The gold standard program (GSP) for smoking cessation: a cohort study of its effectiveness among smokers with and without cancer.

BACKGROUND: Smoking cessation treatment is an important prognostic factor for survival after a cancer diagnosis, especially for tobacco-related cancers. After being diagnosed with lung cancer, approximately 50% of patients continue smoking or frequently relapse after a quit attempt. Given the importance of smoking cessation treatment for cancer survivors, the objective was to compare the effectiveness of a 6-week intensive smoking cessation intervention, the Gold Standard Program (GSP), among cancer survivors compared with smokers without cancer. Second, we compared successful quitting among socioeconomically disadvantaged cancer survivors with that among nondisadvantaged cancer survivors. MATERIALS AND METHODS: This was a cohort study based on 38,345 smokers from the Danish Smoking Cessation Database (2006-2016). Linkage to the National Patient Register was used to identify cancer survivors undergoing the GSP after being diagnosed with cancer (except nonmelanoma skin cancer). Linkage to the Danish Civil Registration System was used to identify participants who died, went missing, or emigrated before the follow-up. Logistic regression models were applied to evaluate effectiveness. RESULTS AND CONCLUSION: Six percent (2438) of the included smokers were cancer survivors at the time they undertook the GSP. Their 6-month successful quitting showed no difference compared to that of smokers without cancer, neither before nor after adjustment; 35% versus 37% in crude rates and an aOR of 1.13 (95% CI: 0.97-1.32). Likewise, the results for disadvantaged compared to nondisadvantaged cancer survivors were not significantly different (32% versus 33% and an adjusted aOR of 0.87 (95% CI 0.69-1.11)). Overall, an intensive smoking cessation program seems effective in helping both people without cancer and cancer survivors become successful quitters.

Unmet informational and supportive care needs of patients with muscle invasive bladder cancer: A systematic review of the evidence.

BACKGROUND: Little is known about the unmet supportive care needs of patients affected by muscle invasive bladder cancer (MIBC). We set out to determine the different domains of unmet supportive care needs for patients affected by MIBC. LITERATURE SEARCH: A systematic review was conducted according to the PRISMA Statement Guidelines. A sensitive search was performed in electronic databases (DARE, Cochrane, MEDLINE, BNI, PsychINFO, EMBASE and CIHAHL) from the earliest date available to January 2017. DATA EVALUATION: 1405 references were retrieved, 8 articles met the eligibility criteria and were appraised and ranked by strength using the levels of evidence. SYNTHESIS: Individual unmet needs were classified into the following domains: patient-clinician communication, daily living needs, health system/information needs, practical needs, family-related needs, social needs, psychological needs, physical needs and intimacy needs. Patients reported high unmet needs at diagnosis and into survivorship. CONCLUSIONS: This review contributes to a greater understanding of the unmet supportive care needs of patients affected by MIBC. Findings reflect a paucity of research, but existing studies indicated needs commonly related to intimacy, informational, physical and psychological needs. Despite the emerging evidence-base, the current within study limitations precludes our understanding about how the needs of patients evolve over time.

The impact of supportive nursing care on the needs of men with prostate cancer: a study across seven European countries.

BACKGROUND: Prostate cancer is for many men a chronic disease with a long life expectancy after treatment. The impact of prostate cancer therapy on men has been well defined, however, explanation of the consequences of cancer treatment has not been modelled against the wider variables of long-term health-care provision. The aim of this study was to explore the parameters of unmet supportive care needs in men with prostate cancer in relation to the experience of nursing care. METHODS: A survey was conducted among a volunteer sample of 1001 men with prostate cancer living in seven European countries. RESULTS: At the time of the survey, 81% of the men had some unmet supportive care needs including psychological, sexual and health system and information needs. Logistic regression indicated that lack of post-treatment nursing care significantly predicted unmet need. Critically, men's contact with nurses and/or receipt of advice and support from nurses, for several different aspects of nursing care significantly had an impact on men's outcomes. CONCLUSION: Unmet need is related not only to disease and treatment factors but is also associated with the supportive care men received. Imperative to improving men's treatment outcomes is to also consider the access to nursing and the components of supportive care provided, especially after therapy.

Preoperative risk factors related to bladder cancer rehabilitation: a registry study.

INTRODUCTION: Patients diagnosed with (muscle-) invasive bladder cancer (IBC) are more likely to harbour comorbidities due to their advanced age at diagnosis. Under-nutrition is a predictor for postoperative morbidity and mortality in cancer patients, but under-reported in urology. Understanding the IBC patient profile before major surgery could facilitate and optimise outcome of the surgical patient. BACKGROUND/OBJECTIVES: To identify preoperative risk factors for early rehabilitation before radical cystectomy (RC). SUBJECTS/METHODS: A historical registry-based study of 76 patients referred for RC at Aarhus University Hospital, Denmark (DK) in 2009. Early rehabilitation was defined by length of stay (LOS) postoperatively with a cutoff ≥11 days. High comorbidity was expressed by the charlson comorbidity index score (CCI) ≥3. LOS was calculated by linking the unique Civil Registration Number with the National Patient Registry. Preoperative nutritional risk was identified using the screening tool, nutritional risk score 2002 (NRS) of the European Society of Clinical Nutrition and Metabolism. Multivariate analysis was used to identify risk factors for early rehabilitation. RESULTS: The proportion of patients at preoperative nutritional risk was 26% (95% confidence interval (CI): (95% CI: 17; 37) and 43% of patients held a high CCI (95% CI: 33; 55). Prolonged LOS was independently associated with female gender (P=0.02) and age ≥70 years (P=0.04). NRS and CCI were not associated with LOS. CONCLUSIONS: Attention should be focused on women and elderly patients undergoing RC to optimise early rehabilitation and reduce LOS. It is still unknown whether preoperative nutritional risk and comorbidity are obstacles in early rehabilitation of RC patients.

