A case-control study evaluating differences in resource utilization between diabetic and non-diabetic cancer patients undergoing chemotherapy

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6126-6126
Author(s):  
M. D. Robertson ◽  
T. J. George ◽  
M. Chang ◽  
L. C. Richardson

6126 Background: Patients with diabetes mellitus (DM) and cancer have been noted to have worse overall and disease-free survival compared to those without DM. However, there is a paucity of data addressing why diabetic cancer patients have worse outcomes. We performed a retrospective case-control study to evaluate cancer patients undergoing chemotherapy comparing persons with and without DM to evaluate differences in resource utilization and mortality. Methods: Using chart review and tumor registry data from January 2001 through December 2003, we identified DM patients 18 years or older, treated with chemotherapy at the Gainesville Veterans Administration Medical Center (GVAMC) for lung, colon, or head and neck cancer. Non-diabetic (Non-DM) controls were matched for age, cancer type and stage. A comorbidity score was calculated based on a previously validated measurement scale, Adult Comorbidity Evaluation 27 (ACE-27). The primary outcome measure was the number of inpatient hospital days in the first year after diagnosis. Secondary outcome measures included the total number of outpatient visits, emergency room (ER) visits, infusion room visits for chemotherapy, blood transfusions, home health consults, telephone calls, and mortality. Results: A total of 42 DM cases and 42 non-DM controls were identified who had undergone similar treatments with radiation and surgery. The DM patients had higher comorbidity ACE 27 scores when corrected for the cancer being treated, median 3.0 versus 2.0, p < 0.005. The table summarizes the results. Mortality was the same (15) for both the DM and non-DM patients at one year. Conclusions: Cancer patients with DM undergoing chemotherapy have significantly more comorbidities and utilize more outpatient visits compared to non-DM. However, all other measures of resource utilization and mortality appear similar. Further studies to identify causes of increased utilization should be done. [Table: see text] No significant financial relationships to disclose.

MicroRNA ◽  
2021 ◽  
Vol 10 ◽  
Author(s):  
Farhana Nazneen ◽  
Md. Shalahuddin Millat ◽  
Md. Abdul Barek ◽  
Md. Abdul Aziz ◽  
Mohammad Sarowar Uddin ◽  
...  

Background: The prevalence of Cervical Cancer (CC) is disproportionately higher in developing countries. It is the second most frequent cancer type among Bangladeshi women and the primary cause of morbidity and mortality. However, no previous data reported the association of miR-218-2 gene polymorphisms in Bangladeshi cervical cancer patients. Aim: This case-control study was designed to find the link between the rs11134527 polymorphism in miR-218-2 and CC. Methods: A total of 488 subjects were recruited, comprising 256 cervical cancer patients and 232 healthy females. Genotyping was conducted with the tetra-primer ARMS-PCR technique to detect the association. Results: The results of genotype data showed that rs11134527 obeyed the Hardy-Weinberg equilibrium in both CC cases and controls (P >0.05). Overall, the polymorphism was found to be significantly associated with an increased risk of cervical cancer with AG genotype (AG vs. GG: OR = 2.26, 95% Cl = 1.40-3.66, P = 0.0008), AA genotype (AA vs. GG: OR = 3.64, 95% Cl = 2.17-6.10, P <0.0001), dominant model (AG+AA vs. GG: OR = 2.75, 95% Cl = 1.75-4.31, P <0.0001), recessive model (AA vs. GG+AG: OR = 2.08, 95% Cl = 1.41-3.08, P = 0.0002), and A allele (A vs. G: OR = 1.94, 95% Cl = 1.51-2.51, P <0.0001). All of these correlations remained statistically significant after performing Bonferroni correction (P <0.008). Conclusion: Our study suggests that the rs11134527 polymorphism in the miR-218-2 gene contributes to the susceptibility of CC in Bangladeshi women.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S617-S617
Author(s):  
Arunmozhi S Aravagiri ◽  
Ayutyanont Napatkamon ◽  
Sabhyata Sharma ◽  
Timothy Collins ◽  
Chimezie Ubbaonu ◽  
...  

