Depression Treatment and Healthcare Expenditures among Elderly Medicare Beneficiaries with Newly-diagnosed Depression and Incident Breast, Colorectal or Prostate Cancer

Abstract

Objectives

Depression is associated with high healthcare expenditures, and depression treatment may reduce healthcare expenditures. However, to date, there have not been any studies on the effect of depression treatment on healthcare expenditures among cancer survivors. Therefore, this study examined the association between depression treatment and healthcare expenditures among elderly with depression and incident cancer.

Methods

The current study utilized a retrospective longitudinal study design using the linked Surveillance, Epidemiology and End Results (SEER)-Medicare database. Elderly (>66 years) fee-for-service Medicare beneficiaries with newly diagnosed depression and incident breast, colorectal or prostate cancer (N = 1,502) were followed for a period of 12 months after depression diagnosis. Healthcare expenditures were measured every month for a period of 12 months follow-up period. Depression treatment was identified during the six months follow-up period. The adjusted associations between depression treatment and healthcare expenditures were analyzed with Generalized Linear Mixed Model (GLMM) regressions with gamma distribution and log-link after controlling for other factors.

Results

The average 1-year total healthcare expenditures after depression diagnosis were $38,219 for those who did not receive depression treatment; $42,090 for those treated with antidepressants only; $46,913 for those treated with psychotherapy only and $51,008 for those treated with a combination of antidepressants and psychotherapy. As compared to no depression treatment, those who received antidepressants only, psychotherapy only, or combination of antidepressants and psychotherapy had higher healthcare expenditures. However, second-year expenditures did not significantly differ among depression treatment categories.

Conclusions

Among cancer survivors with newly-diagnosed depression, depression treatment did not have a significant effect on expenditures in the long-term.

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Depression Treatment and Healthcare Expenditures among Elderly Medicare Beneficiaries with Newly-diagnosed Depression and Incident Breast, Colorectal or Prostate Cancer

Abstract

Objectives

Depression is associated with high healthcare expenditures, and depression treatment may reduce healthcare expenditures. However, to date, there have not been any studies on the effect of depression treatment on healthcare expenditures among cancer survivors. Therefore, this study examined the association between depression treatment and healthcare expenditures among elderly with depression and incident cancer.

Methods

The current study utilized a retrospective longitudinal study design using the linked Surveillance, Epidemiology and End Results (SEER)-Medicare database. Elderly (>66 years) fee-for-service Medicare beneficiaries with newly diagnosed depression and incident breast, colorectal or prostate cancer (N = 1,502) were followed for a period of 12 months after depression diagnosis. Healthcare expenditures were measured every month for a period of 12 months follow-up period. Depression treatment was identified during the six months follow-up period. The adjusted associations between depression treatment and healthcare expenditures were analyzed with Generalized Linear Mixed Model (GLMM) regressions with gamma distribution and log-link after controlling for other factors.

Results

The average 1-year total healthcare expenditures after depression diagnosis were $38,219 for those who did not receive depression treatment; $42,090 for those treated with antidepressants only; $46,913 for those treated with psychotherapy only and $51,008 for those treated with a combination of antidepressants and psychotherapy. As compared to no depression treatment, those who received antidepressants only, psychotherapy only, or combination of antidepressants and psychotherapy had higher healthcare expenditures. However, second-year expenditures did not significantly differ among depression treatment categories.

Conclusions

Among cancer survivors with newly-diagnosed depression, depression treatment did not have a significant effect on expenditures in the long-term.

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Signet ring cell carcinoma of resectable metastatic colorectal cancer has rare surgical value

Background and Objectives

Signet ring cell carcinoma (SRCC) is a uniquely separated subgroup in metastatic colorectal cancer (mCRC). The aims are to investigate the value of resection in patients with resectable metastatic signet ring cell colorectal cancer.

Methods

Patients with mCRC who underwent resection in Surveillance, Epidemiology, and End Results database during 1998–2010 were retrospectively analyzed. Kaplan–Meier and COX models were used to analyze the differences in the survival. Logistic regression models were used to evaluate the relationship between SRCC and other clinicopathological factors.

