Read by QxMD icon Read

Financial toxicity

Xiao Zhang, Guigao Lin, Liming Tan, Jinming Li
Tacrolimus is effective for the prevention of acute rejection, but is also highly toxic and has great intra- and inter-individual variability in transplant patients. Genetic variation and other factors influence the response of an individual to tacrolimus treatment. Therefore, even if therapeutic drug monitoring is universally applied, rejection and toxicity still occur. Although the appropriate action on pharmacogenomic variability provides a cornerstone for the precise tacrolimus prescription, at present there are many obstacles to translating it into clinical practice...
March 15, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Craig A Schuring, Daniel L Dodge, Tyler J Whitcomb, Geoffrey C Wall, Hayden L Smith, Greg A Hicklin
Toxic exposures with serious outcomes have increased over the last decade. Limited data exists on the pattern and outcomes of overdose-exposure patients requiring intensive care unit (ICU) admission. The primary objective of this study was to characterize the causes, treatments, and outcomes of toxic exposures in a mid-sized Midwestern health system. The secondary objective was to report cumulative economic costs associated with these patients. Data were obtained from medical records of patients 18 years or older with a diagnosis code of overdose admitted to the ICU at 2 teaching hospitals between August 1, 2012, and July 31, 2014...
March 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
Bahendeka Silver, Kaushik Ramaiya, Swai Babu Andrew, Otieno Fredrick, Sarita Bajaj, Sanjay Kalra, Bavuma M Charlotte, Karigire Claudine, Anthony Makhoba
A diagnosis of diabetes or hyperglycemia should be confirmed prior to ordering, dispensing, or administering insulin (A). Insulin is the primary treatment in all patients with type 1 diabetes mellitus (T1DM) (A). Typically, patients with T1DM will require initiation with multiple daily injections at the time of diagnosis. This is usually short-acting insulin or rapid-acting insulin analogue given 0 to 15 min before meals together with one or more daily separate injections of intermediate or long-acting insulin...
March 5, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Genia Dubrovsky, Nhan Huynh, Joshua D Rouch, John P Koulakis, David P Nicolau, Christina A Sutherland, Seth Putterman, James C Y Dunn
BACKGROUND: Surgical site infections (SSIs) pose a significant health and financial burden. A key aspect of appropriate prophylaxis is the administration of antibiotics intravenously (IV). However, subcutaneous administration of antibiotics is not well described in the literature. During surgery, we hypothesize that subcutaneous injection may provide better protection against SSIs. To better understand the kinetics after subcutaneous injection, we describe the serum concentrations of cefazolin in a porcine model...
April 2018: Journal of Surgical Research
Wiebke Schmidt, David Raymond, David Parish, Ian G C Ashton, Peter I Miller, Carlos J A Campos, Jamie D Shutler
The need to ensure future food security and issues of varying estuarine water quality is driving the expansion of aquaculture into near-shore coastal waters. It is prudent to fully evaluate new or proposed aquaculture sites, prior to any substantial financial investment in infrastructure and staffing. Measurements of water temperature, salinity and dissolved oxygen can be used to gain insight into the physical, chemical and biological water quality conditions within a farm site, towards identifying its suitability for farming, both for the stock species of interest and for assessing the potential risk from harmful or toxic algae...
January 2018: Aquacultural Engineering
Handerson Rodrigues Silva Lima, Josany Saibrosa da Silva, Emanuel Airton de Oliveira Farias, Paulo Ronaldo Sousa Teixeira, Carla Eiras, Lívio César Cunha Nunes
Cancer is a leading cause of death worldwide, often being treated with antineoplastic drugs that have high potential for toxicity to humans and the environment, even at very low concentrations. Therefore, monitoring these drugs is of utmost importance. Among the techniques used to detect substances at low concentrations, electrochemical sensors and biosensors have been noted for their practicality and low cost. This review brings, for the first time, a simplified outline of the main electrochemical sensors and biosensors developed for the analysis of antineoplastic drugs...
