Universal screening for Lynch syndrome (LS) in colorectal cancer (CRC) and survival.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 415-415 ◽  
Author(s):  
Sigurdis Haraldsdottir ◽  
Christina Sing-Ying Wu ◽  
Heather Hampel ◽  
Wendy Frankel ◽  
Xueliang Jeff Pan ◽  
...  
Keyword(s):  
Universal Screening ◽  
Gene Sequencing ◽  
Rank Test ◽  
Continuous Variables ◽  
State University ◽  
Chi Square ◽  
Chi Square Test ◽  
The Difference ◽  
The Ohio State University ◽  
Or Gene

415 Background: It has been argued that universal screening for LS should be performed on all patients (pts) diagnosed with CRC because screening LS pts and their relatives can detect early cancers and improve outcomes. This approach is being adopted by many comprehensive cancer centers around the country. The Ohio State University (OSU) began screening for deficient mismatch repair (dMMR) proteins by immunohistochemistry (IHC) on all CRC cases in 2006. This retrospective study aims to assess whether universal screening with IHC followed by conclusive testing (BRAF mutation in setting of MLH1 deficiency, and/or gene sequencing) affects pts survival. Methods: All CRC pts diagnosed at OSU from 3/2006-6/2012 with dMMR testing per IHC were included, and their charts were reviewed. Chi-square test was used to for categorical parameters, t-test was used for continuous variables, and the log-rank test for overall survival (OS) to compare the difference between pts with full conclusive testing vs those without full testing. Patients who expired within 4 weeks of diagnosis were excluded (n=10) from the OS analysis. Results: One hundred and twenty-two tumors (15.7% of 777 tumors tested) had dMMR by IHC during the study period. Fifty-one pts went on to have conclusive testing done; thirteen patients (25.5%) were diagnosed with LS, 29 patients (56.9%) had MLH1-hypermethylated tumors, and 9 patients (17.6%) were not found to have MMR mutations on gene sequencing. In an OS analysis, patients undergoing conclusive testing had significantly longer survival as compared to those with abnormal IHC without further testing (median OS not reached vs. 38 months, p=0.04). The difference was similar and remained marginally significant (p= 0.04-0.09) after correcting for age, stage and testing date using different models. Conclusions: Patients who had conclusive testing after initial abnormal universal screening with IHC had significantly longer OS compared to pts who had abnormal IHC without follow-up testing. It is possible that ascertainment bias and pts compliance influenced survival so larger prospective studies that document stage and treatment are needed to determine if increased surveillance in the setting of a LS diagnosis leads to better OS.

Effect of genetic counseling on detection of Lynch syndrome (LS) in colorectal cancer (CRC) patients (pts).

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 419-419
Author(s):  
Sigurdis Haraldsdottir ◽  
Heather Hampel ◽  
Wendy Frankel ◽  
Christina Sing-Ying Wu ◽  
Xueliang Jeff Pan ◽  
...  
Keyword(s):  
Gene Sequencing ◽  
Ohio State University ◽  
Continuous Variables ◽  
State University ◽  
Chi Square ◽  
Dna Mismatch ◽  
Chi Square Test ◽  
Or Gene ◽  
Pathology Reports

419 Background: LS, characterized by germline mutations in MLH1, MSH2, MSH6, or PMS2, leads to defective DNA mismatch repair (dMMR) and causes 2%-3% of CRC cases. Ohio State University (OSU) began immunohistochemistry (IHC) screening on all CRC cases in 2006. In 2006 results were reported in pathology reports without further follow-up. From 2007 to 2010 genetic clinic (GC) counselors contacted pts and recommended further testing. Since 2011, GC counselors met pts at a follow-up appointment. This retrospective study aims to assess if type of follow-up after abnormal IHC, affects rate of conclusive testing. Methods: All CRC pts diagnosed at OSU from 03/06-06/12 had MMR testing per IHC. All pts’ charts were reviewed. Conclusive testing, following the initial MMR IHC, includes either MLH1-hypermethylation testing and/or gene sequencing to identify LS from non-LS pts. Chi-square test was used for categorical parameters and t-test for continuous variables to compare differences between pts with conclusive test vs those without. Results: One-hundred and twenty two tumors of 777 (15.7%) tested had dMMR by IHC. The GC follow-up of abnormal results significantly affected the rate of conclusive testing. The rate of conclusive testing went from 14.3% in 2006 to 38.4% in 2007-2010 and after 2011, 90.5% of the pts had conclusive testing done. Among 51 pts undergoing full testing, 13 pts were diagnosed with LS, 29 pts had MLH1-hypermethylated tumors, and 9 pts were not found to have any mutations on gene sequencing. Conclusions: Conclusive testing rates after abnormal universal screening with IHC improved significantly with GC involvement and was most effective when GC counselors met with the pts during their appointment. [Table: see text]

