A Nationwide analysis of mortality trends in geriatric and non-geriatric patients with oral cavity tumors.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17510-e17510
Author(s):  
Bushra Waseem ◽  
Germame Hailegiorgis Ajebo ◽  
Allan N. Krutchik ◽  
Achuta Kumar Guddati
Keyword(s):  
African American ◽  
Oral Cavity ◽  
Geriatric Patients ◽  
Linear Trend ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Mortality Trends ◽  
Alaskan Native ◽  
Significant Difference ◽  
American Black

e17510 Background: Squamous cell carcinoma is the most common histological-subtype of oral cavity tumors and no major advances in its treatment have occurred recently. However, p16 positive tumors have been noted to have a better prognosis than p16 negative tumors. Older patients have increasingly been found to have p16 positive oral cavity cancers. This study explores the incidence based mortality of geriatric patients irrespective of p16 status. Methods: Data from Surveillance, Epidemiology, and End Results (SEER) Database was extracted to study the incidence-based mortality for the years 2000 to 2014. Incidence-based mortality for all stages of oral cavity tumors was queried and the results were grouped by age (geriatric vs. non-geriatric) and race (Caucasian/White, African American/Black, American Indian/Alaskan native and Asian/Pacific Islander). All stages and both genders were included in the analysis. T-test was used to determine statistically significant difference between various subgroups. Linear trend lines were used to visualize the mortality trends between various subgroups (Geriatric vs. Non- geriatric and Caucasian vs. African American). Results: Incidence-based mortality for oral cavity tumors has worsened since 2000 to 2014 for geriatric patients (p < 0.05) when compared to non-geriatric patients in both Caucasian/White patients and African American/Black patients. The results are summarized in the table below. Conclusions: The similarity in incidence-based mortality for geriatric patients with oral cavity tumors is high in all races and may imply age as a significant risk factor in these patients. A stage-specific, gender-specific and age-binned analysis may help differentiate these concerning trends. [Table: see text]

Comparison of mortality trends in geriatric and nongeriatric patients with salivary gland tumors.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23026-e23026
Author(s):  
muhammad Sarfraz Nawaz ◽  
Jigarkumar R. Parikh ◽  
Achuta Kumar Guddati
Keyword(s):  
African American ◽  
Salivary Gland ◽  
Geriatric Patients ◽  
Environmental Influence ◽  
Salivary Gland Tumors ◽  
Mortality Data ◽  
Mortality Trends ◽  
Geriatric Population ◽  
Black Patients ◽  
Significant Difference

e23026 Background: The treatment of salivary gland tumors has not changed significantly in the past two decades. However, its increased incidence in the geriatric population poses new challenges for their management. This study explores the incidence-based mortality (IBM) trends in the geriatric and non-geriatric population for the time period of 2000 to 2014 and compares the trends between races. Methods: Mortality data was extracted from the Surveillance, Epidemiology, and End Results (SEER) Database for the years 2000 to 2014. IBM for all stages of salivary gland tumors was queried and the results were grouped by age (geriatric vs. non-geriatric) and race (Caucasian/White, African American (AA)/Black, American Indian/Alaskan native and Asian/Pacific Islander). All stages and both genders were included in the analysis. T-test was used to determine statistically significance difference between various subgroups. Linearized trend lines were used to visualize the mortality trends between various subgroups (Geriatric vs. Non- geriatric and Caucasian vs. African American). Results: IBM for salivary gland tumors has worsened since 2000 to 2014 for both geriatric and non-geriatric patients (P < 0.05), There was a statistically significant difference between these two groups in both Caucasian/White and AA/Black patients. Notably, the worst IBM rates were noted in non-geriatric AA/Black patients followed by non-geriatric Caucasian/White patients. However, there was no statistical difference in IBM between geriatric patients of Caucasian/White and AA/Black descent. Conclusions: The similarity in IBM for geriatric patients with salivary gland tumors in both Caucasian/White and AA/Black groups suggest that the effects of race may not be pronounced in the elderly population. The high rate of IBM in non-geriatric AA/Black patients may suggest environmental influence and warrants further study.

