scholarly journals Largely varying patterns and trends of primary cancer-directed resection for gastric carcinoma with synchronous distant metastasis in Europe and the US: a population-based study calling for further standardization of care

2021 ◽  
Vol 13 ◽  
pp. 175883592110278
Author(s):  
Lei Huang ◽  
Lina Jansen ◽  
Rob H.A. Verhoeven ◽  
Jelle P. Ruurda ◽  
Liesbet Van Eycken ◽  
...  
Keyword(s):  
Gastric Carcinoma ◽  
Distant Metastasis ◽  
Associated Factors ◽  
Large Population ◽  
Population Based ◽  
Primary Cancer ◽  
Association Patterns ◽  
Adjacent Structures ◽  
The Us

Aims: The role of resection remains debated in cases of metastatic gastric carcinoma (mGC). Some mGCs are technically resectable. At the population level, the real-world application of resection for mGC remains largely unclear in most Western countries. This large, population-based international investigation aimed to reveal the resection patterns and trends for mGC and the treatment-associated factors in Europe and the US. Methods: Data on cases with microscopically-confirmed primary invasive stomach carcinoma with distant metastasis were obtained from the nationwide cancer registries of the Netherlands, Belgium, Norway, Sweden, Estonia, and Slovenia and the US Surveillance, Epidemiology, and End Results-18 database. We calculated age-standardized rates of primary cancer-directed resection and assessed resection trends using linear regression. We investigated associations of treatment with patient and cancer factors using multivariable-adjusted log-binomial regression. Results: Among 133,321 patients with gastric cancer, overall, 40,215 cases with mGC diagnosed between 2003–2017 were investigated. Age-standardized resection rates significantly declined over time in the US, Belgium, Sweden, and Norway (by 5–14%). Resection rates greatly differed from 5% to 16% in 2013–2014. Cases with older ages, cardia tumors, or tumors involving adjacent structures were significantly less often operated across most countries. Sex was not significantly associated with resection. Across countries the association patterns and strengths differed largely. With multivariable adjustment, resection rates decreased significantly in all countries except Slovenia and Estonia (prevalence ratio per year = 0.90–0.98), and the decreasing trends were consistently observed in various stratifications by age and location. Conclusion: In Europe and the US, resection patterns and trends largely varied across countries for mGCs, which were mostly less often resected in the early 21st century. Various resection-associated factors were shown, with greatly varying association patterns and strengths. Our report could aid to identify discrepancies in clinical practice and highlight the great need for further clarifying the role of resection in mGCs to enhance standardization of care.

The Impact of In-group Favoritism on Trade Preferences

2017 ◽  
Vol 71 (4) ◽  
pp. 827-850 ◽  
Author(s):  
Diana C. Mutz ◽  
Eunji Kim
Keyword(s):  
Well Being ◽  
Population Based ◽  
Trading Partner ◽  
Relative Advantage ◽  
Trade Policies ◽  
Partner Country ◽  
The Us ◽  
Trade Preferences ◽  
The Impact

AbstractUsing a population-based survey experiment, this study evaluates the role of in-group favoritism in influencing American attitudes toward international trade. By systematically altering which countries gain or lose from a given trade policy (Americans and/or people in trading partner countries), we vary the role that in-group favoritism should play in influencing preferences.Our results provide evidence of two distinct forms of in-group favoritism. The first, and least surprising, is that Americans value the well-being of other Americans more than that of people outside their own country. Rather than maximize total gains, Americans choose policies that maximize in-group well-being. This tendency is exacerbated by a sense of national superiority; Americans favor their national in-group to a greater extent if they perceive Americans to be more deserving.Second, high levels of perceived intergroup competition lead some Americans to prefer trade policies that benefit the in-group and hurt the out-group over policies that help both their own country and the trading partner country. For a policy to elicit support, it is important not only that the US benefits, but also that the trading partner country loses so that the US achieves a greater relative advantage. We discuss the implications of these findings for understanding bipartisan public opposition to trade.