scholarly journals Disparity in the Hospitals Utilization among Regions in Indonesia

2021 ◽  
Vol 9 (E) ◽  
pp. 1461-1466
Author(s):  
Trias Mahmudiono ◽  
Agung Dwi Laksono
Keyword(s):  
Health Care ◽  
Multinomial Logistic Regression ◽  
Individual Characteristics ◽  
Health Care Facilities ◽  
Hospital Utilization ◽  
Continuous Variables ◽  
Chi Square ◽  
Care Facilities ◽  
Chi Square Test ◽  
The Difference

Abstract: The utilization of hospital services is a benchmark for the success of a health care referral system. Indonesia as the largest archipelago in the world encounters challenging conditions along with lack of infrastructure posed economic and health disparity among its regions. Disparities as a result of this development also have an impact on the accessibility of health care facilities. Regions with good economic movements tend to have good accessibility to health care facilities. For this reason, reducing disparity to achieve universal health services is the goal of health planners and policy makers. Chi Square test was used to test dichotomy variables and t-tests was performed for analysing the difference among continuous variables. These tests were employed to assess the hypothesis that there was significant regional difference in the access of health care in Indonesia. Estimation using multinomial logistic regression test was used to study the disparity between regions in hospital utilization. The results of this study showed that disparities between regions in Indonesia exist in term of hospital utilization. The disparities in hospital utilization among regions in Indonesia were associated with: marital status, socioeconomic status, education level, occupation and insurance ownership. However, the difference in odds ratio for mortality between regions decreased compared to the previous period. Conclusion. Disparities in the hospital utilization among region in Indonesia was associated with complex factors from individual characteristics through geographic barriers.

Disparity in the Hospitals Utilization among Regions in Indonesia

2020 ◽  
Author(s):  
Agung Dwi Laksono ◽  
Beben Benyamin ◽  
Trias Mahmudiono
Keyword(s):  
Health Care ◽  
Data Collection ◽  
Multinomial Logistic Regression ◽  
Continuous Variables ◽  
Chi Square ◽  
Chi Square Test ◽  
The Difference ◽  
Outpatient Utilization ◽  
Significant Regional Difference ◽  
Ethical Clearance

Abstract Background. The utilization of hospital services is a benchmark for the success of a health care referral system. Indonesia as the largest archipelago in the world encounters challenging conditions along with lack of infrastructure posed economic and health disparity among its regions. Disparities as a result of this development also have an impact on the accessibility of health care facilities.Methods. Chi Square test was used to test dichotomy variables and t-tests were performed for analyzing the difference among continuous variables. These tests were employed to assess the hypothesis that there was significant regional difference in the access of health care in Indonesia. Estimation using multinomial logistic regression test was used to study the disparity between regions in hospital utilization.Results. The results of this study indicate that there were disparities between regions in Indonesia. In the inpatient category all regions have better utilization than the Papua region, except the Sumatra region. The highest disparity occurs between the Nusa Tenggara region and the Papua region. Possibility of utilizing hospital vs. inpatient facilities not using the hospital 1,439 times in adults in the Nusa Tenggara region compared to the Papua region (OR = 1,439; 95% CI = 1,271 - 1,629). In the category of outpatient utilization as well as hospitalization in hospitals, the Papua region has better hospital utilization compared to other regions. The greatest disparity with the Sumatra region (OR = 0.484; 95% CI = 0.392 - 0.597).Conclusion. In conclusion, there were disparities between regions in Indonesia even though the odds ratio for mortality between regions decreased compared to the previous period.Ethical Clearance. The 2013 RISKESDAS survey had ethical clearance that was approved by the national ethical committee in the NIHRD (ethic number: 01.1206.207). Informed consent was used during data collection, which considered aspects of data collection procedure, voluntary, and confidentiality.

