors potentially affecting burnout amongst European oncologists ≤40 (YOs). Methods A survey was conducted using the validated Maslach Burnout Inventory (MBI) and additional questions exploring work/lifestyle factors. Statistical analyses were carried out to identify factors associated with burnout. Results Total of 737 surveys (all ages) were collected from 41 European countries. Countries were divided into six regions. Results from 595 (81%) YOs were included (81% medical oncologists; 52% trainees, 62% women). Seventy-one percent of YOs showed evidence of burnout (burnout subdomains: depersonalization 50%; emotional exhaustion 45; low accomplishment 35%). Twenty-two percent requested support for burnout during training and 74% reported no hospital access to support services. Burnout rates were significantly different across Europe (P < 0.0001). Burnout was highest in central European (84%) and lowest in Northern Europe (52%). Depersonalization scores were higher in men compared with women (60% versus 45% P = 0.0001) and low accomplishment was highest in the 26-30 age group (P < 0.01). In multivariable linear regression analyses, European region, work/life balance, access to support services, living alone and inadequate vacation time remained independent burnout factors (P < 0.05). Conclusions This is the largest burnout survey in European Young Oncologists. Burnout is common amongst YOs and rates vary across Europe. Achieving a good work/life balance, access to support services and adequate vacation time may reduce burnout levels. Raising awareness, support and interventional research are needed.
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Affiliation(s)
- S Banerjee
- Gynaecology Unit Royal Marsden Hospital NHS Foundation Trust, Institute of Cancer Research, London
| | - R Califano
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - J Corral
- Department of Medical Oncology, University Hospital Virgen del Rocio, Seville, Spain
| | - E de Azambuja
- Department of Medical Oncology, Institute Jules Bordet, Brussels, Belgium
| | - L De Mattos-Arruda
- Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - V Guarneri
- Medical Oncology 2 and Department of Surgery, Oncology and Gastroenterology, Istituto Oncologico Veneto IRCCS, University of Padova, Padua, Italy
| | - M Hutka
- NHS Foundation Trust, University Hospital Southampton, Southampton, UK
| | - K Jordan
- Department of Internal Medicine V, Hematology, Oncology and Rheumatology, University Hospital of Heidelberg, Heidelberg, Germany
| | - E Martinelli
- Department of Experimental and Clinical Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - G Mountzios
- Department of Medical Oncology, University of Athens School of Medicine Clinical Therapeutics, Athens, Greece
| | - M A Ozturk
- Department of Medical Oncology, Marmara University School of Medicine, Istanbul, Turkey
| | - M Petrova
- Department of Medical Oncology, Military Medical Academy, Sofia, Bulgaria
| | - S Postel-Vinay
- Drug Development Unit, (DITEP), Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - M Preusser
- Department of Medicine I, Vienna General Hospital (AKH) - Medical University of Vienna, Vienna, Austria
| | - C Qvortrup
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - M N M Volkov
- Oncology Department, Diagnostic Treatment Centre of International Institute of Biological Systems Dr. Sergey Berezin, St. Petersburg, Russian Federation
| | - J Tabernero
- Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - D Olmos
- Prostate Cancer Clinical Research Unit, CNIO - Spanish National Cancer Research Center, Madrid.,Genitourinary Cancer Research Unit, Medical Oncology Department, CNIO-IBIMA Hospitales Universitarios Virgen de la Victoria y Regional de Málaga, Málaga, Spain
| | - M H Strijbos
- Department of Medical Oncology, AZ KLINA, Iridium Cancer Network, Brasschaat, Belgium
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Muhamadejev R, Petrova M, Smits R, Plotniece A, Pajuste K, Duburs G, Liepinsh E. Study of interactions of mononucleotides with 1,4-dihydropyridine vesicles using NMR and ITC techniques. NEW J CHEM 2018. [DOI: 10.1039/c8nj00160j] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The possible binding site of mononucleotides is the phosphate group with important hydrophobic interactions between the mononucleotides and the alkyl chains of DHP derivatives.