Long QT syndrome patients may faint due to neurocardiogenic syncope.

AIMS: Syncope in long QT syndrome (LQTS) is expected to be due to Torsades de Pointes ventricular tachycardia (TdP). Often these patients faint in situations with emotional stress. The aim of the present study was to evaluate whether neurocardiogenic syncope occurs in LQTS. METHODS AND RESULTS: Ten untreated consecutive LQTS patients (age 11-72 years, median 37.5 years, five males and five females from five different families (one KvLQT1 mutation, two HERG mutations in three families and one without established genetic background)) were examined by a head-up tilt-table test (HUT). If syncope did not occur within 25 min, the patient received 0.25 mg nitroglycerine sublingually and the HUT was continued for 20 min. Nine out of 10 patients had a positive HUT. The syncope resulted from a combined vasodepressor and bradycardiac response. There were no cases of TdP. No syncope occurred in a 42-year-old asymptomatic male LQTS patient with a borderline prolonged QTc of 0.45 s and a HERG mutation. In 11 of 21 patients referred for syncope without LQTS a positive HUT was found (P < 0.10). CONCLUSION: Syncope in LQTS can be of neurocardiogenic origin and is not necessarily due to TdP. The reason for neurocardiogenic syncope in LQTS is unknown, but involvement of the autonomic nervous system outside the heart is possible.

[Fatal poisonings among drug addicts in the county of Funen in 1995 and 1996]. / Forgiftningsdødsfald blandt narkomaner i Fyns Amt i 1995 og 1996.

The aim of this investigation was to examine the deaths of drug addicts from poisoning in the county of Funen in 1995 and 1996. The cause of death was related to drugs on the illicit market. Social conditions (homelessness, involvement in crime, psychogenic disease, circumstance of death) are discussed. The study included 47 drug addicts. Median age was 34, age span: 20-43. The main cause of death was poisoning by heroin. In 28% of the drug addicts cocaine was detected and in 13% amphetamine. About half had used benzodiazepines. Few were employees, most were criminals and eight were homeless. Thirty-eight percent were found in public lavatories. Eight had a serious psychiatric diagnosis. We can conclude that the drug addicts are socially marginalized. They abused a mixture of drugs. The drugs detected in the drug addicts compared well with the drugs on the illicit market and cocaine had gained access to the market.

[Fatal cases of poisonings among drug addicts in the county of Funen in 1993]. / Forgiftningsdødsfald blandt narkomaner i Fyns Amt i 1993.

This study includes death from poisoning among drug addicts in 1993 in the county of Funen, in all 24. The development during the last five years shows an increase, especially in the largest city in the county. The drug addicts have several problems, and several of them were well-known in the social welfare system or by the police. Half of the drug addicts had received treatment for their abuse and three persons were receiving treatment at the time of their death. A few--primarily among the youngest--had only used drugs for a short time while one third had abused drugs for several years. The greater part of the deaths were caused by heroin, which is found in different concentrations in the illegal market. Five of the dead persons had just been released from prison and three people had just left 24-hour care centres when they were found dead. Co-operation between the various, treating authorities has to be given a high priority.

[Consumption of addictive drugs among pensioners. A study of the consumption of benzodiazepines and strong analgesics among pensioners who receive drugs free-of-charge]. / Pensionisters brug af afhaengighedsskabende medicin. En undersøgelse af forbruget af benzodiazepiner og staerke analgetika hos pensionister med medicinkort.

The consumption of benzodiazepines and potent analgesics by old age pensioners and early retirees in Odense who had the right to receive medicine free-of-charge was accounted for where the month of March 1990 was concerned. Approximately 26% received financial support for benzodiazepines, 13% for analgesics while further 6% received support for both benzodiazepines and analgesics. The majority of the users were over 60 years and there twice as many women as men. No significant differences were observed in the sex and age distributions between the groups of pensioners who received benzodiazepines and/or analgesics and the group which received only other medicine. Both the direct and the indirect expenses are discussed. Furthermore, it is concluded that, in some of the pensioners, over-consumption is involved and that it is again necessary to emphasize the indications for prescription of these preparations.

[Severely handicapped persons living at home]. / Svaert handicappede i eget hjem.

The records of 34 economically demanding cases according to the Danish legislation on public assistance section 48, part 3 or the legislation on pensions section 17 were reviewed. The persons concerned were mainly young people who remained in their own homes despite severe handicap. Where 2/3 were concerned, progressive disease appeared to be involved. In addition, economical deliberations and assessment of the quality of life were considered.

Fourteen years' survival with an untreated traumatic rupture of the thoracal aorta.

Untreated traumatic rupture of the aorta generally results in sudden death. A case with 14 years' survival after an unrecognized traumatic rupture of the aorta is presented. Chronic traumatic aneurysm of the aorta should be kept in mind in a patient who develops sudden symptoms of arteriosclerotic heart disease months to years after a relevant thoracic trauma.