Uptake and effectiveness of FOLFIRINOX for advanced pancreas cancer: A population-based study.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 245-245
Author(s):  
Safiya Karim ◽  
Jina Zhang-Salomons ◽  
James Joseph Biagi ◽  
Tim Asmis ◽  
Christopher M. Booth
Keyword(s):  
General Population ◽  
Pancreas Cancer ◽  
Study Groups ◽  
Median Number ◽  
Population Based ◽  
Routine Practice ◽  
Chi Square ◽  
Palliative Intent ◽  
Funding Program ◽  
Chi Square Test

245 Background: While FOLFIRINOX is a standard treatment option for advanced pancreas cancer there is little data describing utilization and effectiveness in routine clinical practice. Here we report practice patterns and outcomes in the general population of Ontario, Canada. Methods: Using the Ontario Cancer Registry and New Drug Funding Program we identified all patients with pancreas cancer treated with palliative intent gemcitabine or FOLFIRINOX in Ontario during 2006-2014. FOLFIRINOX became available in Ontario’s single-payer health system in November 2011. Gemcitabine cases were classified as pre-FOLFIRINOX era (2006-2010) or post-FOLFIRINOX era (2011-2014). Cases treated with peri-operative chemotherapy were excluded. Comparisons of proportions between study groups were made using the chi-square test. Overall survival (OS) was measured from date of chemotherapy initiation. Results: During 2006-2014, 3826 patients in Ontario were treated with Gemcitabine (n=3042) or FOLFIRINOX (n=784) chemotherapy for advanced pancreas cancer. Uptake of FOLFIRINOX increased from 41% (206/505) of treated cases in 2012 to 56% (274/486) of treated cases in 2014. Among patients treated after 2011, median age was 69 and 63 years for Gemcitabine and FOLFIRINOX respectively (p<0.001). The proportion of treated cases who received FOLFIRINOX varied considerably across geographic regions (from 26% to 58%, p<0.001). Median number of FOLFIRINOX cycles delivered was 6 (median 10 cycles in pivotal RCT). Median OS of patients treated with Gemcitabine was 5.0 months in 2006-2010 and 4.8 months in 2011-2014. Median OS of FOLFIRINOX patients treated in 2011-2014 was 8.2 months (median 11.1 months in pivotal RCT). Conclusions: Use of FOLFIRINOX in the general population has increased since 2011 with a resulting decrease in use of Gemcitabine. However, outcomes achieved with FOLFIRINOX in Ontario demonstrate a substantial efficacy-effectiveness gap between survival in the pivotal clinical trial and survival in routine practice.

scholarly journals Nonmedical use of prescription drugs: A comparison between intoxication-oriented and other nonmedical users

2021 ◽  
pp. 145507252110180
Author(s):  
Ilona Piispa ◽  
Karoliina Karjalainen ◽  
Niina Karttunen
Keyword(s):  
Prescription Drugs ◽  
Multinomial Logistic Regression ◽  
Study Groups ◽  
Reference Population ◽  
Population Based ◽  
Health Concern ◽  
Chi Square ◽  
Illegal Drug Use ◽  
Nonmedical Use ◽  
Chi Square Test

Aims: Nonmedical use of prescription drugs (NMUPD) is a major public health concern. The aim of the study was to compare intoxication-oriented users to those who utilised prescription drugs nonmedically for other purposes. The characteristics of the study groups, prescription drugs used, motivations for their use and sources of prescription drugs were also examined. Methods: Data were derived from the population-based Drug Survey 2014 which was conducted in Finland. The respondents were divided into intoxication-oriented users ( n = 118) and other nonmedical users ( n = 74) according to the motivation behind their NMUPD. The reference population ( n = 3277) did not report any NMUPD. Pearson’s chi square test was used to compare the distributions. A multinomial logistic regression model was used to estimate the association of sociodemographic background and intoxicant use with NMUPD. Results: Low education level and illegal drug use were associated with intoxication-oriented and other nonmedical use of prescription drugs. Intoxication-oriented use was associated also with younger age and current smoking. Sedatives were the most commonly used prescription drugs among intoxication-oriented users, and opioids among other nonmedical users. Experimentation and facilitating social interactions as a motivation for use were emphasised among intoxication-oriented users. Friends and relatives were the most common sources of prescription drugs for nonmedical use, especially among intoxication-oriented users. Conclusion: The characteristics, motivations and sources of nonmedically used prescription drugs differed in intoxication-oriented and other nonmedical users. These findings may help to identify those at risk for NMUPD. More attention should be paid to the motivations of NMUPD when new prevention and intervention methods are developed.

