scholarly journals Profile of patients with lung cancer assisted at the National Cancer Institute, according to their smoking status, from 2000 to 2007

2014 ◽  
Vol 17 (1) ◽  
pp. 175-188 ◽  
Author(s):  
Mirian Carvalho de Souza ◽  
Ana Glória Godoi Vasconcelos ◽  
Marise Souto Rebelo ◽  
Paulo Antonio de Paiva Rebelo ◽  
Oswaldo Gonçalves Cruz
Keyword(s):  
Lung Cancer ◽  
National Cancer Institute ◽  
Multiple Correspondence Analysis ◽  
Smoking Status ◽  
Lung Cancer Mortality ◽  
Two Dimensions ◽  
Chi Square ◽  
Data Variability ◽  
Chi Square Test

INTRODUCTION: Tobacco use is directly related to the future incidence of lung cancer. In Brazil, a growing tendency in age-adjusted lung cancer mortality rates was observed in recent years. OBJECTIVE: To describe the profile of patients with lung cancer diagnosed and treated at the National Cancer Institute (INCA) in Rio de Janeiro, Brazil, between 2000 and 2007 according to their smoking status. METHODS: An observational study was conducted using INCA's database of cancer cases. To assess whether the observed differences among the categories of sociodemographic variables, characterization of the tumor, and assistance - pertaining to smokers and non-smokers - were statistically significant, a chi-square test was applied. A multiple correspondence analysis was carried out to identify the main characteristics of smokers and non-smokers. RESULTS: There was a prevalence of smokers (90.5% of 1131 patients included in the study). The first two dimensions of the multivariate analysis explained 72.8% of data variability. Four groups of patients were identified, namely smokers, non-smokers, small-cell tumors, and tumors in early stages. CONCLUSION: Smoking cessation must be stimulated in a disseminated manner in the population in order to avoid new cases of lung cancer. The Tumors in Initial Stages Group stood out with greater chances of cure.

A comparison of two models of multidisciplinary lung cancer care within a community-based healthcare system.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 36-36
Author(s):  
Meghan Meadows ◽  
Meredith Ray ◽  
Matthew Smeltzer ◽  
Nicholas Faris ◽  
Carrie Fehnel ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Care ◽  
Cox Regression ◽  
Care Delivery ◽  
Smoking Status ◽  
Multidisciplinary Care ◽  
Chi Square ◽  
Community Healthcare ◽  
Lung Cancer Patients ◽  
Chi Square Test

36 Background: The Multidisciplinary Thoracic Oncology Conference (MTOC) model is easier to implement than the Multidisciplinary Clinic (MDC) model, but does not directly involve patients in decision-making. We compared the processes and outcomes of lung cancer care between patients discussed in a weekly MTOC versus those seen in a MDC. Methods: Prospective observational study of thoroughness of staging, stage confirmation (defined as biopsy of the stage-defining lesion), National Comprehensive Cancer Network guideline-concordant treatment, overall (OS) and event-free (EFS) survival of lung cancer patients in a community healthcare system’s MDC and MTOC from 2014-2019. We used the chi-square test and multivariable logistic regression to evaluate guideline-concordant treatment and stage confirmation; Kaplan-Meier curves and multivariable Cox regression were used to evaluate OS and EFS. We adjusted models for age, sex, race, insurance, smoking status, and histology. Results: 614 patients received care in MDC; 571 in MTOC. MDC patients were older (median age: 69 vs. 67); less likely to be active smokers (44% vs. 47%; p=0.03); more likely to have bimodal (98% v 95%, p=0.02) and trimodal staging (60% v 46%, p<0.0001). The stage-confirmation rate (OR: 1.55; 95% CI: 1.22-1.96) and mediastinal stage confirmation rate (OR: 1.55; 95% CI: 1.23-1.95) were both significantly higher in MDC, even after adjustment (aOR: 1.60; 95% CI: 1.25-2.03); (aOR: 1.58, 95% CI: 1.25-2.00). A higher proportion of patients received guideline-concordant treatment in MDC than in MTOC (82% vs. 73%; OR: 1.63; 95% CI: 1.21-2.20) even after adjustment (aOR: 1.64; 95% CI: 1.20-2.24). However, MTOC patients had significantly better OS (p=0.03) and EFS (p=0.001) than MDC patients and a lower hazard of death (HR: 0.81; 95% CI: 0.67-0.98), even after adjusting for confounding variables (aHR: 0.79 95%CI: 0.66-0.95). Conclusions: Although the processes of lung cancer care delivery were better in MDC than in MTOC, survival was better in MTOC. Patient selection may have played a role in these survival differences. The MTOC model, as implemented, seems competitive with the MDC model and is worthy of further exploration as a more feasible model of multidisciplinary care. [Table: see text]

