Histopathologic Differences between Jewish and Arab Population in Israel at First-Time Presentation with Bladder Cancer

Background. Pathology of urothelial carcinoma may vary in different populations at diagnosis. Our aim was to evaluate the histopathologic differences between Jewish and Arab patients in Israel at first diagnosis of urothelial cancer. Patients and Methods. We retrospectively collected data of all patients with confirmed urothelial cancer, treated at our department between January 2010 and January 2015. We examined the distribution of the histopathologic data among the studied populations. To compare the categorical variables we used the Chi-Square Pearson test. Comparison of independent variables was made by Student’s t-test. P value below 0.05 was considered significant. Results. The study group included 413 patients, 345 Jews and 68 Arabs. The major differences were that Arab patients were younger (62.61 versus 68.55 years, P=0.001), had more aggressive tumors that were detected at a more advanced stage, and had also a higher rate of metastatic disease (7.4% versus 3.2%, P=0.05). Nonurothelial cell tumors were 2.3 times more prevalent in Arab population. Unlike Jewish population, Arab women had higher rate of invasive/metastatic disease compared with Arab men (40% versus 22.4%). Conclusion. At time of diagnosis the tumors were more aggressive in Arab patients, especially in Arab women. The reasons for those differences constitute a target for a separate research. These results should have an impact on prevention medicine and education of physicians treating mixed populations.

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Tumor-informed assessment of molecular residual disease and its incorporation into practice for patients with early and advanced-stage colorectal cancer (CRC-MRD Consortia).

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.4108 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 4108-4108 ◽

Cited By ~ 1

Author(s):

Pashtoon Murtaza Kasi ◽

Farshid Dayyani ◽

Van K. Morris ◽

Scott Kopetz ◽

Aparna Raj Parikh ◽

...

Keyword(s):

Colorectal Cancer ◽

Metastatic Disease ◽

Residual Disease ◽

Early Stage ◽

Circulating Tumor Dna ◽

Response To Treatment ◽

Chi Square ◽

Multiplex Pcr Assay ◽

Crc Management ◽

First Time

4108 Background: Circulating tumor DNA (ctDNA) testing can be used for the assessment of molecular residual disease (MRD) in patients with early-stage or advanced colorectal cancer (CRC). Prospective evaluation of this methodology in clinical practice has been limited to-date. Methods: A personalized and tumor-informed multiplex PCR assay (Signatera 16-plex bespoke mPCR NGS assay) was used for the detection and quantification of ctDNA for MRD assessment. We analyze and present results from an ongoing early adopter program of ctDNA testing across the spectrum of CRC management. Results: Here we present a total of 250 patients with colon (n=200), rectal (n=40), and other lower gastrointestinal cancers (n =10; anal, appendiceal, small bowel). MRD positivity rates and ctDNA quantification (mean tumor molecules/mL) are shown in Table. ctDNA detection was significantly associated with stage of disease (p<0.0001 Chi-square: 70.33). Additionally, in patients with radiologically measurable active metastatic disease, ctDNA detection rate was 100%. On the contrary, patients with advanced/metastatic disease who had partial response to treatment or no evidence of disease (NED) showed 28.5% and 19.2% of ctDNA-positivity, respectively. Conclusions: This is the first large, real-world study reporting on the results from a clinically validated MRD assay. For the first time we delineate MRD rates and quantify ctDNA concentration in patients with early-stage and advanced CRC. Furthermore, we provide an initial readout that effective ongoing treatment in patients with CRC may be correlated with ctDNA clearance. Ongoing analysis expanded to a cohort of 1200 clinical cases including correlation with genomic and serial testing will be presented. [Table: see text]

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Breast Cancer Cell Re-Dissemination from Lung Metastases—A Mechanism for Enhancing Metastatic Burden

Journal of Clinical Medicine ◽

10.3390/jcm10112340 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2340

Author(s):

Lucia Borriello ◽

John Condeelis ◽

David Entenberg ◽

Maja H. Oktay

Keyword(s):

