scholarly journals Predictive Value of Carcinoembryonic and Carbohydrate Antigen 19-9 Related to Some Clinical, Endoscopic and Histological Colorectal Cancer Characteristics

2016 ◽  
Vol 35 (3) ◽  
pp. 324-332 ◽  
Author(s):  
Ratko Tomašević ◽  
Tomica Milosavljević ◽  
Dragoš Stojanović ◽  
Zoran Gluvić ◽  
Predrag Dugalić ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Early Detection ◽  
Statistical Significance ◽  
Screening Method ◽  
Public Health Problem ◽  
Diagnostic Procedures ◽  
Serum Levels ◽  
Carbohydrate Antigen ◽  
Cross Sectional ◽  
Histological Characteristics

SummaryBackground: Colorectal cancer (CRC) is an important oncological and public health problem worldwide, including Serbia. Unfortunately, half of the patients are recognized in an advanced stage of the disease, therefore, early detection through specific tumor biomarkers, such as carcinoembryonic (CEA) and carbohydrate antigen 19-9 (CA 19-9), is the only way to cope with CRC expansion.Methods: Our cross-sectional study evaluated the influence of some clinical, endoscopic and histological characteristics of CRC on CEA and CA 19-9 serum levels, to determine whether these biomarkers could be related to CRC detection. The study included 372 participants: 181 suffered from CRC and 191 participants were controls. Endoscopic and histological examinations were used for CRC diagnosis, while additional ultrasound and abdominal computerised tomography imaging were used for staging the disease. Measurement of CEA and CA 19-9 was performed after CRC confirmation.Results: Age, gender, tumor localization, macro-morphological and histological characteristics did not influence biomarkers serum levels. Both were significantly higher (p<0.01) in patients with Dukes D stage of CRC compared with controls. Sensitivity (76.8%) and specificity (76.6%) of CEA alone were higher than for CA 19-9, but with no statistical significance. Furthermore, sensitivity of CEA alone in the Dukes A/B group was similar to the entire CRC patient group.Conclusions: Although not recommended as a screening method for the general population, elevated values of each biomarker indicate further diagnostic procedures and their simultaneous testing can improve the diagnostic sensitivity in early detection of CRC, as shown by the united analysis (AUC 0.842).

scholarly journals Clinicopathological features of Egyptian colorectal cancer patients regarding somatic genetic mutations especially in KRAS gene and microsatellite instability status: a pilot study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Neemat M. Kassem ◽  
Gamal Emera ◽  
Hebatallah A. Kassem ◽  
Nashwa Medhat ◽  
Basant Nagdy ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Microsatellite Instability ◽  
Cpg Island ◽  
Human Cancer ◽  
Statistical Significance ◽  
Public Health Problem ◽  
World Health ◽  
Cpg Island Methylator Phenotype ◽  
Number Of Patients ◽  
The Impact

Abstract Background Colorectal cancer (CRC) is the third most common cause of cancer-related deaths which contributes to a significant public health problem worldwide with 1.8 million new cases and almost 861,000 deaths in 2018 according to the World Health Organization. It exhibits 7.4% of all diagnosed cancer cases in the region of the Middle East and North Africa. Molecular changes that happen in CRCs are chromosomal instability, microsatellite instability (MSI), and CpG island methylator phenotype. The human RAS family (KRAS, NRAS, and HRAS) is the most frequently mutated oncogenes in human cancer appearing in 45% of colon cancers. Determining MSI status across CRCs offers the opportunity to identify patients who are likely to respond to targeted therapies such as anti-PD-1. Therefore, a method to efficiently determine MSI status for every cancer patient is needed. Results KRAS mutations were detected in 31.6% of CRC patients, namely in older patients (p = 0.003). Codons 12 and 13 constituted 5/6 (83.3%) and 1/6 (16.7%) of all KRAS mutations, respectively. We found three mutations G12D, G12C, and G13D which occur as a result of substitution at c.35G>A, c.34G>T, and c.38G>A and have been detected in 4/6 (66.6%), 1/6 (16.7%), and 1/6 (16.7%) patients, respectively. Eleven (57.9%) patients had microsatellite instability-high (MSI-H) CRC. A higher percentage of MSI-H CRC was detected in female patients (p = 0.048). Eight patients had both MSI-H CRC and wild KRAS mutation with no statistical significance was found between MSI status and KRAS mutation in these studied patients. Conclusion In conclusion, considering that KRAS mutations confer resistance to EGFR inhibitors, patients who have CRC with KRAS mutation could receive more tailored management by defining MSI status. MSI-high patients have enhanced responsiveness to anti-PD-1 therapies. Thus, the question arises as to whether it is worth investigating this association in the routine clinical setting or not. Further studies with a larger number of patients are needed to assess the impact of MSI status on Egyptian CRC care.

