scholarly journals Perinatal Outcome in Women with a Vietnamese Migration Background – Retrospective Comparative Data Analysis of 3000 Deliveries

2018 ◽  
Vol 78 (07) ◽  
pp. 697-706
Author(s):  
Nicole Boxall ◽  
Matthias David ◽  
Elisabeth Schalinski ◽  
Jürgen Breckenkamp ◽  
Oliver Razum ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Child Outcomes ◽  
Outcome Data ◽  
Migration Background ◽  
Child Outcome ◽  
Perineal Tear ◽  
Arterial Ph ◽  
Background Exposure ◽  
Perinatal Data ◽  
Grade 3

Abstract Introduction Perinatal data of women with a Vietnamese migration background have not been systematically studied in Germany to date. Numerous details of important maternal and child outcomes were compared and analysed. The studyʼs primary parameters were the frequency of and indication for c-section. Methodology The perinatal data from a Berlin hospital were analysed retrospectively. The women (Vietnamese migration background vs. autochthonous) were grouped using name analysis. Datasets of 3002 women giving birth, including 999 women with a Vietnamese migration background, were included. The associations between primary or secondary cesarean delivery and different child outcomes depending on the migration background (exposure) were studied using logistical regression analysis. Results Women with a Vietnamese migration background have a lower c-section rate of 8.0% for primary and 12.6% for secondary c-section than women without a migration background (11.1% primary and 16.4% secondary c-section respectively). Regression analysis shows that the odds that women with a Vietnamese migration background will have a primary (OR 0.75; p = 0.0884) or secondary c-section (OR 0.82; p = 0.1137) are not significantly lower. A Vietnamese migration background was associated with higher odds for an episiotomy but not for a grade 3 – 4 perineal tear. A Vietnamese migration background does not have a significant influence on poor 5-min Apgar scores ≤ 7 and low umbilical cord arterial pH values ≤ 7.10. Newborns of mothers with a Vietnamese migration background have higher odds of a relatively higher birth weight (> 3110 g). Summary There was no evidence that women with a Vietnamese migration background are delivered more often by caesarean section. There were also no differences as regards important child outcome data from women in the comparator group. Overall, the results do not provide any evidence for poorer quality of care of women with a Vietnamese migration background in Berlin despite the cultural and communication barriers in the reality of care provision.

The More Things Change...Single Parenting Revisited

1995 ◽  
Vol 16 (1) ◽  
pp. 29-52 ◽  
Author(s):  
MARCY GRINGLAS ◽  
MARSHA WEINRAUB
Keyword(s):  
Social Competence ◽  
Behavior Problems ◽  
Child Outcomes ◽  
Male Partner ◽  
Social Supports ◽  
Family Status ◽  
Child Outcome ◽  
Child Functioning ◽  
Raising Children ◽  
Married Mothers

Weinraub and Wolf investigated maternal and preschool child functioning in households headed by solo mothers. Solo mothers—nonadolescent women raising children from birth without a male partner—differed from demographically matched, married counterparts with regard to stress and social supports, yet no differences in child outcomes were observed. Twenty-eight families (70%) from that original sample were reassessed as children entered preadolescence. Child measures included maternal and teacher report of behavior problems, social competence, and academic performance. Maternal measures included parenting, social supports, and stress. According to teachers, preadolescent children of solo mothers had more behavior problems, lower social competence, and poorer school performance than children of married mothers. Solo mothers continued to be less satisfied with emotional supports and reported higher stress. Maternal stress moderated family status effects on child outcome. Longitudinal analyses revealed stability over time for maternal and child variables, with greater vulnerability for children of solo mothers.