Breast Cancer ◽

Cancer Cells ◽

Cancer Cell ◽

Metastatic Disease ◽

Breast Cancer Cells ◽

Lung Metastases ◽

Primary Tumors ◽

Metastatic Burden ◽

First Time ◽

Do So

Although metastatic disease is the primary cause of mortality in cancer patients, the mechanisms leading to overwhelming metastatic burden are still incompletely understood. Metastases are the endpoint of a series of multi-step events involving cancer cell intravasation, dissemination to distant organs, and outgrowth to metastatic colonies. Here we show, for the first-time, that breast cancer cells do not solely disseminate to distant organs from primary tumors and metastatic nodules in the lymph nodes, but also do so from lung metastases. Thus, our findings indicate that metastatic dissemination could continue even after the removal of the primary tumor. Provided that the re-disseminated cancer cells initiate growth upon arrival to distant sites, cancer cell re-dissemination from metastatic foci could be one of the crucial mechanisms leading to overt metastases and patient demise. Therefore, the development of new therapeutic strategies to block cancer cell re-dissemination would be crucial to improving survival of patients with metastatic disease.

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49 A Quality Improvement Project to Assess and Refine the Handover Process at Morning Trauma Meetings

British Journal of Surgery ◽

10.1093/bjs/znab134.352 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

S Sadiq ◽

M Tahir ◽

I Nur ◽

S Elerian ◽

A Malik

Keyword(s):

Categorical Variables ◽

Next Of Kin ◽

Chi Square ◽

Neck Of Femur ◽

Improvement Project ◽

Handover Process ◽

Neck Of Femur Fracture ◽

The Impact ◽

Standard Operating Protocol

Abstract Introduction Poor handover between shifts can result in patient harm. This study was designed to evaluate the impact of implementing a handover protocol on the quality of information exchanged in the trauma handover meetings in a UK hospital. Method A prospective single-centre observational study was performed at an NHS Trust. Ten consecutive weekday trauma meetings, involving 43 patients, were observed to identify poor practices in handover. This data was used in conjunction with the Royal College of Surgeons’ recommendations for effective handover (2007) to create and implement a standard operating protocol (SOP). Following its implementation, a further 8 consecutive meetings, involving a further 47 patients, were observed. The data was analysed using t-test for quantitative variables and chi-square or Fisher’s exact tests for categorical variables. Results An improvement was demonstrated in multiple aspects of trauma handover including past medical history, injury date, results, diagnosis, consent, mark, and starvation status (all p < 0.001). Subgroup analyses showed that handover of neck-of-femur fracture patients including information on baseline mobility (p = 0.04), Nottingham-Hip-Fracture Score (p = 0.01), next-of-kin discussion (p = 0.075) and resuscitation status (p = 0.001) all improved following the intervention. Conclusions These results demonstrate that the implementation of a well-structured handover protocol can improve the transmission of critical information in trauma meetings.

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Edible Insects: Preliminary Study about Perceptions, Attitudes, and Knowledge on a Sample of Portuguese Citizens

Foods ◽

10.3390/foods10040709 ◽

2021 ◽

Vol 10 (4) ◽

pp. 709

Author(s):

Sofia G. Florença ◽

Paula M. R. Correia ◽

Cristina A. Costa ◽

Raquel P. F. Guiné

Keyword(s):

Nutritive Value ◽

Meat Products ◽

Regression Tree ◽

Good Alternative ◽

Classification And Regression Tree ◽

Categorical Variables ◽

Final Conclusion ◽

Edible Insects ◽

Chi Square ◽

Alternative Sources

This study investigated the knowledge, attitudes, consumption habits, and degree of acceptability of edible insects (EI) or derived products among Portuguese consumers. This work consisted of a questionnaire survey, undertaken on a sample of 213 participants. For the treatment of data, basic descriptive statistics were used, complemented with chi-square tests to assess some associations between categorical variables. Moreover, a tree classification analysis was carried out using a classification and regression tree (CRT) algorithm with cross-validation. The results indicated that people tend to have correct perceptions about the sustainability issues associated with the use of insects as alternative sources of protein; however, the level of knowledge and overall perception about their nutritive value is low. Regarding the consumption of EI, it was found that only a small part of the participants had already eaten them, doing it mostly abroad, by self-initiative, in a restaurant or at a party or event. Additionally, it was found that the reluctance to consume insects is higher if they are whole, but when they are transformed into ingredients used in food formulations, the level of acceptance increases. Furthermore, men have shown to have a better perception about EI, be more informed about sustainability, and have a higher level of acceptability when compared to women. As a final conclusion, it was observed that the Portuguese still show some resistance to adhere to the use of insects as replacements for meat products, but the market of insect based products can be a good alternative to overpass the neophobia associated with this type of food.

