scholarly journals Lung Adenocarcinoma Biomarker Incidence in Hispanic Versus Non-Hispanic White Patients

2013 ◽  
Vol 138 (3) ◽  
pp. 390-394 ◽  
Author(s):  
Elizabeth McQuitty ◽  
Wei Zhang ◽  
Heather Hendrickson ◽  
Fermin O. Tio ◽  
Jaishree Jagirdar ◽  
...  
Keyword(s):  
United States ◽  
Lung Adenocarcinoma ◽  
The United States ◽  
Smoking History ◽  
Genetic Changes ◽  
Mutational Frequency ◽  
Hispanic Patients ◽  
Biomarker Testing ◽  
Hispanic White ◽  
White Patients

Context.—Lung cancer is the leading cause of cancer deaths in the United States and worldwide. Biomarker testing is critical to personalized therapy in lung adenocarcinoma and has been extensively investigated in non-Hispanic whites, Asians, and African Americans. However, little information addresses the underlying genetic changes in lung adenocarcinoma among Hispanic patients in the United States. Objective.—To identify targetable biomarkers other than EGFR and EML4-ALK in Hispanic patients with lung adenocarcinoma. Design.—We tested DNA extracted from 85 lung adenocarcinoma specimens collected from 40 Hispanic and 43 non-Hispanic white patients for previously reported mutations in KRAS, MET, BRAF, mTOR, STAT3, JAK2, PIK3CA, AKT1 through AKT3, and PTEN with a custom Sequenom massARRAY assay (Sequenom, San Diego, California). Results.—Mutations in KRAS were identified in 11 cases (13%; 6 Hispanic [7%], 5 non-Hispanic white [6%]) and had no correlation with sex, age, or smoking history. Mutations in PIK3CA were identified in 2 of the 40 Hispanic patients (5%), including one patient (2.5%) with a concurrent KRAS mutation. The tumors were wild type for all other genes tested. Conclusions.—Targetable biomarkers other than EGFR and EML4-ALK were identified in 7 of the 40 Hispanic patients (18%) and 5 of the 43 non-Hispanic white patients (12%), suggesting a similar mutational frequency. Our highly multiplexed genotyping assay detected actionable mutations in 14% (12 of 83) more patients than would have been identified by EGFR and EML4-ALK testing alone.

Disparities in access to surgery for glioblastoma multiforme at high-volume Commission on Cancer–accredited hospitals in the United States

2021 ◽  
pp. 1-10
Author(s):  
Anshit Goyal ◽  
Jad Zreik ◽  
Desmond A. Brown ◽  
Panagiotis Kerezoudis ◽  
Elizabeth B. Habermann ◽  
...  
Keyword(s):  
United States ◽  
Surgical Intervention ◽  
Residential Location ◽  
High Volume ◽  
The United States ◽  
National Cancer Database ◽  
Subgroup Analyses ◽  
Access To Surgery ◽  
Hispanic White ◽  
White Patients

OBJECTIVE Although it has been shown that surgery for glioblastoma (GBM) at high-volume facilities (HVFs) may be associated with better postoperative outcomes, the use of such hospitals may not be equally distributed. The authors aimed to evaluate racial and socioeconomic differences in access to surgery for GBM at high-volume Commission on Cancer (CoC)–accredited hospitals. METHODS The National Cancer Database was queried for patients with GBM that was newly diagnosed between 2004 and 2015. Patients who received no surgical intervention or those who received surgical intervention at a site other than the reporting facility were excluded. Annual surgical case volume was calculated for each hospital, with volume ≥ 90th percentile defined as an HVF. Multivariable logistic regression was performed to identify patient-level predictors for undergoing surgery at an HVF. Furthermore, multiple subgroup analyses were performed to determine the adjusted odds ratio of the likelihood of undergoing surgery at an HVF in 2016 as compared to 2004 for each patient subpopulation (by age, race, sex, educational group, etc.). RESULTS A total of 51,859 patients were included, with 10.7% (n = 5562) undergoing surgery at an HVF. On multivariable analysis, Hispanic White patients (OR 0.58, 95% CI 0.49–0.69, p < 0.001) were found to have significantly lower odds of undergoing surgery at an HVF (reference = non-Hispanic White). In addition, patients from a rural residential location (OR 0.55, 95% CI 0.41–0.72, p < 0.001; reference = metropolitan); patients with nonprivate insurance status (Medicare [OR 0.78, 95% CI 0.71–0.86, p < 0.001], Medicaid [OR 0.68, 95% CI 0.60–0.78, p < 0001], other government insurance [OR 0.68, 95% CI 0.52–0.86, p = 0.002], or who were uninsured [OR 0.61, 95% CI 0.51–0.72, p < 0.001]); and lower-income patients ($50,354–$63,332 [OR 0.68, 95% CI 0.63–0.74, p < 0.001], $40,227–$50,353 [OR 0.84, 95% CI 0.76–0.92, p < 0.001]; reference = ≥ $63,333) were also found to be significantly associated with a lower likelihood of surgery at an HVF. Subgroup analyses revealed that elderly patients (age ≥ 65 years), both male and female patients and non-Hispanic White patients, and those with private insurance, Medicare, metropolitan residential location, median zip code–level household income in the first and second quartiles, and educational attainment in the first and third quartiles had increased odds of undergoing surgery at an HVF in 2016 compared to 2004 (all p ≤ 0.05). On the other hand, patients with other governmental insurance, patients with a rural residence, and those from a non-White racial category did not show a significant difference in odds of surgery at an HVF over time (all p > 0.05). CONCLUSIONS The present analysis from the National Cancer Database revealed significant disparities in access to surgery at an HVF for GBM within the United States. Furthermore, there was evidence that these racial and socioeconomic disparities may have widened between 2004 and 2016. The findings should assist health policy makers in the development of strategies for improving access to HVFs for racially and socioeconomically disadvantaged populations.

