scholarly journals Socio-demographic, reproductive and clinical profile of women diagnosed with cervical cancer in a tertiary care center in middle Kerala

2017 ◽  
Vol 4 (6) ◽  
pp. 2112
Author(s):  
Neha E. L. ◽  
Nishi Roshini Kondakasseril
Keyword(s):  
Health Care ◽  
Cervical Cancer ◽  
Health Education ◽  
Late Stage ◽  
Rural Population ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Advanced Stage ◽  
Stage Disease ◽  
Late Stage Disease

Background: Cervical cancer is a major health problem in rural India. Barriers to cervical cancer control in our country include a lack of awareness of the disease because of illiteracy, poverty, lack of health education and screening programme. The aim of the study was the clinical profile of women diagnosed with cervical carcinoma in a tertiary care centre in the middle part of Kerala in South India.Methods: This prospective observational study was conducted in the Department of Obstetrics and Gynecology, Government medical college Thrissur for a period of two years from January 2014 to December 2016. The characteristics of patient (age, age at menarche and at marriage, parity, reproductive history, place of residence, income, education status, contraception, screening details, clinical presentation and tumor histopathology and stage were obtained. Data was entered in Excel and analysed.Results: Among7224 new patients seeking care from the department, 104 new cases of carcinoma of uterine cervix were identified (0.71%). Mean age was 58.3±8.4 years. 79% women were from rural area. 73% were illiterate, 88.5% belonged to below poverty line (BPL). Post-menopausal bleeding was the commonest clinical presentation (78.8%). Squamous cell carcinoma was the commonest histologic type (88.5%). 50% had first coitus before age of twenty. 94.3% were not aware of any screening procedures and its importance. 67.31% of cases presented in the advanced stage (stage 2B-1V). 75.81% of late stage disease patients were rural population. 96.77% of late stage disease patients were from below poverty line.Conclusions: Carcinoma cervix is more in the low socioeconomic class and rural elderly presented at an advanced stage. Ignorance about the disease and the lack of awareness of the risk factors, need and availability of screening programmes at low cost in Government health care systems was noteworthy. Government health care policies, health education, effective cancer prevention strategies and early cancer detection programmes are yet to reach the outskirts of rural population in Kerala.

Causes of death in nodular lymphocyte predominant Hodgkin's lymphoma.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e20016-e20016
Author(s):  
Anas M Saad ◽  
Ahmed Afifi ◽  
Mohamed Gad ◽  
Muneer J. Al-Husseini ◽  
Firas Baidoun ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Late Stage ◽  
Hodgkin’S Lymphoma ◽  
Causes Of Death ◽  
Early Stage ◽  
Hodgkin's Lymphoma ◽  
Disease Stage ◽  
Advanced Stage ◽  
Stage Disease ◽  
Late Stage Disease

e20016 Background: Nodular lymphocyte-predominant Hodgkin’s lymphoma (NLPHL) accounts for 5% of all cases of HL. The outcomes of patients with NLPHL is generally regarded as better than those with classical HL. However, causes of death (COD) of patients with NLPHL have not been previously described. Methods: The National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program was used to identify all patients with NLPHL diagnosed between 1990 and 2015. Patient characteristics and disease stage, using the Ann-Arbor system, was extracted and tabulated. COD were identified and proportions were calculated for deaths within 5 years and after 5 years of diagnosis for patients with early and late stage NLPHL. Results: We identified 1,937 cases of NLPHL. The majority were younger than 65 years (86%), white (70%), male (67%), and diagnosed between 2001-2015 (85%), when rituximab was introduced. Of all cases, 1336 (69%) were classified as early stage. At a median follow-up of 91 months (IQR 41, 152) for early stage disease, and 73 months (IQR 30-123) for late stage disease, the median cancer-specific or overall survival were not reached. The estimated 5-year survival was 92% and 81% for early stage and late stage disease, respectively. Of all patients with early stage NLPHL, 186 (14%) died by the end of 2015, and 87 (46%) deaths occurred within 5 years of diagnosis. During the first 5 years after diagnosis, COD was NLPHL in 30 (35%). Beyond 5 years from diagnosis, NLPHL was the COD in 27% followed by other cancers (23%), and cardiovascular disease (18%). Of all patients with late stage NLPHL, 107 (21%) died, and 75 (70%) of deaths occurred within 5 years of diagnosis. During the first 5 years after diagnosis, COD was NLPHL in 44 (59%). Beyond 5 years from diagnosis, cardiovascular disease was the COD in 25%, followed by NLPHL (22%). Conclusions: The prognosis of NLPHL is excellent. Of all patients with NLPHL, those with advanced stage disease are more likely to die of their disease within 5 years of diagnosis. Patients with early and advanced stage disease beyond 5 years of diagnosis are more likely to die of causes other than NLPHL.

