Epidemiological features of esophageal cancer. Squamous cell carcinoma versus adenocarcinoma

PURPOSE: To analyze the epidemiological features of patients with esophageal cancer according to the histopathological types: squamous cell carcinoma or adenocarcinoma. METHODS: A total of 100 patients with esophageal cancer, being 50 squamous cell carcinomas and 50 adenocarcinomas were analyzed for demographics, nutritional factors, lifestyle habits, benign pathological conditions associated, like Barrett's esophagus and megaesophagus, tumor stage and survival rates. The nutritional factors evaluated included body mass index, percent weight loss, hemoglobin and albumin serum levels. RESULTS: Esophageal cancer occurred more often in men over 50 years-old in both histological groups. No significant differences on age and gender were found between the histological groups. Squamous cell carcinoma was significantly more frequent in blacks than adenocarcinoma. Alcohol consumption and smoking were significantly associated with squamous cell carcinoma. Higher values of body mass index were seen in patients with adenocarcinoma. Barrett's esophagus was found in nine patients (18%) with adenocarcinoma, and megaesophagus in two patients (4%) with squamous cell carcinoma. The majority of patients were on stages III and IV in both histological groups. The mean survival rates were 7.7 ± 9.5 months for patients with squamous cell carcinoma and 8.0 ± 10.9 months for patients with adenocarcinoma. No significant differences on tumor stage and survival rates were detected between the histological groups. CONCLUSION: Epidemiological features are distinct for the histopathological types of esophageal cancer. Squamous cell carcinoma is associated with black race, alcohol and smoking, while adenocarcinoma is related to higher body mass index, white race and Barrett's esophagus.

The effect of body mass index on therapeutic response to bacterial vaginosis in pregnancy.

Our objective was to determine the effect of body mass index (BMI) on response to bacterial vaginosis (BV) treatment. A secondary analysis was conducted of two multicenter trials of therapy for BV and TRICHOMONAS VAGINALIS. Gravida were screened for BV between 8 and 22 weeks and randomized between 16 and 23 weeks to metronidazole or placebo. Of 1497 gravida with asymptomatic BV and preconceptional BMI, 738 were randomized to metronidazole; BMI was divided into categories: < 25, 25 to 29.9, and > or = 30. Rates of BV persistence at follow-up were compared using the Mantel-Haenszel chi square. Multiple logistic regression was used to evaluate the effect of BMI on BV persistence at follow-up, adjusting for potential confounders. No association was identified between BMI and BV rate at follow-up ( P = 0.21). BMI was associated with maternal age, smoking, marital status, and black race. Compared with women with BMI of < 25, adjusted odds ratio (OR) of BV at follow-up were BMI 25 to 29.9: OR, 0.66, 95% CI 0.43 to 1.02; BMI > or = 30: OR, 0.83, 95% CI 0.54 to 1.26. We concluded that the persistence of BV after treatment was not related to BMI.

The effect of body mass index on therapeutic response to bacterial vaginosis in pregnancy.

Our objective was to determine the effect of body mass index (BMI) on response to bacterial vaginosis (BV) treatment. A secondary analysis was conducted of two multicenter trials of therapy for BV and TRICHOMONAS VAGINALIS. Gravida were screened for BV between 8 and 22 weeks and randomized between 16 and 23 weeks to metronidazole or placebo. Of 1497 gravida with asymptomatic BV and preconceptional BMI, 738 were randomized to metronidazole; BMI was divided into categories: < 25, 25 to 29.9, and > or = 30. Rates of BV persistence at follow-up were compared using the Mantel-Haenszel chi square. Multiple logistic regression was used to evaluate the effect of BMI on BV persistence at follow-up, adjusting for potential confounders. No association was identified between BMI and BV rate at follow-up ( P = 0.21). BMI was associated with maternal age, smoking, marital status, and black race. Compared with women with BMI of < 25, adjusted odds ratio (OR) of BV at follow-up were BMI 25 to 29.9: OR, 0.66, 95% CI 0.43 to 1.02; BMI > or = 30: OR, 0.83, 95% CI 0.54 to 1.26. We concluded that the persistence of BV after treatment was not related to BMI.

Predictive factors for vaginal douching and tampon use among US women: Are these behaviors risk factors for bacterial vaginosis and trichomonas?

