Impact of colonoscopy on patients older than 75.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15096-e15096
Author(s):  
Dhauna Karam ◽  
Mohammed Al-Hamadani ◽  
Shah Pallavi ◽  
Mohamed Shanshal ◽  
Janos Molnar
Keyword(s):  
United States ◽  
Overall Survival ◽  
Survival Time ◽  
The United States ◽  
Young Age ◽  
Screening Colonoscopy ◽  
Rank Test ◽  
P Value ◽  
Age Group ◽  
Mean Survival Time

e15096 Background: Colorectal cancer is the second leading cause of cancer related deaths in the United States. As per current screening guidelines, screening should begin by age 50 and be continued till age 75. Routine screening over 75 years is not recommended. Methods: Our primary objective was to compare survival time in patients undergoing colonoscopy aged 75 years or older to those aged 50-74. The study was conducted at Captain James A. Lovell Federal Health Care Center (FHCC), North Chicago, United States between 2002 and 2012. A retrospective chart review was performed for patients who underwent colonoscopy. Mortality in terms of survival time was compared between patients equal or older than 75 versus those aged 50-74 years with similar procedural indications and life expectancy of 5 years or more. Survival analysis was performed via Kaplan Meier curve with log-rank test. Results: A total of 213 patients were included in the study . Fifty one percent of the patients (108) were 50-74 years old (young age group), while 49% (105) were 75 or older (old age group). Patients had colonoscopy done for following indications: 92 (43%) screening colonoscopy, 62 (29.1%) diagnostic colonoscopy and 59 (27.7%) surveillance colonoscopy. There was no statistical difference between the age groups based on indication of colonoscopy (P = 0.899). Overall mean survival time for all patients was 123.6 months (10.3 years). Survival time was significantly higher for young age group with a mean overall survival of 131.1 months (10.9 years). Older age group had a mean overall survival time of 106.9 months (8.9 years). P-value = 0.009. The highest overall mean survival time was observed in patients who were under 75 and had colonoscopy for screening purposes 138.9 months (11.6 years) (P = 0.019). The lowest overall mean survival time was seen in those who were > 75 years and had colonoscopy due to diagnostic purposes 93.6 months(7.8 years). (P = 0.055) Conclusions: Although statistically significant higher survival time was noted in patients younger than 75, older patients also had a survival time of more than 7 years. This will impact the decision to offer screening colonoscopy to older people who will definitely benefit from the test.

Outcome of Diffuse Large B Cell Lymphoma in the United States: Review of SEER Data.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1567-1567
Author(s):  
Rami S. Komrokji ◽  
Najla H. Al Ali ◽  
S.M. Beg ◽  
Jeffrey A. Schrager ◽  
Malek M. Safa
Keyword(s):  
United States ◽  
Early Stage ◽  
B Cell Lymphoma ◽  
The United States ◽  
Rank Test ◽  
P Value ◽  
Advanced Stage ◽  
Log Rank Test ◽  
Black Patients ◽  
Seer Data