February 13, 2018: Biosensors & Bioelectronics
Budhi Singh Yadav, Suresh C Sharma
PURPOSE: To report the results in terms of feasibility and early toxicity of hypofractionated adjuvant whole breast/chest wall and/or regional nodal radiation therapy for patients with breast cancer. METHODS AND MATERIALS: From June 2013 to October 2014, 50 patients with breast cancer after mastectomy or after breast conservation surgery (BCS) were prospectively included. The institutional ethics committee approved the study, which was registered with ClinicalTrials...
March 15, 2018: International Journal of Radiation Oncology, Biology, Physics
Min-Suk Yang, Ju-Young Kim, Min-Gyu Kang, Suh-Young Lee, Jae-Woo Jung, Sang-Heon Cho, Kyung-Up Min, Hye-Ryun Kang
Background/Aims: There are only a few reports on the direct costs of severe cutaneous adverse reactions (SCARs), including drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN), despite the tremendous negative impact these reactions can have on patients. We estimated the direct costs of treating SCARs. Methods: Patients admitted to a tertiary teaching hospital for the treatment of SCARs from January 1, 2005 to December 31, 2010 were included...
February 23, 2018: Korean Journal of Internal Medicine
Bishal Gyawali, Pan Pantziarka, Sergio Crispino, Gauthier Bouche
Among the various measures proposed to combat the challenge of financial toxicity in cancer care, an important strategy is the use of lower-priced drugs instead of expensive alternatives. However, the oncology community seems to either ignore or more readily reject cheaper drugs in cancer care compared to more expensive alternatives. In this commentary, we present three examples of lower-priced drugs rejected or ignored by the oncology community and contrast this with three expensive drugs where persistent optimism remained despite negative clinical trial results...
2018: Ecancermedicalscience
Caroline Sloan, S Yousuf Zafar
Out-of-pocket spending continues to increase, particularly in cancer care. High out-of-pocket expenditures are associated with increased psychosocial distress, lower adherence, and higher mortality. In order to improve cancer-related outcomes, we must come up with interventions directed at reducing cancer-related financial toxicity. In this article, we highlight the most promising interventions.
January 2018: North Carolina Medical Journal
Raymond Javan Chan, Louisa Gordon, Syed Yousuf Zafar, Christine Miaskowski
No abstract text is available yet for this article.
February 13, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
A D Boelens, R A A Mathôt, A P J Vlaar, C S C Bouman
High-dose methotrexate (MTX) induced acute kidney injury can lead to sustained high systemic MTX levels and severe toxicity. A 39-year-old man with lymphoblastic T-cell lymphoma was admitted to our intensive care unit with elevated serum creatinine and prolonged high serum MTX levels. Standard supportive care was complemented by the addition of a relatively novel agent, glucarpidase, which rapidly lowered the extracellular levels of MTX. Several case series support this effect of glucarpidase, but no randomised controlled trial has been performed to show this leads to better outcome...
January 2018: Netherlands Journal of Medicine
Sultan Alghadeer, Manal Alrohaimi, Abeer Althiban, Nora A Kalagi, Bander Balkhi, Anas A Khan
Introduction: Although the majority of poisoning-related cases can be managed in home settings, reduction of hospital visits and admissions are still important challenge. Thousands of interventions are involved and the appropriate management of poisoning is therefore a major task and burden to any institution. Therefore, the present study was aimed to identify the most common classes of toxic substances and route of poisoning in children and to investigate the pattern of drug and chemical poisoning in suspected case fatalities, the subsequent need for hospital admission and arrival time to hospital...
January 2018: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
Kimlin Tam Ashing, Marshalee George, Veronica Jones
OBJECTIVE: When breast cancer occurs in young women, the medical, physical, psychosocial, and overall impacts can be more severe warranting targeted medical and psychosocial oncology care. Yet, despite their risk for poorer survival and survivorship outcomes, little research has focused on this group with critical gaps concerning ethnic minorities who are particularly medically vulnerable. Therefore, this preliminary study examined demographic characteristics and patient centered outcomes i...