Potential Impact of Pathologic Review on Therapy in Non-Hodgkin’s Lymphoma (NHL): Analysis from the National Comprehensive Cancer Network (NCCN) NHL Outcomes Project.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2816-2816
Author(s):  
Ann LaCasce ◽  
Joyce Niland ◽  
Michelle E. Kho ◽  
Anna terVeer ◽  
Jonathan W. Friedberg ◽  
...  
Keyword(s):  
B Cell ◽  
Final Diagnosis ◽  
Routine Care ◽  
Outcome Data ◽  
Pathologic Diagnosis ◽  
First Line Therapy ◽  
Treatment Category ◽  
Potential Impact ◽  
Grade 3 ◽  
Md Anderson

Abstract Background: Optimal therapy of NHL is critically dependent upon an accurate pathologic diagnosis. High inter-rater reliability has been demonstrated among expert hematopathologists for common B cell NHLs using the WHO classification system. However, less is known about the accuracy and reliability of pathologic diagnosis of lymphoma in the routine care setting. Methods: We used data from the NCCN NHL Outcomes Project, a prospective cohort study collecting comprehensive clinical, treatment, and outcome data for patients seen at 5 participating centers (City of Hope, Dana-Farber, Fox Chase, MD Anderson, and Roswell Park), to compare pathologic diagnosis assigned at referring and NCCN centers. Newly diagnosed patients presenting between 7/00 and 12/04 with a final diagnosis of one of the following NHL subtypes were included in this analysis: follicular lymphoma (FL, grades 1,2,NOS), FL grade 3, marginal zone (MZL, extranodal, nodal, and splenic), small lymphocytic (SLL), diffuse large B-cell (DLBCL) and mantle cell (MCL). Diagnosis was considered concordant if the NCCN institution assigned the same WHO diagnosis as the referring institution. In order to assess the potential impact of diagnostic reclassification on treatment and outcomes, we defined 6 outside institution treatment-oriented categories: Indolent 1 (FL 1,2,NOS, all types of MZL and SLL), Indolent 2 (FL 3), Aggressive (i.e. DLBCL), MCL, Highly Aggressive (e.g. Burkitt or lymphoblastic lymphoma) and Other Cancer. NCCN diagnoses were classified into 4 treatment-oriented categories: Indolent 1, Indolent 2, DLBCL, and MCL. Treatment category was considered concordant if the diagnosis assigned by the referring institution and the NCCN institution mapped to the same treatment category. Results: Of 928 patients eligible for this analysis, 741 had specimens reviewed at both a referring and NCCN institution. Among these patients, the final diagnosis was discordant for 9% (66/741, 95%CI [7%,11%]). The rates of discordance by histologic type (as assigned by the NCCN center) were: FL 6% (13/218), FL3 16%(5/31), MZL 8% (5/60), SLL 29% (9/31), DLBCL 8% (25/304) and MCL 9% (9/97). In SLL, almost half of discordance was due to use of non-WHO diagnoses (n=4). Of the 66 discordant cases, 51 (7% of total, 95% CI [5%, 9%]) were ultimately diagnosed with a histology that mapped to a discordant treatment category. This included 15 patients (29%) whose final diagnosis was a more aggressive histology (DLBCL), potentially curable if treated with appropriate first-line therapy. Conclusions: We found that the vast majority of patients with common NHL were classified accurately by referring centers. For 9% of patients, however, review by an expert hematopathologist resulted in an alternative diagnosis, and for the majority a change in expected treatment potentially impacting therapeutic outcome. Treatment Category NCCN Referring Institution Indolent 1 (N=309) Indolent 2 (N=31) DLBCL (N=304) MCL (N=97) Indolent 1 94% 10% 4% 7% Indolent 2 1% 84% 1% 0 Aggressive 1% 6% 93% 1% MCL 2% 0 0 91% Highly Aggressive 1% 0 1% 1% Other Cancer 1% 0 <1% 0

Phase I/II study of sorefenib and erlotinib for patients with recurrent glioblastoma (GBM) (NABTC 05–02)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 2005-2005
Author(s):  
M. Prados ◽  
M. Gilbert ◽  
J. Kuhn ◽  
K. Lamborn ◽  
T. Cloughesy ◽  
...  
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Single Agent ◽  
Outcome Data ◽  
Recurrent Glioblastoma ◽  
Dose Finding ◽  
Pharmacokinetic Studies ◽  
Eligibility Criteria ◽  
Prior Chemotherapy ◽  
Grade 3

