KRAS testing disparities in the state of New Mexico.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 551-551
Author(s):  
Alissa Greenbaum ◽  
Charles Wiggins ◽  
Angela W. Meisner ◽  
Manuel Rojo ◽  
Anita Kinney ◽  
...  
Keyword(s):  
New Mexico ◽  
Rural Areas ◽  
Treatment Guidelines ◽  
The State ◽  
P Value ◽  
Antibody Treatment ◽  
Patients Âgés ◽  
Stage 4 ◽  
Stage 1 ◽  
Incident Cases

551 Background: ASCO guidelines published in 2009 recommend all patients with metastatic colorectal cancer (CRC) receive KRAS testing to guide anti-EGFR monoclonal antibody treatment. Recent literature examining nation-wide trends via the Surveillance, Epidemiology, and End Results (SEER) database showed New Mexico to exhibit the highest KRAS rates of testing out of 18 registries. We aim to explore disparities in KRAS testing in the state of New Mexico. Methods: The New Mexico Tumor Registry (NMTR), a population-based cancer registry participating in the SEER Program, was queried to identify all incident cases of CRC among New Mexico residents from 2010 to 2013. Chi-square tests were used to identify disparity in KRAS testing with a p-value ≤ 0.05 considered significant. Results: A total of 637 patients were diagnosed with metastatic CRC from 2010-2013. As expected, KRAS testing in Stage 4 patients presented the highest frequency (38.4%), though testing in stage 3 (8.5%), stage 2 (3.4%) and stage 1 (1.2%) was also seen. In those with metastatic disease, younger patients (ages 22-39 and 40-64 years) were more likely to receive testing than patients 65 years and older (p < 0.0001). Patients living in or near a metropolitan center received KRAS testing more often than patients living in non-metro and rural areas (p = 0.016). There were no disparities in testing between male and female patients (39.1 v. 37.7%; p = 0.71) or amongst the predominant ethnic groups (p = 0.66). A small increase in the occurrence of KRAS testing was noted from 2010 to 2013 (34.2 to 42.2%); this trend approached though did not obtain significance (p = 0.07). In stage 4 patients, there were no significant differences in rates of wild-type versus mutant status when examined by age (p = 0.95), sex (p = 0.41), ethnicity (p = 0.41), by progressive years (p = 0.42) or geography (p = 0.35). Conclusions: New Mexico exhibits high rates of KRAS biomarker testing in patients with metastatic CRC. Age and geographic disparities exist in the rates of testing, while sex, ethnicity and the year tested showed no differences. Further study is required to explore the reasons for this disparity in KRAS testing, as well as to determine the motivation for testing in stage 1 through 3 CRC which is contrary to current treatment guidelines.

scholarly journals SELF-REPORTED SEVERITY OF MOOD SYMPTOMS IN PEDIATRIC PATIENTS WITH PERSISTENT POST-CONCUSSION SYMPTOMS (PPCS)

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0014
Author(s):  
Marshall Spiegel ◽  
Jon Minor ◽  
Nancy Phu ◽  
Jared Kliner ◽  
Prem Kumar Thirunagari ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Primary Source ◽  
Brain Dysfunction ◽  
P Value ◽  
Office Visits ◽  
Patients Âgés ◽  
Mood Symptoms ◽  
Stage 4 ◽  
Stage 1 ◽  
The Relationship

Background: There are multiple subtypes identified in patients with Persistent Post Concussion symptoms (PPCS) in young athletes including mood subtype that is traditionally believed to be in higher incidence with PPCS. Although there may be an association of poor mood symptoms with worse PPCS outcomes, empirical analysis of patients’ mood symptoms and the duration of PPCS is scant. By better understanding the incidence of mood symptoms in pediatric PPCS, we may uncover other primary causes of ongoing brain dysfunction. Purpose: To explore the relationship between mood-symptom severity and the duration of PPCS. Methods: A retrospective cohort study of pediatric PPCS patients (age < 18 years) treated at private concussion clinic in Tucson, AZ between 7/2018 to 7/2019. Based on written questionnaires completed by patients at office visits, patients were assigned a mood and anxiety score between 0 and 3, with 0 being the least severe and 1 being the most severe. Patients were also classified into stages 1 through 4 based on PPCS duration (see table). [Table: see text] Results: Data from 59 pediatric patients (ages ranged from 7 to 17 with a mean age of 13.9, 33:26 female to male) were included. ANOVA yielded p-value of 0.94. Average (mean) mood and anxiety scores for each PPCS substage were as follows: 0.9 for stage 1 (n=23); 0.8 for stage 2 (n=18); 0.8 for stage 3 (n=13); 0.6 for stage 4 (n=5). Conclusion: Our review data showed no significance between PPCS stages in regard to average self-reported mood symptoms. Contrary to traditional thinking this preliminary data in pediatric athletes illustrates that mood severity does not increase with increasing PPCS stage. This may suggest that other domains such as migraine or vestibulocular dysfunction may be the primary source of ongoing symptoms.

