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Although development and growth of assisted living (AL) services for the severely mentally ill (SMI) has lasted for decades, and is still ongoing, research on AL services is scarce. Furthermore, the broad variation in AL service models, lack of global taxonomy for AL services and inconsistent reporting of AL service habitants makes the evaluation and comparison of AL services challenging. The purpose of the current study was, for the first time in Finland, to evaluate the applicability of the international Simple Taxonomy for Supported Accommodation (STAX-SA) for recategorization of current national AL service categories for the mentally ill. Data for the study is obtained from the Porvoo ASPA-project. Our main finding was that the correspondence to STAX-SA categorization was good, as 64.7% of the AL service levels could directly be classified to certain STAX-SA types. The strength of STAX-SA categorization was the ability to describe the majority of the 24-hour and part-time service units. STAX-SA ability to describe AL services weakened as the level of AL service decreased but remained reasonable. STAX-SA as a methodological tool has potential in enabling comparative studies on AL services based on the level they provide. STAX-SA has strengths in describing AL units and the services provided in them, especially by differentiating custodial care units from rehabilitation units in AL.

Various studies indicate that air pollution poses an environmental threat to public health, particularly cardiovascular disease (CVD) 1, 2. While the impact of air pollution on an individual scale is relatively low compared to other significant risk factors for cardiovascular diseases, the large number of people affected can result in a substantial increase in the total mortality of the population. Consequently, the effect of air pollution on cardiovascular disease is regarded as a serious issue in public health 3.

Abstract Background This study aimed to evaluate the socio-demographic, clinical, and laboratory risk factors in hospitalized COVID-19 patients during the first 6 months of the SARS-CoV-2 epidemic. Method This retrospective hospital-based cross-sectional study included all laboratory-confirmed cases of the COVID-19 virus that were admitted to the Shohadaye-Khalije-Fars Hospital in Bushehr, Iran, from February 22, 2020 to September 21, 2020. The patients' records were reviewed during the hospitalization period. The global COVID-19 clinical platform, i.e., the World Health Organization Rapid Case Report Form was used as the data collection tool. We conducted the survival analysis using the Kaplan–Meier and the Stepwise Cox regression analyses. Results The analysis included 2108 confirmed cases of COVID-19 with a mean age of 47.81 years (SD 17.78); 56.8% men, 43.2% women and 6.3% (n = 133) deaths. After adjustment, it was found that factors associated with an increased risk of death consisted of chronic kidney disease, intensive care unit admission, cancer, and hemoptysis. The 7-day survival rate was 95.8%, which decreased to 95.1%, 94.0%, and 93.8% on days 14, 21, and 28 of hospitalization, respectively. Discussion and conclusion Older COVID-19 patients with manifestation of hemoptysis and a past medical history of chronic kidney disease and cancer, should be closely monitored to prevent disease deterioration and death, and also should be admitted to the intensive care unit.

Abstract Background and Aims The prospect of using artificial intelligence (AI) in healthcare is bright and promising, and its use can have a significant impact on cost reduction and decrease the possibility of error and negligence among healthcare workers. This study aims to investigate the level of knowledge, attitude, and acceptance among Iranian physicians and nurses. Methods This cross‐sectional descriptive‐analytical study was conducted in eight public university hospitals located in Tehran on 400 physicians and nurses. To conduct the study, convenient sampling was used with the help of researcher‐made questionnaires. Statistical analysis was done by SPSS 21 The mean and standard deviation and Chi‐square and Fisher's exact tests were used. Results In this study, the level of knowledge among the research subjects was average (14.66 ± 4.53), the level of their attitude toward AI was relatively favorable (47.81 ± 6.74), and their level of acceptance of AI was average (103.19 ± 13.70). Moreover, from the participant's perspective, AI in medicine is most widely used in increasing the accuracy of diagnostic tests (86.5%), identifying drug interactions (82.75%), and helping to analyze medical tests and imaging (80%). There was a statistically significant relationship between the variable of acceptance of AI and the participant's level of education (p = 0.028), participation in an AI training course (p = 0.022), and the hospital department where they worked (p

