Survival inequity in vulnerable populations with early-stage hepatocellular carcinoma: a United States safety-net collaborative analysis

BackgroundAccess to health insurance and curative interventions [surgery/liver-directed-therapy (LDT)] affects survival for early-stage hepatocellular carcinoma (HCC). The aim of this multi-institutional study of high-volume safety-net hospitals (SNHs) and their tertiary-academic-centers (AC) was to identify the impact of type/lack of insurance on survival disparities across hospitals, particularly SNHs whose mission is to minimize insurance related access-to-care barriers for vulnerable populations.MethodsEarly-stage HCC patients (2012–2014) from the US Safety-Net Collaborative were propensity-score matched by treatment at SNH/AC. Overall survival (OS) was the primary outcome. Multivariable Cox proportional-hazard analysis was performed accounting for sociodemographic/clinical parameters.ResultsAmong 925 patients, those with no insurance (NI) had decreased curative surgery, compared to those with government insurance (GI) and private insurance [PI, (PI-SNH:60.5% vs. GI-SNH:33.1% vs. NI-SNH:13.6%, p < 0.001)], and decreased median OS (PI-SNH:32.1 vs. GI-SNH:22.8 vs. NI-SNH:9.4 months, p = 0.002). On multivariable regression controlling for sociodemographic/clinical parameters, NI-SNH (HR:2.5, 95% CI:1.3–4.9, p = 0.007) was the only insurance type/hospital system combination with significantly worse OS.ConclusionNI-SNH patients received less curative treatment than other insurance/hospitals types suggesting that treatment barriers, beyond access-to-care, need to be identified and addressed to achieve survival equity in early-stage HCC for vulnerable populations (NI-SNH).     

印度某医疗中心机械性眼外伤患者受伤情况分析

目的:研究农村转诊中心到访以病人机械性眼损伤模式.方法:本研究在Dr.Rajendra Prasad Government Medical College(RPGMC),Kangra(Himachal Pradesh)眼科进行.研究从2013-01-01/2013-12-31,周期12mo,包括数据收集、整理、描述、分析和解释,然后进行为期1 mo的随访.前瞻性研究,包括200例机械性眼损伤的患者,所有患者都接受了问卷调查,并进行详细的眼部检查.根据国际眼损伤类型分为开放性眼球损伤和闭合性眼部损伤.受损的眼睑、泪腺以及颅神经麻痹视为独立存在,通过MS Excel 2007表格使用Epi info7软件进行数据分析.结果:在研究期间,共接收门诊患者21710例,其中200例为机械性眼损伤,占门诊总人数的0.921%.患者年龄为1~80(平均33.12±20.48)岁.151(75.5%)例男性,49(24.5%)例女性患者,男女比例为3:1.200例受试者中,眼部损伤情况分别为:家中(100眼)、运动场所(29眼)、职业损伤(29眼)、道路交通事故(38眼)、暴力冲突(10眼)、学校(3眼)、宗教场所踩踏事故(1眼).就诊时视力达到6/12的有47%,<6/12~6/36有13.5%,<6/36~1/60有6%,<1/60~光感有22%,无光感的4%.7.5%患者视力无法通过国际标准视力表评估.大多数患者为闭合性眼部损伤(54.5%),涉及眼睑、泪腺(23%),开放性眼部损伤为19.5%,3%累及颅神经.结论:眼部机械性损伤是造成单眼失明的常见病因,具有可预防性.     

In-vivo Studies and Molecular Docking of Modeled Mus musculas 8S Lipoxygenase Protein Using Some Natural Bioactive Compounds

Proceedings of the National Academy of Sciences, India Section B: Biological Sciences - Mus musculus 8S Lipoxygenase (8SLOX) is expressed in suprabasal keratinocytes, and the massive accumulation...     

CD34 is not Expressed by Blasts in a Third of B-ALL Patients and its Negativity is associated with Aberrant Marker Expression: A Retrospective Analysis

Background: CD34 antigen is expressed by early hematopoietic progenitor cells and acute leukemia cells. Its expression is associated with good prognosis in acute myeloid leukemia. Literature is sparse on its prognostic significance in B- acute lymphoblastic leukemia (B-ALL) especially from India. Hence the present study was undertaken to analyse the frequency of CD34 expression in B-ALL in Indian patients and determine its prognostic significance by associating with other prognostic markers and aberrant antigen expression. Methods: Seventy-five B-ALL patients diagnosed by flow cytometry over a period of 3½ year were studied. Correlation of CD34 expression was studied with gender, age, total leucocyte count (TLC), French-American-British (FAB) morphological type, immuno-phenotypic markers, cytogenetics and minimal residual disease. Differences between groups were evaluated using Student’s T-test for quantitative data and Chi-square test/Fishers exact T-test for qualitative variables. P value     

Ossifying fibromyxoid tumor: Fine‐needle aspiration cytology findings of a rare soft tissue neoplasm

Ossifying fibromyxoid tumors (OFMTs) are rare tumors of uncertain origin and intermediate (rarely metastasizing) biologic potential, with characteristic morphology of an encapsulated tumor containing polygonal cells in an abundant fibromyxoid matrix surrounded by a peripheral layer of metaplastic lamellar bone. FNA cytology of OFMT has not been sufficiently reported and till date cytological features of only seven cases have been reported so far. We report another case of OFMT in a 55‐year‐old female presenting with longstanding swelling in thigh. On fine‐needle aspiration, a tumor with moderate cellularity and myxoid areas was seen; coupled with compatible radiological findings, a diagnosis of OFMT was suggested. Establishing a correct diagnosis is important as although OFMT is benign in nature, local recurrences or rarely distant metastasis have been seen of this tumor. Hence, a high degree of suspicion with radiological correlation is of utmost importance for identification of this entity.