The prognosis for patients with stage I AH is worse than that for patients with stage I FH. Novel treatment strategies are needed to improve outcomes for patients with AH, especially those with stage III to V disease.
These results demonstrate that approximately one-half of children with unilateral WT who relapse after initial treatment with VAD and radiation therapy can be successfully retreated.
These results demonstrate that a significant proportion of children with Wilms tumor who relapse after initial treatment with VCR and actinomycin D can be successfully re-treated.
Key Points
Question
How are COVID-19 and related disruptions in care associated with changes in the dispensation of medications commonly used among nursing home residents?
Findings
In this population-based cohort study with an interrupted time-series analysis of all nursing home residents from the 630 facilities in Ontario, Canada, the emergence of the COVID-19 pandemic was associated with significant increases in the use of antipsychotics, benzodiazepines, antidepressants, anticonvulsants, and opioids and no meaningful changes in the use of antibiotics or selected cardiovascular medications.
Meaning
The finding of increased use of medications with the potential for adverse effects among nursing home residents during the initial wave of the pandemic warrants ongoing monitoring for prescribing appropriateness and related resident outcomes.
A B S T R A C T PurposeTo assess rates and causes of mortality in patients with Wilms tumor (WT).
MethodsThrough 2002, 6,185 patients enrolled onto the National Wilms Tumor Study between 1969 and 1995 were actively observed. Deaths were classified on the basis of medical records as the result of original disease, late effects (including second malignant neoplasms [SMNs], cardiac causes, pulmonary disease, and renal failure), or other causes. Standardized mortality ratios (SMRs) and Cox regression were used to assess the effects of sex, age, and calendar period of diagnosis on mortality.
ResultsWithin 5 years of WT diagnosis, 819 deaths occurred, and 159 deaths occurred among 4,972 known 5-year survivors. The SMR was 24.3 (95% CI, 22.6 to 26.0) for the first 5 years, was 12.6 (95% CI, 10.0 to 15.7) for the next 5 years, and remained greater than 3.0 thereafter. For deaths in the first 5 years, the mortality risk decreased by 5-year calendar period of diagnosis (rate ratio [RR] ϭ 0.78 per period). No such trend occurred for later deaths. Among 5-year survivors, 62 deaths were attributed to late effects of treatment or disease, including 27 to SMNs. A trend of decreased risk with calendar period of diagnosis was observed for late-effects mortality (RR ϭ 0.86; 95% CI, 0.67 to 1.10) and for SMN mortality (RR ϭ 0.82; 95% CI, 0.55 to 1.21).
ConclusionAlthough the survival outlook for WT patients has improved greatly over time, survivors remain at elevated risk for death many years after their original diagnosis.
These findings are the first to indicate that early MRI-based screening should reduce BC mortality among women treated with RT for adolescent HL. The magnitude of this benefit is superior to that described for other accepted screening indications although MRI can produce a substantial rate of false-positive results.
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