Abstract Introduction: Diffuse large B cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma (NHL). Outcome data of DLBCL among a large population in the United States outside the context of clinical trials has not been reported. We examined survival trends of DLBCL patients among a large population based registry in the last four decades. Method: Surveillance, Epidemiology, and End Results (SEER) histology codes 9680, 9684, 9697 were used to identify all cases of DLBCL between 1973 and 2004. Kaplan-Meier estimates were used for median overall survival (OS). Variables analyzed included age, race, sex, stage, and year of diagnosis. SPSS statistical software was used for analysis. Results: Between 1973 and 2004, 59728 cases of DLBCL were recorded in the SEER data. The mean age of diagnosis was 63 years. 32505 (54.4%) were male and 27223 (45.6%) were female. The majority of patients, 51795 (86.7%), were white, 3733 (6.3%) were black, and 4200 (7%) were other races. Staging information was available in 57% of the cases, 18091 (30%) were early stage (I, II), 15862 (27%) were advanced stage (III, IV) and in 25775 (43%) the stage was unknown/missing. The overall median survival was 25 months. The 5 year OS was 36%. The relative 5 year OS was 47%. The median OS for females was 28 months compared to 21 months for males (log rank test, P value < 0.005). The median OS for white patients was 25 months compared to 16 months for black patients (log rank test, P value <0.005). The median OS improved over time. Specifically, for patients diagnosed between 1973–1979, 1980–1989,1990–1999, and 2000–2004 the median OS was 15, 18, 20, and 47 months, respectively (p value <0.005) (see Figure). The improvement in median OS was seen among both sexes, all ages and races. Also, the improvement in OS was seen in both early and advanced stages. For the period 2000–2004, 24,303 patients were identified. Of these 57% were males, 86% were white and 7% were black. Fifty percent were early stage and 44% were advanced stage; the stage was unknown in 6%. The median OS was 47 months. The 4 year overall survival was 46%. The median OS for early stage was not reached and was 19 months for patients with advanced stage (log rank test, p value <0.005). Outcome was better in white patients compared to black patients: 47 months compared to 29 months, respectively (log rank test, p value 0.001). No differences between males and females were noted. The median OS for patients <60 years old was not reached compared to 23 months for patients over the age of 60. In a Cox regression model all variables analyzed (age, sex, race, stage and year of diagnosis by decade) were statistically significant independent factors. Conclusion: This is the first report on outcome of DLBCL in the SEER data. The outcome of DLBCL in the United States has improved significantly in the era of monoclonal antibodies. Black patients had inferior outcome. No sex differences in outcome are noted in the recent years. The SEER data analysis has several limitations namely lack of accurate staging information, IPI scoring and treatment details. Figure Figure

scholarly journals Frequency of myocarditis in cases of fatal meningococcal infection in children: observations on 31 cases studied at autopsy

1999 ◽  
Vol 32 (5) ◽  
pp. 517-522 ◽  
Author(s):  
Norma S. Garcia ◽  
Jane S. Castelo ◽  
Valmin Ramos ◽  
Greyce S.M. Rezende ◽  
Fausto E.L. Pereira
Keyword(s):  
United States ◽  
South Africa ◽  
Survival Time ◽  
High Frequency ◽  
Myocardial Dysfunction ◽  
Case Series ◽  
The United States ◽  
Meningococcal Infection ◽  
Mean Survival Time ◽  
The Mean

The frequency of myocarditis associated with meningococcal disease in children was reported only in two autopsied series (United States and South Africa). Here we report the frequency of associated myocarditis in 31 children who died of meningoccal infection at Hospital Infantil N.S. da Glória in Vitória, Espirito Santo State, Brazil. The diagnosis was confirmed by isolation of Neisseria meningitidis . At least three sections of fragments of both atria and ventricles were studied using the Dallas Criteria for the morphologic diagnosis of myocarditis. The mean age was 47.6 ± 39.8 months and the mean survival time after the onset of symptoms was 46.1 ± 26.5h (12-112h). Myocarditis was present in 13 (41.9%) patients, being of minimal severity in 11 cases and of moderate severity in 2 cases. There were no cases with severe diffuse myocarditis. The frequency of myocarditis was not influenced by sex, presence of meningitis, survival time after the onset of symptoms or use of vasoactive drugs. The frequency of myocarditis reported here was intermediate between the values reported in the only two case series published in the literature (57% in the United States and 27% in South Africa). Although our data confirm the high frequency of myocaditis in meningoccal disease, further investigations are necessary to elucidate the contribution of myocarditis to myocardial dysfunction observed in cases of meningococcal infection in children.

scholarly journals IL15RA and SMAD3 Genetic Variants Predict Overall Survival in Metastatic Colorectal Cancer Patients Treated with FOLFIRI Therapy: A New Paradigm

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1705
Author(s):  
Elena De Mattia ◽  
Jerry Polesel ◽  
Rossana Roncato ◽  
Adrien Labriet ◽  
Alessia Bignucolo ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Metastatic Colorectal Cancer ◽  
Cancer Patients ◽  
Prognostic Score ◽  
Chemotherapeutic Agents ◽  
Rank Test ◽  
P Value ◽  
Genetic Determinants ◽  
New Paradigm

