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]

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

scholarly journals Head-Down Tilt Bed Rest Studies as a Terrestrial Analog for Spaceflight Associated Neuro-Ocular Syndrome

2021 ◽  
Vol 12 ◽  
Author(s):  
Joshua Ong ◽  
Andrew G. Lee ◽  
Heather E. Moss
Keyword(s):  
United States ◽  
Experimental Model ◽  
Space Flight ◽  
Visual Loss ◽  
Small Sample Size ◽  
Bed Rest ◽  
The United States ◽  
Small Sample ◽  
Preventative Measures ◽  
Ocular Changes

Astronauts who undergo prolonged periods of spaceflight may develop a unique constellation of neuro-ocular findings termed Spaceflight Associated Neuro-Ocular Syndrome (SANS). SANS is a disorder that is unique to spaceflight and has no terrestrial equivalent. The prevalence of SANS increases with increasing spaceflight duration and although there have been residual, structural, ocular changes noted, no irreversible or permanent visual loss has occurred after SANS, with the longest spaceflight to date being 14 months. These microgravity-induced findings are being actively investigated by the United States' National Aeronautics Space Administration (NASA) and SANS is a potential obstacle to future longer duration, manned, deep space flight missions. The pathophysiology of SANS remains incompletely understood but continues to be a subject of intense study by NASA and others. The study of SANS is of course partially limited by the small sample size of humans undergoing spaceflight. Therefore, identifying a terrestrial experimental model of SANS is imperative to facilitate its study and for testing of preventative measures and treatments. Head-down tilt bed rest (HDTBR) on Earth has emerged as one promising possibility. In this paper, we review the HDTBR as an analog for SANS pathogenesis; the clinical and imaging overlap between SANS and HDTBR studies; and potential SANS countermeasures that have been or could be tested with HDTBR.

An electrophoretic study of representatives of subgenus Diploxylon of Pinus

1989 ◽  
Vol 67 (6) ◽  
pp. 1750-1759 ◽  
Author(s):  
Roopa R. Karalamangala ◽  
Daniel L. Nickrent
Keyword(s):  
United States ◽  
Cluster Analysis ◽  
Phylogenetic Trees ◽  
Small Sample Size ◽  
The United States ◽  
Small Sample ◽  
Genetic Affinity ◽  
Electrophoretic Study ◽  
Isozyme Loci

Relationships among 14 taxa in subgenus Diploxylon of Pinus from Mexico and the United States were analyzed using 15 isozyme loci obtained from both frozen and fresh needle tissue. The phenogram obtained from cluster analysis of genetic distance values and phylogenetic trees implementing the distance Wagner procedure were in general agreement with classifications based on morphological features. Pinus leiophylla is genetically distinct from other species. Two groupings, one comprising P. oocarpa and P. pringlei and another comprising P. lawsonii and P. teocote, correspond to sections Serotinus and Teocote (sensu Martínez), respectively. Classification of the remaining eight taxa has varied, ranging from their placement in three, two, or only one section. Isozyme analysis resulted in a group that included P. cooperi, P. douglasiana, P. durangensis, P. michoacana, and P. montezumae, which suggests genetic affinity between Sections Pseudostrobus and Montezumae (sensu Martínez). This result corresponds more closely to the placement of these species in subsection Pseudostrobi. The distant relationship between P. engelmannii and the ponderosa pines may be anomalous (an artifact of small sample size) or may indicate greater genetic divergence than previously recognized.

scholarly journals Survival and Outcomes for T-Cell Lymphomas in a Ubiquitous Hispanic Community: A Texas Cancer Registry Retrospective Study

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 17-18
Author(s):  
Gerardo Manuel Rosas ◽  
Sushanth Kakarla ◽  
Brian Warnecke ◽  
Sarah Allison Smith ◽  
Joel E Michalek ◽  
...  
Keyword(s):  
United States ◽  
Overall Survival ◽  
Retrospective Study ◽  
T Cell ◽  
Cancer Registry ◽  
Research Funding ◽  
The United States ◽  
Poverty Index ◽  
T Cell Lymphomas ◽  
Kaplan Meier

