Unique perspectives from the transgender community: A retrospective chart review of cancer care needs for transgender patients.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 6566-6566
Author(s):  
Carolyn Moloney ◽  
Margaret Allen ◽  
Deirdre O'Mahony ◽  
Derek Power ◽  
Richard Bambury ◽  
...  
Keyword(s):  
Cancer Care ◽  
Medical Records ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Well Being ◽  
Smoking History ◽  
Desmoid Tumour ◽  
Cancer Support ◽  
Incidence And Mortality ◽  
And Gender

6566 Background: It is estimated that 1% of a population experience some degree of gender non-conformity. There is scant information worldwide on cancer incidence and mortality for this population however due to a lack of investigating large-scale prospective studies. National cancer registries do not hold demographics on this population. Current literature indicates transgender people may face an increased cancer risk. Transgender patients may avoid screening programmes for cancers which are themselves gendered. Transgender patients can feel excluded from gender specific cancer support groups. We set out to identify how cancer services in Ireland can better meet transgender people’s unique needs. Methods: Medical oncology consultants in the South/South-West of Ireland were contacted to identify patients who identified as transgender or gender non-conforming. We carried out a retrospective chart review of the four transgender patients identified. We analysed staging at diagnosis, family supports, smoking history, alcohol use and whether cancer treatment affected gender transitioning treatment and if this had documented effects on mental well-being. We also noted if medical records reflected a new name or change of gender and if not, whether original name and gender used for chemotherapy and blood product administration. Results: All four patients were diagnosed with relatively advanced disease at diagnosis- Stage IIIc high grade ovarian cancer, stage IV gastrointestinal tumour, stage IVb diffuse large B Cell and locally advanced extra-abdominal desmoid tumour. Of the four patients, three had a smoking and alcohol history on diagnosis. All four patient’s recent medical correspondence reflected a name and gender change but the medical records did not reflect this. Three patients had documented depression for which they were attending psychiatry services. It was noted that two patients had gender transitioning treatment postponed due to cancer care. Minimal family support was noted for two patients. Conclusions: The transgender community is a growing population that will continue to integrate into mainstream society. Our retrospective chart review adds to a growing body of evidence which suggests gender minorities may suffer from cancer-related disparities and have an increased need for psychosocial support. As in other studies, it is difficult to identify these individuals. We should identify gender minority individuals and report this data in medical records in order to build much needed epidemiological information.

A Comparison of Sexual Arousal in Men Exposed to Visual Stimuli With and Without Facial Blurring

Sexual Abuse ◽  
2019 ◽  
Vol 32 (6) ◽  
pp. 619-633 ◽  
Author(s):  
Leah Rosetti ◽  
Susan Curry ◽  
Lisa Murphy ◽  
John B. Bradford ◽  
J. Paul Fedoroff
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Effect Sizes ◽  
Modest Effect Size ◽  
Legal Challenges ◽  
And Gender ◽  
Gender Categories ◽  
Facial Images ◽  
Modest Effect

The role of the facial images in arousal and attraction has been examined before but never via penile plethysmography (PPG). This retrospective chart review aimed to determine the significance and magnitude of differences in arousal measured by PPG in 1,000 men exposed to slide stimuli with or without facial blurring in subjects of various ages. Arousal in response to blurred stimuli was significantly higher than nonanonymized stimuli with modest effect sizes for slides across age and gender categories. Facial blurring increased differences in arousal between adults and adolescents with a modest effect size. Our findings support the use of facial blurring to further protect the anonymity of models and limit the ethical and legal challenges of using slide stimuli with child models.

A Descriptive Report of Bleeding Complications Secondary to Warfarin Therapy

2003 ◽  
Vol 38 (1) ◽  
pp. 36-39 ◽  
Author(s):  
Daphne Bernard ◽  
Arjun P. Dutta ◽  
Monika N. Daftary
Keyword(s):  
Medical Records ◽  
Chart Review ◽  
Warfarin Therapy ◽  
Common Factors ◽  
Retrospective Chart Review ◽  
Descriptive Statistics ◽  
Bleeding Complications ◽  
Comorbid Conditions ◽  
Factors Associated ◽  
Anticoagulation Intensity

Purpose This study identified factors that contributed to bleeding complications associated with warfarin therapy that were documented as adverse drug reactions (ADRs). Methods A retrospective chart review was performed using the Medical Records Department's “E” code list of anticoagulant-related ADRs. Descriptive statistics were used to identify common factors associated with bleeding complications related to warfarin use. Results Patients 60 years of age or older experienced 78% of all events; a majority (81%) of reports involved the presence of comorbid conditions such as congestive heart failure, carcinoma, or sepsis. A supratherapeutic INR was documented for 75% of patients with anticoagulant-related ADRS. Conclusions Age, comorbid conditions, and anticoagulation intensity were identified as possible factors contributing to documented ADRs associated with warfarin therapy.