scholarly journals The Role of DNA Methylation in the Development and Progression of Lung Adenocarcinoma

2007 ◽  
Vol 23 (1-2) ◽  
pp. 5-30 ◽  
Author(s):  
Keith M. Kerr ◽  
Janice S. Galler ◽  
Jeffrey A. Hagen ◽  
Peter W. Laird ◽  
Ite A. Laird-Offringa
Keyword(s):  
United States ◽  
Lung Cancer ◽  
Dna Methylation ◽  
Lung Adenocarcinoma ◽  
Western Europe ◽  
Cpg Islands ◽  
The United States ◽  
Smoke Inhalation ◽  
Genetic Changes ◽  
Never Smokers

Lung cancer, caused by smoking in ∼87% of cases, is the leading cause of cancer death in the United States and Western Europe. Adenocarcinoma is now the most common type of lung cancer in men and women in the United States, and the histological subtype most frequently seen in never-smokers and former smokers. The increasing frequency of adenocarcinoma, which occurs more peripherally in the lung, is thought to be at least partially related to modifications in cigarette manufacturing that have led to a change in the depth of smoke inhalation. The rising incidence of lung adenocarcinoma and its lethal nature underline the importance of understanding the development and progression of this disease. Alterations in DNA methylation are recognized as key epigenetic changes in cancer, contributing to chromosomal instability through global hypomethylation, and aberrant gene expression through alterations in the methylation levels at promoter CpG islands. The identification of sequential changes in DNA methylation during progression and metastasis of lung adenocarcinoma, and the elucidation of their interplay with genetic changes, will broaden our molecular understanding of this disease, providing insights that may be applicable to the development of targeted drugs, as well as powerful markers for early detection and patient classification.

Acral melanocytic lesions in the United States: Prevalence, awareness, and dermoscopic patterns in skin-of-color and non-Hispanic white patients

2016 ◽  
Vol 74 (4) ◽  
pp. 724-730.e1 ◽  
Author(s):  
Reshmi Madankumar ◽  
Priyanka V. Gumaste ◽  
Kathryn Martires ◽  
Panta R. Schaffer ◽  
Sonal Choudhary ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Melanocytic Lesions ◽  
Hispanic White ◽  
White Patients

scholarly journals SARS-CoV-2 Vaccine Acceptability in Patients on Hemodialysis: A Nationwide Survey

2021 ◽  
pp. ASN.2021010104
Author(s):  
Pablo Garcia ◽  
Maria E. Montez-Rath ◽  
Heather Moore ◽  
Johnie Flotte ◽  
Chris Fults ◽  
...  
Keyword(s):  
United States ◽  
Native American ◽  
Side Effects ◽  
The United States ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Vaccine Acceptability ◽  
Increased Risk ◽  
Hispanic White ◽  
White Patients

