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31.

Purpose

The purpose of this study was to evaluate trends in demographics and outcomes of pediatric breast cancer in a United States population-based cohort.

Methods

The Surveillance, Epidemiology, and End Results (SEER) database was utilized to identify all pediatric patients with malignant breast tumors between 1973 and 2014. Analysis was performed using Stata Statistical Software version 13.1. Associations between categorical variables were made using X2 test. Log-rank test was used for univariate survival analysis. Kaplan–Meier analysis investigated five-year survival rates across several variables. Adjusted analysis was performed using a Cox Proportional-Hazards regression.

Results

134 patients with breast malignancies were identified. Carcinoma was the most prevalent histology (48.5%), followed by fibroepithelial tumors (FETs) (35.1%), and sarcoma (14.2%). FETs were twice as common in black compared to nonblack patients (56.3% vs. 29.0%, p?<?0.01). Analyzing histology by stage revealed that 100% of FETs were early stage disease (p?<?0.0001). 46.7% of the tumors tested were ER/PR negative, more than twice as many compared to the published adult estimate of 20.0%. Unadjusted survival analysis revealed worse survival for patients with adenocarcinoma/sarcomas, advanced stage, and high grade disease, without a survival difference between races.

Conclusion

Breast cancer remains a rare malignancy among pediatric patients. Although black patients were found to have more noncarcinomatous tumors with less advanced disease, this did not confer a survival advantage.

Type of study

Retrospective cohort study.

Level of evidence

Level III.  相似文献   
32.
Vitamin D is responsible for multiple metabolic functions in humans. Rickets are the most common disease caused by vitamin D deficiency. It is caused by poor calcium intake resulting in poor serum-ionized calcium. The purpose of this study is to develop a rapid, sensitive, and feasible method to determine the 25-hydroxy-vitamin D3 (25(OH)D3) levels in blood samples for clinical assessment. In this study, gas chromatography coupled mass spectrometry with trimethylsilyl derivatization (TMS-GC-MS) is the most suitable protocol for quantitative analyses of 25(OH)D3. Performance of method was evaluated and compared with liquid chromatography and immunoassay. Method validation has been carried out with plasma specimens. The limit of quantitation of TMS-GC-MS method is 1.5 ppb with good linear correlation. Furthermore, the dietary intake and nutritional status of vegetarian and non-vegetarians in Taiwan were assessed by our validated method. As a result, this vitamin D nutrition survey demonstrates that most Taiwanese people have insufficient vitamin D. Due to dietary habits; the male vegans may have the highest risk of vitamin D deficiency.  相似文献   
33.
Abstract