Comparative assessment of overweight/obesity among rural and urban reproductive-age women in Ethiopia: Evidence from a cross-sectional 2016 national survey

2021 ◽  
pp. 026010602098234
Author(s):  
Gizachew Worku Dagnew ◽  
Melash Belachew Asresie
Keyword(s):  
Family Size ◽  
Health Problem ◽  
Rural Women ◽  
Alcohol Intake ◽  
Statistical Significance ◽  
Public Health Problem ◽  
Reproductive Age ◽  
P Value ◽  
Cross Sectional ◽  
Reproductive Age Women

Background: Overweight/obesity has become a global health problem for both developed and developing regions. Nowadays, overweight/obesity among childrearing-age women has become rapidly increasing in both urban and rural areas. Aim: This study aimed to assess the variation of overweight/obesity among urban and rural reproductive-age women in Ethiopia. Methods: For this study, the 2016 Ethiopia Demographic and Health Survey data were used. The survey was a community-based cross-sectional study, which used a two-stage stratified cluster sampling technique to select the participants. A total of 13,451 reproductive-age women were included in the analysis. Both descriptive and analytical analysis was performed. A p-value of less than 0.05 was used as the measure of statistical significance. Results: The prevalence of overweight/obesity among urban reproductive-age women was statistically higher ( p = 21.5%; 95% confidence interval (CI): 18.2–25.1) than the rural women ( p = 3.5%; 95% CI: 2.9%–4.2%). Women who attend secondary or above education, women in the age groups 25–34 and ≥ 35 years, and high wealth index (rich) had higher odds of overweight/obesity in both urban and rural women. Moreover, women who were married, who had a large family size, and who have a history of alcohol intake had higher odds of overweight/obesity among urban women. Conclusions: Overweight/obesity among reproductive-age women is a public health problem in Ethiopia, especially for women who are living in urban settings. Therefore, it is important to establish targeted overweight reduction programs with particular emphasis on urban, older aged, educated, and married women. Additionally, encouraging the limitation of the number of family size and alcohol intake can reduce women’s overweight/obesity.

scholarly journals Cost-Effectiveness of Colorectal Cancer Genetic Testing

2021 ◽  
Vol 18 (16) ◽  
pp. 8330
Author(s):  
Abdul Rahman Ramdzan ◽  
Mohd Rizal Abdul Manaf ◽  
Azimatun Noor Aizuddin ◽  
Zarina A. Latiff ◽  
Keng Wee Teik ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Genetic Testing ◽  
Cost Effectiveness ◽  
Cancer Survival ◽  
Screening Method ◽  
Targeted Prevention ◽  
Activity Based Costing ◽  
Cross Sectional ◽  
Increased Risk ◽  
The Cost

Colorectal cancer (CRC) remains the second leading cause of cancer-related deaths worldwide. Approximately 3–5% of CRCs are associated with hereditary cancer syndromes. Individuals who harbor germline mutations are at an increased risk of developing early onset CRC, as well as extracolonic tumors. Genetic testing can identify genes that cause these syndromes. Early detection could facilitate the initiation of targeted prevention strategies and surveillance for CRC patients and their families. The aim of this study was to determine the cost-effectiveness of CRC genetic testing. We utilized a cross-sectional design to determine the cost-effectiveness of CRC genetic testing as compared to the usual screening method (iFOBT) from the provider’s perspective. Data on costs and health-related quality of life (HRQoL) of 200 CRC patients from three specialist general hospitals were collected. A mixed-methods approach of activity-based costing, top-down costing, and extracted information from a clinical pathway was used to estimate provider costs. Patients and family members’ HRQoL were measured using the EQ-5D-5L questionnaire. Data from the Malaysian Study on Cancer Survival (MySCan) were used to calculate patient survival. Cost-effectiveness was measured as cost per life-year (LY) and cost per quality-adjusted life-year (QALY). The provider cost for CRC genetic testing was high as compared to that for the current screening method. The current practice for screening is cost-saving as compared to genetic testing. Using a 10-year survival analysis, the estimated number of LYs gained for CRC patients through genetic testing was 0.92 years, and the number of QALYs gained was 1.53 years. The cost per LY gained and cost per QALY gained were calculated. The incremental cost-effectiveness ratio (ICER) showed that genetic testing dominates iFOBT testing. CRC genetic testing is cost-effective and could be considered as routine CRC screening for clinical practice.

