Cancer information overload may be a crucial determinant of adjuvant aromatase inhibitor adherence.

OBJECTIVE: Medication non-adherence is the leading preventable cause of death among cancer patients. We aimed at investigating whether an online search on cancer treatments creates information overload and to determine the effect of online search on treatment adherence in postmenopausal breast cancer (BC) patients receiving adjuvant aromatase inhibitor (AI) treatment. PATIENTS AND METHODS: A total of 103 patients completed the demographic and medical information form, Cancer Information Overload (CIO) scale, Hospital Anxiety Depression Scale (HADS), and Modified Medication Adherence Questionnaire (MAQ). RESULTS: More than half of the patients (n=55, 53.4%) performed an additional online search on BC treatment. Median HADS-Anxiety scores, HADS-Depression scores, CIO scores, and percentage of patients with a low MAQ status were 10.00 (7.00-13.00) and 4.00 (3.00-6.75) (p<0.001), 11.00 (6.00-14.00) and 4.00 (2.00-6.00) (p<0.001), 24.00 (17.00-28.00) and 12.00 (10.00-15.00) (p<0.001), and 63.6% (n=35) and 39.6% (n=19) (p=0.018) for the searcher and non-searcher groups, respectively. Co-morbidity(s) (OR 2.407, 95% CI 1.017-5.700, p=0.046) and CIO score (OR 1.126, 95% CI 1.006-1.259, p=0.039) were independent predictive factors of a low MAQ score. CONCLUSIONS: CIO is one of the main determinants of non-adherence to adjuvant AI treatment. An additional online search on cancer treatment may negatively contribute to patients' CIO, depression, and anxiety levels and does not seem to be beneficial for treatment adherence.

Added value of diffusion-weighted magnetic resonance imaging for the diagnosis of perianal fistula.

PURPOSE: To evaluate the added value of diffusion-weighted (DWI) magnetic resonance imaging (MRI) by comparison with T2-weighted images alone in the diagnosis of perianal fistula. MATERIAL AND METHODS: MRI examinations of 123 patients (97 men, 26 women; mean age, 41.9 years) with suspected perianal fistula were retrospectively evaluated by two radiologists. Fat-suppressed T2-weighted fast spin echo images, DWI (b values, 0 and 1000s/mm2) and fat-suppressed gadolinium chelate-enhanced T1-weighted images were evaluated for each patient by using a four-point scale. Confidence scores and sensitivities were calculated for T2-weighted images alone, the combination of DWI and T2-weighted images and the combination of gadolinium chelate-enhanced T1-weighted images and T2-weighted images. The combination of gadolinium chelate-enhanced and T2-weighted images was used as reference standard. RESULTS: Perianal fistulas were present in 92/123 patients (74.8%). An almost perfect interobserver agreement was found for T2-weighted images (kappa=0.868), the combination of gadolinium chelate-enhanced T1-weighted images and T2-weighted images (kappa=0.96) and the combination of DWI and T2-weighted images (kappa=0.90). The confidence scores for the diagnosis of perianal fistula for the combination of gadolinium chelate-enhanced T1-weighted images and T2-weighted images were greater than those of T2-weighted images alone for observer 1 (P<0.001) and observer 2 (P=0.009). The confidence scores of the combination of DWI and T2-weighted images were greater than those of T2-weighted images alone for observer 1 (P<0.001) and observer 2 (P=0.032). Sensitivity and specificity of the combination of DWI and T2-weighted images were greater than those of T2-weighted images alone for both observers. CONCLUSION: DWI has a significant added value compared to T2-weighted imaging alone in the diagnosis of perianal fistula.

Clinical and prognostic importance of XIAP and USP8 in advanced stages of non-small cell lung cancer.

PURPOSE: To investigate the relationship of the apoptosis regulators X-linked inhibitor of apoptosis (XIAP) and ubiquitin specific protease 8 (USP8) with clinical parameters, survival and response to chemotherapy in patients with advanced stages of non-small cell lung cancer (NSCLC). METHODS: The study included 34 NSCLC patients (28 females, 6 males) and 44 healthy individuals (17 males, 27 females) as a control group. XIAP and USP8 levels were determined by ELISA. RESULTS: The median serum XIAP level of the patients and the control group showed no significant difference. USP8 level was higher in patients than in controls (p<0.0001). In univariate analysis, there was no significant relationship between XIAP and USP8 serum levels and age, sex, performance status, weight loss, stage of disease, histopatological type and response to chemotherapy. Response to chemotherapy did not differ between the high and low XIAP and USP8 groups . There was no significant difference in progression- free survival (PFS) (p=0.432 and p=0.50, respectively) and overall survival (OS) (p=0.989 and p=0.90, respectively) between the low and high XIAP and USP8 groups. CONCLUSION: No relationship was found in serum XIAP and USP8 levels with clinical parameters, response to chemotherapy, PFS and OS in patients with advanced stages of NSCLC.

Sociotropic or autonomous personality and problem solving in peritoneal dialysis patients.

This study investigated the sociotropic and autonomous personality characteristics and perceived problem solving ability of continuous ambulatory peritoneal dialysis (CAPD) patients, and their relationship with quality of life. The study included 14 CAPD patients and 54 healthy volunteers. Sociotropy and autonomy scores were significantly higher in CAPD patients than in the healthy control group. Among CAPD patients, there was a significant correlation between problem solving and serum phosphate, parathormone levels and erythrocyte sedimentation rate. There was a negative correlation between total dialysis time and sociotropy in CAPD patients, and a positive correlation between general health/pain perception and autonomy. Appropriate medical management, time on dialysis and positive self-perception of health were correlated with better problem solving ability and higher autonomous but lower sociotropic personality styles.