BACKGROUND Non-Hodgkin Lymphomas (NHL) represent one of the most common cancers in the United States, accounting for about 4% of all cancers and it is estimated over 77,000 people (including children and adults) will be diagnosed with NHL in the United States in 2020. Depending on the data, it is estimated T-cell lymphomas make up anywhere from 7 to 15% of all NHLs. Given their relative rarity compared to other sub-types of lymphomas (and malignancies at large), there is a scarce literature regarding their outcomes in ethnic minority groups. Retrospective reviews of cancer registries and SEER databases have demonstrated conflicting evidence regarding outcomes in Hispanics (HI) with some studies suggesting worse overall survival (OS) in this group (Clin Lymphoma Myeloma Leuk. PMID: 26198444), while others suggest comparable outcomes in the setting of healthcare homogeneity (Leuk Lymphoma. PMID: 25012944). MATERIALS/METHODS This is a retrospective study of a cohort of patients diagnosed with T-cell NHL from the Texas Cancer Registry (2006-2016). Patients were identified by the International Classification of Diseases for Oncology Third Edition (ICD-O-3) code list. Data was provided to us completely de-identified. Key variables collected included gender, ethnicity, dates at diagnosis and death, payer, stage, treatment, and poverty index. Categorical outcomes were summarized with frequencies and percentages and age, the only continuously distributed outcome, with the mean and standard deviation. The significance of variation in distribution of categorical outcomes with ethnicity [HI, non-Hispanic (NH)] was assessed with Fisher's Exact tests or Pearson's Chi-square as appropriate; age was assessed with T-test or Wilcoxon. Survival time was measured in years from date of primary diagnosis to date of death. Survival distributions were described with Kaplan-Meier curves and significance of variation in median survival with ethnicity was assessed with log rank testing. At risk tables were computed based on the Kaplan-Meier estimate of the survival curve. All statistical testing was two-sided with a significance level of 5%. Corrections for multiple testing were not applied. The R language was used throughout. RESULTS We identified 2074 patients with T-cell NHL (n= 902 Peripheral T Cell, NOS; 295 Angioimmunoblastic T Cell; 577 Anaplastic Large T Cell; 120 NK/T-cell; and 180 Adult T-cell Leukemia/Lymphoma). 553 were HI (26%), 1521 NH (74%). Median age of diagnosis in HI was 50.1 vs 57.4 in NH (p = <0.001). Males were more frequently affected, 63.8% in HI vs 58.9% in NH (p = 0.048). Most frequent poverty index was 20-100% for HI vs 10-19.9% for NH (p < 0.001). Most frequent payor for both groups were Medicare with 24.3% in HI vs 35.3% in NH (p < 0.001). Most common stage at diagnosis in both groups was III/IV with 50.3% in HI vs 49.7% in NH (p = 0.031). Most frequent chemotherapy included multiple agents for both, 55.7% in HI vs 44.2% in NH (p < 0.001). Majority in both groups had neither hematologic transplant 90.2% in HI vs 85.3% in NH (p = 0.073) nor radiation, 84.4% in HI vs 82.9% in NH (p = 0.076). Median overall survival (OS) in HI was 1.7 years vs 1.9 in NH; survival probability for HI vs NH at 2 years was 0.46 vs 0.49, at 5 years 0.37 vs 0.35, and at 10 years 0.24 vs 0.23 with no statistically significant difference in OS probability (p=0.89). CONCLUSION Our study demonstrates that amongst the population of Texas, HI with T-cell NHL have similar outcomes when compared to their NH counterparts. Breakdown of our cohort demonstrated similar healthcare utilization, as well as diagnostic and treatment modalities amongst both groups. Within the context of healthcare equality, we ascertained similar outcomes amongst groups, which is in agreement with previous reports claiming homogeneity of medical care helps overcome ethnic disparities. Figure Disclosures Diaz Duque: ADCT Therapeutics: Research Funding; Molecular Templates: Research Funding; AstraZeneca: Research Funding; Hutchinson Pharmaceuticals: Research Funding; Seattle Genetics: Speakers Bureau; Verastem: Speakers Bureau; AbbVie: Speakers Bureau.

Abstract WP105: A Practical Wake up Tpa Protocol at a United States Based Comprehensive Stroke Center Hub and Its Telestroke Spokes

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Navdeep S Sangha ◽  
Duy Le ◽  
Raeesa Dhanji ◽  
Denise Gaffney ◽  
David McCartney ◽  
...  
Keyword(s):  
United States ◽  
Small Sample Size ◽  
Statistical Significance ◽  
The United States ◽  
Small Sample ◽  
The Difference ◽  
Waking Up ◽  
Comprehensive Stroke Center ◽  
Stroke Center ◽  
Main Barrier