Cadmium (Cd) as environmental pollutant can induce severe damage, particularly to the testis. This study investigated the effects of Caffeic acid phenethyl ester (CAPE) on testicular dysfunction induced by Cd. Adult mice were intraperitoneally injected with cadmium chloride (CdCl2) with different doses of CAPE pretreatment. After CdCl2 injection, body/testis weight ratio decreased, Cd levels accumulated and zinc levels decreased in testis. Furthermore, Cd intoxication caused a significant increase of oxidative stress levels, antioxidant enzymes activities, and glutathione levels. Interestingly, significant improvements were observed after the administration of CAPE. Our results demonstrated the protective effect of CAPE, linking Cd testicular dysfunction to oxidative stress.  相似文献   
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35.
手术室新护士三年阶梯式培训模式探讨   总被引:18,自引:2,他引:16  
目的探讨手术室新护士三年培训模式和方法。方法采用三年阶梯式培养模式,建立完整的系统培训架构,包括培训对象的界定、培训原则及目的、培训目标师资队伍的培养、阶段培养计划、使用培训手册、培训考核体系的建立、培训评价体系的建立等。结果新护士培训系统、科学。结论新护士三年阶梯式培养值得深入研究和推广应用。  相似文献   
36.
Background. It has been reported that gender differences in cardiovascular outcomes found in adults also are present in children who undergo surgical repair for congenital heart disease. Methods. California statewide hospital discharge data 1989–99 were used to study outcomes in children <18 years undergoing cardiac surgery. Hospital discharge data were linked to death registry data to study postdischarge death within 30 days of discharge. We used logistic regression to evaluate the effect of gender on mortality controlling for age, race and ethnicity, type of insurance, household income, date and month of surgery, type of admission, hospital case volume, and various types of procedures. Results. There were 25 402 cardiac surgery cases with 1505 in‐hospital deaths (mortality rate of 5.92%). An additional 37 deaths occurred within 30 days after hospital discharge. Crude mortality rates for males (5.99%) and females (5.84%) were not significantly different. However, fewer neonates were female and females underwent a higher proportion of low‐risk procedures than males. Logistic regression revealed that females, compared with males, had a significantly higher odds ratio (OR) for in‐hospital mortality (OR = 1.18, P < .01) and overall (up to 30 days post discharge) mortality (OR = 1.18, P < .01). The risk‐adjusted length of hospital stay was similar between females and males while charges per hospital day were slightly higher in females than males. The prevalence of Down syndrome, pulmonary hypertension, and failure to thrive were higher in females. Conclusions. Female gender is associated with an 18% higher in‐hospital and 30‐day postdischarge mortality as compared with male gender. There was no difference in length of hospital stay between males and females. The mechanism by which female gender acts as a risk factor requires further investigation.  相似文献   
37.
目的:观察脑出血后血肿周围半胱氨酸天冬氨酸蛋白酶3的表达。及尼莫地平对其的影响。方法:实验于2004—07在大连医科大学中心实验室进行。取120只SD雄性大鼠随机分为3组:①尼莫地平组(n=50):尾壳核注射自体股动脉血50μL复制脑出血模型,造模即刻腹腔注射尼莫地平1.6mg/kg(即8μL/g),以后每天1次。②模型组(n=50):同前造模,术后腹腔注射等量生理盐水。③假手术组(n=20):手术,但进针人尾壳核后不注血。各组分为术后6,24,48,72h、5d 5个时间点。造模动物醒后进行Bederson评分,评估其行为和神经功能缺陷(0—3分。评分越高,神经功能缺陷越重,评分≥2分为造模成功)。人组动物在以上5个时间点进行Bederson评分后,麻醉状态下处死取脑,经尾壳核行冠状切片,行免疫组化测定半胱氨酸天冬氨酸蛋白酶3表达。结果:80只大鼠进入结果分析。①Bederson评分:模型组、尼莫地平组大鼠醒后迅速出现偏瘫,24h后评分趋于稳定,至72h之间评分最高,然后逐渐下降,5d时仍有体征。模型组、尼莫地平组各时间点评分均高于对照组(P〈0.01),尼莫地平组术后48,72h评分低于模型组(P〈0.05)。②血肿周围组织半胱氨酸天冬氨酸蛋白酶3表达:假手术组进针侧脑组织表达很少,模型组6h后即有表达,24h达高峰,持续72h后逐渐下降,5d后仅有少量表达;尼莫地平组动态变化趋势与模型组相同,但各时间点的数值均较低,尤其是术后24~72h(P〈0.01)。结论:①脑出血后血肿周围组织中半胱氨酸天冬氨酸蛋白酶3表达升高,提示其与脑出血血肿周围组织损伤有一定关系。②尼莫地平降低脑出血后血肿周围组织中半胱氨酸天冬氨酸蛋白酶3表达,从而减轻细胞凋亡程度,对神经细胞起到保护作用,降低神经功能缺陷。  相似文献   
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Burkitt’s lymphoma is a high-grade, rapidly growing B-cell neoplasm. It is recognized by its aggressive course, brief median survival, and low rates of long-term survival. The authors discuss the case of a patient who acutely presented with intraabdominal complications from a new onset of Burkitt’s lymphoma. The clinical and pathological features, staging, treatment options, and survival data are reviewed. In addition, the role of surgical intervention is carefully analyzed.  相似文献   
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