Colorectal cancer survival in the USA and Europe: a CONCORD high-resolution study.

OBJECTIVES: To assess the extent to which stage at diagnosis and adherence to treatment guidelines may explain the persistent differences in colorectal cancer survival between the USA and Europe. DESIGN: A high-resolution study using detailed clinical data on Dukes' stage, diagnostic procedures, treatment and follow-up, collected directly from medical records by trained abstractors under a single protocol, with standardised quality control and central statistical analysis. SETTING AND PARTICIPANTS: 21 population-based registries in seven US states and nine European countries provided data for random samples comprising 12 523 adults (15-99 years) diagnosed with colorectal cancer during 1996-1998. OUTCOME MEASURES: Logistic regression models were used to compare adherence to 'standard care' in the USA and Europe. Net survival and excess risk of death were estimated with flexible parametric models. RESULTS: The proportion of Dukes' A and B tumours was similar in the USA and Europe, while that of Dukes' C was more frequent in the USA (38% vs 21%) and of Dukes' D more frequent in Europe (22% vs 10%). Resection with curative intent was more frequent in the USA (85% vs 75%). Elderly patients (75-99 years) were 70-90% less likely to receive radiotherapy and chemotherapy. Age-standardised 5-year net survival was similar in the USA (58%) and Northern and Western Europe (54-56%) and lowest in Eastern Europe (42%). The mean excess hazard up to 5 years after diagnosis was highest in Eastern Europe, especially among elderly patients and those with Dukes' D tumours. CONCLUSIONS: The wide differences in colorectal cancer survival between Europe and the USA in the late 1990s are probably attributable to earlier stage and more extensive use of surgery and adjuvant treatment in the USA. Elderly patients with colorectal cancer received surgery, chemotherapy or radiotherapy less often than younger patients, despite evidence that they could also have benefited.

Independent Chronicle Vol. XLVI No. 3470- July 14, 1814

A semi-weekly paper that was published from 1801 to 1817. It was previously called the Independent chronicle and the universal advertiser, and was later the Independent chronicle and Boston patriot (Semiweekly). Publishers were Abijah Adams and Ebenezer Rhoades. Topics of interest in this issue include: Page 1: report of Independence Day celebration including multiple toasts to the military; Page 2: report of South Carolina militia marching home; report of U.S. schooner Alligator being lost to a tornado in Port Royal; report of 10,000 militia and 2,000 regular Army troops to be used in defense of the District of Columbia and vicinity; report U.S. is to try to raise 100,000 militia for defense; news of British deserters providing information to the U.S.; report of skirmishes along the U.S. coast; statement from U.S. Navy Capt. David Porter stating he had taken possession of Sir Henry Martin's Island; report of British troops burning a militia barracks in Lewiston, N.Y.; 4 accounts of the battle of Chippewa and the taking of Fort Erie; statement from Maj. Gen. Brown in praise of his troops in the battle of Chippewa; copy of General Brown's orders to attack at Fort Erie; essay arguing against U.S. citizens boarding enemy ships; report of peace treaty rumours; Page 3: account of Capt. Porter's capture and subsequent escape from the British; list of American prisoners held on the British ship Nymph; report of British cargo ship captured by U.S. war ship; Proclamation from James Madison pardoning military deserters if they return to military service; announcement to officers and soldiers in the military offering reward for the return of military deserters; Page 4: 2 reward advertisements for return of military deserters;

Article - "Dorothy Rungeling Enters "Powder Puff" Air Derby, 1958

An article about Dorothy Rungeling in her third Derby competition in 1958. She will be co-piloted by Miss Susan Koch and the route will take them from San Diego, California to Charleston, South Carolina.

Programa de preparación física para controlar el desequilibrio muscular lumbo-pelvico como factor de riesgo de la pubalgia en los jugadores de la categoría sub 21 del club deportivo los millonarios

El presente trabajo es el resultado de un exhaustivo proceso investigativo a cerca de los factores de riesgo que predisponen al futbolista de alta competencia a padecer una entidad patológica severamente incapacitante como es la Pubalgia, la cual interfiere en el desempeño del mismo. Inicialmente el trabajo se centra en la revisión y comprensión de los conceptos básicos relacionados con salud, perfil del fisioterapeuta, actividad física, altas demandes cinéticas, anatomía y biomecánica normal de la Pélvis y sus alteraciones, definición de la Pubalgia, los principales factores de riesgo tanto intrínsecos como extrínsecos y el manejo médico y fisioterapéutico de esta entidad patológica.