scholarly journals Conjunctival Melanoma in Childhood and Adolescence: A Systematic Review

2019 ◽  
Vol 5 (6) ◽  
pp. 387-395 ◽  
Author(s):  
Ben W.R. Balzer ◽  
Svetlana Cherepanoff ◽  
Anthony M. Joshua ◽  
Michael Giblin ◽  
Robert Max Conway ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Metastatic Disease ◽  
Small Sample Size ◽  
Management Strategies ◽  
Disease Recurrence ◽  
Small Sample ◽  
Excision Biopsy ◽  
Childhood And Adolescence ◽  
Conjunctival Melanoma ◽  
History Of

Background: Conjunctival melanoma is rare in adults and rarer in children. We systematically reviewed the presentation, diagnostic and management strategies as well as outcomes for conjunctival melanoma in children and adolescents. Methods: The following databases were searched: Medline, Embase, Web of Science and Scopus for cases of conjunctival melanoma occurring in children and adolescents < 18 years of age. Results: Seventeen studies with 32 patients (18 males) were identified. The median age at presentation was 11 years (range 4–18 years). Most patients were white. Most patients presented with a conjunctival mass or naevus with a recent history of growth or change. Excision biopsy provided diagnosis and management for all cases. Adjuvant chemotherapy and radiotherapy were also used. One patient had metastatic disease at diagnosis and 3 developed metastatic disease (range 1–10 months). Two patients died from disease and one was alive with metastatic disease. Two patients had disease recurrence. Outcomes were observed to be better where diagnosis was made earlier and “no-touch” excision biopsy was performed in an appropriate specialist setting. Conclusions: Conjunctival melanoma occurs rarely in children and adolescents. Surgery is the mainstay of management. The prognosis is guarded in metastatic disease due to the small sample size and limited follow-up.

Investigating the Dynamics of Suicidal Ideation

Crisis ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 65-69 ◽  
Author(s):  
Nina Hallensleben ◽  
Lena Spangenberg ◽  
Thomas Forkmann ◽  
Dajana Rath ◽  
Ulrich Hegerl ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Small Sample Size ◽  
Unipolar Depression ◽  
Small Sample ◽  
History Of ◽  
Severity Of Depression ◽  
Ecological Momentary ◽  
Depressive Episodes ◽  
Ema Method ◽  
Shed Light

Abstract. Background: Although the fluctuating nature of suicidal ideation (SI) has been described previously, longitudinal studies investigating the dynamics of SI are scarce. Aim: To demonstrate the fluctuation of SI across 6 days and up to 60 measurement points using smartphone-based ecological momentary assessments (EMA). Method: Twenty inpatients with unipolar depression and current and/or lifetime suicidal ideation rated their momentary SI 10 times per day over a 6-day period. Mean squared successive difference (MSSD) was calculated as a measure of variability. Correlations of MSSD with severity of depression, number of previous depressive episodes, and history of suicidal behavior were examined. Results: Individual trajectories of SI are shown to illustrate fluctuation. MSSD values ranged from 0.2 to 21.7. No significant correlations of MSSD with several clinical parameters were found, but there are hints of associations between fluctuation of SI and severity of depression and suicidality. Limitations: Main limitation of this study is the small sample size leading to low power and probably missing potential effects. Further research with larger samples is necessary to shed light on the dynamics of SI. Conclusion: The results illustrate the dynamic nature and the diversity of trajectories of SI across 6 days in psychiatric inpatients with unipolar depression. Prediction of the fluctuation of SI might be of high clinical relevance. Further research using EMA and sophisticated analyses with larger samples is necessary to shed light on the dynamics of SI.

Case series: COVID-19 infection causing new-onset diabetes mellitus?

