ABSTRACT
INTRODUCTION: Palliative radiotherapy (PRT) is frequently used to treat symptoms of advanced cancer, however benefits are questionable when life expectancy is limited. The 30-day mortality rate after PRT is a potential quality indicator, and results from a recent meta-analysis suggest a benchmark of 16% as an upper limit. In this population-based study from Queensland, Australia, we examined 30-day mortality rates following PRT and factors associated with decreased life expectancy. METHODS: Retrospective population data from Queensland Oncology Repository was used. Study population data included 22,501 patients diagnosed with an invasive cancer who died from any cause between 2008 and 2017 and had received PRT. Thirty-day mortality rates were determined from the date of last PRT fraction to date of death. Cox proportional hazards models were used to identify factors independently associated with risk of death within 30 days of PRT. RESULTS: Overall 30-day mortality after PRT was 22.2% with decreasing trend in more recent years (P = 0.001). Male (HR = 1.20, 95% CI = 1.13-1.27); receiving 5 or less radiotherapy fractions (HR = 2.97, 95% CI = 2.74-3.22 and HR = 2.17, 95% CI = 2.03-2.32, respectively) and receiving PRT in a private compared to public facility (HR = 1.61, 95% CI = 1.51-1.71) was associated with decreased survival. CONCLUSION: The 30-day mortality rate in Queensland following PRT is higher than expected and there is scope to reduce unnecessarily protracted treatment schedules. We encourage other Australian and New Zealand centres to examine and report their own 30-day mortality rate following PRT and would support collaboration for 30-day mortality to become a national and international quality metric for radiation oncology centres.
Subject(s)
Neoplasms , Palliative Care , Humans , Queensland , Male , Female , Retrospective Studies , Aged , Neoplasms/radiotherapy , Neoplasms/mortality , Middle Aged , Quality Indicators, Health Care , Aged, 80 and over , Life Expectancy , AdultABSTRACT
@#The objective of this study wasto determine the factorial validity of the Chinese version of the General Family Functioning subscale (GF-12) and to assess parents’ perceived family functioning of children with or without chronic respiratory disease in Malaysia. Thirty two parents of children with chronic respiratory disease and 30 parents of healthy children were recruited. The GF-12 was administered at baseline and 2 weeks later. Confirmatory factor analysis showed that our instrument was a 1-factor model assessing general family functioning. Cronbach’s α value was 0.950. Test-retest reliability coefficient ranged from 0.490-0.790. The overall mean (standard deviation) score was not significantly different between parent’s perceived family functioning of children with or without respiratory disease [1.83(0.63) versus 1.65(0.46), p=0.385]. The Chinese version of the GF-12 was found to be a valid and reliable instrument to assess family functioning in Malaysia. Parents in the present study showed healthy perceived family functioning (total score >2.00)
ABSTRACT
Cryptococcosis is an opportunistic yeast infection caused by Cryptococcus neoformans that remains the most common systemic fungal infection in immunosuppressed patients and often presents with signs of meningitis. Primary cutaneous cryptococcosis (PCC) is a more rare clinical identity that is characterized by skin lesions confined to 1 body region, often presenting as a whitlow or phlegmon with positive culture for C neoformans and no evidence of simultaneous dissemination. We report a rare case of PCC in a 73-year-old man with intact cell-mediated immunity.
Subject(s)
Cryptococcosis/diagnosis , Cryptococcus neoformans/isolation & purification , Dermatomycoses/diagnosis , Hand Dermatoses/microbiology , Immunocompetence , Aged , Cryptococcosis/drug therapy , Dermatomycoses/drug therapy , Hand Dermatoses/drug therapy , Humans , Itraconazole/therapeutic use , MaleABSTRACT
We present a measurement of the longitudinal spin asymmetry A(||) in photoproduction of pairs of hadrons with high transverse momentum p(T). Data were accumulated by the HERMES experiment using a 27.5 GeV polarized positron beam and a polarized hydrogen target internal to the HERA storage ring. For h(+)h(-) pairs with p(h(1))(T)>1.5 GeV/c and p(h(2))(T)>1.0 GeV/c, the measured asymmetry is A(||) = -0. 28+/-0.12(stat)+/-0.02(syst). This negative value is in contrast to the positive asymmetries typically measured in deep inelastic scattering from protons, and is interpreted to arise from a positive gluon polarization.
