scholarly journals EPID-03. COMPARISON OF SURVIVAL IN ADULT AND PEDIATRIC PATIENTS WITH MEDULLOBLASTOMA: A 2018 SEER BASED ANALYSIS

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii319-iii319
Author(s):  
Hanna M Moisander-Joyce ◽  
Anoushka Sinha ◽  
Shannon Fernandez-Ledon ◽  
Davon T Lee ◽  
Satoki Hatano ◽  
...  
Keyword(s):  
Large Cell ◽  
Adult Brain ◽  
World Health ◽  
Rank Test ◽  
Seer Database ◽  
Treatment Protocols ◽  
Treatment Comparison ◽  
Survival Difference ◽  
Adults And Children ◽  
Health Organization

Abstract Medulloblastoma (MB) is the most common high-grade primary brain malignancy in children and accounts for 1% of adult brain tumors. Previous studies have compared survival in pediatric and adult MB from the National Cancer Institute Surveillance Epidemiology and End Results (SEER) database finding no difference. However, diagnostic subgroup analyses are limited. We examined survival in children (age 0–19) and adults (20–79) coded as MB in the 2018 SEER database (2000–2016), using Kaplan Meier analysis, log-rank test and Cox proportional hazard ratios (HR) with 95% confidence intervals (CI).). MB in SEER-18 is defined as ICD-O-3 histology codes 9470–9474 (n=1,728). ICD 9473, supratentorial PNET (sPNET, n=97) is biologically distinct so was analyzed separately. 5-year survival for MB, excluding sPNET, was similar in children (n = 1,091, 75.3%) and adults (n= 488, 79.1%) (HR=0.97, CI: 0.79 – 1.17, p=0.50). Subtype analyses showed no survival difference comparing adults and children with desmoplastic nodular MB (n=222, p=0.09), large cell MB (n=73, p=0.46), or MB NOS (n=1330, p=0.10). In contrast, children with sPNET had improved survival (n=65, 72.3%) compared to adults (n=29, 51.7%) (HR = 2.0, CI: 1.10 – 3.92; p=0.02,). In conclusion, 2018 SEER data for MB continue to show no survival difference between adults and children, suggesting adult patients could appropriately be entered on pediatric MB treatment protocols. Further analyses of the 2018 data are ongoing adjusting for sex, race, and treatment. Comparison of adults and children with MB and sPNET will be re-evaluated using the new 2016 World Health Organization classification.

Survival in adult and pediatric patients with medulloblastoma: A 2018 SEER-based analysis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e14529-e14529
Author(s):  
Hanna Moisander-Joyce ◽  
Anoushka Sinha ◽  
Shannon Fernandez-Ledon ◽  
Davon Lee ◽  
Satoki Hatano ◽  
...  
Keyword(s):  
Age Groups ◽  
Large Cell ◽  
Adult Brain ◽  
World Health ◽  
Rank Test ◽  
Seer Database ◽  
Treatment Protocols ◽  
Survival Difference ◽  
Improved Outcomes ◽  
Adults And Children

e14529 Background: Medulloblastoma (MB) is a malignant neuroectodermal tumor accounting for 30% of pediatric and only 1% of adult brain tumors. In previous studies comparing survival in pediatric and adult MB from the National Cancer Institute Surveillance Epidemiology and End Results (SEER) database no difference has been found. However, diagnostic subgroup analyses have been limited. Methods: We examined survival in children (age 0-19) and adults (20-79) coded as MB in the 2018 SEER database (2000-2016). We used Kaplan Meier analysis, log-rank test and Cox proportional hazard ratios (HR) with 95% confidence intervals (CI). MB in SEER-18 is defined as ICD-O-3 histology codes 9470–9474 (n = 1,728). ICD 9473, supratentorial PNET (sPNET, n = 97) is biologically distinct and therefore it was analyzed separately. Results: We found that 5-year survival for MB, excluding sPNET, was similar in children (n = 1,091, 75.3%) and adults (n = 488, 79.1%) (HR = 0.97, CI: 0.79 – 1.17, p = 0.50). Furthermore, subtype analyses showed no survival difference comparing adults and children with desmoplastic nodular MB (n = 222, p = 0.09), large cell MB (n = 73, p = 0.46), or MB NOS (n = 1330, p = 0.10). Yet, children with sPNET had improved 5-year survival (n = 65, 72.3%) compared to adults (n = 29, 51.7%) (HR = 2.0, CI: 1.10 – 3.92; p = 0.02,). These findings indicate that while survival in patients with MB is similar across age groups, children with sPNET have improved outcomes. Conclusions: In summary, 2018 SEER data for MB continue to show no survival difference between adults and children, suggesting adult patients could appropriately be entered on pediatric MB treatment protocols. Further analyses of the 2018 data are ongoing adjusting for sex, race, and treatment (chemotherapy or radiation). For sPNET, the apparent improved outcomes for children merit further detailed investigation and will be re-evaluated using the new 2016 World Health Organization classification.