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Affiliation(s)
- R. Muhamadejev
- Latvian Institute of Organic Synthesis
- Riga LV-1006
- Latvia
| | - M. Petrova
- Latvian Institute of Organic Synthesis
- Riga LV-1006
- Latvia
| | - R. Smits
- Latvian Institute of Organic Synthesis
- Riga LV-1006
- Latvia
| | - A. Plotniece
- Latvian Institute of Organic Synthesis
- Riga LV-1006
- Latvia
| | - K. Pajuste
- Latvian Institute of Organic Synthesis
- Riga LV-1006
- Latvia
| | - G. Duburs
- Latvian Institute of Organic Synthesis
- Riga LV-1006
- Latvia
| | - E. Liepinsh
- Latvian Institute of Organic Synthesis
- Riga LV-1006
- Latvia
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Manolov V, Hadjidekova S, Petrova J, Vasilev V, Petrova M, Kunchev T, Jelev Y, Jeliazkov P, Gramatikova Z, Voleva S, Tzatchev K, Traykov L. Evaluation of serum hepcidin concentrations in Parkinson’s disease patients. Parkinsonism Relat Disord 2018. [DOI: 10.1016/j.parkreldis.2017.11.257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hristozkova M, Zayova E, Stancheva I, Geneva M, Dimitrova L, Petrova M. Establishment of Efficient Protocol for Rapid and Massive Micropropagation of Greek oregano (Origanum heracleoticum L.). Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- M Hristozkova
- Institute of Plant Physiology and Genetics, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - E Zayova
- Institute of Plant Physiology and Genetics, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - I Stancheva
- Institute of Plant Physiology and Genetics, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - M Geneva
- Institute of Plant Physiology and Genetics, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - L Dimitrova
- Institute of Plant Physiology and Genetics, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - M Petrova
- Institute of Plant Physiology and Genetics, Bulgarian Academy of Sciences, Sofia, Bulgaria
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Yagubyan R, Petrova M, Storchai M, Mohan R, Nakade M, Sobolev M. MON-P282: Early Enteral Pharmaconutrition in Prevention of Postoperative Intestinal Failure. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30807-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Petrova M, Barclay M, Barclay SS, Barclay SIG. Between "the best way to deliver patient care" and "chaos and low clinical value": General Practitioners' and Practice Managers' views on data sharing. Int J Med Inform 2017; 104:74-83. [PMID: 28599819 DOI: 10.1016/j.ijmedinf.2017.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 05/08/2017] [Accepted: 05/13/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE In the UK, General Practitioners and Practice Managers are key to enabling health information exchange (typically referred to as 'data sharing'). This study aimed to survey GPs and PMs for familiarity, engagement with and perceptions of patient data sharing. METHODS Cross-sectional survey. All 107 general practices in England's second largest Clinical Commissioning Group, Cambridgeshire & Peterborough CCG. Descriptive statistics; hierarchical logistic regression; thematic analysis. RESULTS 405 (64%) responses were received - from 338 (62%) GPs and 67 (71%) PMs. Familiarity and engagement were highest for local frail elderly and end of life care projects (>76% had used). The greatest difference in use concerned the now suspended national care.data initiative: PMs had odds of reporting use 75 times higher than GP partners (95% CI 27-211). Patient confusion was the most pronounced challenge and improved coordination the most pronounced expected benefit. Frequency of discussions with patients varied with IT competence (OR 4.2 for most competent users relative to least, 95% CI 1.7-10.7) and clinical system (OR 0.3, 95% CI 0.1-0.5). Patient reservations were reported more frequently by respondents who rated their IT competence as highest (OR 3.3, 95% CI 1.5-7.6), perceived more data sharing challenges (OR for a 1-point increase in challenges perception score 3.4, 95% CI 2.1-5.6) and by PMs (relative to GP partners, OR 18.0, 95% CI 7.9-41.3). CONCLUSIONS Familiarity with and use of data sharing projects was high among GPs and PMs. Both their individual and organisational characteristics were associated with the reported frequency of discussions and patients' responses. Improved awareness of the impact of provider characteristics and attitudes on patients' decisions about data sharing may enhance the equity and autonomy of those decisions.
