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Living with Metastatic Cancer: A Roadmap for Future Research. Cancers (Basel) 2020; 12:cancers12123684. [PMID: 33302472 PMCID: PMC7763639 DOI: 10.3390/cancers12123684] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/03/2020] [Accepted: 12/05/2020] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Although people with metastatic cancer are living longer with their disease, they are faced with challenges that can interfere with their quality of life. These challenges include worsening disease, survival time, symptoms, distress, and financial problems. The aim of this review paper is to describe a framework to guide future efforts to address these challenges. The framework includes the risk factors (predisposing factors), triggers (precipitating factors), and responses (perpetuating factors) that contribute to the onset and maintenance of problems in living with metastatic cancer. We conclude by suggesting areas for future work to prevent problems, manage triggers, and reduce unhelpful responses. Abstract Living with metastatic cancer, or metavivorship, differs from cancer survivorship and has changed as novel treatments have increased survival time. The purpose of this narrative review is to describe factors that impact challenges in metavivorship within a conceptual framework to guide future research. This review focuses on the specific metavivorship outcomes of progressive disease, survival time, symptoms, distress, financial toxicity, and quality of life. We describe the predisposing, precipitating, and perpetuating (3P) model of metavivorship. Understanding the biological, psychological, and social 3P factors that contribute to the development and maintenance of challenges in metavivorship provides a roadmap for future research. Implications of this model include prevention by targeting predisposing factors, management of precipitating factors after onset of metastatic disease, and treatment of perpetuating factors to reduce symptoms and improve quality of life during the chronic phase of metavivorship. This can be accomplished through biopsychosocial screening efforts, monitoring of patient-reported outcomes, education and communication interventions, interdisciplinary symptom management, advance care planning, and behavioral interventions to cultivate psychological resilience.
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302
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Zwas DR, Keren A, Amir O, Gotsman I. Treatment of Heart Failure Patients with Anxiolytics Is Associated with Adverse Outcomes, with and without Depression. J Clin Med 2020; 9:jcm9123967. [PMID: 33297471 PMCID: PMC7762354 DOI: 10.3390/jcm9123967] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/26/2020] [Accepted: 12/03/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Few studies have evaluated the effect of pharmacologic treatment of anxiety on outcomes in heart failure (HF) patients. This study examined the impact of treatment with anxiolytics on clinical outcomes in a real-world sample of HF patients with and without depression. METHODS Patients diagnosed with HF were retrieved from a large HMO database. Patients prescribed anxiolytic medication and patients diagnosed with depression and/or prescribed anti-depressant medication were followed for cardiac-related hospitalizations and death. RESULTS The study cohort included 6293 HF patients. Treatment with anxiolytics was associated with decreased one-year survival compared to untreated individuals, with a greater reduction in survival seen in patients diagnosed with depression and/or treated with anti-depressants. Multi-variable analysis adjusting for age, sex, NYHA class, cardiac risk factors and laboratory parameters found that treatment with anxiolytics remained a predictor of mortality even when adjusting for depression. Depression combined with anxiolytic treatment was predictive of increased mortality, and treatment with anxiolytics alone, depression alone and anxiolytic treatment together with depression were each associated with an increased hazard ratio for a composite outcome of death and hospitalization. CONCLUSIONS In this real-world study of HF patients, both treatment with anxiolytics and depression were associated with increased mortality, and anxiolytic therapy remained a predictor of mortality when adjusting for depression. Treatment of anxiety together with depression was associated with the highest risk of mortality. Safe and effective treatment for anxiety and depression is warranted to alleviate the detrimental impact of these disorders on quality and of life and adverse events.
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Affiliation(s)
- Donna R. Zwas
- Heart Institute, Hadassah University Hospital, Jerusalem 91120, Israel; (A.K.); (O.A.); (I.G.)
- Heart Failure Center, Clalit Health Services, Tel Aviv 16250, Israel
- Correspondence: ; Tel.: +972-2-6776564; Fax: +972-2- 6411028
| | - Andre Keren
- Heart Institute, Hadassah University Hospital, Jerusalem 91120, Israel; (A.K.); (O.A.); (I.G.)