2005 Background: Single agent targeted therapy has been disappointing in GBM. Combination therapy simultaneously targeting both EGFR and the MAP kinase pathway may be more effective. Methods: The NABTC conducted a phase I/II study of sorafenib (VEGFR/PDGFR/Raf inhibitor) in combination with erlotinib (EGFR inhibitor) in recurrent GBM. Eligibility criteria included histologically proven GBM, radiologic progression, > 18 yrs old, KPS > 60, adequate bone marrow reserve, and organ function. There was no limit on the number of prior therapies for phase I and no more than two prior relapses for phase II. No enzyme-inducing antiepileptic drugs were allowed. Dose-finding used a standard 3 + 3 design and the MTD was defined as the dose with DLTs in 1/6 or fewer patients. The primary endpoint for the phase II component was PFS6 (p0 = 15%; p1 = 35%). A 2-stage design was used. If > 4 of the initial 19 patients achieved PFS6, an additional 14 patients would be accrued for a total of 33 patients. Results: In phase I, 17 patients were enrolled. Median age 50 years (35–69); median prior chemotherapy 1 (1–3). The initial doses were sorafenib 200 mg bid and erlotinib 100mg qd. MTD was 400 mg bid of sorafenib daily combined with 100 mg of erlotinib daily. At this dose 1/6 evaluable patients had a DLT (grade 4 lipase). Other grade 3 or 4 toxicities included transaminitis, hypertension, hypophosphatemia, and increased lipase. Pharmacokinetic studies showed no alterations in sorafenib PK, but no accumulation of erlotinib, suggesting a drug-drug interaction with sorafenib altering erlotinib metabolism or clearance. In phase II, 19 patients were accrued to stage I. Median age 51 years (30–75); median prior chemotherapy 2 (range 1–3). Phase II toxicity and outcome data are not yet mature but will be available at the time of presentation. Conclusions: This combination was moderately well-tolerated. MTD was below other combination phase I studies. Sorafenib affected the PK of erlotinib preventing drug accumulation. Phase II toxicity and outcome data will be reported. [Table: see text]

NCCTG N057K phase II trial of everolimus, temozolomide, and radiotherapy in patients with newly diagnosed glioblastoma: A North Central Cancer Treatment Group trial.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 2031-2031
Author(s):  
Daniel Ma ◽  
Evanthia Galanis ◽  
David Schiff ◽  
Wenting Wu ◽  
Patrick J. Peller ◽  
...  
Keyword(s):  
Phase Ii ◽  
Residual Disease ◽  
Methylation Status ◽  
Mtor Inhibitors ◽  
Outcome Data ◽  
Hematologic Toxicity ◽  
Newly Diagnosed ◽  
Drug Induced ◽  
Flt Pet ◽  
Grade 3

2031 Background: The mammalian target of rapamycin (mTOR) functions within the PI3K/Akt pathway as a critical modulator of cell survival. Preclinical studies in GBM indicate that the combination of mTOR inhibitors, such as everolimus (RAD001), with either radiation therapy (RT) or temozolomide (TMZ) provide increased tumor cell killing. Methods: Newly diagnosed GBM pts were eligible for the study. RAD001 was dosed orally at 70 mg/week weekly, starting 1 week prior to RT/TMZ, and continued throughout RT/TMZ, adjuvant TMZ and then until progression. This was a single arm phase II design powered to detect a true overall survival at 12 months (OS12) of 73% (vs 58% in historical controls). Secondary endpoints were toxicity, response rate, and time to progression (TTP). A subgroup of patients with measurable residual disease were eligible for the PET imaging component of the study, consisting of an 18FLT-PET/CT scan performed before and after the initial two doses of RAD001 but before the first dose of RT or TMZ. Results: 103 patients were accrued to phase II of which 100 were evaluable. The median age was 60.5 years (23-81), median ECOG PS was 1, 46 patients had GTR, 33 STR, and the remainder had biopsy at diagnosis. Treatment tolerance was acceptable: 17% patient had at least one grade 3 hematologic toxicity; 14% had at least one grade 4 hematologic toxicity, 42% had at least one grade 3 non-heme toxicity, while 12% had at least one grade 4 non-heme toxicity. No increased incidence of infectious complications was observed and there were no treatment related deaths. Median PFS was 5.3 months (1.3-21.4), with 22 patients progression free. Mature OS data will be available at the meeting. MGMT methylation status analysis is ongoing. Of the pts who had evaluable FLT-PET data, three of eight (37.5%) had a drop in SUVmax >25% after two treatments of RAD001. Conclusions: RAD001 with standard of care chemoradiation had moderate toxicity. Serial 18FLT-PET was feasible for evaluating drug-induced changes in tumor proliferation following RAD001. Final outcome data and association of MGMT status with outcome will be reported at the meeting.