scholarly journals Effect of different stages on match outcomes during high level judo competitions

2020 ◽  
Vol 15 (1) ◽  
pp. 14
Author(s):  
Bayram Ceylan ◽  
Furkan Öztürk ◽  
Sükrü Serdar Balci
Keyword(s):  
Efficiency Index ◽  
Descriptive Statistics ◽  
The Other ◽  
Continuous Variables ◽  
Chi Square ◽  
Men And Women ◽  
Chi Square Test ◽  
Judo Athletes ◽  
The Difference ◽  
High Level

<p>This study aimed to demonstrate the effect of successive stages of high-level judo competitions on match outcome and the factors effecting it. A total of 4550 official matches in both men and women were included in the analysis. Frequencies and percentages were used for descriptive statistics. Mean and standard deviations with 95% confidence intervals were also presented. The difference in the variables investigated for each stage of judo competitions was analysed with the Chi-square test. Continuous variables were analysed with the Kruskal-Wallis test. The way competitors won a match differed in elimination, final stages, and medal matches (<em>p</em>=.02). When the difficulty of the matches increased, the percentage of the matches ended with <em>ippon </em>decreased and the percentage of the matches resulted with <em>waza-ari</em> increased. The percentage of the matches without any <em>shido</em> decreased from the elimination to the finals while there was a significant increase in the percentage of the matches with s<em>hido </em>(<em>p</em>=.01). The match duration was found to increase from eliminations to the finals (<em>p</em>=.00). The efficiency index of the winner athletes during the first stage was higher than the other stages (<em>p</em>&lt;.05). In conclusion, high-level judo athletes won a match with different scores at different stages during high-level judo competitions. Moreover, athletes were awarded with penalties more during the finals compared to eliminations, and match duration incrementally increased from the eliminations to the finals.</p>

scholarly journals SORE THROAT

2018 ◽  
Vol 25 (09) ◽  
pp. 1421-1425
Author(s):  
Liaqat Ali ◽  
Sabir Khan ◽  
Haroon Israr ◽  
Aamir Furqan
Keyword(s):  
Sore Throat ◽  
Sampling Technique ◽  
P Value ◽  
Continuous Variables ◽  
Chi Square ◽  
Significant Difference ◽  
Chi Square Test ◽  
Spss Software ◽  
The Difference ◽  
Trial Setting

Objectives: To compare the effect of ketamine nebulization and ketamine gargleon post operative sore throat. Study Design: Randomized control trial. Setting: Department ofAnaesthesia Ibn e Sina Hospital. Multan and National, Lahore. Period: May 2016 to May 2017.Methodology: After provision form ethical committee and informed consent to be included instudy. Patients of age 20-60 years, ASA status I and II, elective surgeries under GA and both sexwere included in the study through consecutive sampling technique. SPSS software was used toanalyze all variables included in the study continuous variables were measured and presentedas mean and standard deviation, categorical measurement were measured in numbers andpercents. Chi square test was applied to check the difference among both groups. P value ≤0.05 was considered as significant. Results: Overall, 100% (n=160) patients were included, inthis study; divided into two equal groups, 50% (n=80) in each, gargled ketamine group (GKgroup) and nebulization group (NK group) respectively. The incidence of postoperative sorethroat at 0, 2, 4, and 24 hours, in GK group, was (n=8) 40%, (n=4) 20%, (n=3) 15% and (n=3)15%respectively. While, at corresponding time point in group NK it was (n=1) 5%, (n=7) 35%,(n=4) 20% and (n=2) 10%respectively. Conclusion: The observations of our study revealedthat ketamine nebulization and ketamine gargles having no significant difference in reductionof POST incidence.