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Affiliation(s)
- Mila Petrova
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
| | - Matthew Barclay
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Sam S Barclay
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Stephen I G Barclay
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Powell RA, Schwartz L, Nouvet E, Sutton B, Petrova M, Marston J, Munday D, Radbruch L. Palliative care in humanitarian crises: always something to offer. Lancet 2017; 389:1498-1499. [PMID: 28422014 DOI: 10.1016/s0140-6736(17)30978-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 02/27/2017] [Accepted: 03/07/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Richard A Powell
- MWAPO Health Development Group, PO Box 459-00621, Village Market, Nairobi, Kenya.
| | - Lisa Schwartz
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Elysée Nouvet
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | | | - Mila Petrova
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | | | - Daniel Munday
- Palliative Medicine and Health Services Research, International Nepal Fellowship, Kathmandu, Nepal
| | - Lukas Radbruch
- University Hospital Bonn, Bonn, Germany; Center of Palliative Care, Malteser Hospital Seliger Gerhard Bonn/Rhein-Sieg, Bonn, Germany
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Morgan G, Lambertini M, Kourie HR, Amaral T, Argiles G, Banerjee S, Cardone C, Corral J, De Mattos-Arruda L, Öztürk A, Petrova M, Poulsen L, Strijbos M, Tyulyandina A, Vidra R, Califano R, de Azambuja E, Garrido Lopez P, Guarneri V, Reck M, Moiseyenko V, Martinelli E, Douillard JY, Stahel R, Voest E, Arnold D, Cardoso F, Casali P, Cervantes A, Eggermont AMM, Eniu A, Jassem J, Pentheroudakis G, Peters S, McGregor K, Rauh S, Zielinski CC, Ciardiello F, Tabernero J, Preusser M. Career opportunities and benefits for young oncologists in the European Society for Medical Oncology (ESMO). ESMO Open 2016; 1:e000107. [PMID: 28255451 PMCID: PMC5174792 DOI: 10.1136/esmoopen-2016-000107] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 11/01/2016] [Indexed: 11/03/2022] Open
Abstract
The European Society for Medical Oncology (ESMO) is one of the leading societies of oncology professionals in the world. Approximately 30% of the 13 000 ESMO members are below the age of 40 and thus meet the society's definition of young oncologists (YOs). ESMO has identified the training and development of YOs as a priority and has therefore established a comprehensive career development programme. This includes a leadership development programme to help identify and develop the future leaders in oncology. Well-trained and highly motivated future generations of multidisciplinary oncologists are essential to ensure the optimal evolution of the field of oncology with the ultimate goal of providing the best possible care to patients with cancer. ESMO's career development portfolio is managed and continuously optimised by several dedicated committees composed of ESMO officers and is directly supervised by the ESMO Executive Board and the ESMO President. It offers unique resources for YOs at all stages of training and includes a broad variety of fellowship opportunities, educational courses, scientific meetings, publications and resources. In this article, we provide an overview of the activities and career development opportunities provided by ESMO to the next generation of oncologists.
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Affiliation(s)
- Gilberto Morgan
- Department of Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of Oncology, Skåne University Hospital, Lund, Sweden
| | - Matteo Lambertini
- Department of Medical Oncology, U.O. Oncologia Medica 2, IRCCS AOU San Martino-IST,Genova, Italy
| | | | - Teresa Amaral
- Portuguese Air Force Health Direction, Lisbon, Portugal; Department of Dermatology, Center for Dermatooncology, Tübingen, Germany
| | - Guillem Argiles
- Department of Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
| | - Susana Banerjee
- Department of Medical Oncology, The Royal Marsden Hospital, London, UK
| | - Claudia Cardone
- Department of Medical Oncology, Second University of Naples, Naples, Italy
| | - Jesus Corral
- Department of Oncology, Virgen del Rocio University Hospital,Sevilla, Spain
| | | | - Akif Öztürk
- Department of Medical Oncology, American Hospital,Istanbul, Turkey
| | - Mila Petrova
- Department of Medical Oncology, Nadezhda Hospital,Sofia, Bulgaria
| | - Laurids Poulsen
- Department of Oncology, Aalborg University Hospital,Aalborg, Denmark
| | | | | | - Radu Vidra
- Department of Oncology, The Oncology Institute "Prof. Dr. Ion Chiricuta", Cluj Napoca, Romania
| | - Raffaele Califano
- Department of Medical Oncology, The Christie NHS Foundation Trust,Manchester, UK
| | | | | | - Valentina Guarneri
- Department of Medical Oncology 2, Istituto Oncologico Veneto IRCCS, University of Padova, Padova, Italy