Abstract P256: Association Between Antidepressants Use and Intracerebral Hemorrhage: Florida Stroke Registry

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Mithilesh Siddu ◽  
Antonio Bustillo ◽  
Carolina M Gutierrez ◽  
Kefeng Wang ◽  
Hannah Gardener ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Oral Anticoagulants ◽  
Large Population ◽  
Multivariable Analysis ◽  
Population Based ◽  
Prior History ◽  
Stroke Registry ◽  
The Us ◽  
History Of ◽  
Antidepressant Use

Introduction: SSRIs, the most commonly prescribed antidepressants (AD) in the US, are linked to an increased intracerebral hemorrhage (ICH) risk possibly related to impaired platelet function. In the Florida Stroke Registry (FSR), we studied the proportion of cases presenting with ICH amongst AD users and the rate of SSRI prescription amongst stroke patients discharged on AD. Methods: From Jan 2010 to Dec 2019 we included 127,915 cases from FSR in whom information on AD use was available. Multivariable logistic regression was used to evaluate ICH proportions amongst AD and non-AD users and rates of prescribed SSRIs at discharge. Results: The rate of ICH amongst prior AD users (n=17,009, median age 74, IQR=19) and non-AD users (n=110,906, median age 72, IQR=21) were 11% and 14% respectively. Prior AD users were more likely to be female (17% vs. 10% male), non-Hispanic White (16% vs. 8% non-Hispanic Black vs. 12% Florida Hispanic vs. 6% Puerto Rican Hispanic), have hypertension (HTN) (14.% vs. 10%), diabetes mellitus (DM) (16% vs.12%), use oral anticoagulants (OAC) (17 % vs. 13%), antiplatelets (AP; 17% vs. 11%), and statins (17% vs. 10%) prior to hospital presentation. In multivariable analysis adjusting for age, race, prior history of HTN, DM, prior OAC, AP and statin use, AD users just as likely to present with spontaneous ICH as compared to non-AD users (OR=0.92, 95% CI 0.85, 1.01). A total of 3.4% of all ICH patients and 9% of those in whom AD information was available were discharged home on an AD (74 % SSRI, 24% other AD). Conclusion: In this large population-based study, we did not find an association between prior AD use and an increased rate of ICH. Importantly AD (mostly SSRIs) are commonly prescribed to patients with ICH in routine clinical practice. The association between types, duration, and safety of antidepressant use in ICH patients deserves further studies.

Abstract P005: Comparative Effectiveness of Rivaroxaban versus Warfarin for the Treatment of Patients with Non-valvular Atrial Fibrillation

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Faye L Norby ◽  
Lindsay G Bengtson ◽  
Lin Y Chen ◽  
Richard F MacLehose ◽  
Pamela L Lutsey ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Real World ◽  
Proportional Hazards ◽  
Large Population ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Gi Bleeding ◽  
Cox Proportional Hazards Models ◽  
The Us

Background: Rivaroxaban is a novel oral anticoagulant approved in the US in 2011 for prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF). Information on risks and benefits among rivaroxaban users in real-world populations is limited. Methods: We used data from the US MarketScan Commercial and Medicare Supplemental databases between 2010 and 2013. We selected patients with a history of NVAF and initiating rivaroxaban or warfarin. Rivaroxaban users were matched with up to 5 warfarin users by age, sex, database enrollment date and drug initiation date. Ischemic stroke, intracranial bleeding (ICB), myocardial infarction (MI), and gastrointestinal (GI) bleeding outcomes were defined by ICD-9-CM codes in an inpatient claim after drug initiation date. Cox proportional hazards models were used to assess the association between rivaroxaban vs. warfarin use and outcomes adjusting for age, sex, and CHA2DS2-VASc score. Separate models were used to compare a) new rivaroxaban users with new warfarin users, and b) switchers from warfarin to rivaroxaban to continuous warfarin users. Results: Our analysis included 34,998 rivaroxaban users matched to 102,480 warfarin users with NVAF (39% female, mean age 71), in which 487 ischemic strokes, 179 ICB, 647 MI, and 1353 GI bleeds were identified during a mean follow-up of 9 months. Associations of rivaroxaban vs warfarin were similar in new users and switchers; therefore we pooled both analyses. Rivaroxaban users had lower rates of ICB (hazard ratio (HR) (95% confidence interval (CI)) = 0.72 (0.46, 1.12))) and ischemic stroke (HR (95% CI) = 0.88 (0.68, 1.13)), but higher rates of GI bleeding (HR (95% CI) = 1.15 (1.01, 1.33)) when compared to warfarin users (table). Conclusion: In this large population-based study of NVAF patients, rivaroxaban users had a non-significant lower risk of ICB and ischemic stroke than warfarin users, but a higher risk of GI bleeding. These real-world findings are comparable to results reported in published clinical trials.