A new paradigm in cancer chemotherapy derives from the interaction between chemotherapeutics, including irinotecan and 5-fluorouracil (5-FU), and the immune system. The patient’s immune response can modulate chemotherapy effectiveness, and, on the other hand, chemotherapeutic agents can foster tumor cell immunogenicity. On these grounds, the analysis of the cancer patients’ immunogenetic characteristics and their effect on survival after chemotherapy represent a new frontier. This study aims to identify genetic determinants in the immuno-related pathways predictive of overall survival (OS) after FOLFIRI (irinotecan, 5-FU, leucovorin) therapy. Two independent cohorts comprising a total of 335 patients with metastatic colorectal cancer (mCRC) homogeneously treated with first-line FOLFIRI were included in the study. The prognostic effect of 192 tagging genetic polymorphisms in 34 immune-related genes was evaluated using the bead array technology. The IL15RA rs7910212-C allele was associated with worse OS in both discovery (HR: 1.57, p = 0.0327, Bootstrap p-value = 0.0280) and replication (HR:1.71, p = 0.0411) cohorts. Conversely, SMAD3 rs7179840-C allele was associated with better OS in both discovery (HR:0.65, p = 0.0202, Bootstrap p-value = 0.0203) and replication (HR:0.61, p = 0.0216) cohorts. A genetic prognostic score was generated integrating IL15RA-rs7910212 and SMAD3-rs7179840 markers with inflammation-related prognostic polymorphisms we previously identified in the same study population (i.e., PXR [NR1I2]-rs1054190, VDR-rs7299460). The calculated genetic score successfully discriminated patients with different survival probabilities (p < 0.0001 log-rank test). These findings provide new insight on the prognostic value of genetic determinants, such as IL15RA and SMAD3 markers, and could offer a new decision tool to improve the clinical management of patients with mCRC receiving FOLFIRI.

Trends in glassy cell cervical cancer in the United States from 1973-2015: Analysis based on SEER database.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17502-e17502
Author(s):  
Anahat Kaur ◽  
Shuai Wang ◽  
Tarek N. Elrafei ◽  
Lewis Steinberg ◽  
Abhishek Kumar
Keyword(s):  
United States ◽  
Cervical Cancer ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Small Sample Size ◽  
Black Population ◽  
The United States ◽  
Small Sample ◽  
Cervix Uteri ◽  
Kaplan Meier

e17502 Background: Glassy cell carcinoma of cervix (GCCC) is a rare histological subtype of cervical cancer which has historically been associated with rapidly progressive disease, early development of metastases and overall poor prognosis. We attempt to define real-world trends in GCCC in the United States based on data from SEER (Surveillance, Epidemiology and End Results) database. Methods: We extracted data from the US National Cancer Institute's SEER 2018 dataset using ICD-O code for ‘Cervix Uteri Glassy Cell Carcinoma’. All patients who were diagnosed between 1973-2015 were included. Statistical analysis was done using SPSS 26. Kaplan Meier curve was used for survival analysis. Results: Data for a total of 57 patients with GCCC was available from 1975 to 2017. Median age at diagnosis was 38 years (range 30.5-44.5). Increased frequency of cases was noted in white females (77.2%) as compared to black population (22.2%). Most cases initially presented with localized or regional spread (47.4% and 40.4% respectively) with distant metastasis seen in only 10.5% patients. Data analysis revealed that 63.2% patients had Grade III poorly differentiated carcinoma, 66.7% received radiation therapy, 57.9% underwent chemotherapy and 59.6% had cancer direceted surgery performed. Calculated mean overall survival was 121.9 months. We were unable to calculate 5 year and 10 year median overall survival due to small sample size and censored data. Conclusions: GCCC is a rare histologic type of cervical cancer that presents at a younger age, is more frequently seen in white females and is commonly associated with localized or regional spread at time of initial presentation.[Table: see text]

PUBLIC HEALTH

PEDIATRICS ◽  
1960 ◽  
Vol 25 (2) ◽  
pp. 343-347
Author(s):  
George M. Wheatley ◽  
Stephen A. Richardson
Keyword(s):  
Public Health ◽  
United States ◽  
Cause Of Death ◽  
United States Public Health ◽  
The United States ◽  
Vital Statistics ◽  
West Germany ◽  
Medical Attention ◽  
Age Group ◽  
Number Of Children

IN ALL COUNTRIES for which there are vital statistics, accidents are a major cause of death and disability among children. In countries where the food supply is adequate and infectious diseases have been brought under control, accidents have become the leading cause of death in the age group 1 to 19 years. For example, in such countries as Australia, Canada, Sweden, West Germany, and the United States, more than one-third of all deaths in this age group are caused by accidents. The number of children who are injured by accidents fan exceeds the number who are killed. Although no accurate international figures are available, the Morbidity Survey conducted by the United States Public Health Service indicates that in the United States, for every child under 15 killed by accident, 1,100 children are injured severely enough to require medical attention or to be restricted in their activity for at least a day.