BackgroundPatients on dialysis are at increased risk for COVID-19–related complications. However, a substantial fraction of patients on dialysis belong to groups more likely to be hesitant about vaccination.MethodsWith the goal of identifying strategies to increase COVID-19 vaccine uptake among patients on hemodialysis, we conducted a nationwide vaccine acceptability survey, partnering with a dialysis network to distribute an anonymized English and Spanish language online survey in 150 randomly selected facilities in the United States. We used logistic regression to evaluate characteristics of vaccine-hesitant persons.ResultsA total of 1515 (14% of eligible) patients responded; 20% of all responders, 29% of patients aged 18–44 years, and 29% of Black responders reported being hesitant to seek the COVID-19 vaccine, even if the vaccine was considered safe for the general population. Odds of vaccine hesitancy were higher among patients aged 18–44 years versus those 45–64 years (odds ratio [OR], 1.5; 95% confidence interval [95% CI], 1.0 to 2.3), Black patients versus non-Hispanic White patients (OR, 1.9; 95% CI, 1.3 to 2.7), Native Americans or Pacific Islanders versus non-Hispanic White patients (OR, 2.0; 95% CI, 1.1 to 3.7), and women versus men (OR, 1.6; 95% CI, 1.2 to 2.0). About half (53%) of patients who were vaccine hesitant expressed concerns about side effects. Responders’ main information sources about COVID-19 vaccines were television news and dialysis staff (68% and 38%, respectively).ConclusionsA substantial proportion of patients receiving in-center hemodialysis in the United States are hesitant about seeking COVID-19 vaccination. Facilitating uptake requires outreach to younger patients, women, and Black, Native American, or Pacific Islander patients, and addressing concerns about side effects.

scholarly journals The impact of race and ethnicity on outcomes in 19,584 adults hospitalized with COVID-19

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254809
Author(s):  
Ann M. Navar ◽  
Stacey N. Purinton ◽  
Qingjiang Hou ◽  
Robert J. Taylor ◽  
Eric D. Peterson
Keyword(s):  
United States ◽  
Race And Ethnicity ◽  
The United States ◽  
Lower Mortality ◽  
Real World Data ◽  
Black Adults ◽  
Increased Risk ◽  
Hispanic Patients ◽  
The Impact ◽  
White Patients

Introduction At the population level, Black and Hispanic adults in the United States have increased risk of dying from COVID-19, yet whether race and ethnicity impact on risk of mortality among those hospitalized for COVID-19 is unclear. Methods Retrospective cohort study using data on adults hospitalized with COVID-19 from the electronic health record from 52 health systems across the United States contributing data to Cerner Real World DataTM. In-hospital mortality was evaluated by race first in unadjusted analysis then sequentially adjusting for demographics and clinical characteristics using logistic regression. Results Through August 2020, 19,584 patients with median age 52 years were hospitalized with COVID-19, including n = 4,215 (21.5%) Black and n = 5,761 (29.4%) Hispanic patients. Relative to white patients, crude mortality was slightly higher in Black adults [22.7% vs 20.8%, unadjusted OR 1.12 (95% CI 1.02–1.22)]. Mortality remained higher among Black adults after adjusting for demographic factors including age, sex, date, region, and insurance status (OR 1.13, 95% CI 1.01–1.27), but not after including comorbidities and body mass index (OR 1.07, 95% CI 0.93–1.23). Compared with non-Hispanic patients, Hispanic patients had lower mortality both in unadjusted and adjusted models [mortality 12.7 vs 25.0%, unadjusted OR 0.44(95% CI 0.40–0.48), fully adjusted OR 0.71 (95% CI 0.59–0.86)]. Discussion In this large, multicenter, EHR-based analysis, Black adults hospitalized with COVID-19 had higher observed mortality than white patients due to a higher burden of comorbidities in Black adults. In contrast, Hispanic ethnicity was associated with lower mortality, even in fully adjusted models.

The tyrosine kinase TEK is differentially expressed in non-small cell lung adenocarcinomas.

2020 ◽  
Author(s):  
Shahan Mamoor
Keyword(s):  
United States ◽  
Tyrosine Kinase ◽  
Lung Adenocarcinoma ◽  
Microarray Data ◽  
The United States ◽  
Small Cell ◽  
Small Cell Lung ◽  
Significant Differential Expression ◽  
Lung Cancers ◽  
Lung Adenocarcinomas

Non-small cell lung adenocarcinoma (NSCLC) is a leading cause of death in the United States and worldwide (1, 2). We mined published microarray data (3, 4, 5) to discover genes associated with NSCLC. We identified significant differential expression of the tyrosine kinase TEK in tumors from patients with NSCLC. TEK may be of relevance to the initiation, progression or maintenance of non-small cell lung cancers.

