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"Reich, Adam"
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Incidence of bone metastases in patients with solid tumors: analysis of oncology electronic medical records in the United States
Background
Bone metastases commonly occur in conjunction with solid tumors, and are associated with serious bone complications. Population-based estimates of bone metastasis incidence are limited, often based on autopsy data, and may not reflect current treatment patterns.
Methods
Electronic medical records (OSCER, Oncology Services Comprehensive Electronic Records, 569,000 patients, 52 US cancer centers) were used to identify patients ≥18 years with a solid tumor diagnosis recorded between 1/1/2004 and 12/31/2013, excluding patients with hematologic tumors or multiple primaries. Each patient’s index date was set to the date of his or her first solid tumor diagnosis in the selection period. Kaplan-Meier analyses were used to quantify the cumulative incidence of bone metastasis with follow-up for each patient from the index date to the earliest of the following events: last clinic visit in the OSCER database, occurrence of a new primary tumor or bone metastasis, end of study (12/31/2014). Incidence estimates and associated 95% confidence intervals (CI) are provided for up to 10 years of follow-up for all tumor types combined and stratified by tumor type and stage at diagnosis.
Results
Among 382,733 study patients (mean age 64 years; mean follow-up 940 days), breast (36%), lung (16), and colorectal (12%) tumors were most common. Mean time to bone metastasis was 400 days (1.1 years). Cumulative incidence of bone metastasis was 2.9% (2.9–3.0) at 30 days, 4.8% (4.7–4.8) at one year, 5.6% (5.5–5.6) at two years, 6.9% (6.8–7.0) at five years, and 8.4% (8.3–8.5) at ten years. Incidence varied substantially by tumor type with prostate cancer patients at highest risk (18% – 29%) followed by lung, renal or breast cancer. Cumulative incidence of bone metastasis increased by stage at diagnosis, with markedly higher incidence among patients diagnosed at Stage IV of whom11% had bone metastases diagnosed within 30 days.
Conclusions
These estimates of bone metastasis incidence represent the experience of a population with longer follow-up than previously published, and represent experience in the recent treatment landscape. Underestimation is possible given reliance on coded diagnoses but the clinical detail available in electronic medical records contributes to the accuracy of these estimates.
Journal Article
Stand up and sing! : Pete Seeger, folk music, and the path to justice
This book celebrates folk singer Pete Seeger--his life, his music, and his incredible activism.
BOOK
Contradictions in the Commodification of Hospital Care
The \"moralized markets\" school within economic sociology has convincingly demonstrated variation in the relationship between economic activity and moral values. Yet this scholarship has not sufficiently explored either the causes of this variation or the consequences of this variation for organizational practice. By examining different moral-market understandings and practices in the context of a single market-based organizational field, this article highlights the contradictory character of processes of commodification, as different historically institutionalized ideas conflict, in different ways, with the market logic that increasingly organizes the field as a whole. The article examines the contradictory commodification of hospital care in three hospitals within one Northern California community.
Journal Article
Fab four friends : the boys who became the Beatles
\"Told through a lyrical text and ... paintings, this book spotlights four ordinary boys growing up amid the rubble of postwar England who found music to be a powerful, even life-saving, force\"--Amazon.com.
Book
Generalized Pustular Psoriasis: Divergence of Innate and Adaptive Immunity
Generalized pustular psoriasis (GPP) is a severe, relapsing, immune-mediated disease characterized by the presence of multiple sterile pustules all over the body. The exact pathomechanisms behind GPP remain elusive, although increased interest in the genetic basis and immunological disturbances have provided some revealing insights into the underlying signaling pathways and their mutual interaction. The genetic background of GPP has been thoroughly investigated over the past few years. The conducted studies have identified genetic variants that predispose to pustular forms of psoriasis. The loss-of-function mutation of the interleukin 36 receptor antagonist gene, along with rare gain-of-function mutations in the gene that encodes the keratinocyte signaling molecule (CARD14), are examples of the uncovered abnormalities. Interleukin 36 (IL-36), along with neutrophils, is now considered a central cytokine in GPP pathogenesis, with IL-36 signaling providing a link between innate and adaptive immune responses. More recently, a new concept of inflammation, caused by a predominantly genetically determined abnormal activation of innate immune response and leading to inflammatory keratinization, has arisen. GPP is currently considered a representative of this novel group of skin conditions, called autoinflammatory keratinization diseases. As no therapeutic agents have been approved for GPP to date in the United States and Europe, the novel anti-IL-36R antibodies are particularly promising and may revolutionize management of the disease.