BPI19-018: Cancer Screening Rates and Adherence of Uninsured Cancer Patients in Free Clinics

2019 ◽  
Vol 17 (3.5) ◽  
pp. BPI19-018
Author(s):  
Katherine Robinson ◽  
Amber Todd ◽  
Abu-Sayeef Mirza ◽  
Madeline Macdonald ◽  
Noura Ayoubi ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Chart Review ◽  
Pearson Correlation ◽  
Demographic Data ◽  
Retrospective Chart Review ◽  
Cancer Surveillance ◽  
Screening Colonoscopy ◽  
Smoking History ◽  
Free Clinics ◽  
Uninsured Population

Background: There are limited studies documenting the prevalence of malignancies and the cancer screening practices of the uninsured population. Cancer survivors require continued cancer surveillance and screening for recurrence and second primaries. However, screening may be suboptimal among the uninsured. Our objective was to identify and document the screening rates and adherence to ACS guidelines in our local uninsured community. Methods: Demographic data, cancer history and associated cancer screening measures were extracted from electronic medical records of patients managed in 8 free clinics between January 2016 and December 2017 in the Tampa Bay Area. Frequencies, proportions, and Pearson correlation coefficients were used to describe the population and statistically significant relationships. Using the ACS cancer screening recommendations, the charts were reviewed for appropriate cancer screening. Results: From manual chart review, 6,958 charts were reviewed and 201 (2.89%) patients had a diagnosis of cancer. The average age was 55.58 years and 134 (66.67%) were women. Most common malignancies included breast cancer (49, 24.38%), prostate (18, 8.96%), colorectal (13, 6.47%), leukemia/lymphoma (11, 5.47%), cervical (10, 4.98%), melanoma (10, 4.98%), ovarian (9, 4.48%), thyroid (9, 4.48%), renal (6, 2.99%), bladder (5, 2.49%), and uterine (5, 2.49%). Of the 201 patients diagnosed with cancer, 104 (51.74%) met the guidelines for a screening mammogram; however, only 49 (47.12%) had this completed. 115 (57.21%) met the guidelines for a screening Papanicolaou smear; 28 (24.35%) had it completed. 145 (72.14%) met the guidelines for a screening colonoscopy; 23 (15.86%) had it completed. 39 (19.4%) met the guidelines for prostate screening; 3 (7.69%) had it completed. Of the 201 patients, 14 (6.97%) reported a greater than 30 pack smoking history but no patients were screened with a low-dose CT of the thorax. Of the 10 patients with melanoma, 3 (30%) mentioned having routine skin exams. Conclusions: The uninsured population have many barriers to obtaining health care and appropriate screening for malignancies. This retrospective chart review highlights the need for easier access to screening. Increasing screening rates in the uninsured population will decrease cancer mortality as well as being cost effective to the community. It is important for free clinic providers to emphasize guideline-directed cancer screening at every visit.

scholarly journals P.075 Incidence of Stroke Associated With Antithrombotic Agent Interruption

2021 ◽  
Vol 48 (s3) ◽  
pp. S40-S40
Author(s):  
HE Snyder ◽  
A Cao ◽  
R Rana ◽  
L Li ◽  
F Masood
Keyword(s):  
Ischemic Stroke ◽  
Medical Records ◽  
Chart Review ◽  
Significant Proportion ◽  
Retrospective Chart Review ◽  
Primary And Secondary Prevention ◽  
Antithrombotic Agent ◽  
Healthcare Burden ◽  
Stroke Centre ◽  
Significant Mortality

