This paper leverages the risk apportionment technique of Eeckhoudt, Rey, and Schlesinger (2007) to explore higher-order risk preferences regarding others' health, together with preferences for ex-ante and ex-post inequality in social risk distributions, and their mutual effects. An experiment conducted with university students playing the role of unbiased observers displayed a reluctance to accept risks affecting social health and a dislike for pre-existing unequal conditions. Subsequently, the evidence pointing toward ex-post inequality seeking displays a substantially weaker degree of support than that for ex-ante inequality aversion. Recognizing the independence of ex-ante inequality aversion from risk aversion, we establish that fundamental utilitarian concepts offer no pertinent relevance for individual assessment of societal health risks regarding well-being. Our research on precautionary distribution, activated when a specific societal group faces increased health risks, shows a considerable division in preferences.
Reference 101007/s11238-023-09928-w provides access to supplementary materials for the online version.
The supplementary materials connected to the online version are situated at 101007/s11238-023-09928-w.
Compared to the general population, patients diagnosed with cancer show a markedly increased susceptibility to cardiovascular mortality, a well-recognized trend. Cardio-oncology aims to proactively manage cardiovascular disease or complications in cancer patients, encompassing risk reduction, detection, monitoring, and treatment strategies. While oncology exhibits significant progress in early detection and drug development, the resulting benefits are unequally distributed, due to socioeconomic disparities, racial inequities, a lack of community support, and access barriers to high-quality medical care, thus creating health disparities among marginalized groups. Through this review, we will explore the determinants behind discrepancies in cardio-oncologic care experiences for Hispanic/Latinx, Black, Asian and Pacific Islander, Indigenous communities, sex and gender minorities, and immigrant groups. Cardio-oncology outcome variations are attributable to the frequency of cancer screenings, hereditary cardiac/oncologic risk factors, cultural stressors, the prevalence of tobacco exposure, and inadequate physical activity. Bioactive metabolites We will also explore the obstacles to cardio-oncologic care in these communities, considering their racial and socioeconomic factors. To effectively combat the disparities in cardiovascular and cancer care experienced by minority groups, urgent action is imperative, as appropriate and timely care is essential.
Colorectal surgery's most severe complication is anastomotic leakage (AL). Intraoperative assessment of colonic vascular perfusion in real time is facilitated by indocyanine green (ICG) angiography. Our study aimed to analyze how ICG affected the AL rate in individuals who had undergone transanal total mesorectal excision (TaTME) to treat rectal cancer.
This retrospective cohort study, performed at our center between October 2018 and March 2022, aimed to examine the clinical characteristics of rectal cancer patients who underwent TaTME, with propensity score matching (PSM) applied subsequently. To determine the primary outcome, the proximal colonic transection line modification and the clinical AL rate were assessed.
After implementing propensity score matching (PSM), the non-ICG group consisted of 143 patients, while the ICG group also consisted of 143 patients. In the non-ICG cohort, the proximal colonic transection line was altered in seven patients, whereas 18 patients in the ICG group underwent modifications (49%).
An increase of 125% was demonstrated, with a statistically significant p-value of 0.0023. The non-ICG group displayed a substantially higher rate of AL diagnosis (161%, 23 patients) compared to the ICG group (35%, 5 patients), demonstrating a statistically significant difference (p < 0.0001). The hospital readmission rate was less in the ICG group (0.7%) than the non-ICG group.
The data revealed a strong relationship between the factors, indicated by a p-value of 0.0003 and a 77% correlation. There were no statistically discernible disparities in fundamental lines and other outcomes between groups.
ICG angiography, a safe and practical method, aids in identifying potentially problematic colonic vascular perfusion and allows modification of the proximal colonic transection line, leading to a substantial decrease in adverse local events and hospital readmissions.
ICG angiography, a safe and reliable technique, aids surgeons in identifying poor colonic vascular perfusion, enabling alterations to the proximal colonic transection line. This results in a substantial decrease in adverse events and hospital readmissions.
