Water impacts are usually the most troublesome issue associated with all types of mining, but especially with hard-rock mines like Pascua-Lama.
More recently, there has been further work that supports the routine use of NSAIDs in treating the most troublesome symptoms associated with cancer (Madeddu et al, 2012).
A recent pan-European survey into the QoL of 1743 patients with ovarian cancer by Oskay-Ozcelik et al. reported that alopecia was the single most troublesome side effect, with 42% patients reporting being bothered by alopecia [ 6].
The RQLQ was developed to measure the functional problems (physical, emotional, social, and occupational) and those are the most troublesome to adults with either seasonal or perennial rhinoconjunctivitis of either allergic or nonallergic origin.
Mini-Asthma QoL measures functional impairments that are most troublesome to subjects with asthma during the 2 weeks prior to responding to the survey, and has four domains: 1) symptoms (5 items); 2) activity limitation (4 items); 3) emotional function (3 items); and 4) environmental stimuli (3 items).
The mini-AQLQ [ 23] has been developed to measure the impact of asthma and its treatment that are most troublesome to adults with asthma according to the patient's perspective and contains 15 questions in four domains: symptoms, activity limitation, emotional function and environmental stimuli.
The most troublesome tolerability issue with GLP-1 RA is the incidence and duration of GI side effects, in particular nausea and vomiting, that may account in clinical practice for the low treatment adherence and higher withdrawal rates, which are a greater problem than what has been reported in clinical trials (1, 2, 12).
Nasal congestion (NC) has been described as one of the most troublesome symptoms for patients with allergic rhinitis (AR) and is associated with poorer sleep, mood, and productivity [ 1, 2].
While MPXV is thought to have a lower potential for human-to-human transmission than VARV, it is currently the most troublesome orthopoxvirus for humans, with sporadic outbreaks occurring most commonly in the African Congo [35].
The principal mechanisms the world has devised to deal with them -- foreign aid, nongovernmental institutions, the World Bank, the United Nations -- have not succeededin dealing with the most troublesome and difficult cases.
