As best responses, 3 patients had partial responses and 3 achieved stable disease. Patients were followed for ≥17 months; progression-free survival ranged from 3 to 15 months, and overall survival ranged from 4 to 17 months. CONCLUSION These 7 cases provide real-world data for the use of lenvatinib plus everolimus in patients with mRCC with primary resistance to first-line VEGF-targeted TKIs or ICI combination therapy. INTRODUCTION In 31 to 75 percent of cases, errors in laboratory medicine have preanalytical causes such as erroneous blood sampling. Erroneous blood sampling may lead to false test results and additional laboratory cost; it may increase analyzing time and endanger the health of patients and employees. In particular, under- and overfilling of blood sampling tubes can considerably distort laboratory values. So far there has been a lack of studies investigating the effect of a tailored training for ward staff to improve preanalytical procedures on blood sampling. ISSUE Can a tailored preanalytical training significantly reduce the number of commented under- and overfilled coagulation samples, reduce the number of hemolytic serum and lithium heparin samples and increase the number of standards-compliant blood sampling? METHODS In an intervention study we compared the number of commented under- and overfilled coagulation tubes and the number of hemolytic serum and lithium heparin samples on the basis of laboratoryted under- and overfilled coagulation tubes and of hemolytic serum and lithium heparin samples decreased in the before/after and in the annual comparison, and the number of standards-compliant blood samplings increased in before/after comparison. CONCLUSION The training contributed significantly to reducing the number of commented coagulation samples and hemolytic serum and lithium heparin samples and to increasing standards-compliant blood sampling. There is a need to investigate to what extent this concept can be transferred to other wards, and in which intervals further trainings should be conducted in order to maintain these positive effects. BACKGROUND To investigate whether pulmonary hypertension and suicide attempts are correlated. METHODS This study enrolled 7,727 pulmonary hypertension patients and 7,727 comparison subjects. The multivariate Cox proportional hazard model was used to calculate the adjusted hazard ratios (HRs) after adjustment for variables that were associated with suicide attempts in univariate model. RESULTS After adjustment for variables which were associated with suicide attempt, pulmonary hypertension patients had significantly higher adjusted HRs (95% confidence interval[CI]) of 2.08 (1.85, 2.34) for a suicide attempt. CONCLUSIONS We found that pulmonary hypertension was associated with a higher risk of suicide attempt. BACKGROUND Anticoagulation reduces stroke risk in patients with atrial fibrillation (AF) but under-prescribing in eligible patients has been commonly reported. Introduction of the direct acting oral anticoagulants (DOACs) was considered to potentially improve prescribing due to increased anticoagulant options. At the time of release to the Australian market, there were limited studies investigating anticoagulant usage during hospitalisations for AF. Therefore, the aim of this study was to investigate prescribing of oral anticoagulants during hospitalisation admissions for AF during the time of DOAC introduction to the Australian market. METHOD A retrospective study was conducted of admissions to a tertiary Queensland hospital during 1 July 2012 to 10 June 2015. Patients were categorised according to oral anticoagulant therapy on both hospital admission and discharge. Changes to therapy and patient factors associated with prescribing were analysed. RESULTS A total of 1,911 patients were included with 3,396 admissions during the study period. There was a significant increase in the number of patients initiated on anticoagulant therapy during their first admission with higher rates of initiation of DOACs compared to warfarin. Ischaemic heart disease and high bleed risk were significantly associated with reduced prescribing of anticoagulant therapy on first and second admission respectively, while patients with a history of stroke or transient ischaemic attack were significantly more likely to receive therapy. CONCLUSION The introduction of the DOACs to the Australian market increased initiation of anticoagulants to hospitalised patients with AF across all stroke risk categories. The availability of greater anticoagulant options has increased initiation of therapy but there remains potential to further optimise anticoagulant prescribing by targeting therapy according to guidelines and patient factors. PURPOSE The purpose of this study is to quantify the prevalence of dyspareunia and its impact on quality of life (QOL) in adolescent and young adult women (AYA) diagnosed with endometriosis. METHODS Eligible participants from the Women’s Health Study From Adolescence to Adulthood, a longitudinal cohort study, were AYA 18-25 years who reported having had sexual intercourse. We included n = 151 AYA with a surgical diagnosis of endometriosis and n = 287 without known endometriosis. Participants completed a questionnaire including the Short Form-36 (SF-36) QOL survey, on which lower scores indicate impairment. Dyspareunia was defined as answering “yes” to having had pain during/within 24 hours following sexual intercourse. Normative-based scores for SF-36 subscales were calculated and compared between groups using linear regression adjusted for age, body mass index, educational level, and race. RESULTS Participants with endometriosis experienced dyspareunia twice as often (79%) than AYA without endometriosis (40%, p less then .0001). RO4929097 supplier In participants with and without endometriosis, all SF-36 subscale scores were significantly lower in AYA with dyspareunia than without. For six subscales, the negative impact was significantly stronger in AYA with endometriosis than those without, and mean scores were all less than the normative score, indicating impairment. CONCLUSIONS More than three quarters of AYA with endometriosis and two thirds without experience dyspareunia that negatively impacts both physical and mental health QOL scores. This impairment is stronger in those with endometriosis. Given the importance of relationships and peer engagement for identity formation during adolescence, dyspareunia could be particularly impactful. Clinicians should ask patients not only about contraception and prevention of sexually transmitted infections, but inquire about how dyspareunia may impact mental and physical well-being.