Current medical research and opinion
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Objective: To explore health-related quality of life (HRQoL) and assess preferences for medical treatment attributes to obtain information of the relative importance of the different attributes in a Danish population with ulcerative colitis (UC). Methods: We used data from an online survey collected in March 2018 among people with self-reported UC. A total of 302 eligible respondents answered the HRQoL questionnaires (EuroQol-5 Dimensions (EQ-5D-5L) and the Short Inflammatory Bowel Disease Questionnaire (SIBDQ)), and 212 also completed the discrete choice experiment (DCE). ⋯ Additionally, respondents stated a preference for avoiding taking steroids, for fast onset of effect and for oral formulations. Conclusions: HRQoL correlates with disease severity, and patients with UC have lower HRQoL than the general population. The most important treatment attribute was efficacy, but patients also would like to avoid steroids, value fast onset of effect and prefer oral formulations.
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Background: Current healthcare professional consensus-generating methodologies work by forcing consensus, which risks corrupting original opinions and often fails to assess prior expert knowledge awareness. Experience gained with a novel method in a progressive life-long rare disease, X-linked hypophosphataemia, which addresses these risks is presented here. Methods: Four case-studies are reported, presenting a novel methodology comprised of two survey rounds. ⋯ Less frequent Round 1 items had various degrees of prompted agreement consensus; some did not reach the consensus threshold of >50% participant agreement. Conclusions: Observed proportional group awareness and consensus is quicker than the Delphi technique and its variants, providing objective assessments of expert knowledge and standardized categorization of items regarding awareness, consensus and prompting. Further, it offers tailored management of each item in terms of educational need and further investigation.
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Objectives: The purpose of this study was to assess (1) the trends of and (2) the factors associated with health information technology (HIT) use among older adults in the U. S. Methods: A decade (2009-2018) of data from the U. ⋯ Conclusions: This study found an increasing trend of HIT use among older adults in the U. S. from 2009 to 2018. Healthcare providers should be conscious of older adults' increased HIT use patterns and guide them to proper health management.
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Objective: To evaluate the risk of death from Alzheimer's disease among cancer survivors in a population-based setting. Methods: Within Surveillance, Epidemiology and End Results (SEER)-9 registries, cancer patients who were diagnosed between 1975 and 2016 have been reviewed. Observed/expected ratios for the risk of death from Alzheimer's disease were calculated for the overall group as well as for clinically defined subgroups. "Observed" is the number of observed deaths from Alzheimer's disease in the studied group, while "Expected" is the number of deaths from Alzheimer's disease in a demographically similar group within the US and within the same period. ⋯ Death from Alzheimer's disease seems to be particularly associated with older age at time of cancer diagnosis (O/E for patients ≥70 years: 1.29 [95% CI: 1.26-1.31] versus O/E for patients <70 years: 1.01 [95% CI: 0.98-1.03]), American Indian race (O/E for American Indian patients: 1.94 [95% CI: 1.30-2.78] versus O/E for White patients: 1.12 [95% CI: 1.10-1.14]), localized tumor stage (O/E for patients with localized disease stage: 1.13 [95% CI: 1.11-1.15] versus O/E for patients with distant disease stage: 1.04 [95% CI: 0.93-1.15]) and brain tumors (O/E for brain tumors: 2.54 [95% CI: 1.42-4.19]). Conclusion: Long-term cancer survivors (≥10 years) are more likely to die from Alzheimer's disease compared to the US general population. This risk seems to be higher among patients with older age at the time of cancer diagnosis, American Indian race and those with brain tumors.
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Retraction Of Publication Retracted Publication
Modulation of sensitization processes in the management of pain and the importance of descending pathways: a role for tapentadol?
Objective: This paper presents and discusses recent evidence on the pathophysiological mechanisms of pain. The role of tapentadol - an analgesic molecule characterized by an innovative mechanism of action (i.e. µ-opioid receptor [MOR] agonism and inhibition of noradrenaline [NA] reuptake [NRI]) - in the modulation of pain, and the most recent pharmacological evidence on this molecule (e.g. the µ-load concept) are also presented and commented upon. Methods: Narrative review. ⋯ The synergistic interaction of these two mechanisms allows a strong analgesic effect by acting on both ascending and descending pathways. Of note, the reduced µ-load of tapentadol has two important consequences: first, it limits the risk of opioid-related adverse events, as well as the risk of dependence; second, the NA component becomes predominant at least in some types of pain with consequent specific clinical efficacy in the treatment of neuropathic and chronic pain. Conclusions: According to these characteristics, tapentadol appears suitable in the treatment of chronic pain conditions characterized by both a nociceptive and a neuropathic component, such as osteoarthritis or back pain.