ABSTRACT
BACKGROUND: The MIRCIT trial was a randomized, double-blind, placebo-controlled study of advanced Non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: Patients were randomized to receive 10 mg or 20 mg of melatonin or placebo. Assessment of health-related quality of life (HRQoL) was completed at baseline, and at 2, 3 and 7 months. Survival and adverse events were collected. DNA damage marker 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG) was measured during the first three months of chemotherapy. RESULTS: Patients in the melatonin-treated group had better adjusted HRQoL scores, with a slightly significantly better score (2.69 points, 95% confidence interval (CI)=0.01-5.38, p=0.049) being found in social well-being. Median survival was 7.3 months (95% CI=3.42-11.14) without significant difference. A great amont of DNA damage marker was observed in the placebo-treated group, and this was associated with lower survival (r(2)=-0.656, p=0.02), implying the protective effect of melatonin in healthy cells. CONCLUSION: Melatonin in combination with chemotherapy did not affect survival and adverse events of advanced patients with NSCLC, but there was a trend for better HRQoL.
Subject(s)
Carcinoma, Non-Small-Cell Lung/drug therapy , Lung Neoplasms/drug therapy , Melatonin/administration & dosage , 8-Hydroxy-2'-Deoxyguanosine , Antineoplastic Agents/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Antioxidants/adverse effects , Antioxidants/therapeutic use , Carcinoma, Non-Small-Cell Lung/mortality , Cisplatin/therapeutic use , DNA Damage/genetics , Deoxyguanosine/analogs & derivatives , Deoxyguanosine/analysis , Disease-Free Survival , Double-Blind Method , Female , Humans , Lung Neoplasms/mortality , Male , Melatonin/adverse effects , Middle Aged , Placebos , Quality of Life , Treatment OutcomeABSTRACT
The purpose of this study was to assess the efficiency of hospital pharmacy services and to determine the environmental factors affecting pharmacy service efficiency. The technical efficiency of a hospital pharmacy was assessed to evaluate the hospital's ability to use pharmacy manpower in order to produce the maximum output of the pharmacy service. Data Envelopment Analysis (DEA) was used as an efficiency measurement. The two labor inputs were pharmacists and support personnel and the ten outputs were from four pharmacy activities: drug dispensing, drug purchasing and inventory control, patient-oriented activities, and health consumer protection services. This was used to estimate technical efficiency. A Tobit regression model was used to determine the effect of the hospital size, location, input mix of pharmacy staff, working experience of pharmacists at the study hospitals, and use of technology on the pharmacy service efficiency. Data for pharmacy service input and output quantities were obtained from 155 respondents. Nineteen percent were found to have full efficiency with a technical efficiency score of 1.00. Thirty-six percent had a technical efficiency score of 0.80 or above and 27% had a low technical efficiency score (< 0.60). The average TE score increased in respect to the hospital size (0.60, 0.71, 0.75, and 0.83 in 10, 30, 60, and 90-120 bed hospitals, respectively). Hospital size and geographic location were significantly associated with pharmacy service efficiency.
Subject(s)
Pharmacy Service, Hospital/methods , Efficiency, Organizational , Hospitals, District , Humans , Pharmacy Service, Hospital/organization & administration , Pharmacy Service, Hospital/standards , ThailandABSTRACT
BACKGROUND: Peritonitis is a major complication of continuous ambulatory peritoneal dialysis (CAPD) patients. Information on the specific risk of peritonitis is important in reducing this common complication. MATERIAL AND METHOD: A single center retrospective cohort study was done to assess time to first peritonitis event and risk factors in Thai CAPD population. RESULTS: Between January 1995 and December 2005, 322 incident CAPD patients were recruited for the present study. During the study period of 4,281 patient-months, 198 episodes of first peritonitis were recorded. The median peritonitis-free time was 13.7 months. A Cox regression model showed that an increase in level of baseline albumin and hematocrit by 1 g/dL and 1% would decrease risk of peritonitis by 27% and 3%, respectively (hazard ratio (95%CI): 0.73 (0.59-0.91) and 0.97 (0.94-1.00)). A neutral effect of self and caregiver performer was observed in the present study. CONCLUSION: The present study confirmed the susceptibility of hypoalbuminemia and anemia to peritonitis. Awareness of particular risk groups should be achieved to prevent peritonitis.
