Objectives Primary objectives were to evaluate the use of potentially inappropriate medication (PIM) use in elderly heart failure (HF) patients and the factors associated with the number of PIMs. Secondary objectives were to test for the correlation between PIMs and quality of life (QOL) and depression. Methods A cross‐sectional study was conducted among 125 elderly Lebanese HF patients with left ventricular ejection fraction <50%. Data on socio‐demographics, clinical data and medications were collected. Patients were interviewed with Minnesota living with Heart Failure Questionnaire (MLHFQ) and Patient Health Questionnaire‐9 (PHQ‐9). Medication profile per patient was evaluated for PIMs using Beers Criteria. The correlations between the number of PIMs and the MLHFQ, PHQ‐9 and the number of medications were tested using Pearson’s correlation. Linear regression was done to predict the factors associated with the number of PIMs. Key findings Patients were taking a total of 1035 medications with a mean of 8.28 ± 3.14 medications. In total, 80.0% of patients were taking at least one PIM. Diuretics (55.2%) and proton pump inhibitors (41.6%) were most commonly prescribed PIMs. The number of PIMs was moderately correlated with the number of medications and the MLHFQ score. Linear regression showed that the number of medications, age ≥85 years, chronic kidney disease and HF with New York Heart Association III were associated with more PIMs. Conclusions A high percentage of PIMs was found among a sample of elderly Lebanese HF patients. HF multidisciplinary team is needed to control the prescription of PIMs in this vulnerable population.
Background There is an increase in the use of neoadjuvant chemotherapy (NACT) to downstage breast cancer. Sentinel lymph node biopsy (SLNB) has replaced Axillary lymph node dissection (ALND) as a standard of care for the treatment of breast cancer patients with negative axilla at presentation. However, the reliability of SLNB after NACT in patients with initially node-positive breast cancer is still controversial and debatable. This meta-analysis was conducted to investigate the accuracy and feasibility of SLNB after NACT in patients presented with positive axillary lymph nodes. Methods A comprehensive literature search was conducted using Medline, PubMed, Embase, Central, and SCOPUS for studies from their date of inception till April 2021 on the performance of SLNB following NACT in clinically node-positive breast cancer patients. We included prospective studies including breast cancer patients with positive lymph nodes at diagnosis, receiving neoadjuvant chemotherapy before undergoing an SLNB, irrespective of their molecular subtypes or breast cancer stage. We excluded retrospective studies, case reports, review articles, and letter to editors. The main outcomes of interest were the false negative rate (FNR) and the identification rate (IR). We also aimed to investigate the accuracy, negative predictive value (NPV), positive predictive value (PPV), specificity, and sensitivity of the SLNB procedure. Results An aggregate of 33 studies were included in this meta-analysis enrolling 4624 patients. The pooled identification rate (IR) was 88% (95% CI: 86-90; heterogeneity I2: 80.93 %) and the false negative rate (FNR) was 13% (95% CI: 11-15; heterogeneity I2: 72.31%). The pooled accuracy, NPV, PPV, specificity and sensitivity were 91.8% (95% CI: 69.39 -114.3), 82.8% (95%CI: 60.19-105.52), 98.2% (95%CI: 65.86 -130.63), 93.7% (95 CI%: 32.4 -155.03), 82.1% (95%CI: 58.38- 107.24) respectively. Conclusion In this comprehensive meta-analysis, we were able to review the largest number of studies (N=33) and patients (N=4624). We carried out this study with the intention to overcome the limitations of previously conducted meta-analyses such as including retrospective studies and a mixed population of clinically node-positive and node-negative breast cancer patients. Based on current findings, the usage of SLNB instead of ALND for the treatment of node-positive breast cancer patients is acceptable. However, further analysis is needed for the improvement of SLNB performance. Keywords: Sentinel lymph node biopsy; Breast cancer; Node positive; Neoadjuvant chemotherapy. Citation Format: Mariam Zahwe, Abir Ghzaiel, Malak Ghezzawi, Sarah El Iskandarani, Marwa Diab, Lara Soueid, Miryam El Jibbawi, Ahmad Najia, Khalil El Asmar, Eman Sbaity. Performance of Sentinel Lymph Node Biopsy after Neoadjuvant Chemotherapy in Clinically Node Positive Breast Cancer Patients: Systematic Review and Meta-analysis [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-07-25.
Purpose To review the literature on health research collaborations by academic entities and to identify the main phases, components, and concepts of these research collaborations. Method The authors conducted a systematic review of the literature, searching 4 databases in March 2022 for studies on health research collaboration between an academic entity (individual, group, or institution) and any other entity included. They excluded non–health-related studies and studies in which collaboration was not for the purpose of research. From included studies, reviewers abstracted data about the 4 main phases of research collaborations (initiation, conduct, monitoring, and evaluation) and synthesized their corresponding components and concepts using thematic analysis method. Results A total of 59 studies met inclusion criteria. These studies described building research collaborations between an academic entity and other academic entities (n = 29; 49%), communities (n = 28; 47%), industry (n = 7; 12%), and/or governmental entities (n = 4; 7%). Of the 59 studies, 22 addressed 2 phases of collaboration, 20 addressed 3 phases, and 17 addressed all 4 phases. All included studies described at least 1 of the components relevant to the initiation phase and at least 1 relevant to the conduct phase. Team structure was the most common component discussed in relation to the initiation phase (n = 48; 81%), and team dynamics was the most common component discussed in relation to the conduct phase (n = 55; 93%). At least 1 of the components relevant to the monitoring phase was reported in 36 studies, and at least 1 component relevant to the evaluation phase was reported in 28 studies. Conclusions This review provides important information for groups aiming to engage in collaborative research. The synthesized list of collaboration phases and their components can serve as a road map for collaborators at different steps of their research.
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