- Heart Failure Center, Clalit Health Services, Tel Aviv 16250, Israel
| | - Offer Amir
- Heart Institute, Hadassah University Hospital, Jerusalem 91120, Israel; (A.K.); (O.A.); (I.G.)
| | - Israel Gotsman
- Heart Institute, Hadassah University Hospital, Jerusalem 91120, Israel; (A.K.); (O.A.); (I.G.)
- Heart Failure Center, Clalit Health Services, Tel Aviv 16250, Israel
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303
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Li Q, Miao Y, Zeng X, Tarimo CS, Wu C, Wu J. Prevalence and factors for anxiety during the coronavirus disease 2019 (COVID-19) epidemic among the teachers in China. J Affect Disord 2020; 277:153-158. [PMID: 32828002 PMCID: PMC7425543 DOI: 10.1016/j.jad.2020.08.017] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/02/2020] [Accepted: 08/05/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To assess the prevalence of anxiety and explore its factors during the Coronavirus Disease 2019 (COVID-19) epidemic among the teachers in China. METHODS We involved 88611 teachers (response rate: 94.75%) from three cities of Henan Province, China, during February 4, 2020 and February 12, 2020. Anxiety was assessed by using Generalized Anxiety Disorder tool (GAD-7). Odds ratios (OR) with 95% Confidence intervals (CI) for potential factors of anxiety were estimated using multiple logistic regression models. RESULTS The overall prevalence of anxiety was 13.67%. The prevalence was higher for women than men (13.89% vs. 12.93%). The highest prevalence of anxiety was 14.06% (SE 2.51%) with age of 60 to 100 years in men, and 14.70% (SE 0.56%) with age of 50 to 60 years in women. Participants located in country-level city school had the lowest prevalence of anxiety across all age categories (12.01% for age of 18-30 years; 12.50% for age of 30-40 years; 12.13% for age of 40-50 years; 9.52% for age of 60-100 years). After adjusting for potential confounders, age, sex, education status, type of teachers, school location, information source, worried level, fear level, and behavior status were found to be associated with anxiety. CONCLUSIONS This large-scale study assessed the prevalence of anxiety in teachers, as well as its potential influence of factors, which is useful for international and national decision-makers.
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Affiliation(s)
- Quanman Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100, Science Avenue, Gaoxin District, Zhengzhou, Henan 450001, P R China
| | - Yudong Miao
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan, P R China
| | - Xin Zeng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100, Science Avenue, Gaoxin District, Zhengzhou, Henan 450001, P R China
| | - Clifford Silver Tarimo
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100, Science Avenue, Gaoxin District, Zhengzhou, Henan 450001, P R China
| | - Cuiping Wu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100, Science Avenue, Gaoxin District, Zhengzhou, Henan 450001, P R China
| | - Jian Wu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100, Science Avenue, Gaoxin District, Zhengzhou, Henan 450001, P R China.
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McLoughlin GM, Wiedenman EM, Gehlert S, Brownson RC. Looking beyond the Lamppost: Population-Level Primary Prevention of Breast Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8720. [PMID: 33255309 PMCID: PMC7727708 DOI: 10.3390/ijerph17238720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/06/2020] [Accepted: 11/18/2020] [Indexed: 12/15/2022]
Abstract
Although innovative and impactful interventions are necessary for the primary prevention of breast cancer, the factors influencing program adoption, implementation, and sustainment are key, yet remain poorly understood. Insufficient attention has been paid to the primary prevention of breast cancer in state and national cancer plans, limiting the impact of evidence-based interventions on population health. This commentary highlights the state of primary prevention of breast cancer and gaps in the current literature. As a way to enhance the reach and adoption of cancer prevention policies and programs, the utility of dissemination and implementation (D&I) science is highlighted. Examples of how D&I could be applied to study policies and programs for chronic disease prevention are described, in addition to needs for future research. Through application of D&I science and a strong focus on health equity, a clearer understanding of contextual factors influencing the success of prevention programs will be achieved, ultimately impacting population health.
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Affiliation(s)
- Gabriella M. McLoughlin
- Implementation Science Center for Cancer Control and Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA; (E.M.W.); (R.C.B.)
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Eric M. Wiedenman
- Implementation Science Center for Cancer Control and Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA; (E.M.W.); (R.C.B.)
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Sarah Gehlert
- Suzanne Dworak-Peck School of Social Work, the University of Southern California, Los Angeles, CA 90089, USA;
- Desmond Lee Professor of Racial and Ethnic Diversity, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA
| | - Ross C. Brownson
- Implementation Science Center for Cancer Control and Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA; (E.M.W.); (R.C.B.)