scholarly journals Clinical and sociodemographic factors associated with late stage cervical cancer diagnosis in Botswana

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tara M. Friebel-Klingner ◽  
Rebecca Luckett ◽  
Lisa Bazzett-Matabele ◽  
Tlotlo B. Ralefala ◽  
Barati Monare ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Rural Women ◽  
Late Stage ◽  
Vaginal Bleeding ◽  
Traditional Healer ◽  
Sociodemographic Factors ◽  
Factors Associated ◽  
Stage Disease ◽  
Late Stage Disease ◽  
Abnormal Vaginal Bleeding

Abstract Background Cervical cancer is the leading cause of female cancer mortality in Botswana with the majority of cervical cancer patients presenting with late-stage disease. The identification of factors associated with late-stage disease could reduce the cervical cancer burden. This study aims to identify potential patient level clinical and sociodemographic factors associated with a late-stage diagnosis of cervical cancer in Botswana in order to help inform future interventions at the community and individual levels to decrease cervical cancer morbidity and mortality. Results There were 984 women diagnosed with cervical cancer from January 2015 to March 2020 at two tertiary hospitals in Gaborone, Botswana. Four hundred forty women (44.7%) presented with late-stage cervical cancer, and 674 women (69.7%) were living with HIV. The mean age at diagnosis was 50.5 years. The association between late-stage (III/IV) cervical cancer at diagnosis and patient clinical and sociodemographic factors was evaluated using multivariable logistic regression with multiple imputation. Women who reported undergoing cervical cancer screening had lower odds of late-stage disease at diagnosis (OR: 0.63, 95% CI 0.47–0.84) compared to those who did not report screening. Women who had never been married had increased odds of late-stage disease at diagnosis (OR: 1.35, 95% CI 1.02–1.86) compared to women who had been married. Women with abnormal vaginal bleeding had higher odds of late-stage disease at diagnosis (OR: 2.32, 95% CI 1.70–3.16) compared to those without abnormal vaginal bleeding. HIV was not associated with a diagnosis of late-stage cervical cancer. Rural women who consulted a traditional healer had increased odds of late-stage disease at diagnosis compared to rural women who had never consulted a traditional healer (OR: 1.61, 95% CI 1.02–2.55). Conclusion Increasing education and awareness among women, regardless of their HIV status, and among providers, including traditional healers, about the benefits of cervical cancer screening and about the importance of seeking prompt medical care for abnormal vaginal bleeding, while also developing support systems for unmarried women, may help reduce cervical cancer morbidity and mortality in Botswana.

scholarly journals Resistance to antibody neutralization in HIV-2 infection occurs in late stage disease and is associated with X4 tropism

AIDS ◽  
2012 ◽  
Vol 26 (18) ◽  
pp. 2275-2284 ◽  
Author(s):  
José M. Marcelino ◽  
Pedro Borrego ◽  
Charlotta Nilsson ◽  
Carlos Família ◽  
Helena Barroso ◽  
...  
Keyword(s):  
Late Stage ◽  
Antibody Neutralization ◽  
Stage Disease ◽  
Late Stage Disease

Receipt of Screening Mammography by Insured Women Diagnosed With Breast Cancer and Impact on Outcomes

2021 ◽  
Author(s):  
Marissa B. Lawson ◽  
Christoph I. Lee ◽  
Daniel S. Hippe ◽  
Shasank Chennupati ◽  
Catherine R. Fedorenko ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Diagnosis ◽  
Late Stage ◽  
Breast Cancer Diagnosis ◽  
Screening Mammography ◽  
Socioeconomic Deprivation ◽  
Tumor Characteristics ◽  
Stage Disease ◽  
Increased Risk ◽  
Late Stage Disease