The use of feminine products such as vaginal douches, tampons, and sanitary napkins are common among women. Despite the results of some studies that suggest an association between douching and bacterial vaginosis, douching remains a topic that is understudied. The possibility of an association between tampon use and infection has not been significantly investigated since the toxic shock outbreak in the 1980s. The first objective of our study was to evaluate demographic, reproductive health, and sexual behavior variables to establish an epidemiologic profile of menstruating women who reported douching and women who reported using sanitary napkins only. The second objective of our study was to evaluate whether the behaviors of douching and using tampons were associated with an increased risk of bacterial vaginosis or trichomonas. We analyzed these factors, using logistic regression, among the 3,174 women from the NHANES cross sectional data from 2001-2004, who met the inclusion criteria determined for our study. We established an epidemiologic profile for women who had the highest frequency of douching reported as women who were age 36-49, had a high school education or GED, black race, not taking oral contraceptives, reported vaginal symptoms in the last month, two or more sexual partners in the last year, or tested positive for bacterial vaginosis or trichomonas. The profile for those who had the highest frequency of exclusive sanitary napkin use included women with less than a high school education, married women, women classified as black or "other" in race, and women who were not on oral contraceptives. While we were able to establish a significant increase in the odds of douching among women who tested positive for bacterial vaginosis or trichomonas, we did not find any significant difference in the odds of exclusive napkin use and testing negative for bacterial vaginosis or trichomonas.^

Trastuzumab use and risk of congestive heart failure in older breast cancer patients

Trastuzumab is a humanized-monoclonal antibody, developed specifically for HER2-neu over-expressed breast cancer patients. Although highly effective and well tolerated, it was reported associated with Congestive Heart Failure (CHF) in clinical trial settings (up to 27%). This leaves a gap where, Trastuzumab-related CHF rate in general population, especially older breast cancer patients with long term treatment of Trastuzumab remains unknown. This thesis examined the rates and risk factors associated with Trastuzumab-related CHF in a large population of older breast cancer patients. A retrospective cohort study using the existing Surveillance, Epidemiology and End Results (SEER) and Medicare linked de-identified database was performed. Breast cancer patients ≥ 66 years old, stage I-IV, diagnosed in 1998-2007, fully covered by Medicare but no HMO within 1-year before and after first diagnosis month, received 1st chemotherapy no earlier than 30 days prior to diagnosis were selected as study cohort. The primary outcome of this study is a diagnosis of CHF after starting chemotherapy but none CHF claims on or before cancer diagnosis date. ICD-9 and HCPCS codes were used to pool the claims for Trastuzumab use, chemotherapy, comorbidities and CHF claims. Statistical analysis including comparison of characteristics, Kaplan-Meier survival estimates of CHF rates for long term follow up, and Multivariable Cox regression model using Trastuzumab as a time-dependent variable were performed. Out of 17,684 selected cohort, 2,037 (12%) received Trastuzumab. Among them, 35% (714 out of 2037) were diagnosed with CHF, compared to 31% (4784 of 15647) of CHF rate in other chemotherapy recipients (p<.0001). After 10 years of follow-up, 65% of Trastuzumab users developed CHF, compared to 47% in their counterparts. After adjusting for patient demographic, tumor and clinical characteristics, older breast cancer patients who used Trastuzumab showed a significantly higher risk in developing CHF than other chemotherapy recipients (HR 1.69, 95% CI 1.54 - 1.85). And this risk is increased along with the increment of age (p-value < .0001). Among Trastuzumab users, these covariates also significantly increased the risk of CHF: older age, stage IV, Non-Hispanic black race, unmarried, comorbidities, Anthracyclin use, Taxane use, and lower educational level. It is concluded that, Trastuzumab users in older breast cancer patients had 69% higher risk in developing CHF than non-Trastuzumab users, much higher than the 27% increase reported in younger clinical trial patients. Older age, Non-Hispanic black race, unmarried, comorbidity, combined use with Anthracycline or Taxane also significantly increase the risk of CHF development in older patients treated with Trastuzumab. ^

Les peuples de l'Afrique /

Final page of text is correctly numbered 258. It is followed by the table of contents on one leaf, the first page of which is unnumbered with the verso being incorrectly numbered 158.

The future of Africa : being addresses, sermons, etc., etc., delivered in the Republic of Liberia /

Mode of access: Internet.

The African times and orient review.

Publication suspended Sept. 1914-Dec. 1916.

The future of Africa; being addresses, sermons, etc., etc., delivered in the Republic of Liberia /

Reprint of the 1862 ed.

The claims of the Negro, ethnologically considered. : An address before the literary societies of Western Reserve College, at commencement, July 12, 1854. /

Last page blank.