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO 63110, USA
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305
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Zhu J, Zhou Y, Ma S, Chen R, Xie S, Liu Z, Li X, Wei W. The association between anxiety and esophageal cancer: A nationwide population-based study. Psychooncology 2020; 30:321-330. [PMID: 33098157 DOI: 10.1002/pon.5580] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 10/06/2020] [Accepted: 10/18/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Research on generalized anxiety disorder (GAD) and its association with esophageal cancer (EC) is sparse. The study aimed to explore the association between GAD and EC. METHODS A multicenter, population-based study in high-risk regions for EC (ECHRRs) was conducted from 2017 to 2019. All participants received free endoscopy screening. If the esophageal endoscopy results were suspicious, the pathological biopsy was performed to confirm normal, esophagitis, low-grade intraepithelial neoplasia (LGIN), high-grade intraepithelial neoplasia (HGIN), and EC. Information on participants' exposure to risk factors was collected. GAD was assessed with Generalized Anxiety Disorder Scale-7. RESULTS With esophageal endoscopy, 25,650 participants in ECHRRs were examined, 9586 of whom were suspicious and confirmed by esophageal pathology. The detection rate of EC and precancerous lesions was 6.83% (1751/25,650), with 1377 LGIN (5.37%), 272 HGIN (1.06%), and 102 EC (0.40%) cases. The overall mean GAD score (95% CI) and prevalence among 25,650 participants with endoscopy were 1.96 (1.93-1.99) and 16.90%, respectively. The mean GAD score and prevalence among 9586 participants with pathology were 1.96 (1.91-2.02) and 17.98%, respectively. The mean GAD scores of patients confirmed with normal, esophagitis, LGIN, HGIN, and EC were 1.73 (1.62-1.85), 1.91 (1.85-1.97), 1.94 (1.80-2.08), 3.98 (3.73-4.23). and 2.97 (2.49-3.45), respectively (p < 0.001). The corresponding prevalence of GAD were 5.21%, 18.72%, 17.72%, 43.75%, and 36.27%, respectively (p < 0.001). The age- and gender-adjusted odds ratios (ORs) between GAD and each esophageal lesion type were 1.02 (0.99-1.04), 1.01 (0.98-1.04), 1.27 (1.21-1.33), and 1.16 (1.08-1.24), respectively. The ORs (95% CIs) of the positive associations were 1.08 (1.05-1.12), 1.03 (0.99-1.07), 1.35 (1.29-1.42), and 1.19 (1.10-1.29) after further adjustment for potential confounders (all p < 0.001). Sensitivity analysis showed that the positive association persisted. CONCLUSIONS GAD was significantly higher in patients with EC and precancerous lesions. Focusing on and alleviating anxiety in high-risk groups (including patients with HGIN and EC) may be an effective strategy for EC prevention and control. Further prospective studies are warranted to validate the results.
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Affiliation(s)
- Juan Zhu
- Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, People's Republic of China
| | - Yueyue Zhou
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Shanrui Ma
- Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, People's Republic of China
| | - Ru Chen
- Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, People's Republic of China
| | - Shuanghua Xie
- Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, People's Republic of China
| | - Zhengkui Liu
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Xinqing Li
- Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, People's Republic of China
| | - Wenqiang Wei
- Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, People's Republic of China
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306
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Different independent associations of depression and anxiety with survival in patients with cancer. J Psychosom Res 2020; 138:110218. [PMID: 32911441 PMCID: PMC7614809 DOI: 10.1016/j.jpsychores.2020.110218] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/03/2020] [Accepted: 08/12/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Depression and anxiety have both been reported to predict worse subsequent survival in people with cancer. However, depression and anxiety are mutually associated and we lack understanding of their independent associations with survival. We therefore aimed to investigate these in a large sample of patients with common cancers. METHODS We analysed data on 19,966 patients with common cancers (breast, colorectal, gynaecological, lung and prostate) who had attended specialist NHS outpatient clinics in Scotland, UK. Hospital Anxiety and Depression Scale (HADS) data were linked with demographic, cancer and mortality data. We estimated the independent associations of depression (HADS depression score) and anxiety (HADS anxiety score) with survival by fitting (separately for each cancer) Cox proportional hazards models which incorporated cubic splines to allow for non-linear associations. We also adjusted for potential confounders. RESULTS The median time from HADS completion to death or censoring was 1.9 years. Greater depression was found to be strongly associated with worse survival from all cancers. When adjusted for anxiety, this association remained in males and increased in females. Greater anxiety was also associated with worse survival in nearly all cancers. However, when adjusted for depression, the association of anxiety with worse survival was lost. In females the association reversed direction so that greater anxiety was associated with better survival. CONCLUSION Although often considered together as aspects of 'emotional distress', depression and anxiety have different independent associations with survival in patients with cancer and should therefore be considered separately.