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Rujuta Katkar ◽  
Narasa Raju Madam
Keyword(s):  
Diabetes Mellitus ◽  
Severe Acute Respiratory Syndrome ◽  
Cell Damage ◽  
Small Sample Size ◽  
Case Series ◽  
Small Sample ◽  
Onset Diabetes ◽  
History Of ◽  
New Onset Diabetes Mellitus ◽  
New Onset

Objectives: This paper seeks to explore the hypothesis of the potential diabetogenic effect of SARS-COV-2 (Severe Acute respiratory syndrome coronavirus). Case series presentation: We present a case series of observation among 8 patients of age group ranging from 34 to 74 years with a BMI range of 26.61 to 53.21 Kilogram/square meters that developed new-onset diabetes after COVID-19 infection. Severe Acute Respiratory Syndrome Coronavirus (SARS-COV-2), commonly known as Coronavirus or COVID-19(Coronavirus infectious disease), gains entry into the cells by binding to the Angiotensin-converting enzyme-2(ACE-2) receptors located in essential metabolic tissues including the pancreas, adipose tissue, small intestine, and kidneys. The evidence reviewed from the scientific literature describes how ACE 2 receptors play a role in the pathogenesis of diabetes and the plausible interaction of SARS-COV-2 with ACE 2 receptors in metabolic organs and tissues. Conclusion: The 8 patients without a past medical history of diabetes admitted with COVID-19 infection developed new-onset diabetes mellitus due to plausible interaction of SARS-COV-2 with ACE 2 receptors. The resulting downregulation of ACE-2 and ACE-2 receptors expression caused islet-cell damage resulting into diabetes. The resulting observation has the potential to adversely impact significant number of the globally affected population. Screening patients with COVID-19 for diabetes routinely can help in early detection, significantly reducing morbidity and mortality associated with diabetes. Due to limitations of observational study with a small sample size will require further investigation in the form of Clinical trial.

Impact of race on biomarker testing among HER2- advanced breast cancer (ABC) patients (pts) in the United States: Results from a real-world study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10598-10598
Author(s):  
Reshma L. Mahtani ◽  
Alexander Niyazov ◽  
Katie Lewis ◽  
Lucy Massey ◽  
Alex Rider ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Targeted Therapies ◽  
Small Sample Size ◽  
The United States ◽  
Small Sample ◽  
Access To Treatment ◽  
History Of ◽  
Biomarker Testing ◽  
Abstract Data ◽  
The Impact

10598 Background: African Americans (AA) have the highest breast cancer (BC) mortality rate. Access to treatment is a known contributing factor. In the past 4 years, several targeted therapies for HER2- BC have become available which require testing for specific biomarkers. This study assessed the impact of race on biomarker testing rates in HER2- ABC pts receiving treatment in the US. Methods: Oncologists were recruited to abstract data from medical charts for the next 8-10 pts receiving treatment with HER2- ABC during Sept 2019-Apr 2020. Pts records were stratified by race and categorized into 3 mutually exclusive cohorts [White/Caucasian (White), AA, Other]. The other race cohort was excluded from this analysis due to small sample size. Differences in pt demographics/clinical characteristics were analyzed via Fisher’s exact tests. Testing rates for actionable biomarkers (i.e. BRCA1/2, PIK3CA, PD-L1) were compared between White and AA pts utilizing logistic regressions controlling for age, known family history of a BRCA-related cancer, hormone receptor (HR) status and practice setting (academic vs. community). Further analyses by age will be presented. Results: This analysis included 378 pts records, provided by 40 oncologists. Mean age was 64 years; 77% had HR+/HER2- ABC; 20% had advanced triple negative breast cancer (TNBC), 3% had ABC with an unknown HR status. Compared to White pts, AA pts were significantly more likely to have advanced TNBC (27% vs. 18%, p<0.05). Compared to White pts, AA pts had significantly lower BRCA1/2 mutation (mut) testing rates (Table). Numerically lower rates of PIK3CAmut and PD-L1 testing were observed among AA pts (Table). BRCA1/2mut positivity rate (germline [g] and/or somatic [s]) was higher among AA vs. White pts (30% vs. 22%). Positivity rate for PIK3CAmut was lower for AA vs. White pts (8% vs. 11%). Conclusions: A higher than expected BRCA1/2mut positivity rate was observed than previously reported in the literature. This is likely because this analysis included s BRCA1/2mut and represented a high risk pt population. Across all biomarkers assessed, AA pts had lower testing rates than White pts. This suggests racial disparities in testing rates of actionable biomarkers. Consistent with guidelines, and with the increased availability of targeted therapies, focused efforts should be developed to increase biomarker testing in AA pts. Funding: Pfizer Biomarker Testing Rates by Race.[Table: see text]