scholarly journals TOBACCO SMOKING

2015 ◽  
Vol 22 (04) ◽  
pp. 460-465
Author(s):  
Muhammad Aslam ◽  
Muhammad Asif ◽  
Saima Altaf
Keyword(s):  
Lung Cancer ◽  
Tobacco Cessation ◽  
Smoking Status ◽  
Control Design ◽  
Case Control ◽  
Chi Square ◽  
Cancer Disease ◽  
Data Set ◽  
Quit Smoking ◽  
Chi Square Test

Objective: To assess the risk of different cancer sites among the male smokersof the Southern Punjab, Pakistan. Study Design: Case-control design. Period: March - July2012. Setting: A data set of 596 males, belonging to the Southern Punjab was collectedfrom the Outdoor Ward of Cancer, Oncology Ward of Nishtar Hospital and Multan Institute ofNuclear Medicine and Radiotherapy (MINAR) Hospital. Method: Through a self-administeredquestionnaire, smoking status and respondent’s history and medical record of various typesof cancers were noted. The Chi-square test was used to assess the association betweentobacco smoking and cancer disease. For the risk analysis, odds ratios and attributable riskwere computed. Results: Among the respondents, 49.0% smoked tobacco. From the medicalrecord, 438 respondents were confirmed cancerous. The average age to start tobacco wasnoted to be 23.41 ± 4.85 while the age was 45.29 ± 12.24 years for tobacco cessation. Thepercentage of lung cancer among smokers is 24.01 which is highest among all the statedcancer sites. The risk of a smoker getting all types of the stated cancers is at least three times.The risk of lung cancer attributed to smoking is 17.65 and 50.7% of all the stated cancers.Conclusions: Smokers in the Southern Punjab can greatly reduce their risk (more than 50%)of cancer if they quit smoking.

Would screening benefit 75- to 84-year-old patients with non-small cell lung cancer (NSCLC)?

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 7055-7055
Author(s):  
Jessica Lake ◽  
John Charles Flickinger ◽  
John M. Varlotto ◽  
Abram Recht ◽  
Malcolm M. DeCamp ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cox Regression ◽  
Lung Cancer Screening ◽  
Lung Cancer Mortality ◽  
Chi Square ◽  
Old Patients ◽  
Aggressive Therapy ◽  
Significant Difference ◽  
The Usa ◽  
Chi Square Test

7055 Background: The Lung Cancer Screening Trial has shown an overall survival (OS) benefit and reduced lung cancer mortality in the 55-74 age group (gp). We chose to evaluate whether NSCLC patients aged 75-84 are increasing in the USA and whether they would benefit from aggressive therapy. Methods: SEER-17 was used to calculate NSCLC rates during the years 2000-2008. SEER-9 was used to estimate the proportional change in both 55-74 and 75-84 gp from 1973-2008. OS was analyzed in a modern population from SEER-17 (2004-2008) to assess the effects of increasingly aggressive therapy (observation(Ob), radiation (RT) or lobectomy (LB)) for a proposed screening population with T1N0 tumors. Chi-square test and Cox Regression (CR) were used to evaluate OS. Paired T-tests assessed changes in rates and proportions over time. Results: The 55-74 gp rose from 64.4% in 1973 to 67.25% in 1984, but fell to 58.8% by 2008, while the 75-84 gp rose from 12.1% in 1973 to 24% in 2008 (p<0.01), similar in both sexes. The rates/100,000 have been increasing in the 75-84 gp (p=0.02), mainly in females (p=0.003) while the rates in the 55-74 gp did not vary, but fell for men (p=0.03). In the Ob gp (n=1344), NSCLC was the most common cause of death (COD) in the 55-74 (29.8%) and 75-84 gp (40.6%), more than all other CODs combined (median survival (MS) = 11mn). CR revealed that OS was associated with the 55-74 gp (0.59) and females (0.62) (p < 0.001). In the RT gp (n=1870), MS was 14mn and lung cancer was the most common COD at 27.7% (55-74) and 28.8% (75-84), again more than all other CODs combined. CR found that females (0.68) and black race (0.72) had better OS (p<0.017), but age was not. MS was 24 mn in the LB group (n=9384). COD from NSCLC and all other CODs was 8.2% and 6.1% (55-74) and 10.9% and 11.4% (75-84). CR showed that 55-74 (0.36), females (0.58), and Asians (0.73) had lower death rates (all p<0.015). Mean OS between the 55-74 (26.0) and 75-84 (24.2) gp showed a small yet significant difference. Conclusions: Rates and proportions of NSCLC have been steadily increasing in the 75-84 gp. These data show that COD by lung cancer decreased significantly with increasingly aggressive treatment and treatment reduced the effects of age gp on survival. We feel that screening may be of benefit to the 75-84 gp.