Dehospitalization for people with severe mental illness (SMI) has continued for decades and led to the development of assisted living (AL) services. However, there is little knowledge on how the increasing use of AL services relates to the time trends of different psychiatric services. This study utilizes a 23-year time series data from Finland to evaluate the use of AL services in relation to the use of psychiatric inpatient and specialized psychiatric outpatient care. This population-based data from 1996 to 2018 was extracted from the Sotkanet Statistics and Indicator Bank, administered by the Finnish Institute for Health and Welfare (THL). The analyses of the time trends in different levels of psychiatric AL services, classified according to support given to AL habitants, was possible to perform from the year 2006 onwards. The Joinpoint Regression analysis was applied to estimate time trends of the indicators selected for our study. In the whole 23-year study period, an increased rate of habitants in psychiatric AL services was correlated with an increased number of specialized psychiatric outpatient visits (r = 0.766, p

Abstract Background Urinary schistosomiasis is a serious threat in endemic territories of Africa and the Middle East. The status of female urinary schistosomiasis (FUS) in published literature between 2016 and 2020 was investigated. Methods A systematic search in PubMed, Scopus, Google Scholar, and Web of Science, based on the ‘Preferred Reporting Items for Systematic Reviews and Meta-analyses’ checklist, and a meta-analysis using random-effects model to calculate the weighted estimates and 95% confidence intervals (95% CIs) were done. Results Totally, 113 datasets reported data on 40,531 women from 21 African countries, showing a pooled prevalence of 17.5% (95% CI: 14.8–20.5%). Most studies (73) were performed in Nigeria, while highest prevalence was detected in Mozambique 58% (95% CI: 56.9–59.1%) (one study). By sample type and symptoms, vaginal lavage [25.0% (95% CI: 11.4–46.1%)] and hematuria 19.4% (95% CI: 12.2–29.4%) showed higher FUS frequency. Studies using direct microscopy diagnosed a 17.1% (95% CI: 14.5–20.1%) prevalence rate, higher than PCR-based studies 15.3% (95% CI: 6.1–33.2%). Except for sample type, all other variables had significant association with the overall prevalence of FUS. Conclusions More studies are needed to evaluate the true epidemiology of FUS throughout endemic regions.

Abstract Background and Aims Marital relationship and its quality are among the major psychological factors affecting the multiple aspects of a person's health status. Chronic diseases are also among the factors that affect various aspects of the lives of millions of people including their marital quality status. One of the most important underlying chronic diseases is diabetes. Since the correlation between diabetes mellitus and marital quality has been neglected, this systematic review, as the first one, aims to investigate the association between marital quality and diabetes mellitus. Methods A comprehensive search was conducted among three databases (Medline, Scopus, and Web of Science) until September 2021, which resulted in 189 articles. After assessing the studies based on the inclusion criteria, 14 studies were included. Results The included studies were divided into two general groups. The first group consisted of 3 articles examining the effect of factors related to diabetes on marital quality, and the second group included 11 articles studying the effect of marital quality on diabetes and its factors. In general, the articles investigating the impact of diabetes‐related factors on marital quality showed that diabetes has negative impacts on levels of marital quality. Also, the articles investigating the impact of marital quality on diabetes‐related factors, showed that higher marital quality is associated with a lower risk of developing diabetes, a better quality of life in patients with diabetes, and better adherence to diabetes care regimen. The results regarding diabetes management were conflicting. Gender was mentioned as an important modulator in some of the investigated relationships. Conclusion Marital quality remarkably influences diabetes‐related factors and is itself affected by the condition resulting from diabetes in individuals with diabetes mellitus. However, further studies are required due to the limited number of studies investigating this correlation.

Background: The use of allergen immunotherapy is one of the definitive treatments for allergic diseases due to the cellular and molecular changes developed in the immune system response. The aim of this study was to assess the efficacy of subcutaneous immunotherapy in patients with allergic diseases presenting to the allergy clinic of Persian Gulf Hospital in Bushehr, Iran. Materials and Methods: Patients with respiratory allergic diseases were enrolled in this observational study. The patients who had a positive skin prick test underwent immunotherapy for one year and were randomly included in this study. To evaluate the efficacy of immunotherapy, two questionnaires were completed for all the patients before and one year after the start of immunotherapy, including the Total Nasal Symptom Score (TNSS) and Asthma Control Test (ACT). Results: A total of 878 patients (53.6% male and 46.4% female) entered the study, including 45.8% who had allergic rhinitis, 25.5% with asthma and 28.5% with both diseases. The mean TNSS was examined for 258 patients before and after immunotherapy and was 13.64 and 5.83 (P

