scholarly journals Success Rates for the Objectives of US State Cancer Control Plans: A First Look

2021 ◽  
Vol 28 ◽  
pp. 107327482110415
Author(s):  
Mark R. Williamson

Background A well-designed cancer control plan is an important tool for a nation, state, or community to address the burden of cancer. Furthermore, it provides the opportunity to devise and implement measurable objectives. However, there has been little to no assessment of the success rates of such objectives. Methods I compared the success rate of objectives between US states’ current plan and most recent past plan to determine the proportion of success in the United States overall. I also tested possible reasons for low success rates. Results The mean success rate was 20% for stringent successes (only exact matches between plans) and 28% for loose successes (exact and similar matches between plans). The magnitude of change in percentage between the baseline and target for loose objectives significantly predicted success (P = .0347). Higher change resulted in lower success. However, neither the number of objectives nor the level of overlap significantly predicted success rate. Nor was population size, region, or rural–urban status significantly related to success rate. The most successful states had high proportions of objectives that were measurable and a high number of overlapping objectives. Conclusion I found that objective success rates were low for cancer control plans. To improve success rates, I suggest that future cancer control plans ensure each objective has a measurable baseline and realistically attainable target.

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Tolgahan Kuru ◽  
Haci Ali Olcar ◽  
Ali Bilge ◽  
Gurdal Nusran ◽  
Recai Ozkilic ◽  
...  

Background and Objective. Shoulder dislocations, which often occur anterior, account for about half of all dislocations. There are numerous reduction methods reported for the conservative treatment of acute anterior dislocations. However, there is still an ongoing search for an optimal method given the procedure time, possible complications, success rates, and need for sedation/analgesia in existing methods. This study seeks to explore the effectiveness and safety of Prakash’s method in the treatment of acute shoulder dislocations, which is a novel method in the treatment of anterior shoulder dislocations. Materials and Methods. A total of 19 patients who were admitted to the emergency department with the diagnosis of anterior shoulder dislocation participated in this study. The diagnosis of shoulder dislocation was established in the emergency department with physical examination and anteroposterior shoulder radiography. The method was applied only once to the patients in the sitting position by the same physician without using any help, traction, anesthesia, analgesia, and myorelaxant. Results. The mean age of the patients was 37.3 ± 13.1 years. Among them, 36.8% n=7 were female and 63.2% n=12 were male. Recurrent dislocations were observed in 21.1% n=4 of the patients. The success rate of the method was 94.7% n=18. No complication was noted in the patients. The mean procedure time was 243 ± 38 seconds. Conclusion. Prakash’s method is a safe method for anterior shoulder dislocations that can be quickly performed with no need for sedation, assistance, and traction and has a high success rate.


2007 ◽  
Vol 25 (1-2) ◽  
pp. 41-46 ◽  
Author(s):  
Jorge Vas ◽  
Inmaculada Aguilar ◽  
Emilio Perea-Milla ◽  
Camila Méndez

Background Pain is one of the principal symptoms for which the general public seeks medical attention, and it is frequently treated by GPs. Although acupuncture is mainly practised in the private field, it enjoys growing acceptance in the public system too, which helps bring down the high cost of its use. The aim of the present study is to evaluate the effectiveness of acupuncture and related techniques in treating non-oncological pain during nine years of activity at the Pain Treatment Unit (PTU) within the Andalusian Public Health System (Spain) in the field of primary healthcare. Methods Retrospective review of 5981 electronically stored case histories of patients who sought treatment for non-oncological pain and were seen at the PTU between June 1997 and July 2006. We excluded from this review those patients who had on any occasion been recruited for clinical trials at the PTU. The primary result measure applied was the success rate, defined as an improvement of least 50% on the Global Assessment Index, which is made up of five variables: pain intensity, as measured on a numerical scale of 0–10, pain frequency, consumption of analgesics, level of incapacity and sleep disorders caused by pain (the latter four variables were measured on a 5-point Likert scale of 0–4). Results The majority (84.5%) of the patients treated were women, with a mean age of 58.8 years (range 8–93), and they attended the healthcare clinic because of pain present for over three months (88.8%) and mainly affecting the lower back (58.8%). In the 5690 patients who completed treatment, the mean success rate was 79.7%, with highest rates (93%) being achieved in patients with cephalalgia. The mean reduction in pain intensity was 5.5 (SD 2.5) points amounting to 67% fall from the baseline. There was a reduction of ¢7.1 in the mean weekly expenditure on analgesics per patient. From the regression model, we conclude that the patients who suffered acute or sub-acute pain presented higher success rates than did those with chronic pain (OR, 1.94; 95% CI, 1.53–2.48). Conclusions Acupuncture seems to be effective in treating musculoskeletal pain, and presents no severe adverse events. With acupuncture treatment, the consumption of analgesic and anti-inflammatory drugs is considerably reduced.