scholarly journals Early screening and diagnosis of autism spectrum disorders in Vietnam: A population-based cross-sectional survey

2021 ◽  
Author(s):  
Le Thi Vui ◽  
Duong Minh Duc ◽  
Nguyen Thuy Quynh ◽  
Nguyen Thi Huong Giang ◽  
Vu Thi Thanh Mai ◽  
...  
Keyword(s):  
Autism Spectrum Disorders ◽  
Early Detection ◽  
Public Health Problem ◽  
Population Based ◽  
Autism Spectrum ◽  
Urban Setting ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Spectrum Disorders

Background: Early detection of autism spectrum disorders (ASDs) is essential given the under-reported cases in low- and middle-income countries. This first national representative survey was conducted to explore the prevalence of ASDs amongst 18 and 30 months in seven provinces in Vietnam.Design and Method: During 2017- 2018, a national cross-sectional and population-based survey for autism spectrum disorder (ASD) amongst 40,243 children aged 18 to 30 months was conducted in 7 provinces representing the socio-economic regions of Vietnam. M-CHAT was used to screen children and then confirmed by diagnostic assessment using DSM-IV criteria.Results: The prevalence of ASDs amongst children aged 18 and 30 months in Vietnam was high (0.758% or 1 in 132 children). Urban setting, male gender, and hereditable genes were associated with ASD prevalence.Conclusion: ASDs amongst children aged 18 and 30 months in Vietnam tend to be increasing and are similar to this rate in other middle-income countries but lower than that in Western countries. This under-recognized public health problem amongst children should be addressed by early detection and intervention for families with affected children.

scholarly journals Diagnostic Accuracy of Red Reflex Test (RRT) for Early Detection of Ocular Abnormalities in Newborn

2021 ◽  
pp. 185-191
Author(s):  
Kshitij Aviraj Singh ◽  
Amar Taksande
Keyword(s):  
Early Detection ◽  
Diagnostic Accuracy ◽  
Screening Method ◽  
Cost Effective ◽  
Cross Sectional ◽  
Ocular Abnormalities ◽  
Red Eye ◽  
Optical Media ◽  
Ocular Abnormality ◽  
Reflection Of Light

Background: The Red Reflex is described as the red to orange reflection of light from the fundus of the eye, observed while using a retinoscope or an ophthalmoscope. Red Eye Reflex Test is determined by the optical media transparency which includes vitreous humor, aqueous humor, cornea and tear film and reflection of light from the  back of the eye (fundus) through optical media and into the aperture of the ophthalmoscope. Factors that will block or impede the passage of light through this transparent media or affects its reflection back from fundus will produce an abnormal Red Eye Reflex. Red Eye Reflex (RER) testing is important & effective tool for early detection of ocular abnormalities such as retinal abnormalities, cataract, retinoblastoma and glaucoma. Red reflex is cost effective, can be performed very easily, requires minimal setting, can screen important ocular abnormalities and facilitate their early detection with prompt intervention to prevent long term sequelae associated with the disease. Aim: To find out the diagnostic accuracy of Red Reflex test for diagnosing ocular abnormalities in newborns. Methodology: Ours will be a prospective cross-sectional study where RER examination will be performed within one week of birth of a newborn in a darkened and will correlate the examination findings with respect to ocular findings determined by ophthalmologist to determine its efficacy, sensitivity and specificity in detecting neonatal ocular abnormalities. Expected results: After completion of the study we will be able to determine the accuracy of RRT for ocular abnormality detection in the neonates. We will be able to determine the sensitivity, specificity, PPV & NPV of the red reflex test. If the specificity and the sensitivity is good then we can use RRT as a routine screening method for detection of intraocular abnormalities. Conclusion: To find the Red reflex Test efficacy in screening of the ocular abnormalities in the new born.

scholarly journals The relationship between poor pulmonary function and irregular pulse in the elderly: findings from a nationwide cross-sectional survey in Korea

