Subject(s)
Adenocarcinoma/pathology , Leukemia, Myeloid, Acute/pathology , Neoplasms, Multiple Primary/pathology , Pancreatic Neoplasms/pathology , Adenocarcinoma/therapy , Combined Modality Therapy , Humans , Leukemia, Myeloid, Acute/therapy , Male , Middle Aged , Neoplasms, Multiple Primary/therapy , Pancreatic Neoplasms/therapy , PrognosisABSTRACT
Imatinib mesylate has been associated with the changes in bone turnover. We report a case of the development of tissue calcification in a patient on long-term therapy with this drug. A 48-year-old male patient with gastrointestinal stromal tumor and liver metastasis complained of abdominal pain. His treatment included hepatic artery chemoembolization and partial hepatectomy in addition to chronic imatinib mesylate for 4 years. On physical examination, he had a peritoneal mass just beneath the laparotomy incision scar that, after resection, was found to be dystrophic bone formation. Based on the previous studies suggesting bone changes due to chronic therapy with imatinib mesylate, we believe that the patient's new bone formation was causally related to the use of this drug. To our knowledge, there are no similar reported cases in the literature.
Subject(s)
Antineoplastic Agents/adverse effects , Antineoplastic Agents/therapeutic use , Benzamides/adverse effects , Benzamides/therapeutic use , Calcification, Physiologic/drug effects , Gastrointestinal Stromal Tumors/drug therapy , Piperazines/adverse effects , Piperazines/therapeutic use , Pyrimidines/adverse effects , Pyrimidines/therapeutic use , Humans , Imatinib Mesylate , Male , Middle Aged , Treatment OutcomeABSTRACT
PURPOSE: Prescription stimulant use as "cognitive enhancers" has been described among undergraduate college students. However, the use of prescription stimulants among future health care professionals is not well characterized. This study was designed to determine the prevalence of prescription stimulant misuse among students at an academic health sciences center. METHOD: Electronic surveys were e-mailed to 621 medical, pharmacy, and respiratory therapy students at East Tennessee State University for four consecutive weeks in fall 2011. Completing the survey was voluntary and anonymous. Surveys asked about reasons for, frequency of, and side effects of nonprescription misuse of prescription stimulants. Given the sensitive material, an opportunity to win one of ten $50 gift cards was used as an incentive. RESULTS: Three hundred seventy-two (59.9%) students completed the survey from three disciplines (47.6% medical, 70.5% pharmacy, and 57.6% respiratory therapy). Overall, 11.3% of responders admitted to misusing prescription stimulants. There was more misuse by respiratory therapy students, although this was not statistically significant (10.9% medicine, 9.7% pharmacy, 26.3% respiratory therapy; P = .087). Reasons for prescription stimulant misuse included to enhance alertness/energy (65.9%), to improve academic performance (56.7%), to experiment (18.2%), and to use recreationally/get high (4.5%). CONCLUSIONS: Prescription stimulant misuse was prevalent among participating students, but further research is needed to describe prevalence among future health care workers more generally. The implications and consequences of such misuse require further study across professions with emphasis on investigating issues of academic dishonesty (e.g., "cognitive enhancement"), educational quality, and patient safety or health care quality.
Subject(s)
Central Nervous System Stimulants , Cognition/drug effects , Prescription Drug Misuse , Students, Health Occupations , Academic Medical Centers , Humans , Respiratory Therapy , Students, Medical , Students, PharmacySubject(s)
Brain Neoplasms/therapy , Palliative Care , Adult , Advance Directives , Glioma/therapy , Humans , Palliative Care/methods , Withholding TreatmentSubject(s)
Brain Neoplasms/mortality , Palliative Care , Biomarkers , Brain Neoplasms/diagnosis , Brain Neoplasms/pathology , Humans , Incidence , PrognosisSubject(s)
Ascites/etiology , Ascites/therapy , Neoplasms/complications , Diuretics , Humans , Palliative Care , Paracentesis , Peritoneovenous ShuntSubject(s)
Morals , Personhood , Terminally Ill/psychology , Adult , Age Factors , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Randomized Controlled Trials as Topic , Young AdultSubject(s)
Analgesics, Opioid/therapeutic use , Oxycodone/therapeutic use , Pain/drug therapy , Palliative Care , Analgesics, Opioid/administration & dosage , Analgesics, Opioid/adverse effects , Dose-Response Relationship, Drug , Humans , Oxycodone/administration & dosage , Oxycodone/adverse effectsSubject(s)
Health Care Rationing/organization & administration , Intensive Care Units/organization & administration , Palliative Care/organization & administration , Health Care Rationing/economics , Humans , Intensive Care Units/economics , Palliative Care/economics , Resuscitation Orders , Sociology, MedicalSubject(s)
Hospice Care/methods , Length of Stay/statistics & numerical data , Patient Discharge/statistics & numerical data , Terminally Ill/statistics & numerical data , Age Factors , Aged , Aged, 80 and over , Female , Hospices , Humans , Male , Middle Aged , National Center for Health Statistics, U.S. , Outcome Assessment, Health Care , Patient Admission/statistics & numerical data , Prognosis , Survival Analysis , United States/epidemiologyABSTRACT
Biomedical journals and the pharmaceutical industry share the goals of enhancing transparency and expanding access to peer-reviewed research; both industries have recently instituted new policies and guidelines to effect this change. However, while increasing transparency may elevate standards and bring benefits to readers, it will drive a significant increase in manuscript volume, posing challenges to both the journals and industry sponsors. As a result, there is a need to: (1) increase efficiency in the submission process to accommodate the rising manuscript volume and reduce the resource demands on journals, peer reviewers, and authors; and (2) identify suitable venues to publish this research. These shared goals can only be accomplished through close collaboration among stakeholders in the process.In an effort to foster mutual collaboration, members of the pharmaceutical industry and the International Society for Medical Publication Professionals founded a unique collaborative venture in 2008 - the Medical Publishing Insights and Practices initiative (MPIP). At an MPIP roundtable meeting in September 2009,journal editors, publishers and industry representatives identified and prioritized opportunities to streamline the submission process and requirements, and to support prompt publication and dissemination of clinical trial results in the face of increasing manuscript volume. Journal and sponsor participants agreed that more author education on manuscript preparation and submission was needed to increase efficiency and enhance quality and transparency in the publication of industry-sponsored research. They suggested an authors'guide to help bridge the gap between author practices and editor expectations.To address this unmet educational need, MPIP supported development of an Authors' Submission Toolkit to compile best practices in the preparation and submission of manuscripts describing sponsored research.The Toolkit represents a unique collaboration between the pharmaceutical industry and biomedical journals,and reflects both groups' perspectives on how authors can help raise standards and increase efficiency in publishing industry-sponsored studies. The information provided in the toolkit can be useful to help authors navigate the manuscript