2013 ◽  
Vol 2 (4) ◽  
pp. 388 ◽  
Author(s):  
Jihao Dong ◽  
Jaime Wong ◽  
Ahmad Al-Enezi ◽  
Anil Kapoor ◽  
J. Paul Whelan ◽  
...  

Objective: The open Anderson–Hynes procedure has an overall success rate of 90% for ureteropelvic junction obstruction. Laparoscopic pyeloplasty (LP) was developed to reduce morbidity and hospital stay while preserving the excellent results. We report on the results of our experience with laparoscopic pyeloplasty.Methods: Between January 2001 and May 2006, 77 consecutive patients underwent LP performed by one of 4 surgeons at our institution. Patients were reassessed with ultrasound (U/S) or intravenous pyelogram (IVP) at 6 weeks. Diuretic renal scan and U/S or IVP were performed at 6 months, and subsequent follow-up included a U/S or IVP as well as clinical assessment. Patients were assessed for pain and hydronephrosis on radiologic imaging, clearance on diuretic renal scan (T1/2) and differential renal function.Results: We evaluated 73 patients. The mean patient age was 38 years (range 16–71 yr), the mean operating time was 218 minutes (range 110–409 min), and the mean blood loss was 57 mL (range 25–250 mL). Mean hospital stay was 3.0 days (range 2–7 d). The success rate was 90.4%, and failures were mainly due to poor function after surgery (3 patients). Pyelolithotomy was performed concomitantly on 6 patients, which on average extended operative time by 36 minutes.Conclusion: Our success rates are consistent with the LP experience of other centres and are comparable with rates for the open technique. Patients had short hospital stays, and complications were negligible. With experienced surgeons, LP should be the first-line treatment for ureteropelvic junction obstruction.


2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Nihat Sayin ◽  
Zeynep Alkin ◽  
Abdullah Ozkaya ◽  
Abdulvahit Demir ◽  
Ahmet Taylan Yazici ◽  
...  

Purpose. To investigate the efficacy and safety of 360° selective laser trabeculoplasty (SLT) on medically uncontrolled open-angle glaucoma (OAG) and to evaluate the effects of antiglaucomatous medications on the results of therapy. Materials and Methods. The medical records of 62 eyes of 51 patients with OAG, which did not reach the targeted intraocular pressure (IOP) with maximum antiglaucomatous medical therapy, were retrospectively reviewed. Results. A statistically significant decrease was observed in the mean baseline IOP at 1, 3, 6, and 12 months of followup (P<0.01). The success rate was 64.5% in all of the patients. The success rates did not vary significantly by taking 1, 2, 3, or 4 medications with the rates of 63.6%, 71.4%, 64.2%, and 58.3% (P=0.06). The success rate of eyes on medication more or less than 6 months was 62.5% or 66.7%, respectively (P=0.3). There was a positive correlation between mean baseline IOP and mean reduction in IOP from baseline (P<0.001, r=0.8). Conclusion. Application of 360° of SLT provided an effective and safe IOP reduction in medically uncontrolled OAG. Baseline IOP was found to be the most important factor in the efficacy of therapy.


2019 ◽  
Vol 85 (12) ◽  
pp. 1350-1353 ◽  
Author(s):  
Shannon M. Zielsdorf ◽  
John J. Klein ◽  
Vidya A. Fleetwood ◽  
Martin Hertl ◽  
Edie Y. Chan

The objective of the study was to determine the long-term stricture rate of hepaticojejunostiomy (HJ) performed for benign disease, to compare stricture rates for transplant patients and non-transplant patients, and to compare the success rates of procedural and surgical treatment options. Hospital charts of 135 consecutive patients undergoing HJ between 1998 and 2016 were analyzed retrospectively. The primary outcome was stricture formation. Secondary outcomes were time to stricture diagnosis and success rates of various interventions. The anastomotic stricture rate was 13.3 per cent (18). The mean follow-up period was 4.3 years. The mean time to stricture diagnosis was 2.3 years. Stricture rates were similar between the transplant (19.2%) and nontransplant, non-Whipple group (13%). Strictures were treated with radiological intervention with a 44.4 per cent success rate; each required multiple interventions. Mortality from liver disease after failure of nonoperative management of HJ strictures reached 30 per cent (3). Five of ten patients who failed radiological intervention underwent HJ revision; the success rate was 80 per cent. Anastomotic strictures of HJ performed for benign disease occur in 13 per cent of patients and typically develop within 2.5 years postoperatively. Yet, given the dangerous sequelae of chronic biliary obstruction and potential delay in presentation, a follow-up is recommended for up to 10 years. When strictures occur, HJ revision should be considered early, after two failed radiological interventions.