Background: The purpose of this study was to determine factors associated with receipt of screening mammography by insured women before breast cancer diagnosis, and subsequent outcomes. Patients and Methods: Using claims data from commercial and federal payers linked to a regional SEER registry, we identified women diagnosed with breast cancer from 2007 to 2017 and determined receipt of screening mammography within 1 year before diagnosis. We obtained patient and tumor characteristics from the SEER registry and assigned each woman a socioeconomic deprivation score based on residential address. Multivariable logistic regression models were used to evaluate associations of patient and tumor characteristics with late-stage disease and nonreceipt of mammography. We used multivariable Cox proportional hazards models to identify predictors of subsequent mortality. Results: Among 7,047 women, 69% (n=4,853) received screening mammography before breast cancer diagnosis. Compared with women who received mammography, those with no mammography had a higher proportion of late-stage disease (34% vs 10%) and higher 5-year mortality (18% vs 6%). In multivariable modeling, late-stage disease was most associated with nonreceipt of mammography (odds ratio [OR], 4.35; 95% CI, 3.80–4.98). The Cox model indicated that nonreceipt of mammography predicted increased risk of mortality (hazard ratio [HR], 2.00; 95% CI, 1.64–2.43), independent of late-stage disease at diagnosis (HR, 5.00; 95% CI, 4.10–6.10), Charlson comorbidity index score ≥1 (HR, 2.75; 95% CI, 2.26–3.34), and negative estrogen receptor/progesterone receptor status (HR, 2.09; 95% CI, 1.67–2.61). Nonreceipt of mammography was associated with younger age (40–49 vs 50–59 years; OR, 1.69; 95% CI, 1.45–1.96) and increased socioeconomic deprivation (OR, 1.05 per decile increase; 95% CI, 1.03–1.07). Conclusions: In a cohort of insured women diagnosed with breast cancer, nonreceipt of screening mammography was significantly associated with late-stage disease and mortality, suggesting that interventions to further increase uptake of screening mammography may improve breast cancer outcomes.

Oxidative stress in chronic hepatitis C: not just a feature of late stage disease

2002 ◽  
Vol 36 (6) ◽  
pp. 805-811 ◽  
Author(s):  
Sanjiv K. Jain ◽  
Philip W. Pemberton ◽  
Alexander Smith ◽  
Raymond F.T. McMahon ◽  
Peter C. Burrows ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Late Stage ◽  
Stage Disease ◽  
Late Stage Disease

scholarly journals Gynecological malignancies at tertiary care hospital, Pakistan: A five-year review

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Tayyiba Wasim ◽  
Javeria Mushtaq ◽  
Ahmad Zunair Wasim ◽  
Gul e Raana
Keyword(s):  
Risk Factors ◽  
Ovarian Cancer ◽  
Cervical Cancer ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Advanced Stage ◽  
Gynecological Malignancy ◽  
Abdominal Symptoms ◽  
Gynecological Malignancies

Background & Objective: Gynecological malignancies are important cause of female morbidity and mortality. They pose significant burden on health resources in low middle-income countries. Data on presentation and risk factors can help in early identification and reduce this burden. Our objective was to evaluate frequency, stage of presentation and risk factors of gynecological malignancies in a tertiary care setting. Methods: It was cross sectional study done in Gynecology Department, Services Institute of Medical Sciences, Services Hospital, Lahore from January 2015- December 2019. The records of the patients were retrospectively reviewed to include all cases of gynecologic malignancies. Demographic information, frequency, risk factors, symptoms, grade and stage of tumor was collected. Results: There were 122 patients diagnosed with gynecological malignancy during the study period. Ovarian cancer was seen in 60 (49.18%) patients followed by cervical cancer in 29(23.7%), endometrial cancer 27(22.1%) and vulva 06(4.9%). Mean age for all cancers was 51±12.7 to 55±9.3 except cervical cancer which was seen in 43±8.9 years. Patients with ovarian cancer had significantly more hypertension and diabetes (p<0.05). Heavy menstrual bleeding and postmenopausal bleeding was significantly seen in patients of endometrial and cervical cancer (p<0.05). Abdominal symptoms of pain, mass and distension were seen in patients with ovarian cancer (p<0.05). Majority patients presented in advanced stage. Among ovarian cancer, 52/60(86.6%) were epithelial in origin while 25(86.2%) cervical cancer and all vulva cancers were squamous cell carcinoma. Conclusion: Ovarian cancer was commonest gynecological malignancy followed by cervical cancer. Late presentation with advanced stage was seen in majority of all cancers. doi: https://doi.org/10.12669/pjms.37.3.3596 How to cite this:Wasim T, Mushtaq J, Wasim AZ, Gul-e-Raana. Gynecological malignancies at tertiary care hospital, Pakistan: A five-year review. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.3596 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Natural alteration of HIV-1 co-receptor tropism by contemporaneous HIV-2 infection