scholarly journals Changes in cannabis use according to socioeconomic status among Finnish adolescents from 2000 to 2015

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Noora Knaappila ◽  
Mauri Marttunen ◽  
Sari Fröjd ◽  
Nina Lindberg ◽  
Riittakerttu Kaltiala
Keyword(s):  
Socioeconomic Status ◽  
Parental Education ◽  
Population Based ◽  
Cannabis Use ◽  
Chi Square ◽  
Socioeconomic Groups ◽  
Parental Unemployment ◽  
The Usa ◽  
Chi Square Test ◽  
School Survey

Abstract Background Despite reduced sanctions and more permissive attitudes toward cannabis use in the USA and Europe, the prevalences of adolescent cannabis use have remained rather stable in the twenty-first century. However, whether trends in adolescent cannabis use differ between socioeconomic groups is not known. The aim of this study was to examine trends in cannabis use according to socioeconomic status among Finnish adolescents from 2000 to 2015. Methods A population-based school survey was conducted biennially among 14–16-year-old Finns between 2000 and 2015 (n = 761,278). Distributions for any and frequent cannabis use over time according to socioeconomic adversities were calculated using crosstabs and chi-square test. Associations between any and frequent cannabis use, time, and socioeconomic adversities were studied using binomial logistic regression results shown by odds ratios with 95% confidence intervals. Results At the overall level, the prevalences of lifetime and frequent cannabis use varied only slightly between 2000 and 2015. Cannabis use was associated with socioeconomic adversities (parental unemployment in the past year, low parental education, and not living with both parents). The differences in any and frequent cannabis use between socioeconomic groups increased significantly over the study period. Conclusions Although the overall changes in the prevalence of adolescent cannabis use were modest, cannabis use increased markedly among adolescents with the most socioeconomic adversities. Socioeconomic adversities should be considered in the prevention of adolescent cannabis use.

scholarly journals Changes in Six-Month Prevalence of Circulatory System Diseases among People Aged 20 Years and Older between 2013 and 2018 in Hunan, China

2021 ◽  
Vol 18 (5) ◽  
pp. 2599
Author(s):  
Zhenzhen Rao ◽  
Junjie Hua ◽  
Ruotong Li ◽  
Yanhong Fu ◽  
Jie Li ◽  
...  
Keyword(s):  
Age Groups ◽  
Circulatory System ◽  
Population Based ◽  
Hunan Province ◽  
Rural Residents ◽  
Chi Square ◽  
Circulatory System Diseases ◽  
Chi Square Test ◽  
Urban Rural ◽  
Socio Demographic Factors

Recent changes in population-based prevalence for circulatory system diseases (CSDs) remain unreported either nationally or locally for China. Data were from the two-round health service household interview survey of Hunan Province, China, in 2013 and 2018. A Rao–Scott chi-square test was performed to examine prevalence differences across socio-demographic variables. The overall age-standardized prevalence of CSDs increased substantially between 2013 and 2018 for inhabitants aged 20 years and older (14.25% vs. 21.25%; adjusted odds ratio (OR) = 1.59, 95% CI: 1.24–2.04). Hypertensive disease was the most prevalent type of CSD, accounting for 87.24% and 83.83% of all CSDs in 2013 and in 2018, respectively. After controlling for other socio-demographic factors, the prevalence of CSDs was significantly higher in 2018 (adjusted OR = 1.40), urban residents (adjusted OR = 1.43), females (adjusted OR = 1.12) and older age groups (adjusted OR = 5.36 for 50–59 years, 9.51 for 60–69 years, 15.19 for 70–79 years, and 12.90 for 80 years and older) than in 2013, rural residents, males and the youngest age group (20–49 years). The recent increase in the overall age-standardized CSD prevalence and the large prevalence disparities across urban/rural residents, sex and age groups merit the attention of policymakers and researchers. Further prevention efforts are needed to curb the increasing tendency and to reduce the prevalence of disparities across socio-demographic groups.

scholarly journals Shift Work and Dry Eye Disease in the Korean Working Population: A Population-Based Cross-Sectional Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5492
Author(s):  
Joonho Ahn ◽  
So-Jung Ryu ◽  
Jihun Song ◽  
Hyoung-Ryoul Kim
Keyword(s):  
Shift Work ◽  
Dry Eye ◽  
Population Based ◽  
Cross Sectional Study ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Chi Square ◽  
Cross Sectional ◽  
Shift Workers ◽  
Chi Square Test