Telehealth Music Therapy Services in the United States With Older Adults: A Descriptive Study

2022 ◽  
Author(s):  
Lindsey Wilhelm ◽  
Kyle Wilhelm
Keyword(s):  
United States ◽  
Older Adults ◽  
Music Therapy ◽  
Response Rate ◽  
Descriptive Study ◽  
The United States ◽  
Age Group ◽  
Music Therapists ◽  
Therapy Services ◽  
Therapy Sessions

Abstract In response to the COVID-19 pandemic, many music therapists in the United States turned to telehealth music therapy sessions as a strategy to continue services with older adults. However, the nature and perception of telehealth music therapy services for this age group are unknown. The purpose of this study was to describe music therapy telehealth practices with older adults in the United States including information related to session implementation, strengths and challenges, and adaptations to clinical practice. Of the 110 participants in the United States who responded to the survey (25.2% response rate), 69 reported implementing telehealth music therapy services with older adults and responded to a 32-item survey. Quantitative and qualitative analyses were conducted. Results indicated that while all participants had provided telehealth music therapy for no more than 6 months, their experiences with telehealth varied. Based on participant responses, telehealth session structure, strengths, challenges, and implemented changes are presented. Overall, 48% of music therapists reported that they planned to continue telehealth music therapy with older adults once pandemic restrictions are lifted. Further study on the quality, suitability, and acceptability of telehealth services with older adults is recommended.

CHILDHOOD BURN INJURIES AND DEATHS

PEDIATRICS ◽  
1973 ◽  
Vol 51 (6) ◽  
pp. 1069-1071
Author(s):  
William Berman ◽  
Armond S. Goldman ◽  
Thomas Reichelderfer ◽  
Howard C. Mofenson
Keyword(s):  
United States ◽  
Old Age ◽  
Home Environment ◽  
Motor Vehicle ◽  
The United States ◽  
Burn Injuries ◽  
Medical Attention ◽  
Age Group ◽  
Accidental Death

Accidents kill more people in the United States between 1 and 34 years of age than any single disease. Burns are the second leading cause of nonvehicular "accidental" death. Thirty percent of the 7,800 Americans who die from burns each year are under 15 years of age. In the 1- to 4- year-old age group, burns are the leading cause of accidental death in the home environment and second only to vehicular injuries overall; in the 5- to 14-year-old age group, burn deaths place third, behind motor vehicle and drowning fatalities.1 Each year approximately 2 million people in the United States seek medical attention for burn injuries.

scholarly journals Time to viral load suppression and its associated factors in cohort of patients taking antiretroviral treatment in East Shewa Zone, Oromiya, Ethiopia, 2018

2019 ◽  
Author(s):  
Jemal H Ali
Keyword(s):  
Viral Load ◽  
Marital Status ◽  
Associated Factors ◽  
Plasma Viral Load ◽  
Baseline Viral Load ◽  
Rank Test ◽  
P Value ◽  
People Living With Hiv ◽  
Age Group ◽  
Significant Difference