Results

Among the 3,568 patients, 94 (2.63%) patients had SRCC. The median survival time of patients with SRCC and non-SRCC were 17 and 29 months, respectively (P < 0.001). Multivariate analysis indicated that SRCC was an independent prognostic factor for poor overall survival. Logistic regression model based on variables identified by univariate analysis indicated that younger age (≤50 years old) (P = 0.005), female (P < 0.001), location in colon (P = 0.012), and N positive status (P = 0.003) were independent variables correlated with the SRCC subgroup. SRCC had a dramatically higher invalid surgical outcome rate than non-SRCC (P = 0.001).

Conclusion

SRCC patients might benefit little from the resection of primary and metastatic lesions with a high rate of undergoing invalid operations. J. Surg. Oncol. © 2016 Wiley Periodicals, Inc.

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Adenylyl cyclase 3/adenylyl cyclase-associated protein 1 (CAP1) complex mediates the anti-migratory effect of forskolin in pancreatic cancer cells

Abstract

Pancreatic cancer is one of the most lethal human malignancies. A better understanding of the intracellular mechanism of migration and invasion is urgently needed to develop treatment that will suppress metastases and improve overall survival. Cyclic adenosine monophosphate (cyclic AMP) is a second messenger that has shown to regulate migration and invasion of pancreatic cancer cells. The rise of cyclic AMP suppressed migration and invasion of pancreatic ductal adenocarcinoma cells. Cyclic AMP is formed from cytosolic ATP by the enzyme adenylyl cyclase (AC). There are ten isoforms of ACs; nine are anchored in the plasma membrane and one is soluble. What remains unknown is the extent to which the expression of transmembrane AC isoforms is both modified in pancreatic cancer and mediates the inhibitory effect of forskolin on cell motility. Using real-time PCR analysis, ADCY3 was found to be highly expressed in pancreatic tumor tissues, resulting in a constitutive increase in cyclic AMP levels. On the other hand, ADCY2 was down-regulated. Migration, invasion and filopodia formation in two different pancreatic adenocarcinoma cell lines, HPAC and PANC-1 deficient in AC1 or AC3, were studied. We found that AC3, upon stimulation with forskolin, enhanced cyclic AMP levels and inhibited cell migration and invasion. Unlikely to be due to a cytotoxic effect, the inhibitory effects of forskolin involved the quick formation of AC3/adenylyl cyclase-associated protein 1 (CAP1)/G-actin complex, which inhibited filopodia formation and cell motility. Using Western-blotting analysis, forskolin, through AC3 activation, caused phosphorylation of CREB, but not ERK. The effect of CREB phosphorylation is likely to be associated with long-term signaling changes. This article is protected by copyright. All rights reserved

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Factors Predicting Emotional Cue-Responding Behaviors of Nurses in Taiwan: An Observational Study

Abstract

Objective

Responding to emotional cues is an essential element of therapeutic communication. The purpose of this study is to examine nurses' competence of responding to emotional cues (CRE) and related factors while interacting with standardized patients with cancer.

Methods

This is an exploratory and predictive correlational study. A convenience sample of registered nurses who have passed the probationary period in southern Taiwan was recruited to participate in 15-minute videotaped interviews with standardized patients. The Medical Interview Aural Rating Scale was used to describe standardized patients' emotional cues and to measure nurses' CRE. The State-Trait Anxiety Inventory was used to evaluate nurses' anxiety level before the conversation. We used descriptive statistics to describe the data and stepwise regression to examine the predictors of nurses' CRE.

Results

A total of 110 nurses participated in the study. Regardless of the emotional cue level, participants predominately responded to cues with inappropriate distancing strategies. Prior formal communication training, practice unit, length of nursing practice, and educational level together explain 36.3% variances of the nurses' CRE.

Conclusions

This study is the first to explore factors related to Taiwanese nurses' CRE. Compared to nurses in other countries, Taiwanese nurses tended to respond to patients' emotional cues with more inappropriate strategies. We also identified significant predictors of CRE that show the importance of communication training. Future research and education programs are needed to enhance nurses' CRE and to advocate for emotion-focused communication.