This study aimed to evaluate the association between shift work and dry eye disease (DED) in the general population. The 2011 Korea Health Panel (KHP) was used. Chi-square test and multivariate logistic regression were used to assess the relationship between shift work and DED. Stratification analysis was conducted by sex and age. Overall, the odds ratio (OR) of DED according to shift work did not showed significant results (adjusted OR = 1.230, 95% CI 0.758–1.901). When findings were stratified based on age older or younger than 40 years, the OR of DED increased to 2.85 (95% CI: 1.25–5.90) in shift workers under 40 years of age. Our results show an association between shift work and DED in a group of younger subjects.

scholarly journals Dental anomalies and clinical features in patients with maxillary canine impaction

2012 ◽  
Vol 83 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Emanuele Mercuri ◽  
Michele Cassetta ◽  
Costanza Cavallini ◽  
Donatella Vicari ◽  
Rosalia Leonardi ◽  
...  
Keyword(s):  
Clinical Features ◽  
Study Groups ◽  
Control Group ◽  
Dental Arch ◽  
Dental Anomalies ◽  
Maxillary Canine ◽  
Chi Square ◽  
Facial Profile ◽  
Chi Square Test ◽  
Orthodontic Patients

Abstract Objective: To analyze the prevalence, distribution, clinical features, and relationship with dental anomalies of maxillary canine impaction. Materials and Methods: The complete pretreatment records of 1674 orthodontic patients were examined. Subjects with maxillary impacted canines were divided into two study groups: a palatally displaced canine (PDC) group (114 patients) and a buccally displaced canine (BDC) group (37 patients). These were compared to a control group of 151 patients who were randomly selected from the initial sample without maxillary canine impaction. The significance of associations between canine impaction and dental and clinical features and anomalies was examined with the chi-square test. Results: PDC patients presented with normal overjet and facial profile and a lower degree of dental arch crowding in comparison to the control patients. PDC patients showed a higher prevalence of impaction of other teeth, dental aplasia, transposition, and peg-shaped maxillary lateral incisors (odds ratios 3.3, 2.6, 8.3, and 5.8, respectively). Conclusion: PDC was frequently the only orthodontic problem of patients. BDC group patients did not present with notable differences in clinical and dental features or dental anomalies compared to control subjects.

scholarly journals Exploring the association between adverse maternal circumstances and low birth weight in neonates: a nationwide population-based study in Bangladesh

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e036162
Author(s):  
Md Mostaured Ali Khan ◽  
Md Golam Mustagir ◽  
Md Rafiqul Islam ◽  
Md Sharif Kaikobad ◽  
Hafiz TA Khan
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Rural Areas ◽  
Partner Violence ◽  
Multivariate Logistic Regression Analysis ◽  
Population Based ◽  
Chi Square ◽  
The Sustainable Development ◽  
Chi Square Test ◽  
Study Designs

ObjectiveThis study is concerned with helping to improve the health and care of newborn babies in Bangladesh by exploring adverse maternal circumstances and assessing whether these are contributing towards low birth weight (LBW) in neonates.Study designs and settingsData were drawn and analysed from the Bangladesh Demographic and Health Survey, 2014. Any association between LBW and adverse maternal circumstances were assessed using a Chi-square test with determinants of LBW identified by multivariate logistic regression analysis.ParticipantsThe study is based on 4728 children aged below 5 years and born to women from selected households.ResultsThe rate of LBW was around 19.9% (199 per 1000 live births) with the highest level found in the Sylhet region (26.2%). The rate was even higher in rural areas (20.8%) and among illiterate mothers (26.6%). Several adverse maternal circumstances of the women included in the survey were found to be significant for increasing the likelihood of giving birth to LBW babies. These circumstances included the women being underweight (adjusted odds ratio (AOR) 1.26, 95% CI 1.06 to 1.49); having unwanted births (AOR 1.22, 95% CI 1.03 to 1.44); had previous pregnancies terminated (AOR 1.28, 95% CI 1.05 to 1.57); were victims of intimate partner violence (AOR 1.23, 95% CI 1.05 to 1.45) and taking antenatal care <4 times (AOR 1.23, 95% CI 1.03 to 1.48). Other important risk factors that were revealed included age at birth <18 years (AOR 1.42, 95% CI 1.11 to 1.83) and intervals between the number of births <24 months (AOR 1.25, 95% CI 1.01 to 1.55). When taking multiple fertility behaviours together such as, the ages of the women at birth (<18 years with interval <24 months (AOR 1.26, 95% CI 1.02 to 1.57) and birth order (>3 with interval <24 months (AOR 1.68, 95% CI 1.18 to 2.37), then the risk of having LBW babies significantly increased.ConclusionThis study finds that adverse maternal circumstances combined with high-risk fertility behaviours are significantly associated with LBW in neonates. This situation could severely impede progress in Bangladesh towards achieving the sustainable development goal concerned with the healthcare of newborns.