2020 ◽  
Author(s):  
Sun Hwa Kim ◽  
Seon Young Hwang ◽  
Jinho Shin ◽  
Jin-Kyu Park
Keyword(s):  
Early Detection ◽  
Pulmonary Function ◽  
Screening Method ◽  
Secondary Analysis ◽  
Significant Risk ◽  
The Elderly ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Pulse Palpation ◽  
Irregular Pulse

Abstract Background: Pulse palpation is a useful screening method for early detection of cardiac arrhythmia, which may result from reduced pulmonary function. The aim of this study is to investigate the association between reduced pulmonary function and pulse palpation finding in the elderly. Methods: Secondary analysis was performed using the Korea National Health and Nutrition Examination Survey (n=2347 subjects aged ≥65 years). Pulse palpation was initially performed for 15 seconds and confirmed again for 60 seconds. Results: The prevalence of IP was 61 (2.6%). The mean age of subjects with IP was 73.0 (95% CI 71.7-74.3) years, and 45.8% were male. After adjustment, the lowest FVC or FEV 1 and predicted FVC <80% remained significant risk factors for IP. A restrictive or obstructive pattern also independently predicted IP. Conclusions: The elderly with reduced pulmonary function had a significant risk of irregular pulse, in whom careful pulse palpation may be required for early detection of arrhythmia.

scholarly journals Resurgence of leprosy in post elimination era

2019 ◽  
Vol 5 (4) ◽  
pp. 743
Author(s):  
Swapna Subhash Khatu ◽  
Nachiket Madhukarrao Palaskar ◽  
Garima Laxminarayan Balpande ◽  
Nitin Dinkar Chaudhari
Keyword(s):  
Statistical Significance ◽  
Tertiary Care ◽  
National Level ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Duration Of Treatment ◽  
Cross Sectional ◽  
Leprosy Case ◽  
Leprosy Patients

<p class="abstract"><strong>Background:</strong> Leprosy is a slowly progressive mildly infectious disease caused by <em>Mycobacterium leprae</em> primarily affecting skin and peripheral nerves. After introduction of multidrug therapy in the country recorded leprosy case load has come down. In December 2005, India announced elimination of leprosy as public health problem at national level under the NLEP but new cases are still being registered.</p><p class="abstract"><strong>Methods:</strong> It was a hospital based cross sectional study conducted on over 109 leprosy patients attending a tertiary care hospital in Narhe, Pune during the period from 1<sup>st</sup> January 2018 to 31<sup>st </sup>December 2018. The statistical package for Social Sciences (SPSS) for Windows version (16.0) was used to analyze the data (SPSS Inc., Chicago, IL). Statistical significance was declared at p&lt;0.05 or mentioned otherwise.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 109 patients, 57 were new and 52 were old. Maximum patients belong to age group 40-49 years, 25 patients had type 1 reaction and 18 had type 2 reaction. Out of which 83 were on treatment and 12 are defaulter, 9 were in relapse, 6 patients released from treatment.</p><p class="abstract"><strong>Conclusions:</strong> In post elimination era of leprosy still new cases have been registered and hence the burden and morbidity of the disease is still high in the community. It strongly suggests that by early detection, increasing the duration of treatment and by increasing the community awareness, utilizing information, education and communication at all levels, we can hope to reduce the burden of disease in the community and to achieve the dream of leprosy free India.</p><p class="abstract"> </p>

scholarly journals Pancreatic Duodenal Homeobox Factor-1 and Neurogenin-3 Serum Expression in Gestational Diabetes

2020 ◽  
Vol 15 ◽  
pp. 6
Author(s):  
Arturo González Santana ◽  
Jessica María Rodríguez Cortés ◽  
Leicy Jazmin Ruíz Barrera ◽  
Bacteriologist ◽  
Araceli Consuelo Hinojosa Juárez ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Multiple Regression ◽  
Statistical Significance ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Normal Weight ◽  
Cross Sectional ◽  
Neurogenin 3 ◽  
Glucose Levels ◽  
Normal Gestation