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The use of salivary cortisol as an index of chronic stress that correlates with depression in prostate cancer patients

http://ift.tt/2g8PRAL

Adenylyl cyclase 3/adenylyl cyclase-associated protein 1 (CAP1) complex mediates the anti-migratory effect of forskolin in pancreatic cancer cells

Abstract

Pancreatic cancer is one of the most lethal human malignancies. A better understanding of the intracellular mechanism of migration and invasion is urgently needed to develop treatment that will suppress metastases and improve overall survival. Cyclic adenosine monophosphate (cyclic AMP) is a second messenger that has shown to regulate migration and invasion of pancreatic cancer cells. The rise of cyclic AMP suppressed migration and invasion of pancreatic ductal adenocarcinoma cells. Cyclic AMP is formed from cytosolic ATP by the enzyme adenylyl cyclase (AC). There are ten isoforms of ACs; nine are anchored in the plasma membrane and one is soluble. What remains unknown is the extent to which the expression of transmembrane AC isoforms is both modified in pancreatic cancer and mediates the inhibitory effect of forskolin on cell motility. Using real-time PCR analysis, ADCY3 was found to be highly expressed in pancreatic tumor tissues, resulting in a constitutive increase in cyclic AMP levels. On the other hand, ADCY2 was down-regulated. Migration, invasion and filopodia formation in two different pancreatic adenocarcinoma cell lines, HPAC and PANC-1 deficient in AC1 or AC3, were studied. We found that AC3, upon stimulation with forskolin, enhanced cyclic AMP levels and inhibited cell migration and invasion. Unlikely to be due to a cytotoxic effect, the inhibitory effects of forskolin involved the quick formation of AC3/adenylyl cyclase-associated protein 1 (CAP1)/G-actin complex, which inhibited filopodia formation and cell motility. Using Western-blotting analysis, forskolin, through AC3 activation, caused phosphorylation of CREB, but not ERK. The effect of CREB phosphorylation is likely to be associated with long-term signaling changes. This article is protected by copyright. All rights reserved

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Factors Predicting Emotional Cue-Responding Behaviors of Nurses in Taiwan: An Observational Study

Abstract

Objective

Responding to emotional cues is an essential element of therapeutic communication. The purpose of this study is to examine nurses' competence of responding to emotional cues (CRE) and related factors while interacting with standardized patients with cancer.

Methods

This is an exploratory and predictive correlational study. A convenience sample of registered nurses who have passed the probationary period in southern Taiwan was recruited to participate in 15-minute videotaped interviews with standardized patients. The Medical Interview Aural Rating Scale was used to describe standardized patients' emotional cues and to measure nurses' CRE. The State-Trait Anxiety Inventory was used to evaluate nurses' anxiety level before the conversation. We used descriptive statistics to describe the data and stepwise regression to examine the predictors of nurses' CRE.

Results

A total of 110 nurses participated in the study. Regardless of the emotional cue level, participants predominately responded to cues with inappropriate distancing strategies. Prior formal communication training, practice unit, length of nursing practice, and educational level together explain 36.3% variances of the nurses' CRE.

Conclusions

This study is the first to explore factors related to Taiwanese nurses' CRE. Compared to nurses in other countries, Taiwanese nurses tended to respond to patients' emotional cues with more inappropriate strategies. We also identified significant predictors of CRE that show the importance of communication training. Future research and education programs are needed to enhance nurses' CRE and to advocate for emotion-focused communication.

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The use of salivary cortisol as an index of chronic stress that correlates with depression in prostate cancer patients

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Targeted inhibition of WRN helicase, replication stress and cancer

Publication date: Available online 27 November 2016
Source:Biochimica et Biophysica Acta (BBA) - Reviews on Cancer
Author(s): Natalie Orlovetskie, Raphael Serruya, Ghada Abboud-Jarrous, Nayef Jarrous
WRN helicase has several roles in genome maintenance, such as replication, base excision repair, recombination, DNA damage response and transcription. These processes are often found upregulated in human cancers, many of which display increased levels of WRN. Therefore, directed inhibition of this RecQ helicase could be beneficial to selective cancer therapy. Inhibition of WRN is feasible by the use of small-molecule inhibitors or application of RNA interference and EGS/RNase P targeting systems. Remarkably, helicase depletion leads to a severe reduction in cell viability due to mitotic catastrophe, which is triggered by replication stress induced by DNA repair failure and fork progression arrest. Moreover, we present new evidence that WRN depletion results in early changes of RNA polymerase III and RNase P activities, thereby implicating chromatin-associated tRNA enzymes in WRN-related stress response. Combined with the recently discovered roles of RecQ helicases in cancer, current data support the targeting prospect of these genome guardians, as a means of developing clinical phases aimed at diminishing adaptive resistance to present targeted therapies.



