Selective serotonin reuptake inhibitor (SSRI) use is common among ovarian cancer patients. We examined the effect of SSRIs on survival and progression in ovarian cancer patients and effects of 5-HT on ovarian cancer cell (OCC) proliferation. Ovarian cancer patients from a 6-site study between 1994 and 2010 were included. Cox proportional hazards models were used for multivariate analysis. SSRI use was associated with decreased time to disease recurrence (HR 1.3, CI 1.0-1.6, p=0.03), but not overall survival (HR 1.1, CI 0.9-1.3, p=0.56). Compared to normal ovarian cells, most OCCs had elevated 5-HT2A receptor mRNA expression (up to 1600 fold greater expression). Clonogenic survival increased in cells treated with 10 uM (1.6 fold, p<0.001) and 20uM (1.9 fold, p=0.018) 5-HT. Mice receiving 5-HT injections had increases in tumor weight (p=0.07) and nodules (p=0.08) with increased Ki67 expression. Injections with sertraline doubled mean tumor weight in mice (p=0.16). 5-HT and sertraline both increased Ki67 expression in mouse tumors (p < 0.001).Patients using SSRIs had significantly decreased time to disease progression. It is possible that SSRIs alter serotonin levels in the tumor microenvironment, resulting in activation of proliferation pathways. Further characterization of serotonergic pathways in ovarian cancer is recommended to demonstrate safety of these medications.
The shift towards providing high value cancer care has placed increasing importance on patient experiences. This scoping review summarizes patient experience literature, highlights research gaps, and provides future research directions. We then introduce a new resource that links the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) program with the Centers for Medicare and Medicaid Services Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and longitudinal medical claims data. We conducted a scoping review to identify relevant research within the Medicare CAHPS domain that examine factors associated with patient-reported experiences with their cancer care. Gaps indicate a need for population-based research to explore relationships between cancer patient experiences, healthcare utilization, and subsequent patient outcomes. SEER-CAHPS, a publicly accessible data resource, may assist in addressing these gaps by linking cancer registry (SEER), survey data reported by Medicare beneficiaries (CAHPS), and Medicare claims, providing unique insight into quality of care. Linked data include 231,089 surveys from patients with a cancer diagnosis, and 4,236,529 surveys from patients without a cancer diagnosis. Results indicate substantial gaps in our knowledge of patient experiences and the need for additional resources. SEER-CAHPS links direct patient feedback with cancer registry and Medicare claims, making it an important source of information on experiences and healthcare utilization. Increasing recognition of the importance of patient-centeredness points to the need for population-based studies. Findings from SEER-CAHPS will inform initiatives to improve care delivery.
with antibiotic leftovers or by acquiring antibiotics directly in the pharmacy without a prescription), are behaviours directly related with this misuse, revealing the necessity of interventions directed to health professionals. The aim of this study is to improve the consumption of antibiotics through an educational intervention directed to community pharmacists and primary care physicians. Material and Methods: A cluster randomized trial in the region center of Portugal. Of the 8 clusters, 4 clusters received an educational intervention and the other four clusters did not received any intervention and were included in the control group. Educational intervention consisted of group sessions with physicians and group sessions with pharmacists. In the sessions groups it was presented information about the problem of microbial resistances and each sessions was focused in the identified attitudes that influence the behaviour of physician during antibiotic prescription or the behaviour of pharmacist during the dispensation of antibiotics in pharmacies. At the end of each group session, were distributed flyers and poster about the importance of the adequate use of antibiotics to be divulgated to the patients. The data of antibiotics consumption was compared between the intervention group and the control group. Results: The intervention was well received for the pharmacists and for the physicians included in the study. Comparing the consumption of antibiotics between the two groups, it was observed a decrease in the total consumption of antibiotics in the intervention group during 12 months of the follow-up period after the intervention was made. Conclusions: It was possible decrease the consumption of antibiotics through an educational intervention directed to community pharmacists and primary care physicians.
There is a consensus that birds detect the earth’s magnetic field and use some of its features for orientation and homing purposes. Since the late 1960s, when the first solid behavioral evidence of magnetoreception was obtained, much research has been devoted to describing the ethological aspects of this behavior. The neurophysiological basis of magnetoreception has been much less studied, although a frequently cited 1986 report described a high prevalence (70 %) of magneto-sensitive neurons in the pigeon optic tectum with high signal-to-noise ratios (Semm and Demaine, J Comp Physiol A 159:619–625, 1986). Here, we repeated these neurophysiological experiments using anesthetized as well as awake pigeons and new recording techniques. Our data indicate that magneto-sensitive units do not exist in the avian tectum.
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