Abstract Background Transfusion of blood products has been shown to be associated with increased mortality and risk of infections in critically ill patients and following cardiac surgery [1-2]. However, there is scarce data evaluating this association in patients admitted to hospital wards. Here we seek to see if transfusion of blood products carries the same risk of infection and mortality in more stable patients. Methods This was a retrospective case-control study of patients admitted to the internal medicine wards who received packed red blood cells (PRBC), fresh frozen plasma (FFP) or platelet transfusions, using data from the HCA Healthcare administrative database from 2016 to 2019. Patients admitted with an infection, on steroids or other immunosuppressant medications were excluded. ICD-10 codes at discharge were used to determine hospital acquired infections (HAI). The presence of HAI was the dependent variable. A multivariable logistic regression was used to determine the effects of the independent variables on development of HAI after adjusting for age and Carlson’s Comorbidity Index. Odds ratios and 95% confidence intervals were calculated. Primary outcome of study was presence of HAI, while secondary outcome was mortality in transfused vs. non-transfused patients. Results A total of 1952 subjects were included in the study analysis. Of these, 653 or 33.4% had a HAI during their admission. Adjusted multivariable model showed transfusion of PRBC (OR 1.14, 95%CI 0.85-1.52), platelets (OR 1.41, 95% CI 0.93-2.10) or FFP (OR 1.27 95%CI 0.90-1.75) was not associated with increased odds of having a HAI. The multivariable model however, did show an increase in odds of mortality in patients who were transfused with PRBC (OR 2.51, 95%CI 1.78-3.54), platelets (OR 3.17, 95%CI 2.01-5.0) or FFP (OR 2.78, 95% CI 1.89-4.08) compared to non-transfused. Conclusion Our data failed to show association between transfusion of blood products and HAI. However, it showed there was significant increase in mortality in patients that had received blood products during their admission. Disclosures All Authors: No reported disclosures


1990 ◽  
Vol 14 (2) ◽  
pp. 133-140 ◽  
Author(s):  
Barbara Y. LeGardeur ◽  
Alfredo Lopez‐S ◽  
William D. Johnson

2016 ◽  
Vol 139 ◽  
pp. 29-37 ◽  
Author(s):  
Aneel A. Ashrani ◽  
Rachel E. Gullerud ◽  
Tanya M. Petterson ◽  
Randolph S. Marks ◽  
Kent R. Bailey ◽  
...  

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e042996
Author(s):  
Liang-Jen Wang ◽  
Zi-Yu Tsai ◽  
Ling-Sai Chang ◽  
Ho-Chang Kuo

ObjectiveKawasaki disease (KD) is an acute form of febrile vasculitis that occurs in early childhood. The multisystemic vasculitis common in patients with KD may influence blood perfusion in the brain, and thus caregivers of children with KD may feel stress with regard to caring for them. Intravenous immunoglobulin (IVIG) infusion is the standard treatment for acute KD, and the most serious complication of KD is coronary artery aneurysms (coronary artery lesion (CAL)). This study aimed to investigate the relationships between KD heterogeneity and the risk of patients’ cognitive impairment or caregivers’ parenting stress.DesignA case–control study with consecutive sampling.SettingA medical centre (Kaohsiung Chang Gung Memorial Hospital, Taiwan).ParticipantsThis study consisted of 176 patients with KD (mean age: 5.5 years, 60.8% boys) and 85 healthy children (mean age: 6.4 years, 54.1% boys).Primary and secondary outcome measuresBased on the children’s age, each patient with KD and control subject was administered an assessment using the Mullen Scales of Early Learning or the Wechsler Intelligence Scale, and parenting function of their caregivers was assessed using the Parenting Stress Index (PSI)-Short Form.ResultsWe observed no significant differences in any developmental index, cognitive function or parenting stress between patients with KD and controls. Among the children with KD, IVIG administration nor CAL was associated with children’s cognitive scores. However, the caregivers of patients who had CAL suffered from greater PSI total scores than those of patients without CAL. Furthermore, the caregivers who had education levels of a master’s degree or above showed less parenting stress than those who had an education level of college or lower.ConclusionCaregivers’ education is associated to parenting stress, and caregivers of patients with KD who developed CAL may feel stress about the unpredictable sequela caused by CAL for their children. Such caregivers may require support to fulfil their parenting roles.


Author(s):  
Surender Kumar ◽  
Neha Salaria ◽  
Deepak Verma ◽  
Uma Garg ◽  
Monika Verma

Background- Head and neck squamous cell carcinomas(HNSCC) are one of the most widespread malignancies worldwide. Trace elements such as magnesium are essential at cellular level, and it has been suggested that magnesium plays a role in carcinogenesis. Methods- A hospital based case control study was conducted in a tertiary care medical college with an aim to determine the levels of serum magnesium in patients with head and neck cancer and to  compare  the  levels  of  serum  magnesium  of head and neck cancer patients   with healthy matched control  group  and  derive significance if any. Results- HNSCC was mainly found in males of age group 46 to 55 years. The mean serum Mg value of head and neck cancer patients was 0.71± 0.18 mmol/l while that seen in controls was 0.85± 0.09 mmol/l which was significantly lower(p<0.001). Average serum magnesium levels in stages I, II, III and IV were 0.85, 0.849, 0.682 and 0.554 mmol/l respectively, and a statistically significant association was determined between the two. Conclusion- As the stage of cancer progressed, average magnesium levels decreased congruently, hence establishing that magnesium levels were undeniably correlated to onset as well as progression of HNC. These evidences could be utilized to identify role of magnesium asa potential prognostic biomarker to assess progression of disease or clinical response to various modes of therapy in head and neck cancer patients.


1988 ◽  
Vol 26 (3) ◽  
pp. 429-432 ◽  
Author(s):  
A Karabinis ◽  
C Hill ◽  
B Leclercq ◽  
C Tancrède ◽  
D Baume ◽  
...  

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