Aging is described as an advanced time-related collection of changes that may negatively affect with the risk of several diseases or death. Aging is a main factor of several age-related neurological disorders, including neurodegenerative diseases (Alzheimer’s disease, Parkinson’s disease, and dementia), stroke, neuroinflammation, neurotoxicity, brain tumors, oxidative stress, and reactive oxygen species (ROS). Currently available medications for age-related neurological disorders may lead to several side effects, such as headache, diarrhea, nausea, gastrointestinal (GI) diseases, dyskinesia, and hallucinosis. These days, studies on plant efficacy in traditional medicine are being conducted because herbal medicine is affordable, safe, and culturally acceptable and easily accessible. The Indian traditional medicine system called Ayurveda uses several herbs and medicinal plants to treat various disorders including neurological disorders. This review aims to summarize the data on the neuroprotective potential of the following common Indian spices widely used in Ayurveda: cumin (Cuminum cyminum (L.), Apiaceae), black cumin (Nigella sativa (L.), Ranunculaceae), black pepper (Piper nigrum (L.), Piperaceae), curry leaf tree (Murraya koenigii (L.), Spreng Rutaceae), fenugreek (Trigonella foenum-graecum (L.), Fabaceae), fennel (Foeniculum vulgare Mill, Apiaceae), cardamom (Elettaria cardamomum (L.) Maton, Zingiberaceae), cloves (Syzygium aromaticum (L.) Merr. & L.M.Perry, Myrtaceae), and coriander (Coriandrum sativum (L.), Apiaceae) in age-related neurological disorders.

زمینه و اهداف: اختلالات اضطرابی، شایعترین اختلال روانی کودکان است که شیوع بالایی در ایران دارد. شناسایی علل و تشخیص زود هنگام این گروه از اختلالات می‌تواند اثرات طولانی مدت آن را به حداقل برساند.لذا هدف از این مطالعه بررسی عوامل‌ مؤثر در بروز اختلالات اضطرابی و اضطراب فراگیر درکودکان شهر بوشهر می‌باشد. مواد و روش‌ها: این مطالعه از نوع مقطعی است که در سال ۱۳۹۸ در شهر بوشهر انجام شد. جامعه پژوهش، تمام کودکان ۴تا ۶ سال پیش دبستانی و مهدکودک های این شهر بودندکه به صورت خوشه ای از بین آنها ، نمونه ای به حجم 428 انتخاب شد. ابزار پژوهش، پرسشنامه سنجش اضطراب اسپنس (فرم والدین) بود. به منظور توصیف و تجزیه و تحلیل داده‌ها از روش‌های آمار توصیفی (فراوانی و درصد) و آمار استبناطی (آنالیز واریانس یک طرفه و آزمون تعقيبي شفه) در سطح معنی‌داری 5 درصد در محیط نرم افزار SPSS نسخه ۲۴ استفاده گردید. یافته­ ها: تعداد اعضای خانواده (003/0=P-value)، تحصیلات پدر (00۱/0=P-value) و مادر (00۱/0=P-value)، وضعیت اشتغال پدر (0۳/0=P-value) و جدايي والدین از یکدیگر (00۲/0=P-value)، نوع سرپرست (00۱/0P-value

Introduction: Health literacy plays a remarkable role in determining the status of people who smoke. In recent years, the smoking rate has been increased among university students. Therefore, this study aimed to determine the relationship between health literacy skills and adoption of preventive smoking behaviors among university students. Materials & Methods: In this cross-sectional descriptive study, 347 students living in dormitories affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran, were selected through single-stage cluster sampling in 2016. The data were collected using the health literacy inventory for adults and a researcher-made questionnaire in order to assess the adoption of smoking preventive behaviors. The collected data were analyzed in SPSS software (Version. 16) through descriptive statistics and Pearson correlation coefficient. Ethics code: IR.TMU.REC.1394.172 Findings: The mean scores of health literacy and the adoption of preventive smoking behaviors were 70.52±14.12 and 39.01±19.96, respectively, regarding the total score of 100. Moreover, there was a direct and significant relationship between health literacy (r=0.146) and dimensions of decision making and application of health information (r=0.161), reading (r=0.14), and appraisal (r=0.112) with the adoption of preventive smoking behaviors. However, this association was not statistically significant (P