Background: IV tPA is established as an effective treatment for acute ischemic stroke. Currently it is endorsed up to 4.5 hours of last known well time by major guidelines. A randomized trial, WAKE-UP, displayed its safety and efficacy in patients who presented within 4.5 hours of waking up with their symptoms. Objective: To establish a practical tPA protocol for patients who wake up or are found with stroke symptoms at a large Comprehensive Stroke Center (CSC) and its 13 telestroke spokes (TS) based on the WAKE-UP trial. Methods: A wake up tPA protocol was created and given to all teleneurologists. Door to needle times (DTN) and reasons for no tPA were collected for 12 months post implementation and evaluated for differences between wake up (WU) and non-wake up (NW) patients. Results: 93 WU patients were identified; 23 at CSC and 70 at TS. 11 (47.8%) vs. 4 (5.7%) patients received tPA at CSC and TS, respectively. Median DTN was not significantly different for WU patients at CSC vs. TS (64 vs. 89 mins, p=0.54). Median DTN at CSC was shorter for NW vs. WU (37 vs. 64 mins; p=0.003). Similarly, median DTN at TS trended toward being shorter for NW vs. WU (44 vs. 89 mins; p=0.062). The reasons for no tPA at CSC were no mismatch found in 6 (50%), and MRI unavailability in 6 (50%); at TS were no mismatch found in 11 (16.6%), MRI unavailability in 54 (81,1%) and MRI was contraindicated in 1 (1.5%). Conclusion: Treating WU patients using a CSC Hub and TS model is feasible. DTN are longer for WU vs. NW. In the United States, MRI availability is the main barrier to WU tPA at both CSC and community hospitals. The difference between median DTN for WU between CSC and TS did not reach statistical significance, likely due to the small sample size.

scholarly journals Acid Suppressing Medication Use in Infants in the United States, 2002-2018

2020 ◽  
Author(s):  
michael e johansen
Keyword(s):  
United States ◽  
Logistic Regression ◽  
Sample Size ◽  
Small Sample Size ◽  
Medication Use ◽  
The United States ◽  
Demographic Characteristics ◽  
Small Sample ◽  
Uptake Inhibitors ◽  
Race Ethnicity

Introduction: I attempted to determine rates of use and associations with use of acid-suppressing medications in infants under 2 years old given these are not well studied. Methods: The 2002-2018 Medical Expenditure Panel Survey (MEPS) was used for the analysis. The survey is sponsored by the Agency of Healthcare Research and Quality and is conducted on households to be nationally representative of the non-institutionalized population of the United States. The survey is comprised of two overlapping panels that are each included in the survey for two years. Newborns and infants under 2 years old on December 31 of a survey year were included in the study. Additionally, adult men and women living in the same household between 18-45 years old were considered fathers and mothers of infants. Histamine2-receptor antagonists (H2RA) and proton pump inhibitors (PPI) were identified for infants. H2RA, PPIs, and anti-depressant (selective serotonin re-uptake inhibitors and serotonin-norepinephrine re-uptake inhibitors) were identified for parents. Sex, age (by month for child), race/ethnicity (White non-Hispanic, Black non-Hispanic, Hispanic, or other), region (Northeast, Midwest, South, and West), and poverty category were identified. Chi-squared and adjusted Wald tests were used to determine statistical significance with acid-suppressing medication use between 2010-2018. A multivariable logistic regression predicted any acid suppressing medication use with month of age and month of age2 as independent variables of use for the population between 2009-2018. The study was considered exempt by the OhioHealth Institutional Review Board. Survey weighting was included in all analyses. Results: The study included a total of 16,604 infants between 2002-2018. The rate of any acid suppressing medication increased between 2002-2004. H2RA use was more common than PPI use, especially after 2012. H2RA use appeared to increase after 2015. PPI use initially increased, but then remained relatively stable before appearing to decrease in 2015-2018. Ranitidine clearly had the most users of the H2RA, which was maintained throughout the study period. Lansoprazole had the most users among users of PPIs, but this decreased notably after 2010. Of the infants with a reported PPI, 34.0% (95%CI:23.6-46.3) also had an H2RA reported during the year. In total, 40.8% (95%CI:35.0-46.8) had only 1 reported fill of an acid suppresser. There were 8,075 infants under 2 years of age between 2010-2018. The rate of use was highest in infants between 4-11 months of age at the end of the survey year at 8.6% (95%CI:6.9-10.6). Acid-suppressing medication use was more common among infants in higher income families, White (non-Hispanic) race/ethnicity, infants with private health insurance, parents who reported acid-suppressing medication, maternal anti-depressant use, and certain regions of the country. Discussion: Between 6.9-10.6% of infants used an acid suppressing medication before their second birthday between 2010-2018, of which around 60% had multiple medication fills. It appears that there has been a small increases in use over the last few decades, of which ranitidine appears to be the medication driving the increase. Numerous socio-economic and demographic characteristics were associated with acid suppressing medication use. This study has numerous limitations, including potential under-reporting of acid-suppressing medications, an imperfect identification of parent, unreliable diagnoses (not included in the analysis), and a relatively small sample size. We opted not to run a multivariable logistic regression of socio-economic and demographic characteristics given concern for table 2 fallacy and relatively small sample size. Acid suppressing medication use was common in infants before their second birthday. Additional research should be conducted on efficacy and safety of these medications given the level of use and very low quality of available evidence.