Giant Primary Neuroendocrine Neoplasms of the Liver: Report of 2 Cases With Molecular Characterization

2019 ◽  
Vol 27 (8) ◽  
pp. 893-899
Author(s):  
Laura G. Pastrián ◽  
Ignacio Ruz-Caracuel ◽  
Raul S. Gonzalez
Keyword(s):  
World Health Organization ◽  
Neuroendocrine Tumor ◽  
Large Cell ◽  
The Other ◽  
World Health ◽  
Neuroendocrine Neoplasms ◽  
Molecular Testing ◽  
Well Differentiated ◽  
Grade 3 ◽  
Health Organization

Primary neuroendocrine neoplasms of the liver have occasionally been reported in the liver, though many reports do not convincingly exclude metastases. In this article, we report 2 “giant” hepatic neuroendocrine lesions without evidence of a primary elsewhere after clinical workup. One occurred in a 21-year-old male; the lesion was a large cell neuroendocrine carcinoma measuring 24 cm. The patient died of disease in 10 months. The other occurred in a 25-year-old patient, was 18 cm wide, and was diagnosed as a well-differentiated neuroendocrine tumor, World Health Organization grade 3. The patient died of disease after 30 months. Molecular testing demonstrated only the presence of TP53 mutations in common. These cases expand our knowledge of seemingly primary neuroendocrine neoplasms of the liver, in particular, giant cases measuring more than 8 cm. Guidelines for clinical workup and therapy for these lesions remain unclear, but future thorough workup of such cases is necessary for specific characterization.

scholarly journals Outcomes of Coronavirus Disease 2019 (COVID-19) Related Hospitalization Among People With Human Immunodeficiency Virus (HIV) in the ISARIC World Health Organization (WHO) Clinical Characterization Protocol (UK): A Prospective Observational Study

2020 ◽  
Author(s):  
Anna Maria Geretti ◽  
Alexander J Stockdale ◽  
Sophie H Kelly ◽  
Muge Cevik ◽  
Simon Collins ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
World Health Organization ◽  
Cox Regression ◽  
World Health ◽  
Rank Test ◽  
Hiv Positive ◽  
Protein Levels ◽  
Increased Risk ◽  
Immunodeficiency Virus ◽  
Health Organization

Abstract Background Evidence is conflicting about how human immunodeficiency virus (HIV) modulates coronavirus disease 2019 (COVID-19). We compared the presentation characteristics and outcomes of adults with and without HIV who were hospitalized with COVID-19 at 207 centers across the United Kingdom and whose data were prospectively captured by the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) World Health Organization (WHO) Clinical Characterization Protocol (CCP) study. Methods We used Kaplan-Meier methods and Cox regression to describe the association between HIV status and day-28 mortality, after separate adjustment for sex, ethnicity, age, hospital acquisition of COVID-19 (definite hospital acquisition excluded), presentation date, 10 individual comorbidities, and disease severity at presentation (as defined by hypoxia or oxygen therapy). Results Among 47 592 patients, 122 (0.26%) had confirmed HIV infection, and 112/122 (91.8%) had a record of antiretroviral therapy. At presentation, HIV-positive people were younger (median 56 vs 74 years; P < .001) and had fewer comorbidities, more systemic symptoms and higher lymphocyte counts and C-reactive protein levels. The cumulative day-28 mortality was similar in the HIV-positive versus HIV-negative groups (26.7% vs. 32.1%; P = .16), but in those under 60 years of age HIV-positive status was associated with increased mortality (21.3% vs. 9.6%; P < .001 [log-rank test]). Mortality was higher among people with HIV after adjusting for age (adjusted hazard ratio [aHR] 1.47, 95% confidence interval [CI] 1.01–2.14; P = .05), and the association persisted after adjusting for the other variables (aHR 1.69; 95% CI 1.15–2.48; P = .008) and when restricting the analysis to people aged <60 years (aHR 2.87; 95% CI 1.70–4.84; P < .001). Conclusions HIV-positive status was associated with an increased risk of day-28 mortality among patients hospitalized for COVID-19.

scholarly journals HUBUNGAN MINAT MEMBACA BUKU KIA DENGAN PENGETAHUAN IBU HAMIL TENTANG BUKU KIA