زمینه و اهداف: نظر به افزایش روند مصرف سیگار در بین دانشجویان و قابلیت الگوی اعتقاد بهداشتی در پیشگویی سواد سلامت و پیشگیری از مصرف سیگار و نیز نقش سواد سلامت در پیشگیری از مصرف سیگار، این مطالعه با هدف تعیین تاثیر آموزش مبتنی بر الگوی اعتقاد بهداشتی بر سواد سلامت و پیشگیری از مصرف سیگار در دانشجویان انجام شد. مواد و روش­ها: این مطالعه مداخله‌ای از نوع نیمه­‌تجربی در سال 1396 و در میان 120 نفر از دانشجویان غیرسیگاری دانشگاه علوم­پزشکی­شهید­بهشتی­تهران (60 نفر در هر یک از دو گروه مداخله و کنترل) انجام شد. ابزار گردآوری داده‌ها شامل پرسشنامه روا و پایای مبتنی بر سازه­های حساسیت، منافع و خودکارآمدی درک­شده از الگوی اعتقاد بهداشتی، رفتارهای پیشگیرانه از مصرف سیگار و پرسشنامه سنجش سواد سلامت (HELIA) بود که در دو مرحله قبل و 6 ماه پس از آموزش تکمیل گردید. داده‌های گردآوری­شده با استفاده از آزمون‌های متناسب و نرم‌افزار SPSS نسخه 18 تحلیل شدند. تمامی مراحل مطالعه حاضر طبق موازین اخلاقی اجرا گردید. یافته­ ها: قبل از آموزش، بین متغیرهای جمعیت­شناختی و زمینه­ای، میانگین سازه­های حساسیت، منافع و خودکارآمدی درک­شده، سواد سلامت و رفتارهای پیشگیرانه در دو گروه، تفاوت معنی­دار وجود نداشت (05/0P>). پس از آموزش، مقایسه دو گروه نشان داد که میانگین نمرات سازه­های حساسیت، منافع و خودکارآمدی درک­شده، سواد سلامت و رفتارهای­پیشگیرانه در گروه مداخله به­طور معناداری نسبت به­گروه کنترل، تغییر داشته­است (05/0P

زمینه و اهداف: نظریه شناختی اجتماعی یکی از کارآمدترین نظریه­های مورد استفاده جهت پیش­گویی رفتار مصرف صبحانه و آموزش رفتارهای تغذیه­ای می­باشد. نظر به اهمیت مصرف صبحانه در سلامت جسمي، رواني و اجتماعي دانش­آموزان، این مطالعه با هدف تعیین عوامل مرتبط با مصرف صبحانه براساس نظریه شناختی اجتماعی در دانش­آموزان انجام گرفت. مواد و روش‌ها: این پژوهش یک مطالعه توصیفی تحلیلی از نوع مقطعی بود. در این مطالعه، 360 نفر از دانش­آموزان پسر و دختر مقطع ابتدایی شهر مریوان با روش نمونه گیری خوشه‌ای چندمرحله‌ای، انتخاب و وارد مطالعه شدند. ابزار گردآوری اطلاعات، شامل پرسشنامه‌های ویژگی‌های جمعیتی و زمینه‌ای و پرسشنامه روا و پایای موجود براساس نظریه شناختی اجتماعی درباره مصرف صبحانه بود. پس از جمع‌آوری، داده‌ها وارد نرم افزارSPSS نسخه 16 شدند و با کمک آزمون‌های آماری کای دو و t-test، تحلیل شدند. تمامی مراحل مطالعه حاضر طبق موازین اخلاقی اجرا گردید. یافته‌ها: 6/81 درصد (244 نفر) از دانش‌آموزان دارای الگوی مناسبی از مصرف صبحانه بودند. نتایج آزمون تی‌تست نشان داد که تفاوت آماری معنی‌دار بین سازه‌های پیامد انتظار، ارزشیابی پیامد، خودکارآمدی و خودتنظیمی بین دانش­آموزان با الگوی مناسب و نامناسب مصرف صبحانه، وجود داشت (001/0>P). نتیجه‌گیری: با توجه به وجود ارتباط معنی‌دار بین سازه‌های نظریه شناختی اجتماعی و مصرف صبحانه در دانش‌آموزان، سازه‌های این نظریه می‌تواند عوامل پیشگویی کننده مصرف صبحانه در دانش‌آموزان را بیازماید و برای ارتقای برنامه‌های حمایت کننده از مصرف صبحانه موثر واقع شود.