Journal Article
Trial of Nemolizumab in Moderate-to-Severe Prurigo Nodularis
In patients with prurigo nodularis, a severely pruritic skin disorder, the subcutaneously administered interleukin-31 receptor antibody nemolizumab was tested in a 12-week, phase 2 trial. The intensity of itching and overall severity of the disorder were more greatly reduced with nemolizumab than with placebo.
Journal Article
With God on our side : the struggle for Workers' Rights in a Catholic hospital
When unions undertake labor organizing campaigns, they often do so from strong moral positions, contrasting workers' rights to decent pay or better working conditions with the more venal financial motives of management. But how does labor confront management when management itself has moral legitimacy? In With God on Our Side , Adam D. Reich tells the story of a five-year campaign to unionize Santa Rosa Memorial Hospital, a Catholic hospital in California. Based on his own work as a volunteer organizer with the Service Employees International Union (SEIU), Reich explores how both union leaders and hospital leaders sought to show they were upholding the Catholic mission of the hospital against a market represented by the other. Ultimately, workers and union leaders were able to reinterpret Catholic values in ways that supported their efforts to organize.
More generally, Reich argues that unions must weave together economic and cultural power in order to ensure their continued relevancy in the postindustrial world. In addition to advocating for workers' economic interests, unions must engage with workers' emotional investments in their work, must contend with the kind of moral authority that Santa Rosa Hospital leaders exerted to dissuade workers from organizing, and must connect labor's project to broader conceptions of the public good.
eBook
Selling our souls
Health care costs make up nearly a fifth of U.S. gross domestic product, but health care is a peculiar thing to buy and sell. Both a scarce resource and a basic need, it involves physical and emotional vulnerability and at the same time it operates as big business. Patients have little choice but to trust those who provide them care, but even those providers confront a great deal of medical uncertainty about the services they offer.Selling Our Soulslooks at the contradictions inherent in one particular health care market-hospital care. Based on extensive interviews and observations across the three hospitals of one California city, the book explores the tensions embedded in the market for hospital care, how different hospitals manage these tensions, the historical trajectories driving disparities in contemporary hospital practice, and the perils and possibilities of various models of care.
As Adam Reich shows, the book's three featured hospitals could not be more different in background or contemporary practice. PubliCare was founded in the late nineteenth century as an almshouse in order to address the needs of the destitute. HolyCare was founded by an order of nuns in the mid-twentieth century, offering spiritual comfort to the paying patient. And GroupCare was founded in the late twentieth century to rationalize and economize care for middle-class patients and their employers. Reich explains how these legacies play out today in terms of the hospitals' different responses to similar market pressures, and the varieties of care that result.
Selling Our Soulsis an in-depth investigation into how hospital organizations and the people who work in them make sense of and respond to the modern health care market.
eBook
Skin-Related Sexual Life Questionnaire (SRSLQ): Creation and Validation of the Questionnaire
Background and Objectives: The assessment of sexual dysfunction among psoriatic patients still remains a great diagnostic difficulty due to its subjective and embarrassing character. Various questionnaires have been used to assess sexual dysfunctions associated with skin conditions; however, none of them have been approved as a gold standard. The aim of our study was to create and validate the Skin-Related Sexual Life Questionnaire (SRSLQ) for the assessment of possible sexual dysfunction and related psychological burdens in patients with skin diseases. Materials and Methods: A total of 109 patients, including 45 women and 64 men (1:1.4) suffering from psoriasis and aged between 18 and 73 years (mean 48.0 ± 13.4 years), were included in the study. All subjects completed the 11-item SRSLQ and the Dermatology Life Quality Index (DLQI). In addition, all men were asked to fulfil the five-item version of the International Index of Erectile Dysfunction (IIEF-5) at the time of examination and 7 days after enrollment. The disease severity was assessed via the PASI scale. Results: The statistical analysis of internal consistency of SRSLQ showed very good integrity, with a Cronbach α coefficient of 0.94. The reproducibility level assessed with intraclass correlation coefficient (ICC) amounted to 0.96. A significant correlation between the total score of the 11-item SRSDQ and the DLQI (r = 0.39; p < 0.001) was found, confirming congruent validity. Conclusions: The validated 11-item Skin-Related Sexual Life Questionnaire can be successfully implemented in daily clinical practice as well as in clinical research.
Journal Article