2018 ◽  
Vol 4 (2) ◽  
pp. 188
Author(s):  
Faradina Nur Annisa
Keyword(s):  
Research Result ◽  
Rank Correlation ◽  
Sampling Technique ◽  
World Health ◽  
Rank Test ◽  
Spearman Rank ◽  
Knowledge Based ◽  
Health Organization ◽  
Reading Interest ◽  
Pregnant Mothers

Maternal Mortality Rate (MMR) in Indonesia is still high relatively, recent data from the World Health Organization in 2011 the MMR in Indonesia is 240/100 thousands birth rate. One of the eff ort developed by Ministry of Health is empowering families and people by KIA book. KIA book is an important book for pregnant mothers. One of way to get knowledge well, a person must have an interest to read. This research aimed for knowing the relationship between reading interest of KIA book with pregnant mothers knowledge about KIA book. Research This research used analytic observational with cross sectionalapproach. Population in this research is all of pregnant mothers in the 2nd and 3rd semester that have KIA book in Rural Clinic Pulungdowo Tumpang, with the amount of population is 36 people. Sample taking use purposive sampling technique with the number of 33 people. Data processing displayed in thefrequency distribution table and analyzed using Spearman Rank correlation test, research result shows that half of respondent, 33.3% has high interest and well knowledge. Based Spearman Rank test with signifi cance level 0.05, obtained signifi cance value 0.000  0.05, it means that there is a relationship between reading interest of KIA book with pregnant mothers knowledge about KIA book.Keywords: Reading interest, Pregnant mothers, KIA book, Knowledge

scholarly journals Post-covid condition in adults and children

2021 ◽  
Vol 31 (5) ◽  
pp. 562-570
Author(s):  
Dina V. Baimukhambetova ◽  
Anastasia O. Gorina ◽  
Mikhail A. Rumyantsev ◽  
Anastasia A. Shikhaleva ◽  
Yasmin A. El-Taravi ◽  
...  
Keyword(s):  
Management Strategies ◽  
World Health ◽  
Clinical Protocols ◽  
Healthcare Burden ◽  
Wide Range ◽  
The World ◽  
Adults And Children ◽  
To Come ◽  
Health Organization ◽  
Existing Data

Despite the impressive progress in diagnosis and management of acute COVID-19, data regarding the consequences of this infection are just emerging. The World Health Organization has proposed the term post-COVID condition (PCC) to describe the wide range of sequelae of acute COVID-19. With more than 200 million confirmed cases of COVID-19, PCC may develop into a major problem for many years to come for the millions of COVID-19 survivors worldwide. Few studies were conducted in primary care, and very few studies have focused exclusively on children and adolescents.Objective. To review existing data on PCC. Analysis of manuscripts published in peer-reviewed journals and clinical protocols. PCC is characterized by a wide range of systemic, cardio-pulmonary, gastrointestinal, neurological, and psychosocial symptoms.Conclusion. Although PCC prevalence is difficult to estimate due to methodological limitations of the existing studies, there is no doubt that this problem is a significant healthcare burden. There is a need for further observational and interventional studies to establish optimal PCC prevention and management strategies.

scholarly journals INH preventive pherapy (IPT) for HIV-infected South African children

2011 ◽  
Vol 12 (2) ◽  
pp. 27-30
Author(s):  
Mark F Cotton
Keyword(s):  
South African ◽  
Preventive Therapy ◽  
World Health ◽  
Who Guidelines ◽  
Hiv Status ◽  
Source Case ◽  
Adults And Children ◽  
Health Organization ◽  
Living With Hiv

HIV-infected children have a high risk of acquiring tuberculosis. The World Health Organization (WHO) has released isoniazid preventive therapy (IPT) recommendations for adults and children living with HIV, based on efficacy studies, mainly in adults. Data from children appear conflicting. IPT guidelines for children were developed in response to WHO guidelines at a local meeting, followed by discussions. IPT should be given to all HIV-infected children after exposure to a source case if treatment for active disease is not required. For children whose mothers’ HIV status was known antentally, when tuberculosis has been actively excluded in mothers and at infant follow-up, and when infants have commenced antiretroviral therapy in the first 3 months of life, IPT is not required. Otherwise, all infants and children should be given IPT for 6 months once active tuberculosis has been excluded.

scholarly journals PRESCRIBING TREND AMONG HOSPITALIZED PEDIATRIC PATIENTS IN PRIVATE SECTOR HOSPITAL: A PROSPECTIVE OBSERVATIONAL STUDY IN NADIAD, INDIA

2020 ◽  
pp. 195-198
Author(s):  
SANDIP B PATEL ◽  
YASH P PATEL ◽  
SHISHAV B SHAH
Keyword(s):  
Private Sector ◽  
Pediatric Patients ◽  
Indian Academy ◽  
Essential Medicines ◽  
World Health ◽  
Common Disease ◽  
Treatment Protocols ◽  
Study Results ◽  
Prescribing Trend ◽  
Health Organization