The SCIA Questionnaire: standards for communities for children and adolescents – a tool for the evaluation of good practices

2019 ◽  
Vol 40 (1) ◽  
pp. 1-15
Author(s):  
Cinzia Guarnaccia ◽  
Anna Maria Ferraro ◽  
Maria Lo Cascio ◽  
Simone Bruschetta ◽  
Francesca Giannone
Keyword(s):  
Children And Adolescents ◽  
Short Form ◽  
Small Sample Size ◽  
Small Sample ◽  
Self Report ◽  
Community Treatment ◽  
Short Version ◽  
Therapeutic Communities ◽  
Evaluation Tool ◽  
Content Type

Purpose The purpose of this paper is to present the Italian validation of the standards for communities for children and adolescents (SCIA) Questionnaire, an evaluation tool of communities quality standards, based on the “Service Standards for Therapeutic Communities for Children and Young People – 2nd edition” of the Community of Communities (2009), that enables an empirical, multidimensional and complex evaluation of the therapeutic community (TC) “system”. It is a self-report that sets out and measures variables that allow to get an overview of organisational models and the possible development areas to improve the effectiveness of the protection of child and adolescents in community treatment. The validation and a preliminary analysis to develop a short version of the SCIA are presented. Design/methodology/approach The questionnaire (composed, in the extended form, by 143 items) was administered to 101 community workers, 20 males (19.8 per cent) and 81 females (81.2 per cent) aged between 24 and 61 years (M=36.20, SD=8.4). The analysis of reliability (Cronbach’s α) and a series of exploratory factor analysis allowed to eliminate redundant or less significant items. Findings The short form of the self-report consists of 67 items, divided into seven subscales, which explore different areas of intervention in TCs. Despite the limitations due to the small sample size, the utility of this tool remains confirmed by its clinical use and the development of good operating practices. Originality/value The SCIA Questionnaire responds to the need to adopt empirical variables in the process of evaluation of the communities. The SCIA is also a useful tool for clinical evaluation, as it allows a detailed observation of residential community treatment with children and adolescents that allows to analyse and monitor the structural and organisational aspects and the quality of practices that guide the interventions.

Prognostic implications of tumor sidedness in colorectal cancer patients in South Dakota, 2006-2015.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 46-46
Author(s):  
Jonathan Scott Bleeker ◽  
Muslim Atiq ◽  
Morgan Nelson ◽  
Kay Dosch
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
South Dakota ◽  
Metastatic Disease ◽  
Small Sample Size ◽  
Hepatic Flexure ◽  
Small Sample ◽  
Colon And Rectum ◽  
Prognostic Implications ◽  
Colorectal Cancer Patients