Survival Outcomes of Adults with Acute Myeloid Leukemia – A Study of Native American, Hispanic, and Non-Hispanic Whites Treated In New Mexico (1986 to 2006)

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4365-4365 ◽  
Author(s):  
Nancy Rivera ◽  
Beeling Armijo ◽  
Dulcinea Quintana ◽  
Maryam Abdul-Jaleel ◽  
Sang-Joon Lee ◽  
...  
Keyword(s):  
Overall Survival ◽  
New Mexico ◽  
Native Americans ◽  
Complete Remission ◽  
Ethnic Groups ◽  
Induction Chemotherapy ◽  
Rural Areas ◽  
The State ◽  
Tumor Registry ◽  
Rural Patients

Abstract Abstract 4365 Purpose of study: The three largest ethnic populations in New Mexico are Caucasians, Native Americans, and Hispanics. As the largest tertiary care center in the state, our institution offers treatment to significant numbers of all three groups. In addition, many residents of the state live in rural areas. The goal of this study is to identify potential differences in outcome between ethnic groups from urban or rural areas in patients with newly diagnosed acute myelogenous leukemia (AML) treated at this center from 1986–2006. Methods: A retrospective chart review was performed on patients identified through a New Mexico tumor registry search of all adult patients (≥ 18 years of age) with a new diagnosis of AML treated at this center from 1986 through 2006. The search identified 150 cases. Of those patients, 144 charts were available for review. Six charts could not be located. Electronic, microfilm and paper-based medical records were reviewed. Data was collected for race/ethnicity, sex, zip code, age at diagnosis, pathologic diagnosis, date of diagnosis, cytogenetics, treatments received, total number of chemotherapy cycles, achievement of complete remission, and overall survival from time of diagnosis and from achievement of remission after induction chemotherapy. Date of death was determined from the chart or from New Mexico tumor registry data. Cancer cases who resided in New Mexico counties with large population centers were designated as urban residents and the remaining cases were designated as rural residents. Statistical analysis was performed to examine the effect of the variables mentioned above on overall survival. Summary of results: The analysis included 144 patients (mean age 49.98, range 18–85). For those patients who received chemotherapy the standard treatment was 7+3 followed by high dose cytarabine (1-4 cycles) or similar regimen. There were no statistical differences between survival rates when comparing the three ethnic groups, Caucasians 78 (52%), Hispanics 43 (28%), and Native Americans 23 (15%) (P=0.2496). In agreement with previous reports, statistically significant differences were seen for treatment versus palliative care, cytogenetics and age. The study included 61 urban patients with a mean survival of 426 days and 83 rural patients with a mean survival of 278 days. Analysis revealed a statistically significance in survival for urban versus rural patients who achieved complete remission after induction chemotherapy (P=0.0443). Conclusions: Survival was improved for urban patients who achieved a complete remission after induction chemotherapy versus rural patients (P= 0.0443). Further study should be undertaken to identify the causes of this disparity. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Lselectin Levels in Patients with Endometriosis

2018 ◽  
pp. 50
Author(s):  
Melkiandri Fanggidae ◽  
Maria F.T. Loho ◽  
Maya E. Mewengkang
Keyword(s):  
Clinical Stage ◽  
Cross Sectional Study ◽  
Statistical Test ◽  
P Value ◽  
Age Group ◽  
Cross Sectional ◽  
Stage 4 ◽  
Correlation Tests ◽  
Stage 1 ◽  
Elisa Data

Objective: To investigate the L-selectin profile in endometrioticpatients.Methods: This was a cross-sectional study. Subjects were patientsdiagnosed endometriosis based on clinical examination, transvaginalultrasound, MRI and CT scan at the Department of Obstetricsand Gynecology of Prof. Dr. R.D. Kandou Hospital Manado, SiloamHospital and Network Hospital starting from January 2017 to May2017. The blood samples in patients prior to surgery were taken ona vein and then separated to obtain serum. Further more, serumlevels of L-selectin were measured using enzyme-linked immunosorbentassay (ELISA). Data were analyzed with SPSS version 22.0to see significance level.Results: Of the 18 samples, based on age, endometriosis highest inthe group > 26 years ie 17 patients (94.44%), followed by the agegroup of 21-25 years in 1 patient (5:56%), and none of thepatients in the age group <20 years (0%). Based on parity, themost established on a parity group 0 for 11 patients (61.11%),followed by the 1-3 parity group of 7 patients (38.99%), and nopatients in the parity > 4 (0%). Based on the highest stage is thethird stage as many as 11 people (61.11%), followed by stage 4 of7 patients (38.99%), and none of the patients in stage 1 or stage 2(0%). From a statistical test used to stage endometriosis age, theT test, p value 0.286. From a statistical test according to the levelsof L-selectin on endometriosis stadium used, the T test, p value0.090. Results of correlation tests were used, namely statingPearson test p value of 0.921.Conclusion: L-selectin levels in women with endometriosisincreased according to clinical stage, but not significant in statisticaltests. There is no significant relationship between age withstages or levels of L-selectin in women with endometriosis.Keywords: adhesion, age, endometriosis, L-selectin, stage

