Objective To assess the cancer risk in children and adolescents following exposure to low dose ionising radiation from diagnostic computed tomography (CT) scans.

BackgroundThe prevalence of gout is increasing, and most research on the associated burden has focused on serum urate (sUA) levels. The present study quantifies the impact of the presence of tophi and frequency of acute gout attacks on health-related quality of life (HRQOL), productivity, and healthcare resource utilization.MethodsPatients with self-reported gout (n = 620; 338 in US and 282 across France, Germany, and UK) were contacted based on inclusion in the 2010 US and EU National Health and Wellness Surveys (Kantar Health) and the Lightspeed Research ailment panel. Respondents were categorized into mutually-exclusive groups based on number of gout flares experienced in the past 12 months (0/don’t recall, 1–2, 3, 4–5, 6+), current presence of tophi (none, 1+, or not sure), and sUA level awareness (yes, no). HRQOL (SF-12v2), healthcare provider visits in the last 6 months, and work productivity and activity impairment (WPAI) were compared across groups.ResultsMost patients were males, mean age of 61 years, who reported experiencing at least one acute gout flare in the past 12 months, and 12.3% (n = 76) reported presence of tophi. Among the 27.7% (n = 172) of patients who were aware of their sUA levels, higher sUA was associated with more flares and tophi. Decreased HRQOL was associated with more frequent flares and presence of tophi. In multivariable models predicting outcomes based on presence of tophi and number of flares, both flares (≥4) and tophi (≥1) were associated with HRQOL decrements on physical and mental component summary scores and health utilities (all p < 0.05), after adjustment for age, gender, and time since diagnosis. Flares were also associated with greater activity impairment.ConclusionsImpairments associated with gout flares and presence of tophi, across patients in the US and EU, underscore the importance of effective management of this potentially curable condition.

Flares in patients with chronic gout refractory to conventional therapy significantly affect patient work productivity and social activities.

Introduction: The research objective was to systematically review evidence on neurotrophic tyrosine receptor kinase ( NTRK) gene fusion frequency in solid tumors. Methods: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature review (SLR) was conducted of studies published from January 1987 to 2 January 2020. Selected studies were appraised for use in meta-analysis, with frequency reported as a point estimate with confidence intervals, to estimate NTRK gene fusion tumor incidence and prevalence. Results: The SLR identified 222 studies from North America ( n = 122), Europe ( n = 33), Asia ( n = 41), Brazil ( n = 5), Australia ( n = 2), and multi-continental ( n = 19) reporting NTRK gene fusion frequencies across 101 histologies. Studies were prospective ( n = 43) and retrospective ( n = 179). Testing methods involved DNA ( n = 93), RNA ( n = 72), combined DNA/RNA ( n = 48), protein [immunohistochemistry (IHC), n = 5], and unreported ( n = 5). Sample sizes ranged from 1 to 66,871. Of the 222 studies, 107 were suitable for meta-analysis. Highest NTRK gene fusion frequencies were reported in rare cancers: infantile/congenital fibrosarcoma (90.56%, 95% CI 67.42–100.00), secretory breast cancer (92.87%, 95% CI 72.62–100.00), and congenital mesoblastic nephroma (21.52%, 95% CI 13.06–32.20). Lower frequencies were reported in non-small cell lung cancer (0.17%, 95% CI 0.09–0.25), colorectal adenocarcinoma (0.26%, 95% CI 0.15–0.36), cutaneous melanoma (0.31%, 95% CI 0.07–0.55), and non-secretory breast carcinoma (0.60%, 95% CI 0.00–1.50). Reported frequency was ~0% for some cancers: mesothelioma, renal cell carcinoma, prostate cancer, and bone sarcoma. Estimated global overall NTRK gene fusion tumour incidence and 5-year prevalence in 2018 was 0.52 and 1.52 per 100,000 persons, respectively. Conclusion: This research confirms the rarity and varying frequency of NTRK gene fusion across tumor types. Limitations included relatively low historic NTRK gene fusion testing and reporting, limited study samples for some cancers, and suboptimal molecular testing methods. In this rapidly developing area, gold-standard testing methods and companion diagnostics are needed to capture all NTRK gene fusions.

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