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Phenotypic and Genotypic Characterization and Treatment of a Cohort With Familial Tumoral Calcinosis/Hyperostosis‐Hyperphosphatemia Syndrome 下载免费PDF全文
Mary Scott Ramnitz Pravitt Gourh Raphaela Goldbach‐Mansky Felasfa Wodajo Shoji Ichikawa Michael J Econs Kenneth E White Alfredo Molinolo Marcus Y Chen Theo Heller Jaydira Del Rivero Patricia Seo‐Mayer Bita Arabshahi Malaka B Jackson Sarah Hatab Edward McCarthy Lori C Guthrie Beth A Brillante Rachel I Gafni Michael T Collins 《Journal of bone and mineral research》2016,31(10):1845-1854
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High income, high socioeconomic status, and affluence increase breast cancer incidence. Socioeconomic status in USA breast cancer studies has been assessed by block‐group socioeconomic measures. A block group is a portion of a census tract with boundaries that segregate, as far as possible, socioeconomic groups. In this study, we used US Census income data instead of block groups to gauge socioeconomic status of breast cancer patients in relationship with incidence, prognostic markers, and survival. US state breast cancer incidence and mortality data are from the U.S. Cancer Statistics Working Group, United States Cancer Statistics: 1999–2011. Three‐Year‐Average Median Household Income by State, 2010 to 2012, is from the U.S. Census Bureau, Current Population Survey, 2011 to 2013 Annual Social and Economic Supplements. County incomes are from the 2005–2009 American Community Survey of the U.S. Census Bureau. The American Community Survey is an ongoing statistical survey that samples a small percentage of the population yearly. Its purpose is to provide communities the information they need to plan investments and services. Breast cancer county incidence and survival data are from the National Cancer Institute's Surveillance, Epidemiology and End Results Program (SEER) data base. We analyzed SEER data from 198 counties in California, Connecticut, Georgia, Hawaii, Iowa, New Mexico, Utah, and Washington. SEER uses the Collaborative Stage (CS) Data Collection System. We have retained the SEER CS variables. There was a significant relationship of income with breast cancer incidence in 50 USA states and the District of Columbia in White women (r = 0.623, p < 0.001). There was a significant relationship between node involvement and income in Whites in 198 USA counties. Income was significantly correlated with 5‐year relative survival in Whites with localized breast cancer. Income was not correlated with 5‐year survival of Black race (p = 0.364) or other races (p = 0.624). The multivariate general linear model with income as covariate, 5‐year survival by race as a dependent variable, showed a significant effect of income and White race on 5‐year survival (p < 0.001), unrelated to Black race (p = 0.780) or other races (p = 0.618). In men, we found a nonsignificant positive correlation between county breast cancer incidence and income (r = 0.098, p = 0.168). Breast cancer risk factors, such as delayed childbirth, less breast‐feeding, and use of hormone supplements, are more common in affluent women. Affluent women are more likely to have mammograms, which detect many cancers that might not otherwise be diagnosed. In addition, women in certain affluent ethnic groups—Ashkenazi Jews, Icelanders and the Dutch—are more likely to carry genetic mutations known to predispose to breast cancer. We hypothesize that women with more income can afford better cancer care and survive longer than poorer women. But our hypothesis does not explain why this effect should be limited to White women; or why node involvement increased with income in White women but not in Blacks or Hispanics. Further studies may be worthwhile. 相似文献
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Chandraprakash Umapathy Amit Raina Shreyas Saligram Gong Tang Georgios I. Papachristou Mordechai Rabinovitz Jennifer Chennat Herbert Zeh Amer H. Zureikat Melissa E. Hogg Kenneth K. Lee Melissa I. Saul David C. Whitcomb Adam Slivka Dhiraj Yadav 《Journal of gastrointestinal surgery》2016,20(11):1844-1853
Background
Most studies of acute necrotizing pancreatitis (ANP) focus on short-term outcomes. We evaluated long-term survival and outcomes following ANP.Methods
Patients treated for ANP at the University of Pittsburgh Medical Center from 2001 to 2008 were studied. Data on presentation and course during initial hospitalization and follow-up (median 34 months) was extracted.Results
Mean age of patients (n?=?167) was 53?±?16 years; 70 % were male, 94 % white, 71 % transfers, 52 % biliary etiology, and 78 % had first-attack of acute pancreatitis. Majority had severe disease with high Acute Physiology and Chronic Health Evaluation II (APACHE-II) score (median 11), length of stay (median 26 days), intensive care unit (ICU) admission (87 %), presence of systemic inflammatory response syndrome (SIRS) (90 %), persistent organ failure (60 %), and infected necrosis (50 %). Intervention was needed in 74 %. Eighteen (10.8 %) patients died during index hospitalization, 9 (5.4 %) during the first year, and 13 (7.8 %) after 1 year. Median survival was significantly shorter when compared with age- and sex-matched US general population (9.1 vs. 26.1 years, p?<?0.001). Increasing age (HR 1.05), persistent organ failure (HR 4.5), and >50 % necrosis (HR 3.8) were independent predictors of death at 1 year. In eligible patients, new-onset diabetes, oral pancreatic enzyme replacement therapy, and disability were noted in 45, 25, and 53 %, respectively.Conclusion
ANP significantly impacts long-term survival. A high proportion of patients develop functional derangement and disability following ANP.997.