Background: Antithrombotic medications are used in the primary and secondary prevention of ischemic stroke. Previous studies have identified that up to 5.2% of ischemic strokes are associated with antithrombotic interruption, leading to significant mortality and healthcare burden. Our study aims to identify the prevalence of ischemic strokes presenting to a regional stroke centre associated with antithrombotic interruption, and to understand common reasons for medication interruption. Methods: A retrospective chart review was performed, which included 193 patients with ischemic stroke presenting to Greater Niagara General Hospital from January 2018-December 2019. Baseline demographics were recorded and patient medical records were reviewed for evidence of antithrombotic interruptions. Results: Table 1. Conclusions: Our cohort identified a significant proportion (8.3%) of ischemic strokes with documented antithrombotic interruption. Most common reasons for interruption were non-adherence and discontinuation due to previous adverse event. The results identify possible areas for improvement within patient education and safe re-initiation of antithrombotics following adverse events.

scholarly journals Secondary prevention among uninsured stroke patients: A free clinic study

2020 ◽  
Vol 8 ◽  
pp. 205031212096532
Author(s):  
Madeline R MacDonald ◽  
Sydney Zarriello ◽  
Justin Swanson ◽  
Noura Ayoubi ◽  
Rahul Mhaskar ◽  
...  
Keyword(s):  
Secondary Prevention ◽  
Medical Records ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Free Clinics ◽  
Stroke Patients ◽  
Uninsured Patients ◽  
Patients With Diabetes ◽  
History Of ◽  
Clinic Study

Objectives: Free clinics manage a diversity of diseases among the uninsured. We sought to assess the medical management of stroke in a population of uninsured patients. Methods: A retrospective chart review was conducted to collect chronic disease statistics from 6558 electronic medical records and paper charts at nine free clinics in Tampa, Florida, from January 2016 to December 2017. Demographics and risk factors were compared between stroke patients and non-stroke patients. Medication rates for several comorbidities were also assessed. Results: Two percent (107) of patients had been diagnosed with a stroke. Stroke patients were older (mean (M) = 56.0, standard deviation (SD) = 11.2) than the rest of the sample (M = 43.3, SD = 15.4), p < 0.001 and a majority were men (n = 62, 58%). Of the stroke patients with hypertension (n = 79), 81% (n = 64) were receiving anti-hypertensive medications. Of the stroke patients with diabetes (n = 43), 72% (n = 31) were receiving diabetes medications. Among all stroke patients, 44% were receiving aspirin therapy (n = 47). Similarly, 39% of all stroke patients (n = 42) were taking statins. Conclusions: Uninsured patients with a history of stroke may not be receiving adequate secondary prevention highlighting the risk and vulnerability of uninsured patients. This finding identifies an area for improvement in secondary stroke prevention in free clinics.

scholarly journals Changes in Abnormal Muscle Tension Pattern after Fiberoptic Injection Laryngoplasty

2017 ◽  
Vol 96 (12) ◽  
pp. 472-476 ◽  
Author(s):  
Georges Ziade ◽  
Ghassan Haddad ◽  
Sarah Assaad ◽  
Maher Kasti ◽  
Abdul-Latif Hamdan
Keyword(s):  
Medical Records ◽  
Vocal Fold ◽  
Chart Review ◽  
Muscle Tension ◽  
Retrospective Chart Review ◽  
Injection Laryngoplasty ◽  
Before And After ◽  
Glottal Insufficiency ◽  
The Mean ◽  
Positive Effect

We performed a retrospective chart review to compare the presence and types of abnormal muscle tension patterns (MTPs) in patients who had been diagnosed with glottal insufficiency before and after fiberoptic injection laryngoplasty. The main cause of glottal insufficiency had been unilateral vocal fold paralysis. Our review included an analysis of the medical records and laryngeal videostroboscopic recordings of 16 patients—9 men and 7 women, aged 25 to 87 years (mean: 59). Stroboscopic frames were analyzed for the presence of one or more types of abnormal MTP. Statistical analysis was performed to determine the significance of the change in scores for type II and type III MTP before injection and 1 month after injection. Before injection laryngoplasty, 15 of the 16 patients exhibited evidence of an abnormal MTP; 10 patients had MTP II only, 2 had MTP III only, and 3 patients had both. The mean percentage of frames showing MTP (i.e., MTP score) in patients with MTP II was 66.2% before the injection and 28.9% 1 month after; the decrease was statistically significant (p = 0.001). For MTP III, the corresponding figures were 71.6 and 37.7% (p = 0.043). We conclude that injection laryngoplasty has a positive effect on reducing muscle tension in patients with glottal insufficiency.