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307
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Chen X, Kong J, Diao X, Cai J, Zheng J, Xie W, Qin H, Huang J, Lin T. Depression and prostate cancer risk: A Mendelian randomization study. Cancer Med 2020; 9:9160-9167. [PMID: 33027558 PMCID: PMC7724297 DOI: 10.1002/cam4.3493] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 09/14/2020] [Indexed: 01/22/2023] Open
Abstract
Background The association between depression and prostate carcinogenesis has been reported in observational studies but the causality from depression on prostate cancer (PCa) remained unknown. We aimed to assess the causal effect of depression on PCa using the two‐sample Mendelian randomization (MR) method. Methods Two sets of genetics instruments were used for analysis, derived from publicly available genetic summary data. One was 44 single‐nucleotide polymorphisms (SNPs) robustly associated with major depressive disorder (MDD) and the other was two SNPs related with depressive status as ever depressed for a whole week. Inverse‐variance weighted method, weighted median method, MR‐Egger regression, MR Pleiotropy RESidual Sum, and Outlier test were used for MR analyses. Results No evidence for an effect of MDD on PCa risk was found in inverse‐variance weighted (OR: 1.12, 95% CI: 0.97‐1.30, p = 0.135), MR‐Egger (OR 0.89, 95% CI: 0.29‐2.68, p = 0.833), and weighted median (OR: 1.08, 95% CI: 0.92‐1.27, p = 0.350). Also, no strong evidence for an effect of depressive status on PCa incidence was found using the inverse‐variance weighted method (OR 0.72, 95% CI: 0.35‐1.47, p = 0.364). Conclusions The large MR analysis indicated that depression may not be causally associated with a risk of PCa.
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Affiliation(s)
- Xiong Chen
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P. R. China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P. R. China
| | - Jianqiu Kong
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P. R. China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P. R. China
| | - Xiayao Diao
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P. R. China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P. R. China
| | - Jiahao Cai
- Department of Neurology, Sun Yat-sen Memorial Hospital, Guangzhou, P. R. China
| | - Junjiong Zheng
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P. R. China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P. R. China
| | - Weibin Xie
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P. R. China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P. R. China
| | - Haide Qin
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P. R. China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P. R. China
| | - Jian Huang
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P. R. China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P. R. China
| | - Tianxin Lin
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P. R. China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P. R. China
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308
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Weilandt J, Diehl K, Schaarschmidt ML, Kiecker F, Sasama B, Pronk M, Ohletz J, Könnecke A, Müller V, Utikal J, Hillen U, Harth W, Peitsch WK. Patient preferences for treatment of advanced melanoma: impact of comorbidities. J Dtsch Dermatol Ges 2020; 19:58-70. [PMID: 33015933 DOI: 10.1111/ddg.14293] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 06/15/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Choice of treatment for advanced melanoma is crucially influenced by comorbidities and patient preferences. Our study aimed to investigate the impact of comorbidities on preferences. PATIENTS AND METHODS 150 patients with melanoma stage IIC-IV completed a discrete choice experiment to determine preferences for outcome (overall response rate [ORR], 2-year survival, progression-free survival [PFS], time to response [TTR], kind of adverse events [AE], AE-related treatment discontinuation) and process attributes (frequency and route of administration [RoA], frequency of consultations) of systemic melanoma treatments. The impact of comorbidities was assessed by analysis of variance and multivariate regression. RESULTS Participants with hypertension and other cardiovascular diseases attached significantly greater importance to TTR and RoA than others. Respondents with arthropathy cared more about TTR (β = 0.179, P = 0.047) and RoA, but less about ORR (β = -0.209, P = 0.021). Individuals with diabetes considered AE (β = 0.185, P = 0.039) and frequency of consultations more essential, but ORR less relevant. Those with other malignancies were particularly worried about treatment discontinuation (β = 0.219, P = 0.008), but less about ORR (β = -0.202, P = 0.015). Participants with depression focused more on PFS (β = 0.201, P = 0.025) and less on TTR (β = -0.201, P = 0.023) and RoA (β = -0.167, P = 0.050). CONCLUSIONS Treatment preferences of melanoma patients vary significantly dependent on comorbidities.