46 Background: Tumor “sidedness” is emerging as an important prognostic and predictive factor in patients with metastatic colorectal cancer (CRC), with right sided colon cancer (RC) associated with poorer overall survival (OS) than left sided colon cancer (LC). This distinction has been noted in clinical trials and large databases, where American Indian (AI) populations are generally underrepresented. This project aims to investigate the prognostic implications of CRC sidedness in the state of South Dakota, focusing on the AI population. Methods: Data from patients diagnosed with CRC in the South Dakota cancer registry from January 1, 2006 to December 31, 2015 were analyzed for demographic and presenting features as well as survival outcomes. A total of 3,637 cases were included in the analysis, of which 191 (5%) were AI. Tumors arising from the cecum, ascending colon, hepatic flexure and transverse colon were considered RC while those arising from the splenic flexure, descending colon, sigmoid colon and rectum were considered LC. Results: In all patients, 47.1% of cases were RC; Caucasians (C) were significantly more likely to have RC, as 47.7% of cases in Caucasians were RC, whereas in the AI population, 35.6% cases were RC (p=0.005). Patients with RC were more likely to be female and older and less likely to present with metastatic disease than LC. Tumor sidedness was not associated with OS when analyzing all patients regardless of stage or in patients with non-metastatic disease. In patients with metastatic disease, RC was associated with inferior OS compared to LC [Median OS (mo): 9.9 v. 23.6, p<0.001]. When analyzed by race, RC was associated with inferior OS in C [Median OS (mo): 9.6 v. 23.6, p=0.002] but not in AI [Median OS (mo): 10.2 v. 10.4, p=0.082]. Conclusions: Although limited by small sample size, this analysis is hypothesis generating, as AI patients with CRC were more likely to have LC than Caucasians and the well described prognostic implications of RC were not noted in the AI population. Larger population studies and further investigation as to potential explanations for this finding are recommended.

scholarly journals Impact of Spirituality on Depression, Anxiety and Stress of Students Preparing for Competitive Exams

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Manpreet Ola
Keyword(s):  
Small Sample Size ◽  
Inverse Correlation ◽  
Small Sample ◽  
Female Students ◽  
Significant Inverse Correlation ◽  
Male And Female ◽  
College Ranking ◽  
Self Worth ◽  
History Of ◽  
Age Range

Background: Gradually over the years trend towards education system in our country has changed, it has become highly competitive. On the basis of one’s grades admissions to various “top colleges” is provided, which further leads to “high packaged placements”. On the basis of one’s job status and college ranking their self worth is measured and all this puts lot of burden on students who have to continuously strive to achieve better than their batch mates, their siblings, relatives, neighbors etc. Aim: The aim of the study was to see whether spirituality would have any impact on depression, anxiety and stress in male and female students preparing for competitive exams. Methods: Participants were 60 students (30 males and 30 females) from areas of Rajasthan and Delhi, India, in the age range of 16-25 years, with no history of any psychiatric illness. They gave their consent to participate in the study. Spirituality was assessed using the daily spiritual experience scale by Underwood & Teresi, (2002), depression, anxiety, and stress levels through Depression, Anxiety, Stress Scales (DASS by Lovibond & Lovibond, 1995). Sample was purposive and the data were collected in individual situations. Results: There was difference between male and female students with regard to spirituality, depression, anxiety and stress, however only on the dimension of anxiety the results were significant, where female students had significantly more anxiety than that of male students (t = 2.87, p = .01). With regard to correlation between spirituality, depression, anxiety and stress there was significant inverse correlation for male and female students. However only for anxiety scores in females, there was a significant inverse correlation (r=-.417, p= .01). Conclusion: It can be concluded that spirituality to some extent helps in reducing anxiety. At the same time it is essential for us to realize that spirituality is not the only way to help the young stressed students to cope with this life challenge, the family simultaneously needs to be supportive and not over pressurize the students and should stop comparing them to one or the other. However due to the small sample size the result findings cannot be generalized.

scholarly journals Depression and its characteristics in childhood and adolescence

2020 ◽  
Vol 9 (10) ◽  
pp. e4319108697
Author(s):  
Ana Paula Alves Guilherme ◽  
Mônica Micheli Alexandre ◽  
Mariana Moraes Pinc ◽  
Joice Karina Otênio ◽  
Guilherme Donadel ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Children And Adolescents ◽  
Psychotropic Drugs ◽  
Clinical Investigation ◽  
Behavioral Therapy ◽  
Childhood And Adolescence ◽  
Supportive Psychotherapy ◽  
Interpersonal Therapy ◽  
Treatment Of Depression ◽  
History Of