scholarly journals Does Number of Ports Affect Outcomes in Patients Undergoing Laparoscopic Pyloromyotomy? Retrospective Chart-Review Study

ISRN Surgery ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Tariq O. Abbas ◽  
Adel Ismail
Keyword(s):  
Medical Records ◽  
Chart Review ◽  
Hypertrophic Pyloric Stenosis ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Retrospective Chart Review ◽  
Infantile Hypertrophic Pyloric Stenosis ◽  
Surgical Interventions ◽  
Review Study ◽  
Laparoscopic Pyloromyotomy

Background. Although open Ramstedt's pyloromyotomy is the gold standard for the surgical management of infantile hypertrophic pyloric stenosis, laparoscopic pyloromyotomy has been found highly successful. Various factors, however, can affect the outcomes of surgical interventions in these patients. We observed a relationship between the number of ports used and outcome in patients undergoing laparoscopic pyloromyotomies. Methods. We retrospectively assessed the medical records of selected group of patients who underwent laparoscopic pyloromyotomy in our institution. Factors analyzed included operation time, length of hospital stay, postoperative complications, and time to postoperative full feeding. Results. We observed failure of myotomy in both two patients who underwent laparoscopic pyloromyotomy using only two working ports compared to successful myotomies in the remaining patients. Conclusion. Laparoscopy provides good results in terms of intraoperative exposure and cosmesis. However, standardized surgical technique with two working ports is advisable, and this can trigger further research to be ascertained.

scholarly journals Interventional Pain Management for Cancer Pain: An Analysis of Outcomes and Predictors of Clinical Response

2020 ◽  
Vol 5;23 (9;5) ◽  
pp. E451-E459
Author(s):  
Uri Hochberg
Keyword(s):  
Pain Management ◽  
Pain Relief ◽  
Cancer Pain ◽  
Chart Review ◽  
Rating Scale ◽  
Treatment Plan ◽  
Retrospective Chart Review ◽  
Well Being ◽  
Management Procedures ◽  
Interventional Pain Management

Background: Interventional procedures are offered routinely to patients seen in McGill University’s interdisciplinary cancer pain management program. However, publications on these procedures are scarce, making it difficult to predict which patients may benefit from them. Objectives: We hypothesized that interventional pain procedures offered to cancer patients could provide relief of pain as well as other symptoms. Furthermore, some variables may predict the efficacy of such procedures. Study Design: We conducted a retrospective chart review of interventional pain management procedures. Setting: The procedures reviewed were conducted at the Cancer Pain Program and performed at the interventional suites of the McGill University Health Centre. Methods: The retrospective chart review included interventional pain management procedures performed between June 2015 and March 2017. Demographic data, details about the underlying cancer and about the procedure and peripTrocedural patients’ reported outcomes were recorded for analysis. Results: Eighty-two of 126 procedures were included for analysis. Most patients presented with metastatic disease (75%). Eighty percent of the patients reported pain relief, with the average pain severity decreasing by more than 2 points on a 0-to-10 Numeric Rating Scale for pain (from 6.5 of 10 to 4.2 of 10). Forty-three percent of patients were considered responders (≥ 50% pain relief). Responders also reported a significant decrease in fatigue, depression, anxiety, drowsiness, and improved well-being. Among responders, average daily opioid use decreased significantly, by 60% on average. None of the analyzed variables correlated with the response; however, psychosocial variables like anxiety and depression showed a nonsignificant trend towards predicting procedure failure. Limitations: The core limitations of this study are its size and retrospective nature. Conclusions: In this cohort of cancer pain patients, interventional cancer pain procedures provided effective pain relief and other benefits, including pain relief, reduced burden of symptoms, and reduction of opioid intake, while demonstrating a favorable safety profile. Patients with poorer ratings of depression and fatigue derived less benefit from procedures, suggesting that offering such procedures as part of patients’ treatment plan would be sensible, rather than leaving interventions for later stages. Key words: Cancer pain, pain management, pain intractable, treatment outcomes, palliative care, advanced cancer, cancer, evidence-based madicine

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