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Affiliation(s)
- Juliane Weilandt
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Katharina Diehl
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marthe-Lisa Schaarschmidt
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Felix Kiecker
- Department of Dermatology, Venereology und Allergology, Charité University Medicine Berlin, Berlin, Germany.,Department of Dermatology and Venereology, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Bianca Sasama
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Melanie Pronk
- Department of Dermatology and Allergology, Vivantes Klinikum Spandau, Berlin, Germany
| | - Jan Ohletz
- Department of Dermatology and Allergology, Vivantes Klinikum Spandau, Berlin, Germany
| | - Andreas Könnecke
- Department of Dermatology and Venereology, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Verena Müller
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany.,Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jochen Utikal
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany.,Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Uwe Hillen
- Department of Dermatology and Venereology, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Wolfgang Harth
- Department of Dermatology and Allergology, Vivantes Klinikum Spandau, Berlin, Germany
| | - Wiebke K Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
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309
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Xiao Z, Liu C, Duan J, Zhou T, Liu X, Lu S, Yang Z, Xu F. Pharmacological Targets and Active Components of Gastrodiae rhizoma Against Depression: Findings of Network Pharmacology. INT J PHARMACOL 2020. [DOI: 10.3923/ijp.2020.500.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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310
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Agyapong VIO, Hrabok M, Shalaby R, Mrklas K, Vuong W, Gusnowski A, Surood S, Greenshaw AJ, Nkire N. Closing the COVID-19 Psychological Treatment Gap for Cancer Patients in Alberta: Protocol for the Implementation and Evaluation of Text4Hope-Cancer Care. JMIR Res Protoc 2020; 9:e20240. [PMID: 32750012 PMCID: PMC7450377 DOI: 10.2196/20240] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/14/2020] [Accepted: 07/26/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Cancer diagnoses and treatments usually engender significant anxiety and depressive symptoms in patients, close relatives, and caregivers. Providing psychological support during the coronavirus disease (COVID-19) pandemic presents additional challenges due to self-isolation and social or physical distancing measures in place to limit viral spread. This protocol describes the use of text messaging (Text4Hope-Cancer Care) as a convenient, cost-effective, and accessible population-level mental health intervention. As demonstrated in previous research, this evidence-based program supports good outcomes and high user satisfaction. OBJECTIVE We will implement daily supportive text messaging as a way of reducing and managing anxiety and depression related to cancer diagnosis and treatment in Alberta, Canada. Prevalence of anxiety and depressive symptoms, their demographic correlates, and Text4Hope-Cancer Care-induced changes in anxiety and depression will be evaluated. METHODS Alberta residents with a cancer diagnosis and the close relatives of those dealing with a cancer diagnosis can self-subscribe to the Text4Hope-Cancer Care program by texting "CancerCare" to a dedicated text number. Self-administered, anonymous, online questionnaires will be used to assess anxiety and depressive symptoms using the Hospital Anxiety and Depression Scale (HADS). Data will be collected at onset from individuals receiving text messages, and at the mid- and endpoints of the program (ie, at 6 and 12 weeks, respectively). Data will be analyzed with parametric and nonparametric statistics for primary outcomes (ie, anxiety and depressive symptoms) and usage metrics, including the number of subscribers and user satisfaction. In addition, data mining and machine learning analysis will focus on determining subscriber characteristics that predict high levels of symptoms of mental disorders, and may subsequently predict changes in those measures in response to the Text4Hope-Cancer Care program. RESULTS The first research stage, which was completed in April 2020, involved the creation and review of the supportive text messages and uploading of messages into a web-based text messaging service. The second stage, involving the launch of the Text4Hope-Cancer Care program, occurred in May 2020. CONCLUSIONS Text4Hope-Cancer Care has the potential to provide key information regarding the prevalence rates of anxiety and depressive symptoms in patients diagnosed or receiving care for cancer and their caregivers. The study will generate demographic correlates of anxiety and depression, and outcome data related to this scalable, population-level intervention. Information from this study will be valuable for health care practitioners working in cancer care and may help inform policy and decision making regarding psychological interventions for cancer care. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/20240.