Seasonality of births in affective disorder in an Irish population

1998 ◽  
Vol 13 (7) ◽  
pp. 353-358 ◽  
Author(s):  
M Clarke ◽  
F Keogh ◽  
PT Murphy ◽  
M Morris ◽  
C Larkin ◽  
...  
Keyword(s):  
Seasonal Variation ◽  
Statistical Analysis ◽  
General Population ◽  
Affective Disorder ◽  
Fourth Quarter ◽  
Season Of Birth ◽  
Irish Population ◽  
Chi Square ◽  
Chi Square Test ◽  
Seasonality Of Births

SummarySeasonal variation in the births of patients with schizophrenia is a consistently replicated epidemiological finding. Few studies have investigated this phenomenon among patients with a diagnosis of affective disorder. The majority of season of birth studies have employed the chi square test for statistical analysis, a method that has been subject to some criticism. Using a Kolgomorov-Smirnov type statistic, the quarterly birth distribution of 6,646 patients with an ICD 9/10 diagnosis of affective disorder were compared to the general population. Only the births of those individuals with unipolar forms of affective disorder (n = 4,393) differed significantly from the general population, with significant excesses and deficits in the second quarter and fourth quarter respectively. These results were not altered by application of the displacement test. © 1998 Elsevier, Paris

scholarly journals Online Suicide Identification in the Framework of Rhetorical Structure Theory (RST)

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 847
Author(s):  
Xingyun Liu ◽  
Xiaoqian Liu
Keyword(s):  
Suicide Prevention ◽  
Suicide Ideation ◽  
Population Based ◽  
Structure Theory ◽  
Context Analysis ◽  
Chi Square ◽  
Rhetorical Structure ◽  
Chi Square Test ◽  
Ideation Methods ◽  
Rhetorical Structures

Background: Suicide is a serious social problem. Substantial efforts have been made to prevent suicide for many decades. The internet has become an important arena for suicide prevention and intervention. However, to the best of our knowledge, only one study has analyzed suicidal comments online from the perspective of rhetorical structure with incomplete rhetorical relations. We aimed to examine the rhetorical differences between Chinese social media users who died by suicide and those without suicidal ideation. Methods: The posts of 15 users who died by suicide and 15 not suffering from suicide ideation were annotated by five postgraduates with expertise in analyzing suicidal posts based on rhetorical structure theory (RST). Group differences were compared via a chi-square test. Results: Results showed that users who died by suicide posted significantly more posts and used more rhetorical relations. Moreover, the two groups displayed significant differences in 17 out of 23 rhetorical relations. Limitations: Because this study is largely exploratory and tentative, caution should be taken in generalizing our findings. Conclusions: Our results expand the methods of RST to the online suicidal identification field. There are implications for population-based suicide prevention by combining rhetorical structures with context analysis.

Short-term acenocumarine (A) or dalteparine (D) for the prevention of central venous catheter-related thrombosis (CVCrT) in cancer patients. A randomized controlled study based on serial venographies

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8549-8549 ◽  
Author(s):  
M. De Cicco ◽  
M. Matovic ◽  
R. Pacenzia ◽  
D. Fantin ◽  
M. Caserta ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Controlled Trial ◽  
Venous Catheter ◽  
Median Number ◽  
Controlled Study ◽  
Thrombosis Prophylaxis ◽  
Short Term ◽  
Chi Square ◽  
Randomized Controlled ◽  
Chi Square Test