Comparison of mortality trends in patients with non-salivary gland and salivary gland adenoid cystic carcinoma in the United States population.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17584-e17584
Author(s):  
Girindra Ghanshyam Raval ◽  
Germame Hailegiorgis Ajebo ◽  
Locke Johnson Bryan ◽  
Achuta Kumar Guddati
Keyword(s):  
African American ◽  
Salivary Gland ◽  
Adenoid Cystic Carcinoma ◽  
Neck Region ◽  
Mortality Trends ◽  
Adenoid Cystic ◽  
Black Patients ◽  
Significant Difference ◽  
American Black ◽  
White Patients

e17584 Background: Adenoid cystic carcinoma is the most common histological subtype of malignancy seen in major and minor salivary glands. Although indolent they tend to recur and progress. Adenoid cystic carcinoma also arises from other structures such as lacrimal glands and trachea. This study compares the incidence-based mortality between patients who have salivary and no-salivary origin adenoid cystic carcinomas of the head and neck region over the period of 2000 to 2014. Methods: A nation-wide analysis was conducted utilizing the Surveillance, Epidemiology, and End Results (SEER) Database from the years 2000 to 2014. Incidence-based mortality for all stages of adenoid cystic carcinoma was queried and the results were grouped by race (Caucasian/White, African American/Black, American Indian/Alaskan native and Asian/Pacific Islander) and gender. All stages were included in the analysis. T-test was used to determine statistically significance difference between various subgroups. Linearized trend lines were used to visualize the mortality trends of all sub groups. Results: Incidence-based mortality for salivary gland adenoid cystic carcinomas in African American/Black patients is comparable to Caucasian/White patients despite a higher incidence in Caucasian/White patients (no statistically significant difference was noted). Also, the incidence-based mortality for non-salivary gland adenoid cystic carcinomas of the head and neck region in African American/Black patients was similar to Caucasian/White patients. Essentially no racial difference in mortality was noted between salivary and non-salivary gland tumors. Comparison of mortality between genders in both races in salivary and non-salivary gland tumors also did not show any statistically significant difference. Conclusions: This study showed that adenoid cystic carcinoma of non-salivary gland origin have the same mortality trends as that from salivary gland origin in both Caucasian/White and American/Black patients and in both genders. Given such uniformity, genetic and environmental factors may not play significant role in the progression and outcomes of this disease. Hence, adenoid cystic carcinoma may be treated with similar therapeutic approaches regardless of the origin, gender and race of the patient.

scholarly journals The Role of Past Suicidal Behavior on Current Suicidality: A Retrospective Study in the Israeli Military

2021 ◽  
Vol 18 (2) ◽  
pp. 649
Author(s):  
Leah Shelef ◽  
Jessica M Rabbany ◽  
Peter M Gutierrez ◽  
Ron Kedem ◽  
Ariel Ben Yehuda ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Suicidal Behavior ◽  
Military Service ◽  
Suicide Ideation ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Severity Rating ◽  
Significant Difference

Past suicide attempts are a significant risk factor for future suicidality. Therefore, the present military-based study examined the past suicidal behavior of soldiers who recently made a severe suicide attempt. Our sample consisted of 65 active-duty soldiers (61.5% males), between the ages of 18 and 28 years old (M = 20.4, SD ± 1.3). The inclusion criterion was a recent severe suicide attempt, requiring at least a 24 h hospitalization. This sample was divided into two groups, according to previous suicidal behavior, namely whether their first suicide attempt was before or after enlistment (n = 25; 38.5% and n = 40; 61.5%, respectively). We then examined the lethality and intent of the recent event in regard to this division. Four measures were used to assess the subjects’ suicidal characteristics: the Columbia Suicide Severity Rating Scale, the Self-Harm Behavior Questionnaire, the Suicidal Behaviors Questionnaire-Revised, and the Beck Scale for Suicide Ideation. No significant difference in the severity of the suicide attempts (either actual or potential severity) were found between those who had suicide attempts before enlistment and those who had their first attempt in the service. As a matter of fact, most of the suicide attempts that occurred for the first time during military service had used a violent method (58.3%, n = 21). Finally, using multivariate analyses, we found that current thoughts and behavior, rather than past suicidality, was the strongest predictor for the lethality of suicide attempts.

scholarly journals Venous Thromboprophylaxis in Gastrointestinal Bleeding

2015 ◽  
Vol 29 (3) ◽  
pp. 145-148 ◽  
Author(s):  
Neel Malhotra ◽  
Nilesh Chande
Keyword(s):  
Thrombotic Event ◽  
Antiplatelet Agent ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Primary Diagnosis ◽  
Gi Bleeding ◽  
Duration Of Treatment ◽  
Vte Prophylaxis ◽  
Significant Difference ◽  
Gi Bleed