2018 ◽  
Author(s):  
Joakim Esbjörnsson ◽  
Fredrik Månsson ◽  
Hans Norrgren ◽  
Sarah L. Rowland-Jones
Keyword(s):  
Late Stage ◽  
Stage Disease ◽  
Late Stage Disease ◽  
Underlying Mechanisms ◽  
Disease Understanding ◽  
Hiv 1 ◽  
The Way

In this study, we show that the pathogenic HIV-1 CXCR4-tropism is more common in HIV-1 single (79%) than in HIV-1 and HIV-2 dual-infected individuals (35%), suggesting that contemporaneous HIV-2 infection can affect HIV-1 co-receptor tropism in late-stage disease. Understanding the underlying mechanisms responsible for this natural alteration by HIV-2 could pave the way towards a deeper understanding of the AIDS pathogenesis.

scholarly journals Timing of Antiretroviral Therapy and Systemic Inflammation in Sub-Saharan Africa: Results From the META Longitudinal Cohort Study

2019 ◽  
Vol 220 (7) ◽  
pp. 1172-1177 ◽  
Author(s):  
Mark J Siedner ◽  
Mwebesa Bosco Bwana ◽  
Stephen Asiimwe ◽  
Gideon Amanyire ◽  
Nicholas Musinguzi ◽  
...  
Keyword(s):  
T Cell ◽  
Antiretroviral Therapy ◽  
Cell Count ◽  
Late Stage ◽  
Sub Saharan Africa ◽  
Cd4 T Cell ◽  
Disease Stage ◽  
Stage Disease ◽  
Late Stage Disease ◽  
Cd4 T Cell Count

Abstract Chronic inflammation predicts complications in persons with human immunodeficiency virus infection. We compared D-dimer, soluble CD14, and interleukin 6 levels before and 12 months after antiretroviral therapy (ART) initiation, among individuals starting ART during earlier-stage (CD4 T-cell count >350/µL) or late-stage disease (CD4 T-cell count <200/µL). Female sex, older age, viral load, and late-stage disease were associated with pre-ART biomarkers (n = 661; P < .05). However, there were no differences in biomarkers by disease stage after 12 months of ART (n = 438; P > .05), owing to loss from observation and greater declines in biomarkers in late-stage initiators (P < .001). Earlier initiation of ART is associated with decreased inflammation, but levels seem to converge between earlier and later initiators surviving to 12 months.

The management of sinogenic orbital complications

1995 ◽  
Vol 109 (4) ◽  
pp. 300-303 ◽  
Author(s):  
Bharath Singh
Keyword(s):  
Conservative Treatment ◽  
Eye Movement ◽  
Late Stage ◽  
Stage Disease ◽  
Intravenous Antibiotics ◽  
Late Stage Disease ◽  
Group 3 ◽  
Group 2 ◽  
Orbital Complications ◽  
Group 1

AbstractThe place of conservative treatment in sinogenic orbital complications has not been fully explained in the literature. The question that remains unresolved is – at which stage of the disease is surgery indicated?A study was undertaken in 240 patients with sinogenic orbital complications, to determine this. The patients were divided into three groups according to the stage of the disease as determined clinically: Group 1 (52 patients) with early stage disease, as detected by cellulitis only; Group 2 (76 patients) with intermediate stage, as detected by periorbital cellulitis and proptosis, but with full range of eye movement and unaltered vision: Group 3 (122 patients) with late stage disease, as detected by periorbital cellulitis and gross proptosis. with limitation of eye movement and altered vision.Group I and Group 2 patients were treated conservatively, with intravenous antibiotics and antral lavage. Group 3 patients were treated with intravenous antibiotics and surgery. External frontoethmoidectomy was performed in 31 (bilateral in two), ethmoidectomy in 91 (bilateral in five), sphenoidectomy in 15 and bilateral antral washout in all (122 patients). There was 100 per cent success with conservative treatment in Group 1 patients, whilst in Group 2 there was 98.6 per cent failure. The 75 patients in whom conservative treatment failed were successfully treated with surgery: frontoethmoidectomy was performed in 66 and ethmoidectomy in nine. In Group 3 patients, 100 per cent success was achieved with intravenous antibiotics and surgery.Sinogenic orbital complications can be treated conservatively and surgically, depending on the stage of the disease on presentation. Conservative treatment is only suitable for early complications, i.e. patients with periorbital cellulitis only. For disease beyond this stage i.e. intermediate and late stage disease, surgery is the treatment of choice.

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