scholarly journals The Five Stages of Masculinity: A New Model for Understanding Masculinities

2016 ◽  
Vol 5 (3) ◽  
pp. 268
Author(s):  
Joseph Gelfer
Keyword(s):  
Content Analysis ◽  
The State ◽  
State Of Exception ◽  
New Model ◽  
Stage 4 ◽  
Crisis Of Masculinity ◽  
Stage 1 ◽  
Magazine Articles ◽  
Men And Masculinities

The article uses the so-called “crisis of masculinity” as a jumping-off point for proposing a new model for understanding masculinities called the Five Stages of Masculinity. The five stages outlined in the article are: Stage 1, Unconscious Masculinity; Stage 2, Conscious Masculinity; Stage 3, Critical Masculinities; Stage 4, Multiple Masculinities; Stage 5, Beyond Masculinities. A content analysis of news and magazine articles is provided to give some initial indication as to the proportion of public conversations taking place at each stage. The article concludes by discussing the implications of the Five Stages of Masculinity for the study of men and masculinities, as well as some new thoughts on the nature of the crisis of masculinity via a mobilization of Giorgio Agamben’s concept of the “state of exception.”

Alterations in the number of motoneurons containing immunoreactive calcitonin gene-related peptide(CGRP)& choline acetyltransferase(ChAT) in the cervical spinal cord of the wobbler mouse during the development of the motoneuron disease

1995 ◽  
Vol 53 ◽  
pp. 970-971
Author(s):  
L. Vacca-Galloway ◽  
Y.Q. Zhang ◽  
P. Bose ◽  
S.H. Zhang
Keyword(s):  
Spinal Cord ◽  
Early Stage ◽  
Cervical Spinal Cord ◽  
Wild Type Mouse ◽  
Reflex Response ◽  
Mouse Strains ◽  
Behavioral Tests ◽  
Wobbler Mouse ◽  
Stage 4 ◽  
Stage 1

The Wobbler mouse (wr) has been studied as a model for inherited human motoneuron diseases (MNDs). Using behavioral tests for forelimb power, walking, climbing, and the “clasp-like reflex” response, the progress of the MND can be categorized into early (Stage 1, age 21 days) and late (Stage 4, age 3 months) stages. Age-and sex-matched normal phenotype littermates (NFR/wr) were used as controls (Stage 0), as well as mice from two related wild-type mouse strains: NFR/N and a C57BI/6N. Using behavioral tests, we also detected pre-symptomatic Wobblers at postnatal ages 7 and 14 days. The mice were anesthetized and perfusion-fixed for immunocytochemical (ICC) of CGRP and ChAT in the spinal cord (C3 to C5).Using computerized morphomety (Vidas, Zeiss), the numbers of IR-CGRP labelled motoneurons were significantly lower in 14 day old Wobbler specimens compared with the controls (Fig. 1). The same trend was observed at 21 days (Stage 1) and 3 months (Stage 4). The IR-CGRP-containing motoneurons in the Wobbler specimens declined progressively with age.

A PROPOSED EVALUATION PLAN TO ASSESS THE IMPACT OF A YOUTH DEVELOPMENT PROGRAMME FACILITATED BY THE STATE INFORMATION TECHNOLOGY AGENCY (SITA) IN RURAL SOUTH AFRICA

2017 ◽  
Vol 14 (1) ◽  
pp. 174-181
Author(s):  
Maura Mbunyuza-deHeer Menlah
Keyword(s):  
Information Technology ◽  
Youth Development ◽  
Rural Areas ◽  
Secondary Data ◽  
The State ◽  
State Information ◽  
Evaluation Plan ◽  
Lessons Learnt ◽  
Slow Development ◽  
The Impact

This article reports on a proposed evaluation plan that has been developed to assess the work done by the State Information Technology Agency (SITA). The SITA programme was implemented in response to the South African government’s call to improve the lives of the populations in some rural areas through technology. The programme was meant to address slow development in  rural  areas  that  lack  technological  innovations  and  advances.  In  the proposed evaluation plan a review is made of secondary data, deciding how strategic priorities are to be determined, as well as analysis of the rural context environment. The researcher gives an account of how the evaluation strategies are to be piloted and rolled out thereafter. Lessons learnt are recorded and reported upon. A proposed evaluation plan will be developed, based on the lessons learnt in line with the objectives of the project.