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Relationship of Hydroxychloroquine and Ophthalmic Complications in Patients with Type 2 Diabetes in Taiwan

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158154 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8154

Author(s):

Hung-Chih Chen ◽

Hung-Yu Lin ◽

Michael Chia-Yen Chou ◽

Yu-Hsun Wang ◽

Pui-Ying Leong ◽

...

Keyword(s):

Type 2 Diabetes ◽

Conditional Logistic Regression ◽

Categorical Variables ◽

Control Group ◽

Case Group ◽

Research Database ◽

Continuous Variables ◽

Chi Square ◽

Increased Risk

The purpose of this study is to evaluate the relationship between hydroxychloroquine (HCQ) and diabetic retinopathy (DR) via the national health insurance research database (NHIRD) of Taiwan. All patients with newly diagnosed type 2 diabetes (n = 47,353) in the NHIRD (2000–2012) were enrolled in the study. The case group consists of participants with diabetic ophthalmic complications; 1:1 matching by age (±1 year old), sex, and diagnosis year of diabetes was used to provide an index date for the control group that corresponded to the case group (n = 5550). Chi-square test for categorical variables and Student’s t-test for continuous variables were used. Conditional logistic regression was performed to estimate the adjusted odds ratio (aOR) of DR. The total number of HCQ user was 99 patients (1.8%) in the case group and 93 patients (1.7%) in the control group. Patients with hypertension (aOR = 1.21, 95% CI = 1.11–1.31) and hyperlipidemia (aOR = 1.65, 95% CI = 1.52–1.79) significantly increased the risk of diabetic ophthalmic complications (p < 0.001). Conversely, the use of HCQ and the presence of rheumatoid diseases did not show any significance in increased risk of DR. HCQ prescription can improve systemic glycemic profile, but it does not decrease the risk of diabetic ophthalmic complications.

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Current status of antenatal care of pregnant women—8 provinces in China, 2018

BMC Public Health ◽

10.1186/s12889-021-11154-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wenling Hu ◽

Huanqing Hu ◽

Wei Zhao ◽

Aiqun Huang ◽

Qi Yang ◽

...

Keyword(s):

Health Services ◽

Antenatal Care ◽

Pregnant Women ◽

Community Health ◽

First Trimester ◽

Community Health Services ◽

Current Status ◽

Categorical Variables ◽

Chi Square ◽

Prenatal Care Visit

Abstract Background Antenatal care (ANC) played a crucial role in ensuring maternal and child safety and reducing the risk of complications, disability, and death in mothers and their infants. The objective of this study was to evaluate the current status of ANC emphasizing the number, timing, and content of examinations on a national scale. Methods The data was collected from maternal and newborn’s health monitoring system at 8 provinces in China. After ethical approval, all pregnant women registered in the system at their first prenatal care visit, we included 49,084 pregnant women who had delivered between January 1, 2018 and December 31, 2018. Descriptive statistics of all study variables were calculated proportions and chi-square for categorical variables. Results Of the 49,084 women included in this study, the mean number of ANC visits was 6.95 ± 3.45. By percentage, 78.79% women received ANC examinations at least five times, 39.93% of the women received ANC examinations at least eight times and 16.66% of the women received ANC examinations at least 11 times. The proportion of first ANC examination in first trimester was 61.87%. The percentage of normative ANC examinations and the percentage of qualified ANC examinations were 30.98 and 8.03% respectively. Only 49.40% of the total women received all six kinds of examination items in first ANC examination: 91.47% received a blood test, 91.62% received a urine test, 81.56% received a liver function examination, 80.52% received a renal function examination, 79.07% received a blood glucose test, and 86.66% received a HIV/HBV/syphilis tests. 50.85% women received the first ANC examination in maternal and child health care (MCH) institutions, 14.07% in a general hospital, 18.83% in a township hospital, 13.15% in a community health services center, and 3.08% in an unspecified place. The proportion of women who received each of the ANC examination items in community health services center was the highest, but that in the MCH institutions was the lowest. Conclusions There is a big difference between the results of this study and the data in official reports, this study found the current status of antenatal care is not optimal in China, findings from this study suggest that the systematization, continuity and quality of ANC examinations need to be improved.

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The characteristics and risk factors of human papillomavirus infection: an outpatient population-based study in Changsha, Hunan

Scientific Reports ◽

10.1038/s41598-021-94635-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Bingsi Gao ◽

Yu-Ligh Liou ◽

Yang Yu ◽

Lingxiao Zou ◽

Waixing Li ◽

...