Efeito de diferentes divisões territoriais na flutuação aleatória de indicadores socioeconômicos relacionados à determinação social da saúde

This research aimed to analyse the effect of different territorial divisions in the random fluctuation of socio-economic indicators related to social determinants of health. This is an ecological study resulting from a combination of statistical methods including individuated and aggregate data analysis, using five databases derived from the database of the Brazilian demographic census 2010: overall results of the sample by weighting area. These data were grouped into the following levels: households; weighting areas; cities; Immediate Urban Associated Regions and Intermediate Urban Associated Regions. A theoretical model related to social determinants of health was used, with the dependent variable Household with death and as independent variables: Black race; Income; Childcare and school no attendance; Illiteracy; and Low schooling. The data was analysed in a model related to social determinants of health, using Poisson regression in individual basis, multilevel Poisson regression and multiple linear regression in light of the theoretical framework of the area. It was identified a greater proportion of households with deaths among those with at least one black resident, lower-income, illiterate, who do not attend or attended school or day-care and less educated. The analysis of the adjusted model showed that most adjusted prevalence ratio was related to Income, where there is a risk value of 1.33 for households with at least one resident with lower average personal income to R$ 655,00 (Brazilian current). The multilevel analysis demonstrated that there was a context effect when the variables were subjected to the effects of areas, insofar as the random effects were significant for all models and with different prevalence rates being higher in the areas with smaller dimensions - Weighting areas with coefficient of 0.035 and Cities with coefficient of 0.024. The ecological analyses have shown that the variable Income and Low schooling presented explanatory potential for the outcome on all models, having income greater power to determine the household deaths, especially in models related to Immediate Urban Associated Regions with a standardized coefficient of -0.616 and regions intermediate urban associated regions with a standardized coefficient of -0.618. It was concluded that there was a context effect on the random fluctuation of the socioeconomic indicators related to social determinants of health. This effect was explained by the characteristics of territorial divisions and individuals who live or work there. Context effects were better identified in the areas with smaller dimensions, which are more favourable to explain phenomena related to social determinants of health, especially in studies of societies marked by social inequalities. The composition effects were better identified in the Regions of Urban Articulation, shaped through mechanisms similar to the phenomenon under study.

Autoeficácia, características sociodemográficas e capacitação profissional: um estudo com servidores de uma Universidade Federal

Self-efficacy, the construct developed by Albert Bandura in 1977 and widely studied around the world, means the individual's belief in his own capacity to successfully perform a certain activity. This study aims to determine the degree of association between sociodemographic characteristics and professional training to the levels of Self-Efficacy at Work (SEW) of the Administrative Assistants in a federal university. This is a descriptive research submitted to and approved by the Ethics Committee of UFRN. The method of data analysis, in quantitative nature, was accomplished with the aid of the statistical programs R and Minitab. The instrument used in research was a sociodemographic data questionnaire, variables of professional training and the General Perception of Self-efficacy Scale (GPSES), applied to the sample by 289 Assistants in Administration. Statistical techniques for data analysis were descriptive statistics, cluster analysis, reliability test (Cronbach's alpha), and test of significance (Pearson). Results show a sociodemographic profile of Assistants in Administration of UFRN with well-distributed characteristics, with 48.4% men and 51.6% female; 59.9% of them were aged over 40 years, married (49.3%), color or race white (58%) and Catholics (67.8%); families are composed of up to four people (75.8%) with children (59.4%) of all age groups; the occupation of the mothers of these professionals is mostly housewives (51.6%) with high school education up to parents (72%) and mothers (75.8%). Assistants in Administration have high levels of professional training, most of them composed two groups of servers: the former, recently hired public servants (30.7%) and another with long service (59%), the majority enter young in career and it stays until retirement, 72.4% of these professionals have training above the minimum requirement for the job. The analysis of SEW levels shows medium to high levels for 72% of assistants in administration; low SEWclassified people have shown a high average of 2.7, considered close to the overall mean presented in other studies, which is 2.9. The cluster analysis has allowed us to say that the characteristics of the three groups (Low, Medium and High SEW) are similar and can be found in the three levels of SEW representatives with all the characteristics investigated. The results indicate no association between the sociodemographic variables and professional training to the levels of self-efficacy at work of Assistants in Administration of UFRN, except for the variable color or race. However, due to the small number of people who declared themselves in color or black race (4% of the sample), this result can be interpreted as mere coincidence or the black people addressed in this study have provided a sense of efficacy higher than white and brown ones. The study has corroborated other studies and highlighted the subjectivity of the self-efficacy construct. They are needed more researches, especially with public servants for the continuity and expansion of studies on the subject, making it possible to compare and confirm the results