Background and Objective: Health literacy as one of the most important issues for promoting public health has gained the attention of policy makers. The quality of life and striving to promote it play an important role in individual and social health. Due to the role of adults as a productive group in the community, we aimed to determine the relationship between health literacy and quality of life in adults. Materials and Methods: This cross-sectional study was conducted among 256 adults aged 18 to 65 years in Karaj, Iran, 2016. The participants were selected using the convenience sampling method. Data were collected using the Health Literacy Inventory for Adults (HELIA) and the Quality of Life questionnaire (SF-12). Then, the data were analyzed using descriptive statistics and Pearson correlation coefficient in SPSS, version 21. Results: In this study, 24.2% (n=62) of the participants had inadequate health literacy and 23.4% (n=60) had relatively adequate health literacy. The mean±SD scores of quality of life in the physical health and mental health domains, as well as the overall quality of life were 16.24±2.68, 20.43±3.89, and 36.68±5.82 out of 48, respectively. Health literacy had a significant positive correlation with physical and mental dimensions of quality of life and overall quality of life (P

Cystic echinococcosis (CE) is a near-cosmopolitan public health concern, especially in developing countries. Parasite ova shed via definitive host feces are responsible for livestock and occasionally human infection, leading to hydatid cysts. Immunization using proper antigens is a good immunoprophylactic strategy. This study was aimed to design a multi-epitope vaccine using EgA31 and EgG1Y162 antigens. Top high-ranked B-cell epitopes and major histocompatibility complex (MHC)-binding epitopes were predicted and selected to construct the vaccine model. Then, physico-chemical features, secondary and tertiary structures, refinement and validations were all evaluated using web servers for the multi-epitope vaccine construct. Finally, non-linear B-cell epitopes were determined for vaccine-antibody interactions. Moreover, the vaccine construct was subjected to disulfide engineering, molecular docking with human MHC-I and MHC-II molecules as well as codon adaptation and in silico cloning processes. In conclusion, this multimeric CE vaccine needs experimental and clinical confirmations to be considered as an actually immunogenic vaccine model.

زمینه و اهداف: پوسیدگی زودرس دندان‌ها در دوران کودکی، شیوع بالایی دارد. با توجه به اهمیت ارائه راهکارهای مطلوب جهت افزایش سطح بهداشت دهان و دندان و ارتقای سلامت کودکان، این مطالعه با هدف تعیین فراوانی پوسیدگی زودرس دندان‌ها در دوران کودکی و برخی از عوامل مرتبط با آن انجام شد. مواد و روش‌ها: این تحقیق یک مطالعه توصیفی-تحلیلی از نوع مقطعی بود و جامعه آماری آن را کودکان 3 الی 6 ساله مهد کودک‌ها و مراکز پیش‌دبستانی شهرستان مریوان در سال 1395 تشکیل می‌دادند که از بین آنها 422 کودک به صورت نمونه‌گیری چندمرحله‌ای انتخاب شدند. در این مطالعه، پوسیدگی زودرس دندانی توسط دو نفر از متخصصان رشته دندانپزشکی سنجش و ثبت شد. همچنین برای متغیرهای دموگرافیک و زمینه‌ای از یک چک‌لیست محقق ساخته استفاده شد. داده‌ها پس از گردآوری وارد نرم‌افزارSPSS نسخه 16 شده و با بکارگیری آمارهای توصیفی و رگرسیون لجستیک تحلیل شدند. تمامی مراحل مطالعه حاضر طبق موازین اخلاقی اجرا گردید. یافته‌ها: 306 نفر (75/2درصد) از کودکان پوسیدگی زودرس دندانی داشتند. نتایج رگرسیون لجستیک نشان داد که پوسیدگی زودرس دندانی با متغیرهای سن بالاتر، تحصیلات پدر (ديپلم و دانشگاهي نسبت به زير ديپلم) و تحصیلات مادر (دانشگاهي نسبت به زير ديپلم) ارتباط معنی دار داشت (p

