Current medical research and opinion
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Maintaining continuity of care after schizophrenia-related hospitalization is challenging for patients and healthcare providers and systems. Prior evidence suggests that second-generation long-acting injectable antipsychotics (SGLAIs) may reduce the risk of treatment nonadherence and readmission versus oral atypical antipsychotics (OAAs). Therefore, quality measures were compared between patients initiated on SGLAIs and OAAs in the United States. ⋯ Less than half of patients initiated on antipsychotics during a schizophrenia-related inpatient stay continued the same treatment post-discharge. However, SGLAI patients were more likely to be adherent to the initiated antipsychotic and to have an outpatient visit, which may suggest improved continuity of care post-discharge relative to OAA patients.
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To describe access and real-world use patterns of esketamine nasal spray among adults with treatment-resistant depression (TRD) with private or public insurance. ⋯ Initial access to esketamine nasal spray may be hindered by prior authorization or claim filing errors. Among patients who initiated esketamine, treatment compliance generally deviates from label recommendations; yet, most of those who received induction per label successfully transition to maintenance with esketamine.
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The systemic immune-inflammation index (SII) is used to assess survival in many cancers. SII has been examined separately in pancreatic head, ampulla, and distal choledochus cancers, and different cut-off values were found. Detecting the location of periampullary cancer before surgery may be difficult or misleading. This study aimed to investigate the use of SII in predicting overall survival (OS) with periampullary cancers regardless of tumor location. ⋯ SII is an independent prognostic risk factor and may be a marker for predicting OS in patients with periampullary cancer. There was no statistical difference between the tumor locations in terms of SII. A single cut-off value of SII may be used for periampullary cancer survival without the need for a pathology specimen.
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Geriatric cancer population is growing. Both cancer and geriatric conditions are associated with some degree of inflammatory burden. To comprehensively present our five years of experience in patients with suspicion of a malignancy, signs and symptoms that are more prominent as indicator of malignancies, conditions that cause malignancy-like symptoms, and common malignancies and newly diagnosed malignancies in geriatric patients with a history of cancer. ⋯ The frequency and presentation patterns of malignancies may differ in older adults. Depressive symptoms are common in geriatric cancer patients. Geriatric patients with a history of malignancy should be evaluated in detail for new primary malignancies.
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Recent evidence suggests that diabetes is a risk factor for thyroid nodules. However, the relationship between complications of type 2 diabetes and the risk of thyroid nodules remains unclear. This present study aims to investigate the association between thyroid nodules and complications of type 2 diabetes. ⋯ One of the key findings of this study is that type 2 diabetes without complications is negatively correlated with the risk of thyroid nodules, while several complications are associated with a significantly increased risk of thyroid nodules.