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Affiliation(s)
- Vincent Israel Opoku Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Marianne Hrabok
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Reham Shalaby
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Kelly Mrklas
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Edmonton, AB, Canada
- Strategic Clinical Networks, Provincial Clinical Excellence, Alberta Health Services, Calgary, AB, Canada
| | - Wesley Vuong
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - April Gusnowski
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Shireen Surood
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Andrew James Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- APEC Digital Hub for Mental Health, Edmonton, AB, Canada
| | - Nnamdi Nkire
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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311
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Akechi T, Mishiro I, Fujimoto S, Murase K. Risk of major depressive disorder in Japanese cancer patients: A matched cohort study using employer-based health insurance claims data. Psychooncology 2020; 29:1686-1694. [PMID: 32779276 PMCID: PMC7589376 DOI: 10.1002/pon.5509] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 07/02/2020] [Accepted: 08/03/2020] [Indexed: 01/17/2023]
Abstract
Objective Patients with cancer are at high risk of depression. However, the risk of major depressive disorder (MDD) after cancer diagnosis has not been studied in a population setting in Japan. This cohort study used a Japanese medical claims database to examine time to MDD in cancer patients and the risk of MDD (hazard ratio; HR) compared with matched cancer‐free controls. Methods Primary endpoint was time to MDD (starting 6 months before cancer diagnosis) in adult (18–74 years) cancer patients; secondary endpoint was time to MDD (6 months before to 12 months after cancer diagnosis) in a matched cohort of cancer patients and cancer‐free controls. Multivariate analyses were performed to determine HRs for all cancers and for each cancer site. Results Of 35 008 cancer patients (mean age, 53.3 years), 2201 (6.3%) were diagnosed with MDD within 66 months. Matched cancer patients (n = 30 372) had an elevated risk of MDD compared with cancer‐free controls (n = 303 720; HR [95% confidence interval] 2.96 [2.77–3.16]). MDD risk was highest in patients with multiple cancers, pancreatic cancer, and brain cancer. Compared with middle‐aged patients, risk was higher in patients <40 years old and lower in patients ≥65 years old; risk tended to be higher in women than in men. Conclusions Compared with cancer‐free individuals, Japanese patients with cancer, mostly <65 years old, had an almost threefold higher risk of developing MDD within 12 months of cancer diagnosis. Physicians should watch for MDD in cancer patients and treat when necessary.
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Affiliation(s)
- Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Izumi Mishiro
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Shinji Fujimoto
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Katsuhito Murase
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
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312
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Licinio J, Wong ML. Molecular Psychiatry, August 2020: new impact factor, and highlights of recent advances in psychiatry, including an overview of the brain's response to stress during infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Mol Psychiatry 2020; 25:1606-1610. [PMID: 32724165 PMCID: PMC7385469 DOI: 10.1038/s41380-020-0845-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/10/2020] [Accepted: 07/10/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Julio Licinio
- State University of New York, Upstate Medical University, Syracuse, NY, 13210, USA.
| | - Ma-Li Wong
- State University of New York, Upstate Medical University, Syracuse, NY, 13210, USA
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313
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Licinio J, Wong ML. Advances in depression research: second special issue, 2020, with highlights on biological mechanisms, clinical features, co-morbidity, genetics, imaging, and treatment. Mol Psychiatry 2020; 25:1356-1360. [PMID: 32555341 DOI: 10.1038/s41380-020-0798-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Julio Licinio
- State University of New York, Upstate Medical University, Syracuse, NY, 13210, USA.
