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  • Lundsgaard Friis posted an update 1 year, 6 months ago

    Benign foregut cysts usually develop in the thorax most of all in the mediastinum. Rare cases involving various abdominal organs, such as liver, stomach or pancreas have been previously published, mostly occurring in the retroperitoneum.

    We herein present an adenocarcinoma of a foregut cyst involving the left side of the diaphragm, left lower lobe of the lung, and left lobe of the liver, successfully removed through multivisceral resection. In between drug holidays, postoperative oncological treatment has been ongoing for nearly 4years. In terms of chemotherapy, FOLFOX 4 regime, capacitabine monotherapy and later on next generation sequencing has been attempted, although the patient refused the later treatment option. Despite multimodality (combined surgical and oncological) treatment, local- and later on loco-regional recurrence has been detected on follow-up staging, influencing further chemotherapy regime. Taking both the fairly unknown type of the tumor and uncertain response rate to oncological therapy into account, prolonged tumor pace with fairly stable general patient state was reached throughout the course of the disease.

    Through surgical tumor resection, and postoperative chemotherapy the patient managed to maintain an acceptable quality of life without major symptoms during ongoing treatment. During our own case, with multiple organ involvement, multivisceral resection, with multimodality treatment had considerable effect in prolonging the lifespan of the patient.

    Through surgical tumor resection, and postoperative chemotherapy the patient managed to maintain an acceptable quality of life without major symptoms during ongoing treatment. During our own case, with multiple organ involvement, multivisceral resection, with multimodality treatment had considerable effect in prolonging the lifespan of the patient.

    The goal of this study was to investigate treatment outcome and related intervention processes of mindfulness-based cognitive therapy versus health qigong-based cognitive therapy versus waitlist control among individuals with mood disorders.

    A total of 187 individuals with mood disorders were randomized and allocated into mindfulness-based cognitive therapy, health qigong-based cognitive therapy, or waitlist control groups. All participants were assessed at three time points with regard to depressive and anxiety symptoms, physical and mental health status, perceived stress, sleep quality, and self-efficacy. Linear mixed models analysis was used to test the individual growth model by studying the longitudinal data.

    Mindfulness-based cognitive therapy and health qigong-based cognitive therapy both produced greater improvements on all outcome measures as compared with waitlist control. Relatively, more reductions of mood symptoms were observed in the health qigong-based cognitive therapy group as compared with the mindfulness-based cognitive therapy group. Health qigong-based cognitive therapy is more conducive to physical health status whereas mindfulness-based cognitive therapy has more favorable mental health outcomes. Individual growth curve models indicated that alterations in perceived stress was the common predictor of mood changes in both intervention groups.

    The predominant emphasis on physical health in health qigong-based cognitive therapy makes it more acceptable and effective than mindfulness-based cognitive therapy as applied in Chinese individuals with mood disorders. The influence of Chinese culture is discussed.

    HKU Clinical Trials Registry. Identifier HKUCTR-2558 . Registered 21st Nov 2018.

    HKU Clinical Trials Registry. PROTAC tubulin-Degrader-1 datasheet Identifier HKUCTR-2558 . Registered 21st Nov 2018.

    Societies strive for fast-delivered, evidence-based and need-oriented depression treatment within budget constraints. To explore potential improvements, selective contracts can be implemented. Here, we evaluate if the German collaborative psychiatry-neurology-psychotherapy contract (PNP), which extends the gatekeeping-based general practitioner (GP) program, improved guideline adherence or need-oriented and timely access to psychotherapy compared to usual care (UC).

    We conducted a retrospective observational cohort study based on health insurance claims data. After we identified patients with depression who were on sick leave due to a mental disorder in 2015, we applied entropy balancing to adjust for selection effects and employed chi-squared tests to compare guideline adherence of the received treatment between PNP, the GP program and UC. Subsequently, we applied an extended cox regression to assess need-orientation by comparing the relationship between accumulated sick leave days and waiting times for treatment options.

    The PNP contract strengthens the relationship between sick leave days and the delay until the beginning of psychotherapy, which suggests improvements in terms of need-oriented access to care. However, we found no indication for increased guideline adherence and – independent of the health plan – a gap in sufficient utilization of adequate treatment options.

    Pulmonary hypertension is a deadly complication of bronchopulmonary dysplasia, the most common pulmonary morbidity of prematurity. Despite these catastrophic consequences, no evidence-based therapies are available for the prevention of pulmonary hypertension in this population. Sildenafil is a potent pulmonary vasodilator approved by the US Food and Drug Administration for the treatment of pulmonary hypertension in adults. Preclinical models suggest a beneficial effect of sildenafil on premature lungs through improved alveolarization and preserved vascular development. Sildenafil may therefore prevent the development of pulmonary hypertension associated with lung disease of prematurity by reducing pulmonary vascular remodeling and lowering pulmonary vascular resistance; however, clinical trial evidence is needed. The present study, supported by the National Institutes of Health’s National Heart Lung and Blood Institute, will generate safety, pharmacokinetics, and preliminary effectiveness data on sildenafillmonary hypertension in premature infants with bronchopulmonary dysplasia. Clinical trials of sildenafil specifically designed for premature infants are urgently needed. The current study will make substantial contributions to scientific knowledge of the safety of sildenafil in premature infants at risk for pulmonary hypertension. Results from the study will be used by investigators to inform the design of a pivotal efficacy trial.

    ClinicalTrials.gov NCT04447989 . Registered 25 June 2020.

    ClinicalTrials.gov NCT04447989 . Registered 25 June 2020.