Keyword(s):

Risk Factors ◽

Protective Factor ◽

Hpv Infection ◽

Population Based ◽

Cross Sectional Study ◽

Categorical Variables ◽

Chi Square ◽

Cross Sectional ◽

Hpv Dna ◽

Test Kit

AbstractThis cross-sectional study investigated the characteristics of cervical HPV infection in Changsha area and explored the influence of Candida vaginitis on this infection. From 11 August 2017 to 11 September 2018, 12,628 outpatient participants ranged from 19 to 84 years old were enrolled and analyzed. HPV DNA was amplified and tested by HPV GenoArray Test Kit. The vaginal ecology was detected by microscopic and biochemistry examinations. The diagnosis of Candida vaginitis was based on microscopic examination (spores, and/or hypha) and biochemical testing (galactosidase) for vaginal discharge by experts. Statistical analyses were performed using SAS 9.4. Continuous and categorical variables were analyzed by t-tests and by Chi-square tests, respectively. HPV infection risk factors were analyzed using multivariate logistic regression. Of the total number of participants, 1753 were infected with HPV (13.88%). Females aged ≥ 40 to < 50 years constituted the largest population of HPV-infected females (31.26%). The top 5 HPV subtypes affecting this population of 1753 infected females were the following: HPV-52 (28.01%), HPV-58 (14.83%), CP8304 (11.47%), HPV-53 (10.84%), and HPV-39 (9.64%). Age (OR 1.01; 95% CI 1–1.01; P < 0.05) and alcohol consumption (OR 1.30; 95% CI 1.09–1.56; P < 0.01) were found to be risk factors for HPV infection. However, the presence of Candida in the vaginal flora was found to be a protective factor against HPV infection (OR 0.62; 95% CI 0.48–0.8; P < 0.001). Comparing with our previous study of 2016, we conclude that the subtype distribution of HPV infection is relatively constant in Changsha. Our data suggest a negative correlation between vaginal Candida and HPV, however, more radical HPV management is required in this area for perimenopausal women and those who regularly consume alcohol.

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Diagnosis despite clinical ambiguity: physicians’ perspectives on the rise in Autism Spectrum disorder incidence

BMC Psychiatry ◽

10.1186/s12888-021-03151-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Michael Davidovitch ◽

Dorit Shmueli ◽

Ran Shmuel Rotem ◽

Aviva Mimouni Bloch

Keyword(s):

Autism Spectrum Disorder ◽

Autism Spectrum ◽

Mental Illnesses ◽

Spectrum Disorder ◽

Medical Community ◽

Categorical Variables ◽

Diagnostic Process ◽

Child Neurology ◽

Chi Square ◽

Child Psychiatrists

Abstract Background To provide insight on physicians’ perspectives concerning recent changes in the incidence and diagnostic process of Autism Spectrum Disorder (ASD) compared to other mental and neurodevelopmental disorders. Method A questionnaire was sent to 191 specialists in child neurology and child development, and 200 child psychiatrists in Israel. Information was collected on professional background, as well as on physicians’ opinions concerning the accuracy and rate of ASD diagnosis compared to that of cerebral palsy (CP), mental illness, and Attention Deficit Hyperactivity Disorder (ADHD). For each closed-ended question, a global chi-square test for categorical variables was performed. Results 115 (60.2%) of specialists in child neurology and development, and 59 (29.5%) of child psychiatrists responded. Most physicians (67.2%) indicated that there was a moderate/significant increase in the incidence of ASD, which was higher than similar responses provided for CP (2.9%, p < 0.01) and mental illnesses (14.4%, p < 0.01), and similar to responses provided for ADHD (70.1%, p = 0.56). 52.8% of physicians believed that in more than 10% of clinical assessments, an ASD diagnosis was given despite an inconclusive evaluation (CP: 8.6%, p < 0.01; mental illnesses: 25.8%, p = 0.03; ADHD: 68.4%, p = 0.03). Conclusion The clinicians perceive both ASD and ADHD as over-diagnosed disorders. The shared symptomology between ASD and other disorders, coupled with heightened awareness and public de-stigmatization of ASD and with the availability of ASD-specific services that are not accessible to children diagnosed with other conditions, might lead clinicians to over-diagnose ASD. It is advisable to adopt an approach in which eligibility for treatments is conditional on function, rather than solely on a diagnosis. The medical community should strive for accurate diagnoses and a continuous review of diagnostic criteria.

