scholarly journals Documentation of infertility prevalence, treatment access and treatment outcomes in developing countries

2008 ◽  
Vol 2008 (1) ◽  
pp. 5-7 ◽  
Author(s):  
K. Nygren ◽  
F. Zegers-Hochschild
Keyword(s):  
Developing Countries ◽  
Treatment Outcomes ◽  
Treatment Access

scholarly journals Is AJCC/UICC Staging Still Appropriate for Head and Neck Cancers in Developing Countries?

OTO Open ◽  
2020 ◽  
Vol 4 (3) ◽  
pp. 2473974X2093831
Author(s):  
Johannes J. Fagan ◽  
Julie Wetter ◽  
Jeffrey Otiti ◽  
Joyce Aswani ◽  
Anna Konney ◽  
...  
Keyword(s):  
Developing Countries ◽  
Head And Neck ◽  
Treatment Outcomes ◽  
Cancer Patients ◽  
Oropharyngeal Cancer ◽  
Head And Neck Cancers ◽  
Anatomical Location ◽  
African Countries ◽  
International Union ◽  
Do So

By 2030, 70% of cancers will occur in developing countries. Head and neck cancers are primarily a developing world disease. While anatomical location and the extent of cancers are central to defining prognosis and staging, the American Joint Committee on Cancer (AJCC)/International Union Against Cancer (UICC) have incorporated nonanatomic factors that correlate with prognosis into staging (eg, p16 status of oropharyngeal cancers). However, 16 of 17 head and neck surgeons from 13 African countries cannot routinely test for p16 status and hence can no longer apply AJCC/UICC staging to oropharyngeal cancer. While the AJCC/UICC should continue to refine staging that best reflects treatment outcomes and prognosis by incorporating new nonanatomical factors, they should also retain and refine anatomically based staging to serve the needs of clinicians and their patients in resource-constrained settings. Not to do so would diminish their global relevance and in so doing also disadvantage most of the world’s cancer patients.

scholarly journals Hepatitis C Treatment Among People Who Use Drugs in an Office-Based Opioid Treatment Program Versus a Syringe Exchange Program: A Real-World Prospective Clinical Trial

2021 ◽  
Vol 21 (8) ◽  
Author(s):  
Andrew Seaman ◽  
Wren Ronan ◽  
Lauren Myers ◽  
Haven Wheelock ◽  
Melinda Butler ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Treatment Outcomes ◽  
Real World ◽  
Treatment Completion ◽  
Opioid Use Disorder ◽  
People Who Use Drugs ◽  
Opioid Use ◽  
Hcv Treatment ◽  
Treatment Access ◽  
Open Label

Background: Hepatitis C Virus (HCV) treatment in people who inject drugs (PWID) is a key component of elimination models but PWID face substantial barriers to treatment access. Despite data showing treatment outcomes among PWID on medications for opioid use disorder (MOUD) are similar to non-PWID outcomes, few studies examine PWID treatment outcomes with only syringe services support. Objectives: To evaluate the effect of recruitment for HCV treatment with elbasvir/grazoprevir (E/G) in a syringe services program (SSP) as compared to an MOUD program for people with opioid use disorder. Methods: This real-world, multi-site prospective open-label pilot study compares treatment of PWID with aspartate aminotransferase to platelet ratio (APRI) < 0.7 and genotype 1a, 1b, and 4 HCV with E/G, engaged in MOUD (n = 25) or an SSP (n = 25). The MOUD arm was enrolled through a federally qualified community health center and SSP arm through a nearby SSP. Prospective arms were compared to an academic hepatology clinic group (n = 50). Sustained virologic response at 12 weeks (SVR12), medication adherence, and treatment discontinuation were evaluated. Results: In the MOUD vs SSP arms, substance use throughout treatment was found in 36% (9/25) vs 100% (25/25); good adherence (> 90% pills taken) in 100% (25/25) vs 68% (17/25); treatment completion 100% (25/25) vs 64% (16/25); and SVR12 rates were 96% (24/25) vs 60% (15/25). In the community standard comparison group, SVR12 was achieved in 94% (47/50). There were two virologic failures or re-infections in the SSP group; all other non-responders were due to missing SVR12 data. Conclusions: While recruitment and follow-up are challenging in SSPs, preliminary data suggests adherence, treatment completion, and SVR12 are high in PWID treated with E/G engaging in SSP or MOUD. All metrics are comparable to community standards for non-PWID for treatment of HCV with direct-antiviral drugs.

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