Toxoplasmosis is a zoonotic parasitic disease of global importance. It is widespread and endemic practically all over the world, with infection prevalence varying by geographic location. The parasite and the disease are neglected, which is illustrated by the lack of baseline information on the prevalence from many regions. Developed, peaceful regions are in better situation to address toxoplasmosis, while the neglected status is particularly pronounced in regions with other challenges. Due to the lack of baseline data, these regions are rarely mentioned in discussions about the neglected status of the disease. A dramatic manifestation of toxoplasmosis, congenital toxoplasmosis, is the dreaded outcome of vertical transmission of the infection from the mother to the unborn child. For this reason, pregnant women are a key target group for primary prevention of T. gondii infections, and baseline data on the prevalence in pregnant women is important. In this cross-sectional seroepidemiological study, we estimated Toxoplasma gondii seroprevalence and evaluated possible risk factors for seropositivity in pregnant women in Kabul, Afghanistan. Altogether 207 of the 431 women included in the study tested positive for immunoglobulin G antibodies against T. gondii, yielding an apparent seroprevalence estimate of 48.03% (95% CI 43.33-52.75). Based on the final multivariable model for T. gondii seropositivity, non-concrete floor in the house and well or river as water source were identified as risk factors for seropositivity, while residence in rural area was a protective factor. The majority of the participants (72.9%) reported that they did not know about T. gondii. Our study is the first to report an estimate of T. gondii seroprevalence in pregnant women in Afghanistan. The high seroprevalence indicates substantial infection pressure, and the results of the risk factor analysis suggest that the environmental route, infection from oocysts, might be the most relevant to address to prevent the infections in the region. Our results contribute to the global discussion on neglected status of toxoplasmosis.

زمینه و اهداف: علیرغم موثر بودن مداخلات مبتنی بر الگوی اعتقاد بهداشتی بر ارتقای رفتارهای پیشگیرانه از مصرف سیگار و ضرورت پیشگیری از مصرف سیگار در بین دانشجویان، پرسشنامه استانداردی در این زمینه در ایران وجود ندارد. لذا در این مطالعه، محققان روایی و پایایی پرسشنامه عوامل مربوط به پیشگیری از مصرف سیگار در دانشجویان براساس الگوی اعتقاد بهداشتی را مورد بررسی قرار دادند. مواد و روش‌ها: این مطالعه مقطعی تحلیلی میان 348 نفر از دانشجویان خوابگاهی دانشگاه علوم پزشکی شهید بهشتی تهران در سال 1395 انجام شد. نمونه‌گیری به صورت خوشه‌ای یک مرحله‌ای انجام شد. برای بررسی روایی صوری و محتوایی از دو روش کیفی و کمی استفاده شد، برای بررسی پایایی پرسشنامه و روایی سازه آن از ضریب آلفای کرونباخ و تحلیل عاملی تائیدی استفاده شد. برای تحلیل داده‌ها از نرم افزارهای لیزرل 8/8 و SPSS نسخه 16 استفاده شد. تمامی مراحل مطالعه حاضر طبق موازین اخلاقی اجرا گردید. یافته‌ها: ضریب تاثیر، نسبت روایی محتوا و شاخص روایی محتوا سازه‌های پرسشنامه به ترتیب در فاصله 4/5 -4/1، 0/97-0/79و 0/96-0/90 بود. مقادیر آلفای کرونباخ برای سازه‌های پرسشنامه بین 0/70 تا 0/90 به دست آمد. الگوی 5 عاملی شامل سازه‌های حساسیت، شدت، موانع، منافع و خودکارآمدی درک شده تایید گردید (3/25= X2/df، 0/96=CFI، 0/081=RMSEA). نتیجه‌گیری: پرسشنامه عوامل مرتبط با پیشگیری از مصرف سیگار براساس الگوی اعتقاد بهداشتی از روایی و پایایی در جمعیت هدف دانشجویان برخوردار بود.

The primary aim of AVACONT was to collect data in the course of routine oncological care from patients with metastatic colorectal cancer (mCRC) treated with bevacizumab supplemented fluoropyrimidine-based chemotherapy doublet in an open, multicentre, observational study in Hungary. Primary endpoint of the study was to determine progression-free survival (PFS). The Full Analysis Set (FAS) comprised 280 patients. Median PFS calculated from enrolment was 270 days in the FAS population. The metastatic involvement of the liver or more than one organ significantly decreased (250 and 245 days), while a clinical response achieved significantly increased (partial response: 404, complete response: 623 days) the mPFS calculated from enrolment. PFS calculated from the start of the first-line treatment was significantly decreased by the presence of mutant RAS gene (481 vs. 395 days). The results confirm the efficacy, known prognostic factors and safety profile of bevacizumab in combination with chemotherapy dosed during standard oncology care in Hungarian centres.

