Objective To determine whether radiation therapy (RT) is denied to patients with lupus and cancer and whether RT causes unusual toxicity in those receiving it. Methods We included patients with lupus followed at the University of Toronto Lupus Clinic between 1972 and 2001 who had developed cancer. Demographic, clinical, and laboratory information were collected prospectively. Pathologic proof of cancer was obtained. Three radiation oncologists blinded for the diagnosis of lupus, the modalities of cancer treatment, and the hypothesis of the study reviewed patient data independently. They assessed the indication for RT and whether it should be curative or symptomatic. Recommendation for RT was considered when at least 2 of the 3 radiation oncologists concurred. A review of the literature was conducted. Results Forty cases of cancer in 38 patients were identified. Most frequent cancer sites were breast (8), skin (8), digestive (7), and hematologic (7). Median patient age was 58 years. The radiation oncologists recommended RT in 26 cases, either with a curative (14) or a symptomatic intent (12). Only 4 patients received RT, 3 with a curative intent and 1 with a symptomatic intent. None of these 4 patients developed any unusual toxicity. The literature review did not support the fact that lupus patients do not tolerate RT. Conclusion Sixty‐five percent of our lupus patients with cancer could have received curative or symptomatic RT but only 10% received it. No patient developed any toxicity. RT may be inappropriately withheld from lupus patients with cancer.

OBJECTIVE -The purpose of this study was to longitudinally examine the effect of diabetes on labor market outcomes.RESEARCH DESIGN AND METHODS -Using secondary data from the first two waves (1992 and 1994) of the Health and Retirement Study, we identified 7,055 employed respondents (51-61 years of age), 490 of whom reported having diabetes in wave 1. We estimated the effect of diabetes in wave 1 on the probability of working in wave 2 using probit regression. For those working in wave 2, we modeled the relationships between diabetic status in wave 1 and the change in hours worked and work-loss days using ordinary least-squares regressions and modeled the presence of health-related work limitations using probit regression. All models control for health status and job characteristics and are estimated separately by sex.RESULTS -Among individuals with diabetes, the absolute probability of working was 4.4 percentage points less for women and 7.1 percentage points less for men relative to that of their counterparts without diabetes. Change in weekly hours worked was not statistically significantly associated with diabetes. Women with diabetes had 2 more work-loss days per year compared with women without diabetes. Compared with individuals without diabetes, men and women with diabetes were 5.4 and 6 percentage points (absolute increase), respectively, more likely to have work limitations.CONCLUSIONS -This article provides evidence that diabetes affects patients, employers, and society not only by reducing employment but also by contributing to work loss and healthrelated work limitations for those who remain employed. Diabetes Care 28:2662-2667, 2005T he medical care costs associated with diabetes create a considerable economic burden for patients, families, and society (1,2). Productivity losses from diabetes have been estimated to be almost half ($40 billion) of the medical costs ($92 billion) associated with diabetes in 2002 (1). As the prevalence of diabetes in the U.S. has increased (3), so too have associated economic burdens (4). The increased prevalence (5) among younger individuals suggests that diabetes will become more common in the working-age population. Consequently, employment and work productivity of individuals with diabetes are important issues for patients, families, employers, and policy makers. In this study, we examine the effect of diabetes on labor market outcomes of employed U.S. adults aged 51-61 using longitudinal data from the Health and Retirement Study (HRS).Several studies have found negative associations between diabetes and employment outcomes (6 -10). The magnitude of the effect of diabetes on employment varies from 4 to 22 percentage points. Diabetes can affect employment in a number of ways. First, diabetes complications may prevent working entirely or increase absenteeism for those who work (11). Second, productivity while at work may also be impaired (12). Third, individuals with diabetes may face employment discrimination. In some cases, especially because of the risk of hypogl...

TUNCELI, KAAN, KEMENG LI, AND L. KEOKI WILLIAMS. Long-term effects of obesity on employment and work limitations among U. S. adults, 1986S. adults, to 1999S. adults, .Obesity. 200614:1637-1646. Objective: To determine the relationships between BMI and workforce participation and the presence of work limitations in a U.S. working-age population. Research Methods and Procedures:We used data from the Panel Study of Income Dynamics, a nationwide prospective cohort, to estimate the effect of obesity in 1986 on employment and work limitations in 1999. Individuals were classified into the following weight categories: underweight (BMI Ͻ 18.5), normal weight (18.5 Յ BMI Ͻ 25), overweight (25 Յ BMI Ͻ 30), and obese (BMI Ն 30). Using multivariable probit models, we estimated the relationships between obesity and both employment and work disability. All analyses were stratified by sex. Results: After adjusting for baseline sociodemographic characteristics, smoking status, exercise, and self-reported health, obesity was associated with reduced employment at follow-up [men: marginal effect (ME) Ϫ4.8 percentage points (pp); p Ͻ 0.05; women: ME Ϫ5.8 pp; p Ͻ 0.10]. Among employed women, being either overweight or obese was associated with an increase in self-reported work limitations when compared with normal-weight individuals (overweight: ME ϩ3.9 pp; p Ͻ 0.01; obese: ME ϩ12.6 pp; p Ͻ 0.01). Among men, the relationship between obesity and work limitations was not statistically significant.Discussion: Obesity appears to result in future productivity losses through reduced workforce participation and increased work limitations. These findings have important implications in the U.S., which is currently experiencing a rise in the prevalence of obesity.

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The results of the analysis demonstrate that medication adherence, persistence, and discontinuation rates are suboptimal in patients with T2DM prescribed OAHAs.

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Switching to Eze/Simva 10/40 mg is projected to be a cost-effective treatment (vs. double-statin) in UK patients with ACS.

BACKGROUND: Primary nonadherence to a medication occurs when a drug is prescribed but the patient fails to pick the prescription up from the pharmacy. Managed care organizations that provide integrated care using electronic medical records (EMR) are an ideal setting to study primary nonadherence.