| | - Ma-Li Wong
- State University of New York, Upstate Medical University, Syracuse, NY, 13210, USA
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314
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Kaur A, Garg S, Shiekh BA, Singh N, Singh P, Bhatti R. In Silico Studies and In Vivo MAO A Inhibitory Activity of Coumarins Isolated from Angelica archangelica Extract: An Approach toward Antidepressant Activity. ACS OMEGA 2020; 5:15069-15076. [PMID: 32637779 PMCID: PMC7330908 DOI: 10.1021/acsomega.0c00887] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/02/2020] [Indexed: 05/08/2023]
Abstract
The current investigation was aimed at in vivo MAOA inhibitory activity of coumarins angelicin, bergapten, and scopoletin isolated from the roots of Angelica archangelica. The isolated compounds were screened for MAOA (pdb ID 2Z5y) binding through molecular docking studies. The molecular docking results displayed that bergapten has a maximum affinity for MAOA, followed by angelicin and scopoletin. In silico prediction of physicochemical parameters indicated that maximum blood-brain barrier (BBB) permeability was observed with angelicin (2.3), followed by bergapten (2.0) and least with scopoletin (0.644). In consonance to the results of molecular docking studies, appreciable in vivo antidepressant activity of angelicin and bergaptan was observed over the mouse model of reserpine-induced depression. The modulation of MAOA in the antidepressant effect of extract and its isolated fractions was also determined. Biochemical examination of the brain tissue indicated that bergapten has maximum MAOA inhibitory activity while scopoletin fails to inhibit brain MAOA.
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Affiliation(s)
- Anudeep Kaur
- Department
of Pharmaceutical Sciences, Guru Nanak Dev
University, Amritsar 143005, India
| | - Saweta Garg
- Department
of Pharmaceutical Sciences, Guru Nanak Dev
University, Amritsar 143005, India
| | - Bilal Ahmad Shiekh
- Department
of Chemistry, Guru Nanak Dev University, Amritsar 143005, India
| | - Nirmal Singh
- Department
of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala 147002, India
| | - Palwinder Singh
- Department
of Chemistry, Guru Nanak Dev University, Amritsar 143005, India
| | - Rajbir Bhatti
- Department
of Pharmaceutical Sciences, Guru Nanak Dev
University, Amritsar 143005, India
- . Phone: 0183-2258802-9, ext. 3543. Cell: 09417278858
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315
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Ye J, Wen Y, Chu X, Li P, Cheng B, Cheng S, Liu L, Zhang L, Ma M, Qi X, Liang C, Kafle OP, Jia Y, Wu C, Wang S, Wang X, Ning Y, Zhang F. Association between herpes simplex virus 1 exposure and the risk of depression in UK Biobank. Clin Transl Med 2020; 10:e108. [PMID: 32564518 PMCID: PMC7403656 DOI: 10.1002/ctm2.108] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Herpes simplex virus-1 (HSV-1) infection is reported to be associated with depression. But limited efforts were made to investigate the relationship between HSV-1 infection and the risk of depression, especially from the genetic perspective. METHODS In UK Biobank cohort, linear and logistic regression analyses were first performed to test the association of HSV-1 seropositivity/antibody with depression, including depression status (N = 2951) and Patient Health Questionnaire (PHQ) score (N = 2839). Using individual genotypic and phenotypic data from the UK Biobank, genome-wide environmental interaction study (GWEIS) was then conducted by PLINK2.0 to evaluate gene × HSV-1 interacting effect on the risk of depression. Finally, gene set enrichment analysis was conducted to identify the biological pathways involved in the observed gene × HSV-1 interaction for depression. RESULT In UK Biobank cohort, significant associations were observed between depression status and HSV-1 (odds ratio [OR] = 1.09; 95% confidence interval [CI], 1.02-1.16; P = 2.40 × 10-2 for HSV-1 antibody and OR = 1.28; 95% CI, 1.12-1.47, P = 2.59 × 10-3 for HSV-1 seropositivity). GWEIS revealed four significant gene × HSV-1 interaction signals for PHQ score (all P < 5.0 × 10-8 ) and the leading loci was SULF2 (rs6094791, P = 8.60 × 10-9 ). Pathway analyses identified 21 pathways for PHQ score and 19 for depression status, including multiple neural development- and immune-related ones, such as KEGG_NEUROACTIVE_LIGAND_RECEPTOR_INTERACTION (false discovery rate [FDR] = 3.18 × 10-2 ) for depression and LU_AGING_BRAIN_UP (FDR = 4.21 × 10-2 ) for PHQ score. CONCLUSION Our results suggested that HSV-1 was associated with the risk of depression, which was modulated by the several genes that were related to the nerve development or immune function.