scholarly journals Characterization of the institutionalization of pharmaceutical services in Brazilian primary health care

2017 ◽  
Vol 51 (suppl.2) ◽  
Author(s):  
Gisélia Santana Souza ◽  
Ediná Alves Costa ◽  
Rafael Damasceno de Barros ◽  
Marcelo Tavares Pereira ◽  
Joslene Lacerda Barreto ◽  
...  
Keyword(s):  
Pharmaceutical Services ◽  
Chi Square ◽  
Cross Sectional ◽  
Significance Level ◽  
Five Dimensions ◽  
Heterogeneous Process ◽  
Chi Square Test ◽  
Computerized System ◽  
Municipal Health

OBJECTIVE: To characterize the current stage of the institutionalization of pharmaceutical services in Brazilian cities. METHODS: This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines), a cross-sectional, exploratory, and evaluative study composed by an information survey in a representative sample of cities, stratified by Brazilian regions. We interviewed municipal secretaries of health, responsible for pharmaceutical services, and pharmacists responsible for the dispensing of medicines. The variables selected from the interviews were grouped into five dimensions that defined three stages of pharmaceutical services institutionalization: incipient (0%-34.0%), partial (35.0%-69.0%), and advanced (70.0%-100%), estimated based on the interviewees’ answers. Frequencies were estimated with 95% confidence intervals. For the statistical association analysis, the Chi-square test was applied, with significance level of p<0.05. RESULTS: Our results show a partial and heterogeneous process of institutionalization of pharmaceutical services in Brazil, and an advanced stage in formal structures, such as the municipal health plans and the existence of a standardized list of medicines. The analysed variables in the “organization, structure, and financing” dimension configured stages that range from partial to advanced. The management presented partial institutionalization, positively showing the existence of computerized system, but also disparate results regarding the autonomy in the management of financial resources. Indispensable items related to the structure expressed disparities between the regions, with statistically significant differences. CONCLUSION: The study showed a partial and heterogeneous process of institutionalization of pharmaceutical services in Brazilian cities, showing regional disparities. Variables related to the normative aspects of institutionalization were positively highlighted in all dimensions; however, it is necessary to conduct new studies to evaluate the institutionalization of pharmaceutical services’ finalistic activities

scholarly journals Genetic characterization of Cryptosporidium spp. and Giardia duodenalis in dogs and cats in Guangdong, China

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Jiayu Li ◽  
Xiaoyu Dan ◽  
Kexin Zhu ◽  
Na Li ◽  
Yaqiong Guo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Genetic Characterization ◽  
Giardia Duodenalis ◽  
Ratio Analysis ◽  
Infection Rates ◽  
Sequence Analyses ◽  
Chi Square ◽  
Significant Difference ◽  
Chi Square Test