Yun?Shin?ChunEmail author Robin?J.?Parker Subbarao?Inampudi Eduardo?Ehrenwald Kenneth?P.?Batts Lawrence?J.?Burgart Clark?W.?Schumacher Jason?A.?Mehling Bjorn?I.?Engstrom Mark?J.?Hill Srinevas?K.?Reddy Timothy?D.?Sielaff 《Journal of gastrointestinal surgery》2016,20(3):564-567
A consensus surveillance protocol is lacking for non-cirrhotic patients with hypervascular liver lesions presumed to represent hepatocellular adenomas. Patients with hypervascular liver lesions <5 cm not meeting criteria for focal nodular hyperplasia or hepatocellular carcinoma underwent surveillance with contrast-enhanced magnetic resonance imaging (MRI) 6, 12, and 24 months after baseline imaging. If lesions remained stable or decreased in size, then surveillance imaging was discontinued. Between 2011 and 2014, 116 patients with hypervascular liver lesions were evaluated. Seventy-nine patients were eligible for the surveillance protocol. Median follow-up was 24 months (range, 1–144 months). One patient (1 %) continued oral contraceptive pill (OCP) use and presented with hemorrhage requiring embolization 5 months after initial diagnosis. Ten patients (13 %) underwent elective embolization or surgical resection for size ≥5 cm. The remaining 68 patients (86 %) continued surveillance without hemorrhage or malignant transformation. Risk factors for requiring intervention during the surveillance period included younger age, larger lesion size, and estrogen use (all p?<?0.05). Patients with hepatocellular adenomas <5 cm can safely be observed after discontinuing OCP with serial imaging 6, 12, and 24 months after diagnosis. If lesions remain stable or decrease in size, then longer-term surveillance is unlikely to identify patients at risk for complications. 相似文献
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Michael A. Moriarty Kenneth G. Nepple Chad R. Tracy Michael E. Strigenz Daniel K. Lee James A. Brown 《Current Urology》2016,9(1):19-23
Background
We analyzed differences in patient selection and perioperative outcomes between robotic-fellowship trained and non-fellowship trained surgeons in their initial experience with robotic-assisted laparoscopic partial nephrectomy.Methods
Data through surgeon case 10 was analyzed. Forty patients were identified from two fellowship trained surgeons (n = 20) and two non-fellowship trained surgeons (n = 20).Results
Fellowship trained surgeons performed surgery on masses of higher nephrometry score (8.0 vs. 6.0, p = 0.007) and more posterior location (60 vs. 25%, p = 0.03). Retroperitoneal approach was more common (50 vs. 0%, p = 0.0003). Fellowship trained surgeons trended toward shorter warm ischemia time (25.5 vs. 31.0 min, p = 0.08). There was no significant difference in perioperative complications (35 vs. 35%, p = 0.45) or final positive margin rates (0 vs. 15%, p = 0.23).Conclusion
Fellowship experience may allow for treating more challenging and posterior tumors in initial practice and significantly more comfort performing retroperitoneal robotic-assisted laparoscopic partial nephrectomy.Key Words: Partial nephrectomy, Robotics, Laparoscopic surgeries, Fellowship training, Perioperative period 相似文献1000.
Caitlan A. Tighe Kristy D. Shoji Natalie D. Dautovich Kenneth L. Lichstein Forrest Scogin 《Journal of behavioral medicine》2016,39(1):170-177
This study explored the association of engagement in pleasant events and global sleep quality, as well as examined the intermediary roles of positive affect and depressive symptoms in this association. Data were derived from the Midlife in the United States-II study. The sample consisted of 1054 community-dwelling adults. Participants completed the Pittsburgh Sleep Quality Index and indicated the frequency and enjoyableness of experiences on a positive events scale. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Positive affect was measured using the Mood and Symptoms Questionnaire. Regression analyses indicated more frequent engagement in pleasant events was associated with better global sleep quality. Depressive symptoms, but not positive affect, partially mediated the association between pleasant events and global sleep quality. The findings suggest that behavioral engagement in pleasant events may be related to global sleep quality via depressive symptoms, but not positive affect. These findings highlight the potential for engagement in pleasant activities to influence both mood and sleep. 相似文献