scholarly journals Obstructive Sleep Apnea among the Lebanese general population: Prevalence, associated factors and knowledge

2020 ◽  
Author(s):  
Aurélie Choucair ◽  
Diana Malaeb ◽  
Souheil Hallit ◽  
Elissar Dagher
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Daytime Sleepiness ◽  
Associated Factors ◽  
Public Awareness ◽  
Large Population ◽  
Population Based ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
Study Results

Abstract Background : To date, there has been no large population-based study associated with public awareness in Lebanon about sleep apnea. Our study investigated the prevalence of, associated factors and knowledge of Obstructive Sleep Apnea (OSA) among a representative sample of Lebanese adults. Methods: A cross-sectional study, conducted between June and August 2019, enrolled 472 people aged above 18 years. A proportionate random sample from all Lebanese Mohafazat was applied. Results: The study results showed that a higher number of cigarettes per day, having diabetes mellitus, myocardial infarction, hypertension and arrhythmia were associated with higher daytime sleepiness. Participants living in the North had less daytime sleepiness, whereas those living in Beqaa had higher daytime sleepiness compared to those living in Beirut. Concerning knowledge, having heard about sleep apnea and having a university level of education were associated with a higher score, whereas having cerebrovascular accidents was associated with lower knowledge scores. Conclusion Complications of OSA are still poorly known, as are certain suggestive symptoms. Given the local relevance of OSA, ongoing health campaigns and innovative educational programs should be assigned to target the general community.

Intracranial Hemangiopericytoma and the Role of Radiation Therapy A Population Based Analysis

Neurosurgery ◽  
2012 ◽  
Vol 72 (2) ◽  
pp. 203-209 ◽  
Author(s):  
Amol J. Ghia ◽  
Pamela K. Allen ◽  
Anita Mahajan ◽  
Marta Penas-Prado ◽  
Ian E. McCutcheon ◽  
...  
Keyword(s):  
Median Overall Survival ◽  
External Beam Radiotherapy ◽  
Univariate Analysis ◽  
Population Based ◽  
Total Resection ◽  
Entire Cohort ◽  
The Us ◽  
Rare Malignancy ◽  
Cause Specific Survival

Abstract BACKGROUND: Intracranial hemangiopericytoma (HPC) is a rare malignancy for which treatment recommendations vary. OBJECTIVE: We sought to characterize outcomes of HPC patients treated with postoperative external beam radiotherapy (PORT). METHODS: A retrospective analysis was conducted using the Surveillance, Epidemiology and End Results (SEER) Program of the US National Cancer Institute. We identified patients with intracranial hemangiopericytoma who underwent surgery alone or PORT. RESULTS: We identified 88 patients with a diagnosis of HPC between 1982 and 2009 treated with surgery alone or PORT. The majority of patients were female (53%) and white (84%) with a median age of 50.5 years (range, 0–92 years). Gross total resection (GTR) was achieved in 55%, and PORT was delivered to 48% of the entire cohort. The median overall survival (OS) and cause-specific survival (CSS) were 111 months and 161 months, respectively. On univariate analysis, age older than 50 years correlated with poor OS (hazard ratio [HR]: 3.43; 95% confidence interval [CI]: 1.70-6.95; P = .001) and CSS (HR: 2.77; 95% CI: 1.18-6.48; P = .019). On multivariate analysis (MVA), age >50 years correlated with poor OS (HR: 3.69; 95% CI: 1.72-7.93; P = .001) and CSS (HR: 2.67; 95% CI: 1.08-6.59; P = .034). On MVA, GTR correlated with improved OS (HR: 0.28; 95% CI: 0.11-0.71; P = .007) and CSS (HR: 0.23; 95% CI: 0.07-0.76; P = .016). In addition, PORT correlated with improved OS (MVA HR: 0.02; 95% CI: 0.00-0.31; P = .005) and CSS (MVA HR: 0.02; 95% CI: 0.00-0.45; P = .015). Patients undergoing STR with PORT compared favorably with those undergoing GTR alone with respect to OS (HR: 0.43; 95% CI: 0.15-1.26; P = .13) and CSS (HR: 0.51; 95% CI: 0.15-1.78; P = .29). CONCLUSION: In intracranial HPC, both PORT and GTR independently correlate with improved OS and CSS.

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