Abstract Background There are only limited number of reports on molecular epidemiology of Cryptosporidium spp. and Giardia duodenalis in dogs and cats in China. This study was conducted to assess the infection rates, genetic identity, and public health potential of these parasites in dogs and cats in Guangdong, China. Methods PCR and sequence analyses were used to identify and genotype Cryptosporidium spp. and G. duodenalis in fecal samples from 641 dogs and 418 cats in Guangdong. Chi-square test and odds ratio analysis were used to compare the occurrence rates of these pathogens and identify risk factors for infection. Results The overall infection rates of Cryptosporidium spp. and G. duodenalis were 6.9% (44/641) and 9.4% (60/641) in dogs, and 6.2% (26/418) and 3.6% (15/418) in cats. Purebred cats (12.4%; χ2 = 5.110, OR = 2.8, P = 0.024) and dogs (10.8%; χ2 = 5.597, OR = 4.8, P = 0.018) were more likely to be infected by Cryptosporidium spp. and G. duodenalis, respectively. Dogs (12.0%; χ2 = 7.589, OR = 2.6, P = 0.006) and cats (13.6%; χ2 = 8.235, OR = 3.5, P = 0.004) under 6 months had significantly higher infection rates of Cryptosporidium spp. than older animals. Household (13.9%; χ2 = 10.279, OR = 2.6, P = 0.008) and pet shop dogs (11.0%; χ2 = 7.182, OR = 2.0, P = 0.048) had higher occurrence of Cryptosporidium spp., as was the case for G. duodenalis occurrence in experimental dogs (13.4%; χ2 = 9.223, OR = 1.9, P = 0.017). Cryptosporidium canis (n = 42), C. muris (n = 1) and Cryptosporidium rat genotype IV (n = 1) were identified in dogs, while C. felis (n = 21), C. parvum (n = 3), C. muris (n = 1) and Cryptosporidium rat genotype IV (n = 1) were identified in cats. In contrast, the canine-specific assemblages C (n = 27) and D (n = 26) and the feline-specific assemblage F (n = 14) were almost exclusively the only genotypes of G. duodenalis in dogs and cats, respectively. There was no significant difference in infection rates of Cryptosporidium spp. and G. duodenalis between diarrheal and non-diarrheal pets. Conclusions While domestic pets in Guangdong are infected with zoonotic Cryptosporidium species, they are mainly infected with host-specific G. duodenalis genotypes. Risk factors for infections differ between Cryptosporidium spp. and G. duodenalis and between dogs and cats.

A study of tolerance to treatment among the most frequent cancer in the elderly

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 18609-18609
Author(s):  
N. G. Pilnik ◽  
R. Werbin ◽  
J. Dirienzo
Keyword(s):  
Breast Cancer ◽  
Lung Cancer ◽  
Colon Cancer ◽  
Gastrointestinal Disease ◽  
The Elderly ◽  
Cancer Type ◽  
Functional Reserve ◽  
Chi Square ◽  
Good General Condition ◽  
Chi Square Test

18609 Background: Besides, aging may influence pharmacological aspects due to functional reserve deterioration and comorbidities, affecting tolerance to treatment and increasing the likelihood of complications. Methods: 166 cancer pts (56 lung, 64 breast, and 46 colon), mean age 72 yrs, treated with Ch/Rt were studied. Lung cancer pts had PS 0:1 (2%); PS 1:17 (30%); and PS2:38 (68%). Breast cancer pts had PS 0:6 (9%); PS 1:25 (39%); PS 2:33 (52%). Colon cancer pts had PS 0:6 (13%); PS 1:17 (37%); PS 2:23 (50%). Comorbidities were hypertension, diabetes, arrhythmia, EPOC, coronary and gastrointestinal disease. All of the pts had adequate cardiac, hepatic, renal and bone marrow functions. Allergy, cardiovascular, gastrointestinal, hepatic, neurological, haematological and renal toxicities, and infection were evaluated following the WHO criteria. Toxicities were studied according to age and comorbidities, and correlated with the use of other medicines. QoL was studied through the improvement of symptoms and PS evolution. The Chi Square test was used for statistical analyses. Results: The prevalence of common toxicities in the lung cancer pts were anemia, 39 pts (70%), infection, 37 pts (66%), leukopenia 33 pts (59%), gastrointestinal 28 pts (50%). The most common toxicities in breast cancer, were leukopenia 43 pts (67%), gastrointestinal 37 pts (58%), infection 36 pts (56%), and anemia 32 pts (50%), while in colon cancer pts the toxicities found were gastrointestinal 38 pts (83%), anemia 33 pts (72%), leukopenia 32 pts (70%), and infection 25 pts (54%). There was no correlation between age and the most frequent toxicities. Grade 2 was the most common level of toxicity reached in all types of cancer studied. There was improvement in QoL when symptoms evolution and PS were evaluated independently of cancer type, 81% (134 pts) for symptoms (p < 0.0001), and 72% (120 pts) for PS (p < 0.0001) respectively. There was no association between age and toxicity grade, irrespective of toxicity type, age and comorbidities. Conclusions: Older pts in good general condition and with controlled morbidities may receive Ch/Rt if this treatment modality results in improvement of their QoL.-Low toxicities occurred in most of these pts, probably due to the fact that pts were adequately selected. No significant financial relationships to disclose.