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Affiliation(s)
- Jing Ye
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Xiaomeng Chu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Ping Li
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Bolun Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Shiqiang Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Li Liu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Lu Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Mei Ma
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Xin Qi
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Chujun Liang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Om Prakash Kafle
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yumeng Jia
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Cuiyan Wu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Sen Wang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Xi Wang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yujie Ning
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
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Liu YC, Chen VCH, Lu ML, Lee MJ, McIntyre RS, Majeed A, Lee Y, Chen YL. The Association between Selective Serotonin Reuptake Inhibitors (SSRIs) Use and the Risk of Bladder Cancer: A Nationwide Population-Based Cohort Study. Cancers (Basel) 2020; 12:cancers12051184. [PMID: 32392848 PMCID: PMC7281365 DOI: 10.3390/cancers12051184] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 02/01/2023] Open
Abstract
Background: Past studies suggest mixed associations between selective serotonin reuptake inhibitor (SSRI) prescription and carcinogenic risk. There is no epidemiological study reporting on the association between SSRI use and the incidence of bladder cancer. The aim of this study is to determine whether SSRI use influences the risk of bladder cancer. Methods: We conducted a nationwide retrospective cohort study by Taiwan’s National Health Insurance Research Database from January 1, 1997 to December 31, 2013. 192,392 SSRI prescribed individuals were randomly matched 1 to 1 with 191,786 individuals who had never received any SSRIs by propensity scores match. The Cox Proportional Hazard models were conducted to examine the risk of bladder cancer between individuals prescribed SSRIs and individuals not prescribed SSRIs. Results: SSRIs were associated with significant reduced risk of bladder cancer with 0.5, 1, and 2 year induction periods (adjusted hazard ratio (aHR) = 0.86, 95% CI (confidence interval) = 0.76–0.98, aHR = 0.85, 95% CI = 0.75–0.97, and aHR = 0.77, 95% CI = 0.66–0.89). When examining the effect of specific SSRI, there was significantly lower risk of bladder cancer in individuals prescribed fluoxetine (6 month induction period: aHR = 0.78, 95% CI = 0.65–0.93; 1 year induction period: aHR = 0.78, 95% CI = 0.65–0.94; 2 year induction period: aHR = 0.73, 95% CI = 0.60–0.89), paroxetine (6 month induction period: aHR = 0.78, 95% CI = 0.61–0.99; 1 year induction period: aHR = 0.79, 95% CI = 0.61–1.01; 2 year induction period: aHR = 0.72, 95% CI = 0.54–0.95), and citalopram (6 month induction period: aHR = 0.74, 95% CI = 0.53–1.03; 1 year induction period: aHR = 0.70, 95% CI = 0.50–0.99; 2 year induction period: aHR = 0.60, 95% CI = 0.41–0.88). Conclusions: Individuals prescribed fluoxetine, paroxetine, or citalopram had a reduced risk of bladder cancer in this large, cross-national database.
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Affiliation(s)
- Yi-Chun Liu
- Taichung Hospital, Ministry of Health and Welfare, Taichung 40343, Taiwan;
| | - Vincent Chin-Hung Chen
- School of Medicine, Chang Gung University, Tauyuan 33302, Taiwan; (V.C.-H.C.); (M.-J.L.)
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
| | - Mong-Liang Lu
- Department of Psychiatry, Wan Fang Hospital and School of Medicine, College of Medicine, Taipei Medical University, Taipei 11696, Taiwan;
| | - Min-Jing Lee
- School of Medicine, Chang Gung University, Tauyuan 33302, Taiwan; (V.C.-H.C.); (M.-J.L.)
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
| | - Roger S. McIntyre
- Department of Psychiatry, University of Toronto, Toronto 399, ON M5T 2S8, Canada;
| | - Amna Majeed
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto 399, ON M5T 2S8, Canada; (A.M.); (Y.L.)
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto 399, ON M5T 2S8, Canada; (A.M.); (Y.L.)
| | - Yi-Lung Chen
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan
- Department of Psychology, Asia University, Taichung 41354, Taiwan
- Correspondence: ; Tel.: +886-4-23323456 (ext. 20106); Fax: +886-4-23321206
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318
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Kawada T. Parkinson's disease and cancer incidence: A risk assessment. J Neurol Sci 2020; 412:116761. [DOI: 10.1016/j.jns.2020.116761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/18/2020] [Accepted: 02/23/2020] [Indexed: 11/28/2022]
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