scholarly journals Prognostic Significance of CSF-1R Expression in Early Invasive Breast Cancer

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5769
Author(s):  
Nazia Riaz ◽  
Samantha Burugu ◽  
Angela S. Cheng ◽  
Samuel C. Y. Leung ◽  
Dongxia Gao ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Biology ◽  
Prognostic Significance ◽  
Outcome Data ◽  
Carcinoma Cells ◽  
Cancer Tissue ◽  
Immune Biomarkers ◽  
Grade 3 ◽  
Positive Correlations ◽  
Aggressive Breast Cancer

Colony-stimulating factor-1 receptor (CSF-1R) signaling promotes an immune suppressive microenvironment enriched in M2 macrophages. Given that CSF-1R inhibitors are under investigation in clinical trials, including in breast cancer, CSF-1R expression and association with immune biomarkers could identify patients who derive greater benefit from combination with immunotherapies. TIMER2.0 and bc-GenExMiner v4.7 were used to assess the correlation of CSF1R mRNA with immune infiltrates and prognosis. Following a prespecified training–validation approach, an optimized immunohistochemistry assay was applied to assess CSF-1R on carcinoma cells and macrophages on breast cancer tissue microarray series representing 2384 patients, coupled to comprehensive clinicopathological, biomarker, and outcome data. Significant positive correlations were observed between CSF1R mRNA and immune infiltrates. High carcinoma CSF-1R correlated with grade 3 tumors >2 cm, hormone receptor negativity, high Ki67, immune checkpoint biomarkers, and macrophages expressing CSF-1R and CD163. High carcinoma CSF-1R was significantly associated with poor survival in univariate and multivariate analyses. Adverse prognostic associations were retained in ER+ cases regardless of the presence of CD8+ T cells. CSF-1R+ macrophages were not prognostic. High carcinoma CSF-1R is associated with aggressive breast cancer biology and poor prognosis, particularly in ER+ cases, and identifies patients in whom biomarker-directed CSF-1R therapies may yield superior therapeutic responses.

Real-world outcomes of underrepresented patient populations treated with immune checkpoint inhibitors (ICIs): African American descent, poor ECOG performance status, and chronic viral infections.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 2587-2587 ◽  
Author(s):  
Neil J. Shah ◽  
Matthew Blackburn ◽  
Michael R Cook ◽  
Anas Belouali ◽  
Michael Serzan ◽  
...  
Keyword(s):  
African American ◽  
Viral Infections ◽  
Checkpoint Inhibitors ◽  
Performance Status ◽  
Outcome Data ◽  
Viral Reactivation ◽  
Ecog Performance Status ◽  
Chronic Viral Infections ◽  
Grade 3 ◽  
Ecog Ps