Objectives: Purpose of this study was to analyze the prescription pattern among the hospitalized pediatric patients in private sector hospital. Methods: The study was conducted from January 2018 to April, 2018 at Shaishav Hospital, Nadiad, Gujarat, India, and 178 patients were included into the study. Results were obtained by applying the World Health Organization (WHO) prescribing indicators as well as Indian Academy of Pediatrics List of Essential Medicines (IAP-LEM). Results: During the study period, infectious disease such as pneumonitis, bronchitis, enteric fever, gastroenteritis, and dehydration were the dominant disease among the patients. Average number of drugs per prescription was four but in many of prescription, poly-pharmacy has shown. Antibiotic agents were the most prescribed drug (38.6%) among different classes of drugs. Use of the parenteral route of drug administration was used beyond the range stated by the WHO (59% prescriptions vs. 13–24% WHO range). We found that doctor followed IAP-LEM (in 99.78% cases) for prescribing as well as for dosing also, which was very impressive. Conclusions: As this study indicates, there is a need of development of evidence-based treatment protocols for common disease condition for the rational use of medication, especially for an antibiotic medication.

Severe Acute Respiratory Syndrome (SARS)

2011 ◽  
Author(s):  
Merion Evans ◽  
Diana J. Bell
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Southern China ◽  
Rapid Identification ◽  
World Health ◽  
Wildlife Trade ◽  
Animal Reservoir ◽  
Treatment Protocols ◽  
Factors Affecting ◽  
Horseshoe Bat ◽  
Health Organization

Severe acute respiratory syndrome (SARS) has been described by the World Health Organization (WHO) as the first serious and readily transmissible disease to emerge in the 21st century (WHO 2003a). The epidemic first appeared in southern China in late 2002 and was finally contained in July 2003 after spreading to 29 countries worldwide and infecting over 8,000 people with 774 reported deaths. The last known cases occurred in April 2004 after a laboratory acquired infection in China. The global response to the SARS epidemic, co-ordinated by WHO, led to the rapid identification of the causal agent, the development of diagnostic tests for the virus, the initiation of treatment protocols, estimation of key epidemiological factors affecting spread and the implementation of a range of public health interventions (WHO 2003a; Anderson et al. 2005).The cause of SARS has been conclusively identified as a previously unknown coronavirus (Peiris et al. 2003a; Ksiazek et al. 2003; Drosten et al. 2003). Early reports suggested a wild animal reservoir for the virus and attention focused on the wildlife trade in southern China (Xu et al. 2004). Numerous animal reservoirs of the SARS coronavirus have since been identified (Shi and Hu 2007). Masked palm civets (Paguma larvata) have been most consistently identified as the intermediate host responsible for passing the virus to humans (Guan et al. 2003; Song et al. 2005; Wang et al. 2005), while the definitive hosts may be the horseshoe bat species (genus Rhinolophus) (Wang et al. 2006 ).

scholarly journals Updates on 2016 CNS tumor classification - Where do we stand?

2019 ◽  
Vol 1 (1) ◽  
pp. 31-34
Author(s):  
Manish Kolakshyapati ◽  
Tejashwi Shrestha ◽  
Anish Man Singh ◽  
Rupendra Bahadur Adhikari ◽  
Prabin Shrestha
Keyword(s):  
International Standards ◽  
World Health ◽  
Patient Treatment ◽  
Molecular Testing ◽  
Diffuse Glioma ◽  
Treatment Protocols ◽  
Cns Tumor ◽  
New Treatment ◽  
Health Organization ◽  
Experimental Trials

The updated 2016 World Health Organization (WHO) classification of central nervous system (CNS) tumors has incorporated the molecular markers together with histological parameters in defining and diagnosing various tumor entities. This has led to major changes and revision of the classification. A number of new entities are classified based on clinical, diagnostic, and prognostic relevance and those without such relevance have been removed. Major changes are incorporated in diffuse glioma, medulloblastoma, pediatric gliomas, and other embryonal tumors. These new requisites make molecular testing a basic requirement for CNS tumor diagnosis and treatment. New treatment protocols are designed and targeted based on the genetic alteration involved in the tumor entity. The update aims to achieve accurate diagnosis, determine precise prognosis and ensure better patient treatment all through facilitating better categorization of clinical and experimental trials. The multidisciplinary team of clinicians treating such tumor patients in a developing country like Nepal should try to adopt this updated version of the classification so as to improve and upgrade the neuro-oncological services to meet the international standards.

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