Evaluation of a New Clinical Test of Fusion Status: A Pilot Study

2019 ◽  
pp. 113-118
Keyword(s):  
Pilot Study ◽  
Ohio State University ◽  
Background Suppression ◽  
Clinical Test ◽  
State University ◽  
Chi Square ◽  
Central Fusion ◽  
Eye Examination ◽  
The Ohio State University ◽  
Chi Square Analysis

Background Suppression is associated with binocular vision conditions such as amblyopia and strabismus. Commercial methods of testing fusion often only measure central fusion or suppression at near. The purpose of this pilot study was to assess a new iPad picture fusion test that assesses foveal and central fusion at near. Methods Participants aged 5 years and older presenting for eye examination at The Ohio State University College of Optometry were enrolled. Results from visual acuity, dry and wet refraction/retinoscopy, stereopsis and cover testing were recorded from the patient chart. The iPad picture fusion test, Worth four-dot, Worth type test with foveal letter targets, and Polarized four-dot were performed by one examiner in a randomized order at 40 cm. Testing was repeated with the anaglyphic filters reversed. Crosstabulation and McNemar chi-square analysis were used to compare the results between fusion testing devices. Results Of the fifty participants (mean age = 17.5), twelve reported suppression and one reported diplopia. Testability was excellent for all tests (98% to 100%). There were no significant differences between tests in reported results (P ≥ 0.22 for all comparisons). No difference in reported fusion or suppression status was observed with change in orientation of the anaglyphic filters. Six participants reported foveal suppression alone at near which was not identified with Worth four-dot at near. Conclusion The iPad picture fusion test provided excellent testability and agreement with commonly used tests of fusion and allowed testing of both central and foveal fusion at near. Nearly half (46%) of participants with suppression reported foveal suppression, supporting the importance of testing for foveal suppression.

scholarly journals Short-Term Effect of Orthodontic Treatment with Clear Aligners on Pain and sEMG Activity of Masticatory Muscles

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 178
Author(s):  
Alessandro Nota ◽  
Silvia Caruso ◽  
Shideh Ehsani ◽  
Gianmaria Fabrizio Ferrazzano ◽  
Roberto Gatto ◽  
...  
Keyword(s):  
Surface Electromyography ◽  
Orthodontic Treatment ◽  
Masticatory Muscles ◽  
Rank Test ◽  
Nominal Data ◽  
Chi Square ◽  
Initial Reduction ◽  
Signed Rank Test ◽  
Chi Square Test ◽  
Semg Activity

Background and objectives: The aim of this study is to evaluate mandibular elevator muscles activity and pain on palpation in the early stages of orthodontic treatment with clear aligners using surface electromyography (sEMG). Materials and methods: Surface electromyography (sEMG) activity and pain level on muscle palpation of masseter and anterior temporalis muscles were recorded in a sample of 16 adult subjects (aged 18–32 years; mean 22.5 +/− 3.5 SD) undergoing orthodontic treatment with clear aligners before the treatment (T0), after 1 month of treatment (two clear aligners) (T1), and after 3 months of treatment (T2) (six clear aligners). A chi-square test for nominal data, a Friedman test, and a Wilcoxon-signed rank test as post hoc analysis were applied. Results: No statistically significant differences in muscular pain were observed. At T1, the sEMG activity of masseter muscles at mandibular rest position showed a statistically significant reduction, but after 3 months (T2), the data appeared similar to T0 (p = 0.03 and p = 0.02). Conclusions: During the treatment with clear aligners, subjects could experience an initial reduction in the masseter basal activity after 1 month of treatment. This effect tends to decrease to baseline levels after 3 months of therapy.

scholarly journals 350. Neurocysticercosis – Gender Differences in Clinical Presentations

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 &lt; 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 &gt; 1 lesion (82.2% vs 56.8%, P= 0.01). Males were more likely to have cystic lesions (64.7% vs 27.9%, P &lt; 0.001) compared to females who had more calcified lesions on presentation (65.1% vs 20.6%, P &lt; 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 &lt; 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