8549 Background: Timing and frequency of non occlusive (nO) or occlusive (O) CVCrT in cancer patients (pts) remain unclear. In this randomized controlled trial we studied these points and evaluated the efficacy and safety of short-term prophylaxis with A or D in the prevention of CVCrT. Methods: Consecutive cancer pts without contraindications to short-term anticoagulation, scheduled for chemotherapy via CVC, were randomly assigned to receive: A 1 mg/day for 3 days before and 8 days after CVC insertion; D 5,000 IU 2 hours before and daily for 8 days after CVC insertion; no anticoagulant treatment (NT). All pts underwent venography (V) at day 8 and 30 after CVC insertion and then every two months until CVC removal . The primary endpoint was V detected CVCrT, evaluated as nO or O when it was partially or completely occlusive of the vein lumen, respectively. Bleeding episodes were recorded. Proportions were compared using chi-square test together with odds ratio (OR). Results: 450 pts were randomized, 348 of whom (120/150 A, 114/150 D, and 114/150 NT) underwent V (median number of procedures 4, range 2–8). Both A and D reduced the frequency of V detected CVCrT (21.9% A vs 55.3% NT, OR= 4.35 (95% CI 2.43–7.69), p<0.001; 40% D vs 55.3% NT, OR= 1.85 (95% CI 1.10–3.13), p=0.02). A was more effective than D (OR= 2.37 (CI 1.34–4.22), p= 0.003). The frequency of O CVCrT was not different in the 3 groups (0.9% A, 5.0% D, 4.4% NT; p= 0.18). Overall, 5.1% of pts with CVCrT were symptomatic, all presenting O CVCrT (42% of pts with O CVCrT were not symptomatic). Most CVCrTs (95.6%) were observed at day 8 after CVC insertion. No major bleeding or pulmonary embolism occurred. Conclusions: In this study, acenocumarine was more effective than dalteparine in reducing V detected CVCrT. The doses of prophylactic agents used in this study proved to be safe. Symptomatic CVCrT evaluation alone underestimates the actual CVCrT frequency. The first days following CVC insertion are at highest risk for CVCrT. Short term thrombosis prophylaxis appears to be superior to no treatment without the expenses and inconveniences inherent in long-term prophylaxis. No significant financial relationships to disclose.

Does a diagnosis of GIST predict a second primary cancer?

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 10537-10537
Author(s):  
Myles JF Smith ◽  
Alyson L. Mahar ◽  
Calvin Law ◽  
Yoo-Joung Ko
Keyword(s):  
Colon Cancer ◽  
General Population ◽  
Kidney Cancer ◽  
Tumor Grade ◽  
Population Based ◽  
Second Primary ◽  
Significant Variable ◽  
Multiple Cancer ◽  
Chi Square ◽  
Increased Risk

10537 Background: There have been reports of a high frequency of metachronous cancers in patients diagnosed with GIST. The purpose of this study was to identify and describe patients with GIST who develop second primary cancers, and to calculate standardized incidence ratios (SIRs) to quantify the risk of additional malignancy. Methods: This was a retrospective, population-based cohort study using SEER data. Individuals diagnosed with GIST from 2001-2009 were identified as having a malignant primary tumor in the digestive tract, and included the following sites: C15.0-C26.9; C48.0-48.8; C49.4-49.5; C80.9 and a recorded histology code of 8935 and 8936. This restricted timeframe was imposed to account for changes in the recording of GIST incidence. Individuals with a previous cancer diagnosis or diagnosed post mortem only were excluded. Multiple primary SIRs and 95% confidence intervals (CI) were calculated using SEER*Stat software (V.7.1.0) and compared to general population rates. The SIR was interpreted as an estimate of relative risk (RR). Comparison of characteristics between single and multiple cancer GIST patients was performed using chi-square tests, p-values of <0.05 were considered significant. Results: We identified n=1397 cases of GIST, of which 1291 analyzed. We observed a statistically significant increased incidence of second tumours in patients with a primary GIST (n=78, RR 1.36, 95% CI:1.1-1.7). Older age (p<0.001) and tumor grade (p=0.014) were associated with second primaries, with grade being the only significant variable remaining after logistic regression. In both sexes we observed a significantly increased incidence of kidney cancer (RR 4.3, 95% CI: 1.7-8.9). In females there was a 3 fold higher incidence of colon cancer (RR 2.96 95% CI: 1.2-6.1). Conclusions: Patients with a diagnosis of GIST have a higher incidence of second cancers when compared with standardized incidence in the general population. High grade GISTs were associated with an additional malignancy. Both sexes were observed to have increased incidence of kidney cancer, with females at an increased risk of developing colon cancer. As part of GIST surveillance, screening for colon cancer in females and kidney cancer in both sexes may be considered.

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