Fragments of the American Dream: Immigration, Race, and Medical Care in the Segregated South, 1929

Public Voices ◽  
2016 ◽  
Vol 13 (2) ◽  
pp. 1
Author(s):  
John R Phillips
Keyword(s):  
United States ◽  
American Dream ◽  
Black Population ◽  
The United States ◽  
Single Woman ◽  
Future Research ◽  
Legal Doctrine ◽  
Quarter Century ◽  
History Of ◽  
Sunflower County

The cover photograph for this issue of Public Voices was taken sometime in the summer of 1929 (probably June) somewhere in Sunflower County, Mississippi. Very probably the photo was taken in Indianola but, perhaps, it was Ruleville. It is one of three such photos, one of which does have the annotation on the reverse “Ruleville Midwives Club 1929.” The young woman wearing a tie in this and in one of the other photos was Ann Reid Brown, R.N., then a single woman having only arrived in the United States from Scotland a few years before, in 1923. Full disclosure: This commentary on the photo combines professional research interests in public administration and public policy with personal interests—family interests—for that young nurse later married and became the author’s mother. From the scholarly perspective, such photographs have been seen as “instrumental in establishing midwives’ credentials and cultural identity at a key transitional moment in the history of the midwife and of public health” (Keith, Brennan, & Reynolds 2012). There is also deep irony if we see these photographs as being a fragment of the American dream, of a recent immigrant’s hope for and success at achieving that dream; but that fragment of the vision is understood quite differently when we see that she began a hopeful career working with a Black population forcibly segregated by law under the incongruously named “separate but equal” legal doctrine. That doctrine, derived from the United States Supreme Court’s 1896 decision, Plessy v. Ferguson, would remain the foundation for legally enforced segregation throughout the South for another quarter century. The options open to the young, white, immigrant nurse were almost entirely closed off for the population with which she then worked. The remaining parts of this overview are meant to provide the following: (1) some biographical information on the nurse; (2) a description, in so far as we know it, of why she was in Mississippi; and (3) some indication of areas for future research on this and related topics.

scholarly journals Race and Politics in the United States

2021 ◽  
Vol 4 (1) ◽  
pp. 174-179
Author(s):  
Howard A. Palley
Keyword(s):  
United States ◽  
Black Population ◽  
The United States ◽  
Thomas Jefferson ◽  
Pursuit Of Happiness ◽  
George Washington ◽  
Declaration Of Independence ◽  
Chattel Slavery ◽  
Race And Politics ◽  
Inalienable Rights

Abstract The Declaration of Independence asserts that “All men are created equal, and that they are endowed by their Creator with certain inalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.” Nevertheless, the United States, at its foundation has been faced with the contradiction of initially supporting chattel slavery --- a form of slavery that treated black slaves from Africa purely as a commercial commodity. George Washington and Thomas Jefferson, both of whom had some discomfort with slavery, were slaveholders who both utilized slaves as a commodity. Article 1 of our Constitution initially treated black slaves as three-fifths of a person for the purposes of apportioning representation in order to increase Southern representation in Congress. So initially the Constitution’s commitment to “secure the blessings of liberty to ourselves and our posterity” did not include the enslaved black population. This essay contends that the residue of this initial dilemma still affects our politics --- in a significant manner.

scholarly journals Gastric Cancer Treatments and Survival Trends in the United States

2020 ◽  
Vol 28 (1) ◽  
pp. 138-151
Author(s):  
Kelly A. Stahl ◽  
Elizabeth J. Olecki ◽  
Matthew E. Dixon ◽  
June S. Peng ◽  
Madeline B. Torres ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Stage Iv ◽  
The United States ◽  
Current Treatment ◽  
Stage I ◽  
Stage Ii ◽  
Chi Square ◽  
Specific Guideline ◽  
Kaplan Meier

Gastric cancer is the third most common cause of cancer deaths worldwide. Despite evidence-based recommendation for treatment, the current treatment patterns for all stages of gastric cancer remain largely unexplored. This study investigates trends in the treatments and survival of gastric cancer. The National Cancer Database was used to identify gastric adenocarcinoma patients from 2004–2016. Chi-square tests were used to examine subgroup differences between disease stages: Stage I, II/III and IV. Multivariate analyses identified factors associated with the receipt of guideline concordant care. The Kaplan–Meier method was used to assess three-year overall survival. The final cohort included 108,150 patients: 23,584 Stage I, 40,216 Stage II/III, and 44,350 Stage IV. Stage specific guideline concordant care was received in only 73% of patients with Stage I disease and 51% of patients with Stage II/III disease. Patients who received guideline consistent care had significantly improved survival compared to those who did not. Overall, we found only moderate improvement in guideline adherence and three-year overall survival during the 13-year study time period. This study showed underutilization of stage specific guideline concordant care for stage I and II/III disease.

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