scholarly journals The prevalence of olfactory dysfunction and its associated factors in patients with COVID-19 infection

2021 ◽  
Author(s):  
Md Mehedi Hasan ◽  
Naima Ahmed Tamanna ◽  
Mohammad Nasimul Jamal ◽  
Md Jamal Uddin
Keyword(s):  
Associated Factors ◽  
Smoking Status ◽  
Age Groups ◽  
Olfactory Dysfunction ◽  
Test Results ◽  
Chi Square ◽  
Younger Patients ◽  
Regular Screening ◽  
Chi Square Test ◽  
Observational Cohort

AbstractObjectiveTo determine the prevalence of olfactory dysfunctions, mainly, anosmia and to identify its associated factors in patients with COVID-19 infection.Study designA hospital-based prospective observational cohort studySettingA COVID dedicated hospital, Square Hospitals Ltd., Dhaka, Bangladesh.MethodsWe collected patients’ information including laboratory-confirmed COVID-19 test results. We used Pearson Chi-square test and logistic regression model to assess the associations between demographic and clinical characteristics and olfactory outcomes.ResultsOut of 600 COVID-19 positive patients, 38.7% were diagnosed with olfactory dysfunction. Our analyses showed that patients’ age, smoking status, cough, dyspnea, sore throat, asthenia, and nausea or vomiting were significantly associated with the anosmia. We observed the risk of developing anosmia was greater in younger patients than in older patients, and this risk decreased as age increased [odds ratio (OR) range for different age groups: 1.26 to 1.08]. Smoking patients were 1.73 times more likely to experience anosmia than non-smoking patients [OR=1.73, 95% confidence interval (CI) = 1.01-2.98]. In addition, patients complained asthenia had a significantly double risk of developing the anosmia [OR = 1.96, CI = 1.23-3.06].ConclusionsOur study shows that about 39% of patients diagnosed with olfactory dysfunction. Patients’ age, smoking status, and asthenia are significantly positively associated with the anosmia. Since anosmia can be a significant marker for the diagnosis of COVID-19, we suggest regular screening of olfactory dysfunction in patients with early symptoms of COVID-19, particularly younger patients, smoker, and complained asthenia.

Comparison of QOPI measure conformance between oncology fellows and attending physicians.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 162-162
Author(s):  
Tian Zhang ◽  
Arif Kamal ◽  
Michael J. Kelley
Keyword(s):  
Best Practice ◽  
Smoking Status ◽  
Medical Center ◽  
Management Plan ◽  
Oral Chemotherapy ◽  
Chart Audit ◽  
Chi Square ◽  
Chi Square Test ◽  
Using Data ◽  
Attending Physicians

162 Background: Quality improvement measures are uniformly applied to all oncology providers, regardless of their positions. Little is known about differences in conformance to these measures between oncology fellows and attending physicians. In order to tailor improvement interventions to these groups, we investigated conformance across QOPI measures for oncology fellows and attending physicians at the Durham VA Medical Center (DVAMC). Methods: Using data collected from the Spring 2013 QOPI cycle, we abstracted information from patients who had received care at the DVAMC between 2011 and 2013 and separated them based on their provider. To validate the data, we abstracted a subset of patient charts, limited to oral chemotherapy quality measures. Descriptive statistics and the Chi square test were calculated for each measure between the two groups. Results: A total of 97 patients were reviewed at DVAMC. Of these, 21 had a fellow and 47 had an attending as their main provider. Fellows and attendings performed similarly on 119 of 125 QOPI measures (core, end of life, symptom, colorectal, and NSCLC modules). Fellows were less likely to assess pain on the most recent visits when compared to attendings (52% vs. 77%, p=0.046) but more likely to document a management plan if the patient had moderate or severe pain (86% vs 75%, p=0.09). Attendings documented the plan for oral chemotherapy more often (93% vs. 60%, p=0.07). However, after the chart audit, we found that fellows actually documented the plan for oral chemotherapy 80% of the time (p=0.21). Fellows were more likely to document smoking status (95% vs. 64%, p=0.007) and to address smoking cessation (86% vs. 62%, p=0.048). Conclusions: Patient care practices tend to be similar between attendings and fellows overall; some of the significant differences may not remain significant after chart audit. Fellows generally mirror behaviors of attending physicians, and attendings have an important role in modeling best practice behaviors for fellows. Different quality measure standards may not be necessary between fellows and attendings.

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