Publications by authors named "Ruby Stein"

Background: Interventions tackling the social aspects of tuberculosis (TB) are widely suggested, yet we miss insights into how policies incorporate these. The language and framing of policies to address TB can lend important insights into how these social drivers are perceived, problematized, and responded to.

Objective: To understand how discourses in current TB policies frame social dimensions of TB, especially concepts of social inequity, gender, and stigma.

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Introduction: Tuberculosis (TB) is a major global health problem and Pakistan is ranked fifth among the 30 high-burden countries in the world. TB-related stigma affects health seeking behaviour and treatment adherence, increasing disease transmission and worsening health outcomes. This study aimed to explore experiences of stigma among people with TB (PWTB) in Rawalpindi to help inform targeted stigma reduction interventions that could improve health seeking behaviour, treatment adherence and the mental well-being of PWTB in Pakistan.

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Purpose: Measuring health-related quality of life (HRQoL) in ovarian cancer patients is critical to understand the impact of disease and treatment. Preference-based HRQoL measures, called health state utilities, are used specifically in health economic evaluations. Real-world patient-reported data on HRQoL and health state utilities over the long-term course of ovarian cancer are limited.

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Introduction: Hyperthermic intraperitoneal chemotherapy (HIPEC) is increasingly being used in patients with stage III ovarian cancer undergoing interval cytoreductive surgery (CRS). It is uncertain whether routine postoperative admission to a critical care setting after CRS-HIPEC is necessary. This study aims to estimate the incidence of patients requiring critical care, and to create a prediction model to identify patients who may forego admission to a critical care setting.

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Article Synopsis
  • The OVHIPEC-1 trial found that combining interval cytoreductive surgery with hyperthermic intraperitoneal chemotherapy improved survival for patients with stage III ovarian cancer compared to surgery alone.
  • Researchers compared the trial's control group to a real-world group of patients in the Netherlands to assess the generalizability of the trial results.
  • Despite some differences in patient characteristics, the overall survival rates were similar between the trial participants and the real-world patients, suggesting that trial outcomes apply to broader patient populations.
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Objective: Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is standard of care in the Netherlands in patients with stage III epithelial ovarian cancer following interval cytoreductive surgery (CRS). Differences in patient selection, technical aspects, and perioperative management exist between centers performing HIPEC. Standardization aims to reduce unwanted variation in clinical practice.

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Importance: The peritoneal surface is a common site of disease in ovarian and colorectal cancer. Peritoneal metastases carry a poor prognosis, despite maximal therapeutic efforts, including surgical removal of tumor deposits and intravenous chemotherapy. Hyperthermic intraperitoneal chemotherapy (HIPEC) is a single intraoperative procedure that delivers chemotherapy directly into the abdominal cavity, leading to high intracellular drug concentration at the peritoneal surface.

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Background: The addition of hyperthermic intraperitoneal chemotherapy (HIPEC) to interval cytoreductive surgery improves recurrence-free and overall survival in patients with FIGO stage III ovarian cancer who are ineligible for primary cytoreductive surgery. The effect of HIPEC remains undetermined in patients who are candidates for primary cytoreductive surgery.

Primary Objective: The primary objective is to evaluate the effect of HIPEC on overall survival in patients with FIGO stage III epithelial ovarian cancer who are treated with primary cytoreductive surgery resulting in no residual disease, or residual disease up to 2.

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Prior to implementation of volatile organic compound (VOC) analysis in clinical practice, substantial challenges, including methodological, biological and analytical difficulties are faced. The aim of this study was to evaluate the influence of several sampling conditions and environmental factors on fecal VOC profiles, analyzed by an electronic nose (eNose). Effects of fecal sample mass, water content, duration of storage at room temperature, fecal sample temperature, number of freeze-thaw cycles and effect of sampling method (rectal swabs vs.

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