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Comparison of Androgen Receptor, VEGF, HIF-1, Ki67 and MMP9 Expression between Non-Metastatic and Metastatic Stages in Stromal and Tumor Cells of Oral Squamous Cell Carcinoma

Life ◽

10.3390/life11040336 ◽

2021 ◽

Vol 11 (4) ◽

pp. 336

Author(s):

Lovorka Batelja-Vuletic ◽

Cedna Tomasovic-Loncaric ◽

Marcello Ceppi ◽

Marco Bruzzone ◽

Aleksandra Fucic ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Oral Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Metastatic Disease ◽

Squamous Cell ◽

Mmp9 Expression ◽

Oral Malignancy ◽

First Time ◽

Epithelium Cells ◽

Diagnostics And Therapy

Objectives: Oral squamous cell carcinoma (OSCC) is the most common oral malignancy with low survival as it is very often diagnosed at an advanced stage, which is why the accurate profiling of the tumor is essential. The aim of this study was to, for the first time, compare in OSCC the frequency of AR, VEGF, MMP9, HiF1beta and Ki67 between the non-metastatic and metastatic disease. Materials and Methods: In the study, 96 non-metastatic and 91 metastatic OSCC patients were analysed for AR, VEGF, MMP9, HiF1beta and Ki67 levels by immunohistochemistry. Results: All of the tested biomarkers significantly differed between non-metastatic and metastatic disease. A significant association was found between >/=20% AR positive epithelium cells in cytoplasm, Ki67 and VEGF in cancer stroma. Ki67, HiF1beta, VEGF and MMP9 were significantly associated with TNM stages. Conclusion: Our results show for the first time an interplay between AR, VEGF, MMP9, HiF1beta and Ki67 in OSCC which may contribute to better diagnostics and therapy selection.

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350. Neurocysticercosis – Gender Differences in Clinical Presentations

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.545 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S244-S244

Author(s):

Bharath Pendyala ◽

Prasanth Lingamaneni ◽

Patricia DeMarais ◽

Lakshmi Warrior ◽

Gregory Huhn

Keyword(s):

Gender Differences ◽

Categorical Variables ◽

Public Health Issue ◽

Diagnostic Code ◽

Continuous Variables ◽

Chi Square ◽

Generalized Seizures ◽

Icd 10 ◽

Chi Square Test ◽

Reported Data

Abstract Background Neurocysticercosis is a Neglected Tropical Disease and an important public health issue. Our goal was to collect and analyze data regarding clinically significant gender differences among our Neurocysticercosis patients. Methods A retrospective chart search with ICD 9/ ICD 10 diagnostic code for Neurocysticercosis and neuroimaging suggestive of Neurocysticercosis was performed for clinical encounters in the hospital or affiliated clinics between years 2013–2018. After a careful chart review, patients who were clinically diagnosed with Neurocysticercosis were included in the study. T-test was used to compare means of continuous variables and chi-square test to compare proportions of categorical variables. Results Among 90 total patients included, male (49.4%) and female (50.6%) distribution were nearly identical. The mean age in females was found to be higher than males (52.5 vs 42.0, P < 0.0001). Almost an equal number of males and females presented with either seizures (63.6% vs 57.8%, P= 0.85), headaches (25.0% vs 28.9%, p= 0.85), or other symptoms (11.4% vs 13.3%, p= 0.85). Males had more generalized seizures compared to females (60% vs 38%, P= 0.37), although this result was not statistically significant. Females were more likely to present with > 1 lesion (82.2% vs 56.8%, P= 0.01). Males were more likely to have cystic lesions (64.7% vs 27.9%, P < 0.001) compared to females who had more calcified lesions on presentation (65.1% vs 20.6%, P < 0.001). Male patients were more likely to have contrast enhancement or edema surrounding the lesions (61.4% vs 33.3%, P= 0.01) and were more likely to require treatment with Albendazole/Praziquantel (75.8% vs 31.7%, P < 0.001). Conclusion Although previously reported data is limited, there is a suggestion that there are gender differences in host immune response and that inflammation surrounding parenchymal lesions is more intense in females. This study suggests that men either present early in the disease phase or have different immune responses than women and require anti-parasitic therapy more frequently. More research in this aspect is needed. Disclosures All Authors: No reported disclosures

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