New Mexico

2017 ◽  
Author(s):  
David K. Jones
Keyword(s):  
New Mexico ◽  
Board Of Directors ◽  
The State ◽  
Governance Model ◽  
The Board Of Directors ◽  
Set Up ◽  
The Right

The fight over an exchange had a very different dynamic in New Mexico because there were no loud voices on the right calling for the state to reject control. Republican Governor Susanna Martinez supported retaining control, but strongly preferred a governance model that allowed insurers to serve on the board of directors and limited the degree of oversight by the board on the types of plans that could be sold on the exchange. Governor Martinez vetoed legislation in 2011 that would have set up a different model of an exchange. Institutional quirks meant the legislature did not have the opportunity to weigh in again for two years, until 2013. By this point it was too late and the state had to rely on the federal website despite passing legislation to run its own exchange.

Traditional and Customary Law: Adat

2018 ◽  
Author(s):  
Simon Butt ◽  
Tim Lindsey
Keyword(s):  
Judicial Review ◽  
Rural Areas ◽  
Small Proportion ◽  
Local Governments ◽  
The State ◽  
Customary Law ◽  
Constitutional Court ◽  
The Past ◽  
Statutory Protection ◽  
Traditional Communities

Many Indonesians—primarily those living in rural areas—still follow customary law (adat). The precise rules and processes of that adat differ significantly from place to place, even within short distances. This chapter shows that for many decades, adat has been subservient to national law. State-made law overrode it, leaving it applicable only in a very small proportion of cases where no national law applied, where judges could apply it as ‘living law’. Even in these cases, many judges ignored adat or distorted it when deciding cases. The 1945 Constitution was amended in 2000 to require the state to formally recognize and respect customary law, as practised in traditional communities. The Constitutional Court has given effect to this in various judicial review cases, as have some statutes enacted in the past decade or so. However, this constitutional and statutory ‘protection’ has been impeded in practice by requirements for traditional communities to be formally ‘recognized’ by their local governments, many of whom have been unresponsive to calls for recognition.

scholarly journals Monetizing the Burden of Childhood Asthma Due to Traffic Related Air Pollution in the Contiguous United States in 2010

2021 ◽  
Vol 18 (15) ◽  
pp. 7864
Author(s):  
Minaal Farrukh ◽  
Haneen Khreis
Keyword(s):  
United States ◽  
Air Pollution ◽  
Economic Impact ◽  
Childhood Asthma ◽  
Ambient Air ◽  
The United States ◽  
The State ◽  
Cost Calculation ◽  
Cost Burden ◽  
Incident Cases

Background: Traffic-related air pollution (TRAP) refers to the wide range of air pollutants emitted by traffic that are dispersed into the ambient air. Emerging evidence shows that TRAP can increase asthma incidence in children. Living with asthma can carry a huge financial burden for individuals and families due to direct and indirect medical expenses, which can include costs of hospitalization, medical visits, medication, missed school days, and loss of wages from missed workdays for caregivers. Objective: The objective of this paper is to estimate the economic impact of childhood asthma incident cases attributable to nitrogen dioxide (NO2), a common traffic-related air pollutant in urban areas, in the United States at the state level. Methods: We calculate the direct and indirect costs of childhood asthma incident cases attributable to NO2 using previously published burden of disease estimates and per person asthma cost estimates. By multiplying the per person indirect and direct costs for each state with the NO2-attributable asthma incident cases in each state, we were able to estimate the total cost of childhood asthma cases attributable to NO2 in the United States. Results: The cost calculation estimates the total direct and indirect annual cost of childhood asthma cases attributable to NO2 in the year 2010 to be $178,900,138.989 (95% CI: $101,019,728.20–$256,980,126.65). The state with the highest cost burden is California with $24,501,859.84 (95% CI: $10,020,182.62–$38,982,261.250), and the state with the lowest cost burden is Montana with $88,880.12 (95% CI: $33,491.06–$144,269.18). Conclusion: This study estimates the annual costs of childhood asthma incident cases attributable to NO2 and demonstrates the importance of conducting economic impacts studies of TRAP. It is important for policy-making institutions to focus on this problem by advocating and supporting more studies on TRAP’s impact on the national economy and health, including these economic impact estimates in the decision-making process, and devising mitigation strategies to reduce TRAP and the population’s exposure.

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