Due to the limited experience with capecitabine plus docetaxel (XT) combination in the first-line treatment of metastatic breast cancer in Hungary, the main objective of the study was to analyze the effectiveness and tolerability of XT therapy. A prospective, open-label, non-randomized, single-arm, multicenter, observational study was designed. All female patients were eligible whose metastatic breast cancer could be treated with the XT protocol according to the summary of product characteristics of the drugs. The median progression free survival was 9.9 ± 3.0 months. Time to treatment failure was 4.6 ± 5.1 months on average. The overall response rate was 28.9 %, the clinical benefit rate was 73.3 %. The treatment was discontinued in 35.6 % of patients due to disease progression and in 20.0 % due to adverse events (AE). 33 patients with a total of 73 AEs have been reported, and 13 of them had serious adverse events (SAE). The efficacy and the safety profile of XT chemotherapy proven in the study are consistent with the results demonstrated in randomized trials. First-line XT chemotherapy effectively improves the PFS in metastatic breast cancer.

Background: Phosphatidylinositol 3-kinase (PI3K) pathway activation in squamous cell carcinoma of the head and neck contributes to treatment resistance and disease progression. Buparlisib, a pan-PI3K inhibitor, has shown preclinical antitumour activity and objective responses in patients with epithelial malignancies. We assessed whether the addition of buparlisib to paclitaxel improves clinical outcomes compared with paclitaxel and placebo in patients with recurrent or metastatic squamous cell carcinoma of the head and neck., Methods: In this multicentre, randomised, double-blind, placebo-controlled phase 2 study (BERIL-1), we recruited patients aged 18 years and older with histologically or cytologically confirmed recurrent and metastatic squamous cell carcinoma of the head and neck after disease progression on or after one previous platinum-based chemotherapy regimen in the metastatic setting. Eligible patients were enrolled from 58 centres across 18 countries and randomly assigned (1:1) to receive second-line oral buparlisib (100 mg once daily) or placebo, plus intravenous paclitaxel (80 mg/m 2 on days 1, 8, 15, and 22) in 28 day treatment cycles. Randomisation was done via a central patient screening and randomisation system with an interactive (voice and web) response system and stratification by number of previous lines of therapy in the recurrent and metastatic setting and study site. Patients and investigators (including local radiologists) were masked to treatment assignment from randomisation until the final overall survival analysis. The primary endpoint was progression-free survival by local investigator assessment per Response Evaluation Criteria In Solid Tumors (version 1.1) in all randomly assigned patients. Efficacy analyses were done on the intention-to-treat population, whereas safety was analysed in all patients who received at least one dose of study drug and had at least one post-baseline safety assessment according to the treatment they received. This trial is registered with ClinicalTrials.gov, number NCT01852292, and is ongoing but no longer enrolling patients., Findings: Between Nov 5, 2013, and May 5, 2015, 158 patients were enrolled and randomly assigned to receive either buparlisib plus paclitaxel (n=79) or placebo plus paclitaxel (n=79). Median progression-free survival was 4·6 months (95% CI 3·5-5·3) in the buparlisib group and 3·5 months (2·2-3·7) in the placebo group (hazard ratio 0·65 [95% CI 0·45-0·95], nominal one-sided p=0·011). Grade 3-4 adverse events were reported in 62 (82%) of 76 patients in the buparlisib group and 56 (72%) of 78 patients in the placebo group. The most common grade 3-4 adverse events (occurring in ≥10% of patients in the buparlisib group vs the placebo group) were hyperglycaemia (17 [22%] of 76 vs two [3%] of 78), anaemia (14 [18%] vs nine [12%]), neutropenia (13 [17%] vs four [5%]), and fatigue (six [8%] vs eight [10%]). Serious adverse events (regardless of relation to study treatment) were reported for 43 (57%) of 76 patients in the buparlisib group and 37 (47%) of 78 in the placebo group. On-treatment deaths occurred in 15 (20%) of 76 patients in the buparlisib group and 17 (22%) of 78 patients in the placebo group; most were caused by disease progression and none were judged to be related to study treatment., Interpretation: On the basis of the improved clinical efficacy with a manageable safety profile, the results of this randomised phase 2 study suggest that buparlisib in combination with paclitaxel could be an effective second-line treatment for patients with platinum-pretreated recurrent or metastatic squamous cell carcinoma of the head and neck. Further phase 3 studies are warranted to confirm this phase 2 finding., Funding: Novartis Pharmaceuticals Corporation., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Unlabelled: Authors presented data of treatment results and course of disease in 487 ovarian cancer patients treated by primary surgery and paclitaxel-carboplatin combination chemotherapy between July 1, 2002 and December 31, 2003., Patients: Most of our patients (87.8%) belonged to the age-group between 40-70 years. Distribution of their histological diagnosis was as 69.6% serous, 10.7% mucinous, 5.1% endometrial and 4.7% undifferentiated carcinoma. The grade distribution was found as 8.4% grade 1, 40.9% grade 2 and 35.9% grade 3., Results: The primary surgery was evaluated as optimal in 41.7%, suboptimal in 37.3% and exploration was performed in 21.1%. Most patients started chemotherapy 20 days after surgery and 74.2% of them got six courses. During the evaluation period 61 intervallum laparotomies were performed, and resulted on 55.7% optimal debulking. Complete remission was found in 58.9%, and partial remission in 14.7% of patients. This treatment resulted on a complete remission in 40.9% at the follow-up of 12 months.