2587 Background: ICIs have now become standard of care treatment for multiple malignancies. However, patients (pts) who are African American decent (AA), have a poor ECOG performance status (PS) or chronic viral infections [human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C (HCV)] were underrepresented in early clinical trials with ICIs and outcome data in these pt populations is not well reported. Methods: We performed a retrospective analysis of pts treated with ICIs (anti-PD(L)-1, anti-CTLA-4, or combination ICIs) across five MedStar Health hospitals from January 2011 to April 2018. Investigator-assessed best responses were noted. CTCAE v4.03 was used to capture immune-related adverse events (irAEs). Results: We identified 765 pts treated with 829 unique ICIs therapies across different malignancies. A total of 203 AA pts, 178 pts with a pre-treatment ECOG PS ≥2, 21pts with HIV, and 50 pts with HBV/HCV were noted. Any grade and grade ≥ 3 irAEs in the HIV cohort were 24% and 10% with an ORR of 29%. Any grade and grade ≥ 3 irAEs in HBV/HCV were 50% and 26% with an ORR of 21%. No viral reactivation or changes in pts anti-viral medications were noted during ICIs treatment. The ORR in AA pts was 35%. Any grade and grade ≥ 3 irAEs in the AA cohort were 27% and 8%, respectively. The ORR in pts with ECOG PS ≥2 was 14%. Any grade and grade ≥ 3 irAEs in this cohort were 20% and 4%. Similar trends were seen in the subset of patients with NSCLC treated with anti-PD(L)1 monotherapy (Table). Outcomes of NSCLC pts treated with anti-PD(L)-1 monotherapy. Conclusions: ICI therapy was not associated with any new safety signal in the above underrepresented populations. Prospective studies are needed to validate this data.[Table: see text]

scholarly journals Air pollution and COVID-19 mortality in the United States: Strengths and limitations of an ecological regression analysis

2020 ◽  
Vol 6 (45) ◽  
pp. eabd4049 ◽  
Author(s):  
X. Wu ◽  
R. C. Nethery ◽  
M. B. Sabath ◽  
D. Braun ◽  
F. Dominici
Keyword(s):  
United States ◽  
Air Pollution ◽  
Regression Analysis ◽  
The United States ◽  
Outcome Data ◽  
Data Availability ◽  
Future Research ◽  
Individual Level ◽  
Ecological Regression

Assessing whether long-term exposure to air pollution increases the severity of COVID-19 health outcomes, including death, is an important public health objective. Limitations in COVID-19 data availability and quality remain obstacles to conducting conclusive studies on this topic. At present, publicly available COVID-19 outcome data for representative populations are available only as area-level counts. Therefore, studies of long-term exposure to air pollution and COVID-19 outcomes using these data must use an ecological regression analysis, which precludes controlling for individual-level COVID-19 risk factors. We describe these challenges in the context of one of the first preliminary investigations of this question in the United States, where we found that higher historical PM2.5 exposures are positively associated with higher county-level COVID-19 mortality rates after accounting for many area-level confounders. Motivated by this study, we lay the groundwork for future research on this important topic, describe the challenges, and outline promising directions and opportunities.

scholarly journals A GROUP FOR PARENTS OF YOUTH WITH CHRONIC PAIN: RATIONALE, STRUCTURE, CONTENT, AND PRELIMINARY OUTCOME DATA

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e2-e2
Author(s):  
Kim Edwards ◽  
C Meghan McMurtry ◽  
Soeun Lee ◽  
Elena Jackson
Keyword(s):  
Chronic Pain ◽  
School Attendance ◽  
Pain Catastrophizing ◽  
Child Outcomes ◽  
Parent Satisfaction ◽  
Outcome Data ◽  
Feedback Form ◽  
School Partnerships ◽  
High Satisfaction ◽  
Pain Symptoms