Patient Characteristics Associated with Differences in Admission Frequency for Diabetic Ketoacidosis in U.S. Children’s Hospitals

Thesis (Master's)--University of Washington, 2016-08

Autoeficácia, características sociodemográficas e capacitação profissional: um estudo com servidores de uma Universidade Federal

Self-efficacy, the construct developed by Albert Bandura in 1977 and widely studied around the world, means the individual's belief in his own capacity to successfully perform a certain activity. This study aims to determine the degree of association between sociodemographic characteristics and professional training to the levels of Self-Efficacy at Work (SEW) of the Administrative Assistants in a federal university. This is a descriptive research submitted to and approved by the Ethics Committee of UFRN. The method of data analysis, in quantitative nature, was accomplished with the aid of the statistical programs R and Minitab. The instrument used in research was a sociodemographic data questionnaire, variables of professional training and the General Perception of Self-efficacy Scale (GPSES), applied to the sample by 289 Assistants in Administration. Statistical techniques for data analysis were descriptive statistics, cluster analysis, reliability test (Cronbach's alpha), and test of significance (Pearson). Results show a sociodemographic profile of Assistants in Administration of UFRN with well-distributed characteristics, with 48.4% men and 51.6% female; 59.9% of them were aged over 40 years, married (49.3%), color or race white (58%) and Catholics (67.8%); families are composed of up to four people (75.8%) with children (59.4%) of all age groups; the occupation of the mothers of these professionals is mostly housewives (51.6%) with high school education up to parents (72%) and mothers (75.8%). Assistants in Administration have high levels of professional training, most of them composed two groups of servers: the former, recently hired public servants (30.7%) and another with long service (59%), the majority enter young in career and it stays until retirement, 72.4% of these professionals have training above the minimum requirement for the job. The analysis of SEW levels shows medium to high levels for 72% of assistants in administration; low SEWclassified people have shown a high average of 2.7, considered close to the overall mean presented in other studies, which is 2.9. The cluster analysis has allowed us to say that the characteristics of the three groups (Low, Medium and High SEW) are similar and can be found in the three levels of SEW representatives with all the characteristics investigated. The results indicate no association between the sociodemographic variables and professional training to the levels of self-efficacy at work of Assistants in Administration of UFRN, except for the variable color or race. However, due to the small number of people who declared themselves in color or black race (4% of the sample), this result can be interpreted as mere coincidence or the black people addressed in this study have provided a sense of efficacy higher than white and brown ones. The study has corroborated other studies and highlighted the subjectivity of the self-efficacy construct. They are needed more researches, especially with public servants for the continuity and expansion of studies on the subject, making it possible to compare and confirm the results

Prevalencia de trauma encéfalo craneal en niños de 0 a 5 años y factores asociados, en el servicio de emergencia pediátrica del HVCM febrero- julio 2014

ANTECEDENTES: El trauma encéfalo craneal (TEC), es una de las principales causas de atención en emergencia pediátrica del país y el mundo. Representa una carga en morbilidad y mortalidad, constituyendo una causa importante de internamiento, complicaciones y muerte en pediatría. OBJETIVOS: Determinar la prevalencia de TEC y factores asociados en niños de 0 a 5 años atendidos en emergencia del Hospital Vicente Corral Moscoso, Febrero- Julio 2014. MÉTODO Y TÉCNICAS Se realizó un estudio transversal en niños de 0 a 5 años con TEC, atendidos en emergencia del HVCM, de febrero a julio del 2014, determinando la prevalencia y factores asociados a TEC; previa firma de consentimiento informado por los representantes. Tras recolectarse los datos, estos fueron codificados y tabulados mediante SPSS versión 20, obteniendo las variables demográficas de estudio. RESULTADOS Se estudiaron 1681 niños, con un promedio en edad de 26,2 meses (DS 20,76). La prevalencia de TEC fue del 10,4%. El TEC leve representó el 8,6% del total de niños. Los factores positivos asociados fueron: estar a cuidado de terceros o sin cuidador (RP: 3,91; IC: 2,94-5,20); pertenecer a un grupo minoritario, indígena o negro (RP: 3,64; IC: 2,46-5,39); siendo el maltrato infantil la variable que más se relacionó con TEC. (RP: 6,11; IC: 3,61-10,65). CONCLUSIONES: La prevalencia de TEC en el HVCM en niños de 0 a 5 años, fue de 10,4%. Asociándose positivamente con etnia indígena o negra, encontrarse sin cuidador o a cargo de terceros y el maltrato infantil.