| | - Martin Reck
- Department of Thoracic Oncology, Lung Clinic Grosshansdorf, Grosshansdorf, Germany
| | - Vladimir Moiseyenko
- St. Petersburg Clinical and Scientific Oncological Center,St. Petersburg, Russian Federation
| | - Erika Martinelli
- U.O.C Oncologia Medica ed Ematologia Dipartimento Medico-Chrirurgico di Internistica Clinica e Sperimentale F. Magrassi e A. Lanzara, Naples, Italy
| | | | - Rolf Stahel
- University Hospital Zurich, Zurich, Switzerland
| | - Emile Voest
- Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Dirk Arnold
- Department of Medical Oncology, Klinik für Tumorbiologie, Freiburg, Germany
| | - Fatima Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | | | - Andrés Cervantes
- Department of Hematology and Clinical Oncology, University of Valencia, Valencia, Spain
| | | | - Alexandru Eniu
- Department of Oncology, The Oncology Institute "Prof. Dr. Ion Chiricuta", Cluj Napoca, Romania
| | - Jacek Jassem
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
| | | | - Solange Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Centre Pluridisciplinaire d'Oncologie, Lausanne, Switzerland
| | | | - Stefan Rauh
- Department of Hematology and Oncology, Centre Hospitalier Emile Mayrisch, Differdange et Esch Grand Duchy of Luxembourg, Esch/Alzette, Luxembourg
| | - Christoph C Zielinski
- Clinical Division of Oncology, Department of Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria
| | | | - Josep Tabernero
- Department of Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Matthias Preusser
- Clinical Division of Oncology, Department of Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria.
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Kaniukov EY, Ustarroz J, Yakimchuk DV, Petrova M, Terryn H, Sivakov V, Petrov AV. Tunable nanoporous silicon oxide templates by swift heavy ion tracks technology. Nanotechnology 2016; 27:115305. [PMID: 26878691 DOI: 10.1088/0957-4484/27/11/115305] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Nanoporous silicon oxide templates formed by swift heavy ion tracks technology have been investigated. The influence of the heavy ion characteristics, such as type of ion, energy, stopping power and irradiation fluence on the pore properties of the silicon oxide templates, has been studied. Furthermore, the process of pore formation by chemical etching with hydrofluoric acid has been thoroughly investigated by assessing the effect of etchant concentration and etching time. The outcome of this investigation enables us to have precise control over the resulting geometry of nanopores arrays. As a result, guidelines for the creation of a-SiO2/Si templates with tunable parameters and general recommendations for their further application are presented.
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Affiliation(s)
- E Yu Kaniukov
- Cryogenic Research Division, Scientific-Practical Materials Research Centre, NAS of Belarus, Minsk 220072, Belarus
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Solodova R, Sokolov M, Galatenko V, Petrova M. Automatic system of diagnosing and treatment in intensive care unit. Intensive Care Med Exp 2015. [PMCID: PMC4797888 DOI: 10.1186/2197-425x-3-s1-a729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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Figueiredo Gomes J, Temido H, Donaire D, Petrova M, Barbosa B, Teixeira Veríssimo M, Carvalho A. P-311: Ramsay Hunt Syndrome - a case report. Eur Geriatr Med 2015. [DOI: 10.1016/s1878-7649(15)30408-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Petrova M. 3045 Neutrophil to lymphocyte ratio (NLR) as a potential surrogate predictive and prognostic biomarker in patients (pts) with advanced EGFR WT non-small cell lung cancer (NSCLC). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31687-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Fernández Macía L, Petrova M, Hubin A. ORP-EIS to study the time evolution of the [Fe(CN)6]3-/[Fe(CN)6]4- reaction due to adsorption at the electrochemical interface. J Electroanal Chem (Lausanne) 2015. [DOI: 10.1016/j.jelechem.2014.10.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Petrova M. [Common legal issues in the gynecologic practice]. Akush Ginekol (Sofiia) 2015; 54:49-51. [PMID: 26411198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Banerjee S, Califano R, Corral J, De Azambuja E, De Mattos-Arruda L, Guarneri V, Hutka M, Jordan K, Martinelli E, Mountzios G, Ozturk M, Petrova M, Postel-Vinay S, Preusser M, Qvortrup C, Strijbos M, Volkov N, Olmos D. Professional Burnout in European Young Oncologists: a European Survey Conducted By the European Society for Medical Oncology (Esmo) Young Oncologists Committee. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu438.37] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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