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‘The Song Inside:’ ‘La Canción por Dentro’: Individual and Dyadic Impact of Breast Cancer for Caregivers of Latina Survivors

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“Facing spousal cancer during child-rearing years: the short-term effects of the Cancer-PEPSONE programme - a single-center randomized controlled trial.”

Abstract

Objective

To measure the short-term effects of the Cancer-PEPSONE programme (CPP) on the partners' received and perceived social support, psychological distress and quality of life (QOL), as well as explore the role of received social support as a mediator of the intervention effects.

Methods

Open single-center randomized controlled trial, trial number 15982171(ISRCTN). Eligible participants were partners of cancer patients who were concomitantly caring for minors (the well parents). The sample consisted of 35 participants randomly allocated to receive either intervention (n = 17) or support as usual (n = 18). At the three-month follow-up (approximately one month after intervention), 24 continued to participate (intervention n = 13, control n = 11). The intervention group selected supporters to participate in CPP (N = 130). Data were obtained using validated questionnaires.

Results

The multivariate analysis of covariance revealed significant intervention effects (p = .03, η²_p = 0.42), with main effects on received and perceived social support. A mediational analysis suggested that CPP may have indirect effects on QOL through received social support.

Conclusions

Even though the long-term effects are yet to be studied, CPP seems to increase social support for the well parents short-term, which in turn may improve their quality of life. Given the study's low sample size, further replications in larger samples are required.

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via IFTTT

‘The Song Inside:’ ‘La Canción por Dentro’: Individual and Dyadic Impact of Breast Cancer for Caregivers of Latina Survivors

http://ift.tt/2gNrn1d

“Facing spousal cancer during child-rearing years: the short-term effects of the Cancer-PEPSONE programme - a single-center randomized controlled trial.”

Abstract

Objective

To measure the short-term effects of the Cancer-PEPSONE programme (CPP) on the partners' received and perceived social support, psychological distress and quality of life (QOL), as well as explore the role of received social support as a mediator of the intervention effects.

Methods

Open single-center randomized controlled trial, trial number 15982171(ISRCTN). Eligible participants were partners of cancer patients who were concomitantly caring for minors (the well parents). The sample consisted of 35 participants randomly allocated to receive either intervention (n = 17) or support as usual (n = 18). At the three-month follow-up (approximately one month after intervention), 24 continued to participate (intervention n = 13, control n = 11). The intervention group selected supporters to participate in CPP (N = 130). Data were obtained using validated questionnaires.

Results

The multivariate analysis of covariance revealed significant intervention effects (p = .03, η²_p = 0.42), with main effects on received and perceived social support. A mediational analysis suggested that CPP may have indirect effects on QOL through received social support.

Conclusions

Even though the long-term effects are yet to be studied, CPP seems to increase social support for the well parents short-term, which in turn may improve their quality of life. Given the study's low sample size, further replications in larger samples are required.

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Abnormal heavy/light chain ratio after treatment is associated with shorter survival in patients with IgA myeloma

Abstract

Immunoglobulin (Ig) heavy/light chain (HLC) assays enable the separate quantification of the different light chain types of each Ig class. We retrospectively analyzed the correlation of heavy/light chain ratio (HLCR) with clinical status and its impact on outcome in 120 patients with multiple myeloma (MM). Abnormal HLCR was seen more frequently in patients with poorer myeloma response, and it appeared to be more sensitive for detecting clonality in IgA myeloma compared to IgG myeloma after treatment. Among the 85 patients who achieved ≥VGPR, the patients remained HLCR abnormal were showed significantly shorter overall survival (OS) compared to those achieving a normal HLCR (not reached vs. 55.5 months, P = 0.032). This correlation was seen in IgA myeloma patients (not reached vs. 30.1 months, P = 0.014), but not in IgG myeloma patients when patients were analysed separately. Univariate and multivariate analysis of factors that may affect survival identified abnormal HLCR at the best response as the only independent risk factor (hazard ratio, 4.7; 95% confidence interval, 1.4 – 15.26; P = 0.012) for shorter OS in this subset of patients. This study highlighted the HLC assay as a prognostic predictor in patients with IgA myeloma.

This article is protected by copyright. All rights reserved.

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