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- Brown, C, et al.
(author)
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A systematic review of miRNAs as biomarkers for chemotherapy-induced cardiotoxicity in breast cancer patients reveals potentially clinically informative panels as well as key challenges in miRNA research
- 2022
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In: Cardio-oncology (London, England). - : Springer Science and Business Media LLC. - 2057-3804. ; 8:1, s. 16-
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Journal article (peer-reviewed)abstract
- Breast cancer patients are at a particularly high risk of cardiotoxicity from chemotherapy having a detrimental effect on quality-of-life parameters and increasing the risk of mortality. Prognostic biomarkers would allow the management of therapies to mitigate the risks of cardiotoxicity in vulnerable patients and a key potential candidate for such biomarkers are microRNAs (miRNA). miRNAs are post-transcriptional regulators of gene expression which can also be released into the circulatory system and have been associated with the progression of many chronic diseases including many types of cancer. In this review, the evidence for the potential application of miRNAs as biomarkers for chemotherapy-induced cardiotoxicity (CIC) in breast cancer patientsis evaluated and a simple meta-analysis is performed to confirm the replication status of each reported miRNA. Further selection of miRNAs is performed by reviewing the reported associations of each miRNA with other cardiovascular conditions. Based on this research, the most representative panels targeting specific chemotherapy agents and treatment regimens are suggested, that contain several informative miRNAs, including both general markers of cardiac damage as well as those for the specific cancer treatments.
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- Reinisch, W., et al.
(author)
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The management of iron deficiency in inflammatory bowel disease - an online tool developed by the RAND/UCLA appropriateness method
- 2013
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In: Alimentary pharmacology & therapeutics. - : Wiley. - 0269-2813. ; 38:9, s. 1109-1118
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Journal article (peer-reviewed)abstract
- BackgroundIron deficiency is a common and undertreated problem in inflammatory bowel disease (IBD). AimTo develop an online tool to support treatment choice at the patient-specific level. MethodsUsing the RAND/UCLA Appropriateness Method (RUAM), a European expert panel assessed the appropriateness of treatment regimens for a variety of clinical scenarios in patients with non-anaemic iron deficiency (NAID) and iron deficiency anaemia (IDA). Treatment options included adjustment of IBD medication only, oral iron supplementation, high-/low-dose intravenous (IV) regimens, IV iron plus erythropoietin-stimulating agent (ESA), and blood transfusion. The panel process consisted of two individual rating rounds (1148 treatment indications; 9-point scale) and three plenary discussion meetings. ResultsThe panel reached agreement on 71% of treatment indications. No treatment' was never considered appropriate, and repeat treatment after previous failure was generally discouraged. For 98% of scenarios, at least one treatment was appropriate. Adjustment of IBD medication was deemed appropriate in all patients with active disease. Use of oral iron was mainly considered an option in NAID and mildly anaemic patients without disease activity. IV regimens were often judged appropriate, with high-dose IV iron being the preferred option in 77% of IDA scenarios. Blood transfusion and IV+ESA were indicated in exceptional cases only. ConclusionsThe RUAM revealed high agreement amongst experts on the management of iron deficiency in patients with IBD. High-dose IV iron was more often considered appropriate than other options. To facilitate dissemination of the recommendations, panel outcomes were embedded in an online tool, accessible via http://ferroscope.com/.
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- Caron, Bénédicte, et al.
(author)
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IOIBD Recommendations for Clinical Trials in Ulcerative Proctitis : the PROCTRIAL Consensus
- 2022
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In: Clinical Gastroenterology and Hepatology. - : Elsevier. - 1542-3565 .- 1542-7714. ; 20:11, s. 2169-2627.e1
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Journal article (peer-reviewed)abstract
- BACKGROUND AND AIMS: Clinical trials evaluating biologics and small molecules in patients with ulcerative colitis are predominantly excluding ulcerative proctitis. The objective of the PROCTRIAL (Definition and endpoints for ulcerative PROCtitis in clinical TRIALs) initiative was to develop consensus statements for definitions, inclusion criteria, and endpoints for the evaluation of ulcerative proctitis in adults.METHODS: Thirty-five international experts held a consensus meeting to define ulcerative proctitis, and the endpoints to use in clinical trials. Based on a systematic review of the literature, statements were generated, discussed, and approved by the working group participants using a modified Delphi method. Consensus was defined as at least 75% agreement among voters.RESULTS: The group agreed that the diagnosis of ulcerative proctitis should be made by ileocolonoscopy and confirmed by histopathology, with the exclusion of infections, drug-induced causes, radiation, trauma, and Crohn's disease. Ulcerative proctitis was defined as macroscopic extent of lesions limited to 15 cm distance from the anal verge in adults. Primary and secondary endpoints were identified to capture response of ulcerative proctitis to therapy. A combined clinical and endoscopic primary endpoint for the evaluation of ulcerative proctitis disease activity is proposed. Secondary endpoints which should be evaluated include endoscopic remission, histological remission, mucosal healing, histologic endoscopic mucosal improvement, disability, fecal incontinence, urgency, constipation, and health-related quality of life.CONCLUSION: In response to the need for guidance on the design of clinical trials in patients with ulcerative proctitis, the PROCTRIAL consensus provides recommendations on the definition and endpoints for ulcerative proctitis clinical trials.
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- Papathanasiou, I. V., et al.
(author)
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Nursing Students' Computer Anxiety and Attitudes Before and During the COVID-19 Pandemic
- 2023
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In: Advances in Experimental Medicine and Biology. - : Springer Nature. - 0065-2598 .- 2214-8019. ; 1425, s. 377-391
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Journal article (peer-reviewed)abstract
- Purpose of this research was to investigate how the COVID-19 pandemic affected the level of computer anxiety of nursing students and also their attitude related to computer use. A cross-sectional study was conducted in two periods, one before the COVID-19 pandemic (1st period) and the second during the COVID-19 pandemic (2nd period). The research instrument consisted of three parts, a questionnaire with questions about demographic and educational characteristics such as gender and semester of study, the Computer Anxiety Rating Scale (CARS), that used to assess the nursing students' levels of computer anxiety and the Computer Attitude Scale (CAS) that used to measure nursing students' positive and negative attitudes towards computers. Data from 957 undergraduate nursing students were obtained. Specifically, in the 1st period, 370 nursing students participated (38.66%), while in the 2nd period 587 (61.34%) undergraduates participated. The anxiety of participants during COVID-19 pandemic period was reduced compared to that of participants before the COVID-19 period. Respondents during the COVID-19 pandemic have fewer negative feelings towards computers, based on their answers in contrast to the participants in the study before the COVID-19 pandemic. Computer anxiety and attitudes have change among nursing students among COVID-19 pandemic. Nursing students after the implementation of online training are reporting positive feeling towards computer use and are more confident for their ICT skills.
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