OBJECTIVE: To study the use of venous thromboembolism (VTE) prophylaxis and the incidence of thrombotic events in patients with acute gastrointestinal (GI) bleeding.METHODS: Individuals admitted with a primary diagnosis of a GI bleed along with any endoscopically confirmed source (over a two-year period) were included. Patient comorbidity and data regarding anticoagulation or antiplatelet agent use before hospitalization were collected, in addition to type of VTE prophylaxis and duration of treatment. The primary end point was the development of VTE (deep vein thrombosis or pulmonary embolism) within one year of presentation.RESULTS: Data from 504 patients admitted with GI bleeding were eligible for review. The total number of VTE events was 20 (4%) while the mortality rate during hospitalization was 4.6%; 397 patients were not given VTE prophylaxis during their hospitalization. Of the patients who were given VTE prophylaxis, 68 received prophylactic heparin or heparin derivatives during their admission. One hundred sixty-five patients had at least one other significant risk factor for VTE including recent or subsequent surgery, past thrombotic event or malignancy. The incidence of thrombosis in those with significant risk factors for VTE was significantly higher than those without (8.5% versus 1.8%; P=0.0009). Overall, there was no significant difference in thrombotic events between individuals receiving pharmacological prophylaxis (1.2%) and those who did not (2.8%) (P=0.4).CONCLUSION: Overall, VTE prophylaxis did not significantly affect thrombotic events in patients admitted for an active GI bleed.

Professional Oral Health Care Reduces the Number of Oropharyngeal Bacteria

2008 ◽  
Vol 87 (6) ◽  
pp. 594-598 ◽  
Author(s):  
A. Ishikawa ◽  
T. Yoneyama ◽  
K. Hirota ◽  
Y. Miyake ◽  
K. Miyatake
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Oral Cavity ◽  
Oral Care ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Oral Health Care ◽  
Silent Aspiration ◽  
Professional Oral Health Care ◽  
Dependent Elderly

Silent aspiration of oropharyngeal pathogenic organisms is a significant risk factor causing pneumonia in the elderly. We hypothesized that regular oral hygiene care will affect the presence of oropharyngeal bacteria. Professional cleaning of the oral cavity and/or the gargling of a disinfectant liquid solution was performed over a five-month period in three facilities for the dependent elderly. Total oropharyngeal bacteria, streptococci, staphylococci, Candida, Pseudomonas, and black-pigmented Bacteroides species were monitored. The levels of these oropharyngeal bacteria decreased or disappeared after weekly professional oral health care, i.e., cleaning of teeth, dentures, tongue, and oral mucous membrane by dental hygienists. After lunch, gargling with povidone iodine was shown to be less effective than professional oral care. These findings indicate that weekly professional mechanical cleaning of the oral cavity, rather than a daily chemical disinfection of the mouth, can be an important strategy to prevent aspiration pneumonia in the dependent elderly.

Postpartum Mental State of Mothers of Twins

2016 ◽  
Vol 11 (1) ◽  
pp. 1-12
Author(s):  
Éva Brantmüller ◽  
Mónika Gyúró ◽  
Kitti Galgán ◽  
Annamária Pakai
Keyword(s):  
Risk Factor ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Threshold Value ◽  
Primary Objective ◽  
Health Visitor ◽  
Maternal Mood ◽  
Significant Difference ◽  
Relevant Risk Factor ◽  
Convenience Sampling

AbstractTwin birth is a relevant risk factor for postnatal depression (PND). The primary objective of our study is to reveal the prevalence of suspected cases of depression and to identify some background factors among mothers of twins. We applied convenience sampling method within a retrospective, quantitative study among mothers given birth to twins for six months, but, at least, three years. The participants completed the self-administered, modular questionnaire and the standard EPDS questionnaire anonymously. 35% of mothers of twins reached or exceeded the threshold value for depression following the first six months after delivery. No significant difference was found in the prevalence of the suspected cases among the primipara and multipara (p=1.000). At the same time, artificial conception proved to be a significant risk factor (p= 0.019). Distraught family life (p=0.001) and unfavorable changes in a domestic partnership (p=0.009) increased the prevalence of the suspected cases of depression significantly. The health visitor is the only person who knows the hierarchy of families with their weaknesses and strengths in the Hungarian primary health care; therefore, her role is unquestionable in the recognition of maternal mood disorders. The health visitor compares the scores of the EPDS questionnaire with the experiences during family visits, and with all of these facts, she refers the person in need to a specialist.