2021 ◽  
Author(s):  
Ilayda Korkmaz ◽  
Melis Palamar ◽  
Sait Egrilmez ◽  
Mehmet Gurdal ◽  
Ayse Yagci ◽  
...  

Abstract Purpose: To evaluate limbal stem cell transplantation (LSCT) success in limbal stem cell deficiency (LSCD) due to chemical injury in a tertiary eye care center in Turkey by using ‘Limbal Stem Cell Working Group’ LSCD grading system.Methods: Medical records of 80 eyes of 80 patients who underwent LSCT for LSCD secondary to chemical injury were included. The patients were divided into 3 groups according to performed surgery as limbal autograft, limbal allograft, cultivated limbal epithelial cell transplantation (CLET). Surgical success was defined as improvement in the post-operative 1st year LSCD stage.Results: The mean age of the patients was 37.9±15.7(4-71) with a Male/Female ratio of 2.4. Forty-five(56.3%) patients were injured with alkaline and 16(20%) were injured with acid substance. The mean follow-up time was 60.3±30.6(6-118.6) months. Limbal autograft, allograft and CLET were performed in 58(72.5%), 12(15%) and 10(12.5%) eyes, respectively. The interval between injury and surgery in limbal autograft, limbal allograft and CLET were 43.3±94.1(0.5-592); 14.5±10.6(2.4-32.5) and 122.8±158.9(21.1-504) months, respectively (p=0.02). The overall surgical success rate was 65%. Surgical success rates in each groups were 65.5%, 41.7% and 90%, respectively (p=0.03).Conclusion: It is vital to accurately determine the stage of the LSCD in order to evaluate the surgical success rates. Surgery type and a longer time interval between the chemical injury and surgery seems to be the most important factors associated with a higher surgical success rate. Despite the limited subject number for subgroups, the results were remarkable to emphasize the significance of the novel LSCD grading system.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Rina Kanaya ◽  
Riki Kijima ◽  
Yasuhiro Shinmei ◽  
Akihiro Shinkai ◽  
Takeshi Ohguchi ◽  
...  

Purpose. To evaluate the long-term outcomes of trabeculectomy with mitomycin C (MMC-TLE) in patients with uveitic glaucoma (UG). Patients and Methods. This was a retrospective, nonrandomized case series study. MMC-TLE was performed on 50 eyes with UG between February 2001 and January 2015 at Hokkaido University Hospital. Age- and sex-matched patients with primary open angle glaucoma (POAG) who underwent MMC-TLE were matched by age and sex and enrolled as controls. Surgical success was defined as an intraocular pressure (IOP) less than 18 or 15 mmHg. The Kaplan–Meier survival curves for surgical failure were analyzed. Results. The mean preoperative IOP in UG and POAG was 27.6 ± 10.6 and 18.0 ± 4.5 mmHg, respectively. After the surgery, the mean IOP in UG and POAG was reduced to 11.7 ± 4.2 and 12.2 ± 3.8 mmHg at 12 months, 11.9 ± 7.0 and 12.1 ± 3.1 mmHg at 36 months, and 13.0 ± 5.2 and 10.6 ± 1.2 mmHg at 120 months, respectively. The success rates (IOP <18 mmHg, IOP reduction >20%) in UG and POAG were 91.7% and 88.0% at 12 months, 82.2% and 75.6% at 36 months, and 66.5% and 61.8% at 120 months, respectively. The success rates (IOP <15 mmHg) in UG and POAG were 64.0% and 58.0% at 12 months, 55.1% and 45.5% at 36 months, and 47.9% and 37.8% at 120 months, respectively. There was no significant difference in the success rate between UG and POAG at 120 months after surgery by either definition of surgical success. Conclusions. MMC-TLE effectively reduced IOP in both UG and POAG. There was no significant difference in the success rate between UG and POAG. Following sufficient inflammation suppression, surgical outcomes of UG may be comparable with those of POAG.