A survey of Instagram users with asthma to evaluate the acceptability of a planned clinical trial intervention (Preprint)

2020 ◽  
Author(s):  
Kerry Spitzer ◽  
Brent Heineman ◽  
Marcella Jewell ◽  
Michael Moran ◽  
Peter Lindenauer
Keyword(s):  
United States ◽  
Social Media ◽  
Health Care Providers ◽  
College Education ◽  
The United States ◽  
Survey Study ◽  
Care Providers ◽  
Healthy Behaviors ◽  
Social Media Platforms ◽  
Hispanic White

BACKGROUND Asthma is a chronic lung disease that affects nearly 25 million individuals in the United States. There is a need for more research into the potential for health care providers to leverage existing social media platforms to improve healthy behaviors and support individuals living with chronic health conditions. OBJECTIVE In this study, we assess the willingness of Instagram users with poorly controlled asthma to participate in a pilot study that uses Instagram as a means of providing social and informational support. In addition, we explore the potential for adapting photovoice and digital storytelling to social media. METHODS A survey study of Instagram users living with asthma in the United States, between the ages of 18 to 40. RESULTS Over 3 weeks of recruitment, 457 individuals completed the pre-survey screener; 347 were excluded. Of the 110 people who were eligible and agreed to participate in the study, 82 completed the study survey. Respondents mean age was 21(SD = 5.3). Respondents were 56% female (n=46), 65% (n=53) non-Hispanic white, and 72% (n=59) had at least some college education. The majority of respondents (n = 66, 81%) indicated that they would be willing to participate in the study. CONCLUSIONS Among young-adult Instagram users with asthma there is substantial interest in participating in a study that uses Instagram to connect participants with peers and a health coach in order to share information about self-management of asthma and build social connection.

The Physiology of Body Weight Regulation: Relevance to the Etiology of Obesity in Children

PEDIATRICS ◽  
1998 ◽  
Vol 101 (Supplement_2) ◽  
pp. 525-539 ◽  
Author(s):  
Michael Rosenbaum ◽  
Rudolph L. Leibel
Keyword(s):  
United States ◽  
Body Weight ◽  
Environmental Factors ◽  
Regulatory System ◽  
The United States ◽  
Genetic Changes ◽  
Adult Body ◽  
Genes Encoding ◽  
Prevalence Of Obesity ◽  
Obesity In Children

The prevalence of obesity in children and adults in the United States has increased by more than 30% over the past decade. Recent studies of the physiology and molecular genetics of obesity in humans have provided evidence that body weight (fat) is regulated. Some of the genes encoding the molecular components of this regulatory system have been isolated from rodents. The increasing prevalence of obesity in the United States apparently represents the interaction of these genes with an environment that encourages a sedentary lifestyle and consumption of calories. The rapid increase in the prevalence of obesity emphasizes the role of environmental factors, because genetic changes could not occur at this rate. Thus, understanding of the relevant genes and how their effects are mediated by environment and development should lead to more effective prophylaxis and therapy of obesity. Although no clear environmental factors have been identified as causative of obesity, the rapid increases in the prevalence of obesity and the seeming voluntary immutability of adult body fatness can be taken as tacit evidence that the pediatric environment can be altered in a way that affects adult body weight.

scholarly journals 1A Nationwide Analysis of U.S. Racial/Ethnic Disparities in Emergency Department Patients with Mental Health and Substance Use Disorders

2021 ◽  
Author(s):  
Joanne Weinreb ◽  
Penina Gavrilova ◽  
Jonathan Avery ◽  
Sean M. Murphy ◽  
Jyotishman Pathak
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Wait Time ◽  
Wait Times ◽  
Hispanic Patients ◽  
Racial Ethnic ◽  
Triage Level ◽  
Hispanic White ◽  
White Patients

Abstract BackgroundRacial and ethnic health disparities have been linked with inequalities in access to health care and outcomes. The present study considers whether inequalities persist between racial/ethnic groups among patients with mental health or substance use disorders who visit the emergency department (ED). MethodsWe analyzed data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 2012-2018, assessing health disparities among patients diagnosed with mental health or substance use disorders by observing whether significant differences exist in ED wait time and length of visit (LOV) for patients of different races/ethnicities. Stratified models were performed to further understand the impact of regions across the U.S., year, and triage level on the association analysis. ResultsFrom 2012-2018, non-Hispanic Black and Hispanic patients experienced significantly longer ED wait times and LOV as compared to White patients. Patients with private insurance experienced significantly shorter wait times compared to patients with self-pay, and shorter LOV than those with Medicaid/ Children’s Health Insurance Program, or Medicare. Male patients had significantly longer LOV compared to female patients. We observed year by year differences in wait times of non-Hispanic Black patients with improvement appearing between the years 2013 to 2016, while LOV remained consistently longer. We observed both regional and triage level differences, with the U.S. Northeast presenting with the most disparities. Additionally, we noted a general upward trend of SUD diagnoses. Conclusion Our analysis suggests that while there has been an overall improvement in median ED wait time through the years, non-Hispanic Black and Hispanic patients experience significantly longer ED wait time compared to non-Hispanic White patients. Additionally, non-Hispanic Black and Hispanic patients have a significantly longer ED LOV compared to non-Hispanic White patients.

Sign in / Sign up

Export Citation Format

Share Document