Performance of Abbreviated Protocols Versus Unenhanced MRI in Detecting Occult Breast Lesions of Mammography in Patients with Dense Breasts

2021 ◽  
Author(s):  
Suhong Zhao ◽  
Peipei Chen ◽  
Guangrui Shao ◽  
Baijie Li ◽  
Huikun Zhang ◽  
...  
Keyword(s):  
Reading Time ◽  
Area Under The Curve ◽  
Lesion Size ◽  
Lower Sensitivity ◽  
Chi Square ◽  
Dense Breast Tissue ◽  
Negative Findings ◽  
Chi Square Test ◽  
The Difference ◽  
Sensitivity Specificity

Abstract Objective: To assess the diagnostic ability of abbreviated protocols of MRI (AP-MRI) compared with unenhanced MRI (UE-MRI) in mammographically occult cancers in patients with dense breast tissue.Materials and Methods: The retrospective analysis consisted of 102 patients without positive findings on mammography who received preoperative MRI full diagnostic protocols (FDP) between January 2015 and December 2018. Two breast radiologists read the UE, AP, and FDP. The interpretation times were recorded. The comparisons of the sensitivity, specificity and area under the curve of each MRI protocol, and the sensitivity of these protocols in each subgroup of different size tumors used the Chi-square test. The paired sample t-test was used for evaluating the difference of reading time of the three protocols.Results: Among 102 women, there were 68 cancers and two benign lesions in 64 patients and 38 patients had benign or negative findings. Both readers found the sensitivity and specificity of AP and UE-MRI were similar (p>0.05), whereas compared with FDP, UE had lower sensitivity (Reader 1/Reader 2: p=0.023, 0.004). For different lesion size groups, one of the readers found that AP and FDP had higher sensitivities than UE-MRI for detecting the lesions ≤10 mm in diameter (p=0.041, p=0.023). Compared with FDP, the average reading time of UE-MRI and AP was remarkably reduced (p < 0.001).Conclusion: AP-MRI had more advantages than UE-MRI to detect mammographically occult cancers, especially for breast tumors ≤10 mm in diameter.

Abstract 14721: Impact of Covid-19 on Cardiology Consultation in Tertiary Care Hospital of a Developing Country

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
ghufran adnan ◽  
Osman Faheem ◽  
Maria Khan ◽  
Pirbhat Shams ◽  
Jamshed Ali
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Reduction Rate ◽  
Care Hospital ◽  
Chi Square ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Drastic Increase ◽  
Chi Square Test ◽  
The Difference

Introduction: COVID-19 pandemic has overwhelmed the healthcare system of Pakistan. There has been observation regarding changes in pattern of patient presentation to emergency department (ED) for all diseases particularly cardiovascular. The aim of the study is to investigate these changes in cardiology consultations and compare pre-COVID-19 and COVID-19 era. Hypothesis: There is a significant difference in cardiology consultations during COVID era as compared to non-COVID era. Method: We collected data retrospectively of consecutive patients who visited emergency department (ED) during March-April 2019 (non-COVID era) and March-April 2020 (COVID era). Comparison has been made to quantify the differences in clinical characteristics, locality, admission, type, number, and reason of Cardiology consults generated. Results: We calculated the difference of 1351 patients between COVID and non-COVID era in terms of cardiology consults generated from Emergency department, using Chi-square test. Out of which 880 (59%) are male with mean age of 61(SD=15). Analysis shows pronounced augmentation in number of comorbidities [Hypertension(6%), Chronic kidney disease (6%), Diabetes (5%)] but there was 36% drop in total cardiology consultations and 43% reduction rate in patient’s ED visit from other cities during COVID era. There was 60% decrease in acute coronary syndrome presentation in COVID era, but fortuitously drastic increase (30%) in type II myocardial injury has been noted. Conclusion: There is a remarkable decline observed in patients presenting with cardiac manifestations during COVID era. Lack in timely care could have a pernicious impact on outcomes, global health care organizations should issue directions to adopt telemedicine services in underprivileged areas to provide timely care to cardiac patients.

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