January 25, 2018: Psycho-oncology
Rebecca L Walker, Marci D Cottingham, Jill A Fisher
Phase 1 healthy volunteer clinical trials-which financially compensate subjects in tests of drug toxicity levels and side effects-appear to place pressure on each joint of the moral framework justifying research. In this article, we review concerns about phase 1 trials as they have been framed in the bioethics literature, including undue inducement and coercion, unjust exploitation, and worries about compromised data validity. We then revisit these concerns in light of the lived experiences of serial participants who are income-dependent on phase 1 trials...
January 12, 2018: Journal of Medicine and Philosophy
Pricivel M Carrera, Hagop M Kantarjian, Victoria S Blinder
"Financial toxicity" has now become a familiar term used in the discussion of cancer drugs, and it is gaining traction in the literature given the high price of newer classes of therapies. However, as a phenomenon in the contemporary treatment and care of people with cancer, financial toxicity is not fully understood, with the discussion on mitigation mainly geared toward interventions at the health system level. Although important, health policy prescriptions take time before their intended results manifest, if they are implemented at all...
January 16, 2018: CA: a Cancer Journal for Clinicians
Mucheli Shravan Sadashiv, Priscilla Rupali, Abi Manesh, Rajesh Kannangai, Ooriapadickal Cherian Abraham, Susanne A Pulimood, Rajiv Karthik, S Rajkumar, Kurien Thomas
Background: Since the time of NACO Antiretroviral (ART) roll-out, generic ART has been the mainstay of therapy. There are many studies documenting the efficacy of generic ART but with the passage of time, failure of therapy is on the rise. As institution of second line ART has significant financial implications both for a program and for an individual it is imperative that we determine factors which contribute towards treatment failure in a cohort of patients on generic antiretroviral therapy...
December 2017: Journal of the Association of Physicians of India
Noah Kittner, Raj P Fadadu, Heather Louisa Buckley, Megan Schwarzman, Daniel M Kammen
More than 6,600 coal-fired power plants generate electricity around the world and serve an estimated five billion people. Globally, coal processing and combustion contribute 46% of annual CO2 emissions, and the resulting gases and particulate matter from coal combustion are harmful on their own and often contain toxic trace metals. The decades-old Kosovo A and B power stations, Europe's largest point sources of air pollution, generate 98% of Kosovo's total electricity and are due for replacement. Kosovo will rely on investment from international financial institutions and external donors to replace these plants...
January 4, 2018: Environmental Science & Technology
Gianni B Scappaticci, Bernard L Marini, Victoria R Nachar, James R Uebel, Vera Vulaj, Ashley Crouch, Dale L Bixby, Moshe Talpaz, Anthony J Perissinotti
The 5-year overall survival (OS) in patients ≥ 60 years old with acute myeloid leukemia (AML) remains < 10%. Clofarabine-based induction (CLO) provides an alternative to low-intensity therapy (LIT) and palliative care for this population, but supporting data are conflicted. Recently, our institution adopted the FLAG regimen (fludarabine, cytarabine, and granulocyte colony-stimulating factor) based on data reporting similar outcomes to CLO in elderly patients with AML unable to tolerate anthracycline-based induction...
December 29, 2017: Annals of Hematology
Sarah K Valentine-Maher, Patricia G Butterfield, Gary Laustsen
Human health is substantially impacted by the state of the environment, and environmental degradation has a disproportionate impact on persons with less immediate access to financial and social power. This article calls for upstream nursing action to address the natural environment in order to turn about health injustices and improve health for all. Such action would move nursing towards a greater actualization of the nursing environmental domain. The health impacts of climate change, air and water quality, and toxic chemical exposure are substantiated and specific policy leadership recommendations are proposed...
December 27, 2017: ANS. Advances in Nursing Science
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"