Abstract Background: Human immuno-deficiency virus is a virus that causes Acquired Immuno- Deficiency Syndrome. The key goal of ART is to achieve and maintain durable viral suppression. Thus, the most important use of the viral load is to monitor the effectiveness of therapy after initiation of ART. The main objective of the study was to determine the time for virological suppression and its associated factors among people living with HIV taking antiretroviral treatments in East shewa zone, Oromiya, Ethiopia. Methods: The study was conducted in East Shewa zone, Oromiya, Ethiopia from August 2017 to January 2018. Patients diagnosed with human immunodeficiency virus presenting to the study health centers between October 3, 2011 and March 1, 2013 were included in the study given the following criteria: age 18 years or greater, eligible to start ART. All patients with baseline viral load measurement were included in the study. Interaction between explanatory variables with the response variable was analyzed by using cross tab features of SPSS, IBM Inc. Significance group comparison was done by Kaplan Meier log rank test. Cox proportional hazard model was used to select significant factors to the variability between groups. Data was collected by using structured questionnaires and interview. A total of ETB 81,120.00 was utilized to carry out the study. Result: plasma viral load was suppressed below detection level in 72% of individuals taking different regimen of ART. The median HIV-1 plasma viral load in the cohort was log 5.3111 copies/ml. Survival curve difference were observed in category of marital status (p-value 0.023) and baseline CD4 values (p-value 0.023) whereas no significant difference were observed in Educational status (p-value 0.404), MUAC (p- value 0.407) BMI(p-value 0.335) and BTB(p-value 0.257). Estimated median time to PVL suppression was 181days (CI: 140.5-221.4) with the age group of 30-39years having minimum time to achieve suppression with 92 days (CI: 60.1-123.8) and the maximum time required to reach the level was age group between 50-59 years. Conclusion: Estimated time to achieve PVL after taking ART was found to be 181 days. Factors affecting time to suppression level was marital status and baseline CD4.

Overall survival in early stage cervical cancer in the United States has improved over the last ten years

2013 ◽  
Vol 131 (1) ◽  
pp. 269-270
Author(s):  
Jocelyn S. Chapman ◽  
Kevin W. Blansit ◽  
Lee-may Chen ◽  
Rebecca Brooks ◽  
Stefanie Ueda ◽  
...  
Keyword(s):  
United States ◽  
Cervical Cancer ◽  
Overall Survival ◽  
Early Stage ◽  
The United States ◽  
Early Stage Cervical Cancer

Abstract WMP60: Temporal Trends in Incidence, Prevalence and Epidemiological Characteristics of Cerebral Venous Thrombosis in the United States

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Fadar Otite ◽  
Smit Patel ◽  
Richa Sharma ◽  
Pushti Khandwala ◽  
Devashish Desai ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Cerebral Venous Thrombosis ◽  
The United States ◽  
P Value ◽  
Joinpoint Regression ◽  
The Us ◽  
Epidemiological Characteristics ◽  
Over Time ◽  
Age And Sex

Background: The primary aim of this study is to describe current trends in racial-, age- and sex-specific incidence, clinical characteristics and burden of cerebral venous thrombosis (CVT) in the United States (US). Methods: Validated International Classification of Disease codes were used to identify all adult new cases of CVT (n=5,567) in the State Inpatients Database of New York and Florida (2006-2016) and all cases of CVT in the entire US from the National Inpatient Sample 2005-2016 (weighted n=57,315). Incident CVT counts were combined with annual US Census data to compute age and sex-specific incidence of CVT. Joinpoint regression was used to evaluate trends in incidence over time. Results: From 2005-2016, 0.47%-0.80% of all strokes in the US were CVTs but this proportion increased by 70.4% over time. Of all CVTs over this period, 66.7% were in females but this proportion declined over time (p<0.001). Pregnancy/puerperium (27.4%) and cancer (11.8%) were the most common risk factors in women, while cancer (19.5%) and central nervous trauma (11.3) were the most common in men. Whereas the prevalence of pregnancy/puerperium declined significantly over time in women, that of cancer, inflammatory conditions and trauma increased over time in both sexes. Annual age and sex-standardized incidence of CVT in cases/million population ranged from 13.9-20.2, but incidence varied significantly by sex (women: 20.3-26.9; men 6.8-16.8) and by age/sex (women 18-44yo: 24.0-32.6%; men: 18-44yo: 5.3-12.8). Age and sex-standardized incidence also differed by race (Blacks:18.6-27.2; whites: 14.3-18.5; Asians: 5.1-13.8). On joinpoint regression, incidence increased across 2006-2016 but most of this increase was driven by increase in all age groups of men (combined annualized percentage change (APC) 9.2%, p-value <0.001), women 45-64 yo (APC 7.8%, p-value <0.001) and women ≥65 yo (APC 7.4%, p-value <0.001). Incidence in women 18-44 yo remained unchanged over time . Conclusion: The epidemiological characteristics of CVT patients in the US is changing. Incidence increased significantly over the last decade. Further studies are needed to determine whether this increase represents a true increase from changing risk factors or artefactual increase from improved detection.

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