The aim of this study was to investigate the familial clustering of nasopharyngeal carcinoma (NPC) in a non-endemic geographical region on the basis of two case reports and a review of the literature. Following an upper respiratory infection, NPC (WHO type III) was detected in a 57-year-old female (Case 1) who presented with nasal symptoms and a year later in her 36-year-old son (Case 2) who presented with enlarged lymph nodes. After a full diagnostic work-up, cT2a cN0 cM0 (stage IIA; Case 1) and cT2a cN2 cM0 (stage III; Case 2) disease were identified, and telecobalt irradiation was administered to both patients. The mother achieved complete remission and has been disease-free during a 14-year follow-up period. After initial complete remission, the son experienced regional (cervical) and base of the skull relapses within 2 years, which were treated unsuccessfully by means of radical neck dissection, a second course of radiotherapy and chemotherapy. Epstein-Barr virus (EBV) was detected in pathology sections from both patients. The authors review 20 additional well-documented cases of familial clustering of NPC in non-endemic geographical regions from the English language literature. This clinical entity typically has WHO type III histology; it may occur following an upper respiratory tract infection, and EBV-related serological titers were elevated in all 20 investigated cases. No consequent promoting factors were identified. The present two cases and the review of the literature strongly suggest that familial clustering of NPC in non-endemic geographical areas may be related to EBV infections. The difference in outcome of our two cases may be explained by the fact that the disease in Case 2 was diagnosed 1 year later than that in Case 1 and hence at a more advanced stage.

Whole-body FDG PET examinations in 10 cases of epipharyngeal tumour (8 males, 2 females, mean age: 48 years) have been performed since January 1999. The PET examinations were aimed at the accurate staging, follow-up of the patients after the treatment, identification of recurrencies and localization of the unknown primary tumor. Functional imaging resulted in "upstaging" in 3 patients as compared to staging by the conventional diagnostic tools. Four additional patients with hyperplastic epipharyngeal tissue were investigated for occult primary cancer after negative results of multiple excisions, resulting in one case of primary epipharyngeal cancer. Correct staging, early detection of recurrencies, localization of occult primary tumor and the better post-therapeutic assessment of epipharyngeal masses all facilitate a more reasonable therapeutic approach, which may improve survival results.

The first quality assurance, audit and control system in the Hungarian "'health" care industry" is described for the medical specialty of radiotherapy. The prerequisites of the elaboration of the programme were an exact knowledge of the current Hungarian infrastructural and staffing conditions, and the radiotherapeutic activities. The recommendations cover the 5 medical universities including the national institute (the Debrecen, Pécs, Semmelweis, Szent-Györgyk Albert Medical Universities, and Haynal Imre University of Health Sciences) and the 5 regional oncological centres in hospitals (Jósa András, Markusovszky, Petz Aladár, Szentpéteri kapu and Uzsoki Hospitals). The departmental functions (patient care, teaching-education, research work and scientific organizing activity) and the structure (organization, infrastructure, staffing conditions, etc.) are described first, followed by the therapeutic principles and clinical process (patient referral and selection, decision-making, priorities in therapy initiation, treatment preparation and execution, etc.). The informal daily/weekly quality assurance programme long applied in the routine patient care has been formalized and supplemented with a weekly audit conference. In the course of the medical audit, all relevant clinical data are reviewed and scored by an internal or an external expert (not participating directly in the treatment process), e.g. for the adequacy of the medical decision preparative process, conformation to the institutional treatment protocol, equipment selection, treatment planning, simulation and portal film, etc. If a major deviation is detected, an immediate correction is initiated; minor deviations need analysis and then preventive and correcting action. As concern the audit of the other activities of the departments, the important indicators and their minimally desirable level are defined. The final goal of the implementation of this programme is high-precision radiotherapy with the best achievable treatment result.