2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Chun-Hsien Lin ◽  
Chun-Yuan Wang ◽  
Ying-Cheng Shen ◽  
Li-Chen Wei

Purpose. To report the epidemiological and clinical data as well as surgical outcomes of canalicular lacerations with Mini-Monoka insertion at a tertiary center in Taiwan and to discuss differences in traumatic pattern, pathogenesis, and surgical outcomes between Taiwan and other countries. Methods. From 2009 to 2018, all 48 patients who underwent canalicular laceration repair with Mini-Monoka stent at a tertiary center in Taiwan were retrospectively analyzed. Demographic and clinical data and surgical outcomes were recorded. Results. The mean age of the 48 patients was 38 years. Single lower canaliculus was involved in 37 (77.1%) patients, upper canaliculus in 10 (20.8%) patients, and both in 1 (2.1%) patient. The most common etiology was motorcycle accident (41.7%), and all traffic accident injuries accounted for 68.75% of cases. Subgroup classification revealed 64.6% of patients (n=31) were categorized in the deep laceration group, and lower anatomical and functional outcomes were noted in deep laceration. The mean follow-up time was 14.5 months. Overall, the anatomical success rate was 87.5%, and the functional success rate was 91.7% after stent removal. Conclusion. Canalicular laceration caused by traffic accidents occurred with a relatively high frequency in Taiwan. Affected patients tended to be middle-aged, and deep laceration accounted for 64.6% of patients. These were contributed by the avulsive eyelid injury mechanism caused by traffic accidents. Furthermore, the deeper lacerated site was located, and the lower anatomical and functional success rates were observed. Early repair after trauma with Mini-Monoka stents achieved good eyelid position (100%) as well as good anatomical (87.5%) and functional (91.7%) success without serious complication.


2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Ahmet Karabulut ◽  
Sevket Gorgulu ◽  
Tanıl Kocagoz

Abstract Background Procedures for coronary chronic total occlusion (CTO) are still a clinical challenge with relatively lower success rates. Recent advances in the biotechnology and introduction of CTO-dedicated guidewires have increased the procedural success rate of CTO interventions. Herein, we aimed to reveal the clinical and angiographic predictors of the crossability of the initial guidewire choice and rational guidewire usage in CTO interventions. A total of 177 patients with an indication for a coronary CTO procedure were included in this study. The use of 1–3 guidewires and crossing of the CTO lesion with the initial guidewire choice was defined as rational guidewire usage. The CTO lesions were classified according to the Japanese chronic total occlusion registry (J-CTO) and EuroCTO scores for evaluating the difficulty of the procedures. Then, a statistical analysis was performed to assess the initial guidewire choice, crossability, and contributors to rational guidewire usage. Results The mean J-CTO score was 1.42 ± 1.16, and the mean EuroCTO score was 1.44 ± 1.18. The success rate of the procedures was 90.4%. The initial guidewire choice crossed the lesion in 44.1% of the cases, in which 1–3 guidewires were used (82.1%). The crossability of the polymeric and moderate stiff tip guidewires was higher (82.1% and 64.1%, respectively), and the Pilot series was the most successful brand (36.2%). Logistic regression analysis confirmed that J-CTO score, procedural technique, guidewire type, and stiffness of the tip were the major predictors of rational guidewire usage. Conclusion Our analysis showed that the use of polymeric and moderate stiff tip guidewires, particularly the Pilot brand, were associated with rational guidewire usage in easy and intermediate difficulty CTO cases.


2021 ◽  
pp. 112067212199999
Author(s):  
Matteo Sacchi ◽  
Gianluca Monsellato ◽  
Edoardo Villani ◽  
Rosario Alfio Umberto Lizzio ◽  
Elena Cremonesi ◽  
...  

Purpose: We compared the efficacy and safety of trabeculectomy and phacotrabeculectomy in patients with glaucoma. Materials and methods: We retrospectively analyzed consecutive patients who underwent trabeculectomy or phacotrabeculectomy. Patients in the trabeculectomy group were pseudophakic. We established three different intraocular pressure (IOP) thresholds (A: <21 mmHg, B: <18 mmHg, and C: <15 mmHg) to measure complete (without medication) and qualified (with medication) success. Success criteria were analyzed through Kaplan-Meier survival curves. Results: Sixty-seven eyes were included (40 trabeculectomy, 27 phacotrabeculectomy). The mean follow-up period was 25.70 ± 14.439 months. The baseline characteristics were similar between the groups. The complete and qualified success rates according to criterion C were significantly higher in the trabeculectomy group ( p = 0.033, p = 0.021, respectively); however, there was a trend toward a higher success rate for all criteria in favor of trabeculectomy. Bleb needling was more frequent in the phacotrabeculectomy group. The mean IOP significantly decreased from 26.46 ± 7.07 to 12.27 ± 4.06 at 12 months ( p < 0.001). The final mean IOP was significantly lower in the trabeculectomy than in the phacotrabeculectomy group (10.95 ± 3.08 vs 13.00 ± 4.56, p = 0.0003). Conclusion: In pseudophakic eyes, trabeculectomy alone achieves a higher success rate, lower mean IOP, and less frequent bleb needlings. More frequent follow-up and prolonged postoperative use of high-dose topical steroids should be considered in patients undergoing phacotrabeculectomy.


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