The histological conversion of lung adenocarcinoma (LUAD) into small-cell lung cancer (SCLC) is a substantial resistance mechanism, particularly in cases of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI)-resistant LUAD. Small cell lung cancer patients facing treatment resistance may find anlotinib suitable for their third-line treatment plan. For individuals with transformed small cell lung cancer (SCLC), etoposide/platinum (EP) as a primary treatment option demonstrates very limited effectiveness. Nonetheless, scant information exists regarding the combined use of EP and anlotinib in treating transformed small cell lung cancer (SCLC). A retrospective analysis of clinical responses in patients with transformed small cell lung cancer (SCLC) from lung adenocarcinoma (LUAD), following epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) treatment failure, was conducted to examine the impact of combining anlotinib with endobronchial procedures (EP).
During the period from September 1, 2019, to December 31, 2022, a retrospective analysis of ten patients, diagnosed with SCLC after developing resistance to EGFR-TKI treatment for LUAD, was conducted across three regional hospitals. EP and anlotinib were administered in combination to all patients for four to six cycles, after which anlotinib maintenance therapy was instituted. To assess clinical efficacy, indices such as objective response rate (ORR), disease control rate (DCR), median progression-free survival (mPFS), median overall survival (mOS), and toxicities were examined.
A median of 201.276 months (ranging from 17 to 24 months) separated EGFR-TKI treatment from SCLC conversion. A genetic evaluation after the transformation indicated that ninety percent of the patients retained their original EGFR gene mutations. In a recent study, further driver genes were found, specifically BRAF mutations (10%), PIK3CA mutations (20%), RB1 loss (50%), and TP53 mutations (60%). The ORR demonstrated 80% success, and the DCR showed 100% success rate. The mPFS, at 90 months (95% confidence interval: 79-101 months), and the mOS, at 140 months (95% confidence interval: 120-159 months), were observed in the study. A minimal rate of grade 3 toxicities, less than 10%, and no grade 4 toxicities or deaths were noted.
Further investigation is required to confirm the safety and efficacy of the EP plus anlotinib regimen in transformed SCLC patients who have developed resistance to EGFR-TKIs.
A promising and safe treatment option in transformed SCLC patients resistant to EGFR-TKIs appears to be the combination of anlotinib and the EP regimen, prompting further exploration.
The most common and severe postoperative complication in cancer patients is postoperative gastrointestinal dysfunction (PGD). Acupuncture, as a form of PGD treatment, has been frequently employed in cancer cases. To ascertain the effectiveness and safety of acupuncture in treating cancer patients with PGD was the primary goal of this study.
We meticulously scrutinized eight randomized controlled trials (RCTs) on acupuncture for post-treatment distress (PGD) in cancer, each published prior to November 2022. Time to first flatus (TFF) and time to first defecation (TFD) were the main outcomes assessed, and time to bowel sound recovery (TBSR) and the total duration of hospital stay (LOS) were supplementary outcomes. Impending pathological fractures The Cochrane Collaboration's Risk of Bias Tool was instrumental in judging the quality of the randomized controlled trials, while the Grading of Recommendations Assessment, Development, and Evaluations (GRADE) system was tasked with evaluating the certainty of the evidentiary basis. LY294002 Employing RevMan 54 for the meta-analysis, a subsequent publication bias test was carried out using Stata 151.
This study utilized data from sixteen randomized controlled trials; these trials featured 877 participants. In a meta-analysis of various treatments, acupuncture displayed a superior capacity to reduce TFF, TFD, and TBSR in contrast to both routine treatments, sham acupuncture, and enhanced recovery after surgery. In contrast to routine treatment and the enhanced recovery after surgery protocol, acupuncture did not diminish the length of stay. The subgroup analysis highlighted a considerable reduction in TFF and TFD following acupuncture treatment. This review's assessment of cancer types revealed that acupuncture effectively mitigated both TFF and TFD. Moreover, combining local and distal acupoints could potentially alleviate TFF and TFD, and the use of distal-to-proximal acupoints could lead to a substantial lessening of TFD. The trials investigated did not identify any adverse reactions associated with acupuncture use.
Acupuncture, a relatively safe and effective modality, can be used to treat cancer-related PGD. The future is anticipated to include more high-quality randomized controlled trials (RCTs), including a wider range of acupuncture techniques and various cancer types, focused on integrating acupoints for preimplantation genetic diagnosis (PGD) in cancer treatment, and further assessing the effectiveness and safety of acupuncture for PGD in cancer patients in regions beyond China.
The systematic review, identified by the identifier CRD42022371219, can be accessed via the link https://www.crd.york.ac.uk/prospero.
The identifier CRD42022371219, found at https://www.crd.york.ac.uk/prospero, designates a specific research protocol.