scholarly journals Comparative Study of Superselective Intra-Arterial Chemoradiotherapy versus Radical Surgery on Distant Metastasis for Advanced Oral Cancer

2014 ◽  
Vol 2014 ◽  
pp. 1-7
Author(s):  
Wataru Kobayashi ◽  
Beng Gwan Teh ◽  
Norihiko Narita ◽  
Ryohei Ito ◽  
Yuki Saito ◽  
...  
Keyword(s):  
Surgical Management ◽  
Distant Metastasis ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Oral Cancers ◽  
Significant Difference ◽  
N Classification ◽  
Neck Recurrence ◽  
T Classification ◽  
Classification And Treatment

Background. Distant metastasis is considerably more frequent in superselective intra-arterial chemoradiotherapy than other radical treatments for advanced oral cancers. However, there is no evidence supporting such claim. The purpose of this study was to report our experience in superselective intra-arterial chemoradiotherapy and conventional surgical management with particular focus on distant metastasis. Methods. One hundred seventy-two patients with oral squamous cell carcinoma in stages III and IV were included in this study. Retrospective analysis for DM rates and background between surgical management and superselective intra-arterial chemoradiotherapy was performed. Results. Distant metastasis developed clinically was detected in 24 out of 141 patients (17.0%) treated surgically and in 6 out of 31 patients (19.4%) treated with superselective intra-arterial chemoradiotherapy. There was no significant difference in the rate of distant metastasis between the 2 groups. Comparison of patients in both groups with and without distant metastasis revealed no differences in age, T classification, N classification, and treatment effect. Neck recurrence was the only significant risk factor for distant metastasis. Conclusion. No significant difference was found in the rate of distant metastasis between patients treated with surgical treatment and superselective intra-arterial chemoradiotherapy, and additional effort is needed to reduce the risk of distant metastasis.

scholarly journals A study to determine risk factors for renal scarring as detected by dimercaptosuccinic acid scan in children with urinary tract infection

2021 ◽  
Author(s):  
Nisha Jacob Arackal Jacob ◽  
Seshagiri Koripadu ◽  
Harishchandra Venkata Yanamandala
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Renal Scarring ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Positive Group ◽  
Recurrent Uti ◽  
Significant Difference ◽  
Dimercaptosuccinic Acid Scan ◽  
Dmsa Scan

Background: The aim of the study was to determine the risk factors for renal scarring detected by DMSA (dimercaptosuccinic acid) scan in children with culture-proven urinary tract infection (UTI).Methods: A hospital based observational case-control study was conducted from 2018 June to 2020 June in children aged between 1 month to 5 years who underwent a DMSA scan following culture-proven UTI (N=72). Of the children fulfilling the criteria, 43 had renal scarring in the DMSA scan as a case group and the remaining 29 children who had no renal scarring were taken as a control group.Results: Of the total 72 cases with culture-positive UTI, 59% of patients had renal scarring and the rest and 40% were scar negative. There was no significant difference in the renal scarring observed with respect to age in the two groups. There was significant (p<0.05) the association noted between renal scarring and VUR (vesicoureteric reflux). A significant difference was observed in the renal scarring between the two groups regarding the presence of recurrent UTI (p=0.000). Although most cases (97.7%) had a fever in the DMSA positive group, this was not a significant risk factor for scarring (p>0.05). In DMSA positive group, circumcision was not a significant risk factor for scarring.Conclusions: VUR and recurrent UTI were significant risk factors for renal scarring in children with culture-proven UTI as detected by DMSA scan. The other risk factors like age, sex, fever, leucocytosis and circumcision were not found to be significant. 

scholarly journals Preoperative Nutritional Status and Risk Factors Associated with Delayed Discharge in Geriatric Patients Undergoing Gastrectomy: A Single-Center Retrospective Study

