Purpose: The aim of this study was to explore the effect of dose-dense sequential chemotherapy with or without paclitaxel primarily on disease-free survival (DFS) and secondarily on overall survival (OS) in patients with high-risk operable breast cancer. Patients and methods: From June 1997 until November 2000, 604 patients with T_1–3N₁M₀ or T₃N₀M₀ tumors were randomized to three cycles of epirubicin 110 mg/m² followed by three cycles of paclitaxel 250 mg/m² followed by three cycles of ‘intensified’ CMF (cyclophosphamide 840 mg/m², methotrexate 47 mg/m² and fluorouracil 840 mg/m²) (group A), or to four cycles of epirubicin followed by four cycles of CMF, as in group A (group B). All cycles were given every 2 weeks with granulocyte colony-stimulating factor support. Results: A total of 595 patients were eligible. Median follow-up was 61.7 months for group A and 62 months for group B. The 3-year DFS was 80% in group A and 77% in group B. Survival rates were 93% and 90%, respectively. The effect of treatment on the hazard of death was different according to hormonal receptor status. More specifically, in patients with negative receptor status the hazard of death was significantly higher for group B (hazard ratio 2.42). Both regimens were well tolerated and severe acute side-effects were infrequent. No cases of severe cardiotoxicity or acute leukemia were recorded. Conclusions: The present study failed to demonstrate a significant difference in DFS or OS between the two treatment groups. However, our study has shown clearly that high-dose paclitaxel can be safely incorporated to dose-dense sequential chemotherapy.

Background: To compare survival between patients with advanced breast cancer (ABC) treated with epirubicin/paclitaxel (Taxol) or paclitaxel/carboplatin (Cp) chemotherapy. Patients and methods: From January 1999 to April 2002, 327 eligible patients with ABC were randomized to receive either paclitaxel 175 mg/m² in a 3-h infusion followed by epirubicin (EPI) 80 mg/m² (group A) or paclitaxel, as in group A, followed by Cp at an AUC of 6 mg × min/ml (group B) every 3 weeks for six cycles. Results: After a median follow-up of 23.5 months, median survival was not significantly different between the two groups (22.4 months versus 27.8 months, P=0.25), whereas median time to treatment failure was significantly longer in patients treated with paclitaxel/Cp (8.1 months in group A versus 10.8 months in group B, P=0.04). Both regimens were well tolerated. In total, 39 patients (24%) in group A and 46 (29%) in group B suffered at least one severe side-effect. Quality-of-life assessment and cost analysis did not reveal any significant differences between the two groups. Conclusion: Our study suggests that the paclitaxel/Cp combination is an effective therapeutic alternative for patients with ABC in which anthracycline administration has the potential of being harmful.

Background: A variety of psychosocial factors have been shown to affect the quality of life of families (FQoL). Aim: This study aimed to assess the impact of mother's demographic characteristics, parental stress, illness perceptions about autism spectrum disorder (ASD), coping strategies, ASD severity and time since diagnosis on FQoL during the initial period following diagnosis (≤6 months). Method: Fifty-three mothers of children newly diagnosed with ASD completed the Beach Center Family Quality of Life Scale, the Autism Parenting Stress Index, the Brief Illness Perception Questionnaire and the Brief Coping Orientation to Problems Experienced Inventory. A descriptive analysis was conducted on the demographic characteristics of the family. Eta coefficients and Pearson's analysis were used to determine the associations between the variables and the FQoL dimensions. Hierarchical regression was used to determine whether variables explained a statistically significant family quality of life variance. Results: Pearson's analysis and eta coefficients indicated several correlations. Hierarchical regression analysis showed that higher parental stress related to core autism symptoms was associated with poorer FQoL (95% CI −0.08 to −0.02, P = 0.001), and higher perceived treatment control was associated with better FQoL (95% CI 0.04–0.16, P = 0.001). In addition, stronger perceived personal control was associated with higher physical/material well-being (95% CI 0.01–0.16, P = 0.022) and higher disability-related support (95% CI 0.30–0.61, P = 0.001). Higher family monthly income was associated with better FQoL (95% CI 0.08–0.027, P = 0.000), whereas marital status (divorced mother) was correlated with poorer FQoL (95% CI −0.68 to −0.16, P = 0.002). Conclusions: Interventions should emphasise managing the disorder's characteristics and implementing psychoeducational and supportive programmes for parents, immediately after the diagnosis, to enhance FQoL.

Objective: Nowadays, smartphones are becoming an indispensable tool due to the popular use of useful applications (apps) that can be downloaded and installed to aid our everyday lives. The quantity of apps manifested as tools for mobile health (mHealth) is undoubtedly high. The mHealth apps are very popular and cover various and different aspects of health. The first app for women in menopause was presented in 2014. Since then, more apps have been developed. The aim of this study is to identify mHealth apps that address the menopause with a focused view on the degree of medical professional involvement and documented evidence base practice in their design, as well as, underline their potential role in raising awareness regarding health in the community. Methods: The official app stores by Google, Apple, Windows and Blackberry were chosen to pool the apps. The keywords used were ‘apps for menopause’, ‘women in menopause’ and ‘menopause’. Eligible apps were selected based on the target consumer, each app’s price, documentation of evidence base practice and documentation of medical professional involvement. Results: This search revealed 35 relevant apps, of which 10 were excluded as they were identified as duplicates available for download by more than one app store. Authors excluded also further three mHealth apps, since they were not written in English, and the assessment was difficult due to the language barrier. A total of 22 mHealth menopause apps were included in this study. Medical professional involvement was noted in 27.3% of the mHealth menopause apps, and 22.7% of the total apps used evidence-based information. The mHealth menopause apps were free of charge in 86.4%. Ninety-one percent of the apps were designed for the consumers, while only 9% of them were suitable for medical professionals. Conclusions: In conclusion, there is a need to improve the mHealth apps available for menopause, by including more medical staff in their development and by establishing clear regulation around the development and the context of an mHealth app.