Currently the accelerated and troubled routine ends up also affecting children and adolescents, who are still unable to develop, express and assimilate what happens to them, internally and externally, understand their pains and suffering; thus, they end up developing mental disorders, such as depression. Given the importance of seeking more information about depression, this study aimed to produce a bibliographic review article on depression in childhood and adolescence and its characteristics. The databases Pubmed (US National Library of Medicine), Scielo (Scientific Electronic Library Online), and Google ScholarⓇ were used in the present study, using the descriptors: depression, psychotropic drugs, mental disorders and psychotherapy. The articles analyzed were written in Portuguese, English and Spanish, for the past 22 years. For the diagnosis of children or adolescents, the clinical investigation has its particularities, the anamnesis must be more in-depth and it must go beyond the parents' complaint and the history of the child or adolescent. During treatments, psychopharmaceuticals can be used, as well as alternative therapies, such as supportive psychotherapy, interpersonal therapy, brief dynamic psychotherapy, behavioral therapy, among others. However, according to studies carried out recently, the use of psychotropic drugs in children and adolescents brings worrying revelations. It is concluded, through the study, that care must be taken both in the diagnosis and in the treatment of depression in children and adolescents.

scholarly journals Prenatal exposure to organophosphate pesticides and risk-taking behaviors in early adulthood

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Sharon K. Sagiv ◽  
Stephen Rauch ◽  
Katherine R. Kogut ◽  
Carly Hyland ◽  
Robert B. Gunier ◽  
...  
Keyword(s):  
Prenatal Exposure ◽  
Risk Taking ◽  
Small Sample Size ◽  
Geometric Mean ◽  
Early Adulthood ◽  
Health Assessment ◽  
Fold Increase ◽  
Small Sample ◽  
Childhood And Adolescence ◽  
Risk Taking Behaviors

Abstract Introduction Previous studies show evidence for associations of prenatal exposure to organophosphate (OP) pesticides with poorer childhood neurodevelopment. As children grow older, poorer cognition, executive function, and school performance can give rise to risk-taking behaviors, including substance abuse, delinquency, and violent acts. We investigated whether prenatal OP exposure was associated with these risk-taking behaviors in adolescence and young adulthood in a Mexican American cohort. Methods We measured urinary dialkyl phosphates (DAPs), non-specific metabolites of OPs, twice (13 and 26 weeks gestation) in pregnant women recruited in 1999–2000 in the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) study, a birth cohort set in a primarily Latino agricultural community in the Salinas Valley, California. We followed up children throughout their childhood and adolescence; at the 18-year visit, adolescent youth (n = 315) completed a computer-based questionnaire which included questions about substance use, risky sexual activity, risky driving, and delinquency and police encounters. We used multivariable models to estimate associations of prenatal total DAPs with these risk-taking behaviors. Results The prevalence of risk-taking behaviors in CHAMACOS youth ranged from 8.9% for smoking or vaping nicotine to 70.2% for committing a delinquent act. Associations of total prenatal DAPs (geometric mean = 132.4 nmol/L) with risk-taking behavior were generally null and imprecise. Isolated findings included a higher risk for smoking or vaping nicotine within the past 30 days (relative risk [RR] per 10-fold increase in prenatal DAPs = 1.89, 95% CI: 1.00, 3.56) and driving without a license (RR = 1.74, 95% CI: 1.25, 2.42). There were no consistent differences by sex or childhood adversity. Discussion We did not find clear or consistent evidence for associations of prenatal OP exposure with risk-taking behaviors in adolescence/early adulthood in the CHAMACOS population. Our small sample size may have prevented us from detecting potentially subtle associations of early life OP exposure with these risk-taking behaviors.

scholarly journals The nature of language problem in Bangladeshi children with cerebral palsy: an observation using neurolinguistic approach

Mediscope ◽  
2018 ◽  
Vol 5 (1) ◽  
pp. 22-27
Author(s):  
F Ferdous ◽  
MF Alam ◽  
MMR Chisty ◽  
JI Ali ◽  
NMW Rahman
Keyword(s):  
Cerebral Palsy ◽  
Small Sample Size ◽  
Tertiary Care ◽  
Small Sample ◽  
Childhood Disability ◽  
Medical College ◽  
Complex Sentences ◽  
History Of ◽  
Children Development ◽  
Tertiary Care Hospitals