2021 ◽  
Author(s):  
Xining Zhao ◽  
Jie Liu ◽  
Ying Wang ◽  
Yuying Yang ◽  
Yan Pan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Postoperative Complications ◽  
Geriatric Patients ◽  
Cox Regression ◽  
Significant Risk ◽  
Related Factors ◽  
Factors Associated ◽  
Delayed Discharge ◽  
Significant Difference

Abstract Background Preoperative malnutrition is an independent risk factor for postoperative complications and survival for gastric cancer (GC) patients. This study aimed to investigate the prevalence of malnutrition and the risk factors associated with the delayed discharge of geriatric patients undergoing gastrectomy. Material and Methods A retrospective study of GC patients (age ≥ 65) who underwent gastrectomy at Zhongshan Hospital from January 2018 to May 2020 was conducted. Clinical data, including demographic information, medical history, surgery-related factors, and perioperative nutritional management were collected and analyzed. Results A total of 783 patients were reviewed. The overall frequency of malnutrition was 31.3% (249/783). The levels of albumin, prealbumin, and hemoglobin were lower in the malnutrition group compared with the well-nourished group. Moreover, 51 (6.5%) patients received preoperative total parenteral nutritional support. All patients received postoperative parenteral nutrition; 194 (77.9%) patients in the malnutrition group received an infusion of carbohydrates with composite amino acid and 55 (22.1%) received total nutrient admixture. No significant difference was found in the duration of postoperative nutrition between the groups (P>0.05). The malnutrition group was associated with a higher rate of surgical site infections (SSIs) (P<0.001). Multivariate cox regression revealed that age >70 years, length of surgery >180 min, and postoperative complications were significant risk factors associated with delayed discharge. Conclusion Malnutrition is relatively common in elderly patients undergoing gastrectomy. Age, length of surgery, and postoperative complications are important risk factors associated with delayed discharge. Elderly GC patients with risk factors urgently require specific attention to shorten hospital stays.

scholarly journals Analysis of trends in mortality in patients with lymphoepithelial carcinoma of the head and neck.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17583-e17583
Author(s):  
Marcus Kyle Weldon ◽  
Takefumi Komiya ◽  
Achuta Kumar Guddati
Keyword(s):  
African American ◽  
American Indian ◽  
Head And Neck ◽  
Pacific Islander ◽  
Black American ◽  
Lymphoepithelial Carcinoma ◽  
Alaskan Native ◽  
Asian Pacific Islander ◽  
American Black ◽  
Asian Pacific

e17583 Background: Squamous cell carcinoma is the most common subtype of malignancy found in patients with Head and Neck malignancy. There are other rare subtypes which are not adequately reported in medical literature. Lymphoepithelial carcinoma consists of lymphocytic infiltration in a background of undifferentiated carcinoma cells and has a high malignant potential. They are most often seen in salivary glands but can also be found in other structures of the head and neck region. This analysis reports the nation-wide mortality of patients diagnosed with lymphoepithelial carcinoma of the Head and Neck. Methods: Data was extracted from the Surveillance, Epidemiology, and End Results (SEER) Database from the years 2000 to 2014. Incidence-based mortality for all stages was queried and results were grouped by gender and race (Caucasian/White, African American/Black, American Indian/Alaskan native and Asian/Pacific Islander). Paired T-test was used to determine statistically significance difference between various subgroups. Results: Incidence-based mortality has been improving for African American/Black patients and has been worsening for Caucasian/White, American Indian/Alaskan native and Asian/Pacific Islander for the period of 2000 to 2014. The differences in mortality trends were statistically different (P < 0.05). The highest mortality rate per 1000 patients was seen in Asian/Pacific Islander population, followed by African American/Black, American Indian/Alaskan native and the least mortality was noted in Caucasian/White patients. When a similar analysis with linearized trend lines on gender was conducted, only African American/Black males and Asian/Pacific Islander females showed an improving trend in mortality. The sample size was a major limitation of this study (Caucasian/White - 134, African American/Black - 30, American Indian/Alaskan native - 5 and Asian/Pacific Islander – 87). Conclusions: Lymphoepithelial carcinoma is a rare subtype of Head and Neck malignancies whose incidence-based mortality showed a worsening trend. This study showed significant race and gender disparity amongst patients with lymphoepithelial carcinoma. Due to its rarity, this subtype warrants further study; especially with regards to its etiology, clinical course and cure rates.

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