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Background: The significant role of red blood cell distribution width (RDW) and D-Dimer as prognostic factors in patients with some blood malignancies has been reported recently., Aim: We designed and performed a meta-analysis to investigate the prognostic roles of RDW and D-Dimer in subjects with diffuse large B-cell lymphoma (DLBCL)., Materials and Methods: We systematically reviewed PubMed-Medline, SCOPUS, EMBASE, Web of Science Core Collection, and Google Scholar up to the present to look for publications on prognostic effects of RDW and D-Dimer in DLBCL patients. For investigation of the associations between RDW and D-Dimer with the overall survival (OS) and progression-free survival (PFS) of the DLBCL cases, hazard ratio (HR) with 95% confidence intervals (CIs) was used., Results: We included 13 eligible studies in the present meta-analysis. The results of pooled analysis showed that increased levels of RDW was related to poor OS (HR = 2.01, 95% CI: 1.62-2.48, p value <.01, I 2  = 0%) and poor PFS (HR = 1.52, 95% CI: 1.24-1.85, p value <.01, I 2  = 16%) among the DLBCL patients. Similarly, a significant relationship was found between increased D-Dimer and poor OS (HR = 2.30, 95% CI: 1.03-5.14, p value <.05, I 2  = 95%) of the DLBCL patients as well. In addition, there was no significant heterogeneity in OS (p value H = 0.65) and PFS (p value H = 0.31) related to RDW among studies included in the meta-analysis., Conclusion: Our finding clearly confirmed that elevated RDW levels and D-Dimer were associated with adverse OS and PFS in DLBCL., (© 2023 The Authors. Cancer Reports published by Wiley Periodicals LLC.)

Introduction: In the course of the implementation of the German Healthcare Development Act [Gesundheitsversorgungsweiterentwicklungsgesetz] of 2021, a funding structure according to sect. 39d of the Social Code Book V [SGB V] was established to promote regional hospice and palliative care networks (RHPN). The funded networks are expected to support the multiprofessional cooperation of hospice and palliative care providers at the structural level. It is still unclear how many existing and newly established network structures are eligible for funding according to sect. 39d SGB V and where these network structures are located regionally. The proportion of actually funded networks is also unknown., Methods: Between January and March 2023, network structures of hospice and palliative care were identified in a tripartite, multi-method survey procedure, consisting of a) research of databases, literature, and internet; b) open quantitative online-survey via SoSciSurvey software, and c) telephone survey of federal offices of health insurers. The data were first documented separately. Then, the research and survey data were combined and analysed via descriptive statistics using SPSS., Results: Based on the aggregated data from the literature-, database- and internet research and the online survey, n=308 network structures of hospice and palliative care could be identified, of which n=37 have applied for network funding according to sect. 39d SGB V. In the survey period, n=47 applications for network funding according to sect. 39d SGB V were submitted to the health insurance funds. There is a high density of network structures in the northern, southern and western federal states, while there are only a few networks in the eastern states. According to the online-survey, 56% (n=136) of all the identified network structures with known sponsorship are organised by providers of specialised outpatient palliative care. 47% (n=29) of the networks with funding interest are organised as independent structures. Of the network structures with known funding status, 18% (n=26) plan to apply for funding according to sect. 39d SGB V in 2024 for the first time., Discussion: There are numerous network structures in hospice and palliative care, but they are differently distributed among the German federal states. The multi-method survey was able to provide a first nation-wide inventory of network structures as well as an assessment of networks with funding interest according to sect. 39 SGB V. A clear distinction between general network structures and structural networks according to sect. 39d SGB V is a challenge. In the next years the number of funding applications is expected to rise., Conclusion: The identification of existing and funded network structures of hospice and palliative care in Germany can be a starting point for a deeper analysis of the structure and the activities of the networks. A quality assessment tool that takes into account both the heterogeneity of the networks and the different dimensions of networking would be helpful., (Copyright © 2023. Published by Elsevier GmbH.)