Cerebral palsy (CP) is the leading cause of childhood disability affecting function and development. The objective of the study was to look into the language problems in Bangladeshi children with CP on the basis of neurolinguistic approach and was conducted during the period of April 2014 to December 2014 at the Department of Linguistics, University of Dhaka among children aged between 3 to 18 years. In the study, a total of 10 children with CP were enrolled purposively from two tertiary care hospitals in Dhaka (Children Development Centre of Sir Salimullah Medical College and Mitford Hospital and National Institute of Mental Health). The mean±SD age was 8.9±4.8 years. Male was predominant (60.0%). History of prolonged labour was 100%, and home attended by untrained birth attendants in 70.0%. The 90.0% of the children understood simple meaningful sentences using two words. The children were unable to understand complex sentences. The 80.0% children did not want to play or make friendship with other children; 40.0% did not understand others’ speech, 50.0% did not express their own speech, and 10.0% did not understand & express their own speech. All the children had deep thong articulation changed to mono thong in case of semi vowel articulation. In case of history of delayed crying at birth, phoneme omission occurred when the children tried to articulate any word. To the best of knowledge, this was the first study done on the neurolinguistic approach in Bengali children, but the limitation of the study were that it was with small sample size, city based and short duration. Therefore, generalization of the results would be difficult. Further studies using larger sample would be better to visualize the extent of the issue in order to insert the children with CP in their social context and to give them quality of life.Mediscope Vol. 5, No. 1: Jan 2018, Page 22-27

MO136RELATIONSHIP BETWEEN UPCR AND EGFR IN C3 GLOMERULOPATHY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Carla Nester ◽  
Patrick Breheny ◽  
Monica Hall ◽  
Alan Charney ◽  
Martin Lefkowitz ◽  
...  
Keyword(s):  
Natural History ◽  
Small Sample Size ◽  
Continuous Variable ◽  
Small Sample ◽  
C3 Glomerulopathy ◽  
University Of Iowa ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Relationship

Abstract Background and Aims Considerable knowledge gaps exist in our understanding of the natural history of C3 glomerulopathy (C3G). Disease rarity, multiple nomenclature changes, and the inclusion of dissimilar cases in historical cohorts have precluded retrospective studies to define the natural course of C3G and identify risks for progression to kidney failure (end stage renal disease/ESRD). In the present analysis, we focus on C3G patients with native kidneys and examine the relationship between reductions in UPCR and disease progression as indicated by changes in eGFR. Method Patients included in this study were consented and enrolled in the University of Iowa C3G ReCom Registry, which was created in 2013. Beginning in 2017, complement activity and renal function data were collected prospectively at approximately 6-month intervals to define the natural history of C3G. Analyses were performed across 1-year periods of time (“spans”). To be included in a span, a patient had to meet the following criteria at the start of the 1-year period: native C3G, eGFR ≥30 mL/min/1.73 m2, UPCR ≥1 g/g and ≥12 years of age. An individual patient could be included in more than one span. Results Analyses were performed using 34 one-year spans for 24 patients who met inclusion criteria at the beginning of the 1-year span. Baseline characteristics for the 34 spans were: male, 59%; mean age, 22.7 years; mean eGFR, 83.1 ml/min/1.73m2; mean UPCR, 2.86 g/g; mean plasma C3, 75.1 mg/dL. Similar analyses using only the first 1-year span for each of the 24 patients produced results that were consistent with those generated using all 1-year spans. Limitations of this study include its small sample size and data variability due to its observational nature. Conclusion The findings of this observational study support the premise that reductions in proteinuria are associated with a more stable eGFR in native kidney C3G. Regression analyses using UPCR as a continuous variable demonstrate the relationship between reduction in UPCR and preservation of eGFR. This association was also observed using both change in eGFR by UPCR reduction subgroup and UPCR-eGFR categorical analyses.

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