Objectives: Pancreatic duodenal homeobox factor-1 (PDX-1) and neurogenin-3 (NGN-3) are progenitor cell markers in the pancreas. The aim was to compare their serum levels in women with and without gestational diabetes mellitus (GDM). Material and Methods: This prospective, cross-sectional study included two groups: (a) Women with normal gestation and (b) with GDM. PDX-1 and NGN-3 serum expression was determined by qRT-PCR. Student’s t-test or the Mann–Whitney U-test was used to contrast both groups and the Pearson or Spearman correlation was used. A multiple regression was done introducing body mass index and the relative expression of both genes as independent variables and glucose as dependent variable. Statistical significance was tested at P ≤ 0.05 level. Results: Thirty-eight patients (mean age was of 29.00 ± 7.74 years) were included, 22 belonged to the normal pregnancies, and 16 to GDM. Using the ΔΔCt method, the expression fold change for PDX-1 was 0.458 and for NGN-3 it was 0.361. There was a significant positive correlation between the expressions of both genes. The multiple regression was significant for both genes expression and glucose levels in case of having normal weight. Conclusion: PDX-1 and NGN-3 low serum expression could be predictors of higher glucose levels in normal pregnancies.

scholarly journals Penggunaan CONUT Score sebagai Prediktor Komplikasi Pasca Pem-bedahan Kanker Kolorektal di RSUP Prof. Dr. R. D. Kandou Manado

2019 ◽  
Vol 11 (1) ◽  
pp. 55
Author(s):  
Hendry Sundah ◽  
Toar Mambu ◽  
Ferdinand Tjandra ◽  
Heber B. Sapan ◽  
Winfrid M. Sumanti
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Nutritional Status ◽  
Screening Method ◽  
Diagnostic Value ◽  
Cross Sectional ◽  
Cross Sectional Design ◽  
The Relationship ◽  
Conut Score

Abstract: Nutritional status is one of the factors that influence the metabolic and physiological conditions. Cancer patients, especially colorectal cancer (CRCA), will suffer from decreased nutritional status during their sickness. CONUT score is beneficial to evaluate the nutritional and immunity status of the patients and has been proved to correlate with post operative complications and length of stay. This study was aimed to evaluate the relationship between CONUT score and postoperative complications in CRCA patients. This was an analytical observational study with a cross sectional design. Subjects were 38 patients of CRCA that underwent operation and were admitted at Surgery Inpatients Installation of Prof. Dr. R. D. Kandou Hospital Manado. The result of logistic regression analysis indicated that there was a significant correlation between CONUT score and the risk of complication. The higher the CONUT score, the higher the risk of complication. The determination of complication diagnostic value based on CONUT score was obtained by using ROC curve. The ROC analysis showed that the AUC of CONUT score was 0.977 >0.700 and the cutoff point of CONUT score was 5.5. Patients with CONUT score >5.50 had a tendency to get postoperative complications with the sensitivity of 86.6%, specifity of 95.6%, and accuracy of 94.74%. Conclusion: CONUT score can be used as a screening method to predict the occurence of postoperative complications in CRCA patients.Kata kunci: colorectal cancer, CONUT score, postoperative complicationsAbstrak: Salah satu faktor yang memengaruhi keadaan metabolik dan fisiologik ialah status nutrisi. Penderita kanker terlebih kanker kolorektal (KKR) akan mengalami pengurangan nutrisi selama perjalanan penyakit. CONUT score bermanfaat untuk mengevaluasi status gizi dan imunitas pasien serta terbukti berkolerasi dengan komplikasi serta jumlah hari rawat di rumah sakit pasca pembedahan. Penelitian ini bertujuan untuk mengetahui hubungan CONUT score dengan komplikasi pasca pembedahan KKR. Jenis penelitian ialah analitik obser-vasional dengan desain potong lintang. Subyek penelitian ialah 38 pasien KKR yang menjalani operasi dirawat di Instalasi Rawat Inap Bedah RSUP Prof. Dr. R. D. Kandou Manado. Hasil analisis regresi logistik menyatakan terdapat hubungan yang sangat bermakna antara CONUT score dan kejadian komplikasi. Hubungan ini menyatakan bahwa makin tinggi CONUT score makin besar risiko terjadinya komplikasi. Penentuan nilai diagnostik kom-plikasi berdasarkan CONUT score diperoleh melalui kurva ROC. Berdasarkan analisis ROC diperoleh AUC CONUT score 0,977 >0,700. Hasil analisis ROC memperoleh titik potong CONUT score = 5,5. Pasien dengan CONUT score >5,50 memiliki kecenderungan mengalami komplikasi dengan sensitivitas 86,6%, spesifitas 95,6%, dan nilai akurasi 94,74%. Simpulan: CONUT score dapat digunakan sebagai metode skrining untuk memrediksi terjadinya komplikasi pasca pembedahan kanker kolorektal.Kata kunci: karsinoma kolorektal (KKR), CONUT score, komplikasi pasca pembedahan

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