Introduction: Several A number of prognostic blood markers related tofor Diffuse Large B-Cell Lymphoma (DLBCL) have been identified, most of which are costly and not easily availableaccessible. Although the relationship between the prognostic role of RDW and some cancers has been well established, the role it   of RDW plays in DLBCL patients is unclear still questionable and requires more investigations., Methods: All patients diagnosed with DLBCL who had referred to Imam Reza Hospital, during  were included in this retrospective cohort study. Based onRegarding their RDW, the subjects were divided into two groups of normal (RDW ≤14.6%) and elevated RDW (RDW > 14.6%) RDW, and the outcomes were investigated., Results: One hundred fifty patients with DLBCL were included in this study. The results showed a significant relationship between the RDW values of the DLBCL patients and stage frequency distribution, relapse, mortality, and complete remission (P value<0.05). It was also found out that elevated RDW > 14.6% was associated with the risk of relapse (OR=2.50, P value<0.05), mortality (OR=3.59, P value<0.01), and lack of complete remission (OR=0.115, P value< 0.01). The results of the survival analysis indicated that the subjects with higher RDWs had a lower median survival rate than those with low RDWs. In addition, the mortality risk for the individuals with RDW > 14.6% was 2.44 times that of those with RDW≤14.6% (HR=2.44, P value<0.05)., Conclusion: The results of this study well indicated that as an independent prognostic factor, RDW was associated with the stage of DLBCL patients, failure to achieve complete remission, disease relapse, and patient mortality. However, further studies are would be needed to realize determine the role of RDW in DLBCL patients.

Background and Aims: Varicocele is one of the most common causes of male infertility in which testicular function is progressively damaged. This study aims to investigate the effect of varicocelectomy and mast cell stabilizers on reducing sperm DNA fragmentation in infertile patients with varicocele., Methods: In this randomized clinical trial, after obtaining ethical approval and informed consent, infertile patients with varicocele were randomly assigned to three groups: varicocelectomy, 1 mg ketotifen, and varicocelectomy plus with 1 mg ketotifen for 3-month follow-up. Semen analysis and estimation of DNA fragmentation index (DFI) were obtained from all people in the studied time periods., Results: In this study, 420 infertile patients with varicocele were included with an average age of 31.6 years. The results showed that sperm morphology, sperm motility, sperm count, and sperm DFI had significant differences after the intervention ( p  < 0.05). Also, the results of semen analysis for each group showed that there was a significant improvement in sperm morphology, motility, count, and DFI index of infertile people with varicocele after the intervention ( p  < 0.05). But the difference was statistically higher in the varicocelectomy plus with 1 mg ketotifen group than in the other groups ( p  < 0.01)., Conclusion: The evidence and results of this study showed that the use of varicocelectomy plus ketotifen in infertile people with varicocele was more effective in improving Semen parameters than the use of mast cell stabilizers or varicocelectomy alone., Competing Interests: The authors declare no conflict of interest., (© 2023 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

Background: During the current pandemic situation, the public health care system must ensure the ongoing provision of regular medical care as well as the treatment of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infected patients. Resident oncologists and their practices are equally affected., Objectives: The study examines resident oncologists' challenges, experiences and approaches in the delivery of care for oncological patients receiving palliative treatment and their relatives during the pandemic. Findings will support future pandemic preparedness for cancer treatment in outpatients., Materials and Methods: Content analyses of 13 guideline-based telephone interviews with resident oncologists., Results: Solid local networks, staff and structural rearrangements and infection control within offices helped oncologists maintaining quality of care. Required treatments have been continued. The interrupted information flow towards patients' relatives and catching up on previously postponed primary, control or follow-up consultations have been reported as a challenge. Other issues have been linked to suspected SARS-CoV‑2 infection in patients and staff. The lack of information, temporal inaccessibility of health care authorities and physicians' associations, and additional costs for infection control material caused further problems., Conclusions: Due to the firmly implemented infection control and the re-organisation of facilities and staff, oncologists have been able to maintain treatment and care for cancer patients and their relatives. Hygiene procedures proved to work well and might be re-activated. An increased use of digital applications for treatment monitoring might be considered. Furthermore, solutions to meet additional financial and personnel demands caused by infection control must be identified. The design of suitable concepts for the prevention of health-related hazards due to visiting bans for relatives and therapeutic staff such as physio- and occupational therapists is inevitable., (© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2021.)