Abstract BACKGROUND Parenting a youth with chronic pain can be challenging and have a significant impact relationally, emotionally and financially on caregivers (Palermo, 2000; Lewandowski et al., 2010). There is a growing literature indicating that parent emotions (e.g., anxiety, depression), cognitions (e.g., coping, pain catastrophizing), and behaviours (e.g., attending to pain symptoms) can moderate a child’s adjustment to chronic pain (Logan & Scharff, 2005; Palermo et al., 2014; Palermo & Eccleston, 2008). Therefore, intervening with parents of youth with chronic pain is believed to foster better outcomes regarding children’s functioning (e.g., school attendance; Coakley & Wihak, 2017). OBJECTIVES No study has evaluated a stand-alone intervention targeted at parents of youth with chronic pain. Consequently, this poster presents a five week parenting group that we developed and ran on four occasions. Preliminary results pertaining to group feasability, satisfaction, and effectiveness will also be presented. DESIGN/METHODS The group is designed to augment the treatment of youth in our program and includes the following topics: chronic pain 101 (psychoeducation), impact of pain on the family, self-care, tools for managing a child’s pain, identifying and overcoming barriers, school partnerships, and celebrating successes. Each session involves homework review, a mindfulness activity, new material (inclusive of a didactic activity), goal-setting, and assigned readings. To date, 41 parents of youth with chronic pain have participated in the four group cycles. Outcomes were measured using the Adult Responses to Children’s Symptoms (ARCS) Questionnaire (Noel et al., 2015; Van Slyke & Walker, 2006) which parents completed at the start and end of the group. Feedback and parent satisfaction were also obtained on a feedback form designed by authors and given on the last session of group. RESULTS Overall, the group demonstrated adequate feasibility, was well-received by parents, and high satisfaction was reported. Preliminary data suggest that the group was helpful in reducing some parental responses associated with maladaptive child outcomes. More specifically, statistically significant decreases in protectiveness, monitoring, and minimizing (subscales of the ARCS) were found after the 5 week intervention. CONCLUSION “Anecdotally, many parents expressed uncertainty about how to respond when adolescents complained of pain and refused to go to school, and parents appeared eager for…strategies to help them negotiate the situation” (Logan & Simons, 2010, p. 833). Our results are consistent with previous literature (Logan & Simons, 2010; Saunders et al., 1994) and suggest that intervening with parents may help improve outcomes for youth with chronic pain.

scholarly journals Association of neutrophil-to-lymphocyte ratio with severe radiation-induced mucositis in pharyngeal or laryngeal cancer patients: a retrospective study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yumiko Kawashita ◽  
Masayasu Kitamura ◽  
Sakiko Soutome ◽  
Takashi Ukai ◽  
Masahiro Umeda ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Retrospective Study ◽  
Cancer Patients ◽  
Systemic Inflammation ◽  
Laryngeal Cancer ◽  
Multivariate Logistic Regression ◽  
Kaplan Meier ◽  
Radiation Induced ◽  
Grade 3

Abstract Background The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation that informs clinical decisions regarding recurrence and overall survival in most epithelial cancers. Radiotherapy for head and neck cancer leads to mucositis in almost all patients and severe radiation-mucositis affects their quality of life (QOL). However, little is known about the NLR for severe mucositis. Therefore, this study aimed to show the association between the NLR and severe radiation-induced mucositis in hypopharyngeal or laryngeal cancer patients. Methods In this retrospective study, we determined the incidence of grade 3 mucositis in 99 patients who were receiving definitive radiotherapy or chemoradiotherapy (CRT) for hypopharyngeal or laryngeal cancer. We performed univariate and multivariate logistic regression analyses to investigate the characteristics of grade 3 mucositis. Kaplan–Meier curves and log-rank tests were used to evaluate the occurrence of grade 3 mucositis between two groups with high (NLR > 5) or low (NLR < 5) systemic inflammation. Results The incidence of grade 3 mucositis was 39%. Univariate logistic regression analysis showed that the NLR (Odd ratio [OR] = 1.09; 95% confidence interval [CI] = 1.02–1.16; p = 0.016) and smoking (OR = 1.02; 95% CI = 1.00–1.03; p = 0.048) were significantly associated with grade 3 mucositis. Multivariate logistic regression analysis showed that the NLR was independently associated with grade 3 mucositis (OR = 1.09; 95% CI = 1.01–1.17; p = 0.021). Kaplan–Meier curves also showed that patients with higher NLR (NLR > 5) prior to radiotherapy developed grade 3 mucositis more frequently than those with lower NLR during radiotherapy (p = 0.045). Conclusion This study suggests that a higher NLR is a risk factor and predictor of severe radiation-induced mucositis in hypopharyngeal or laryngeal cancer patients.

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