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Insurance Payer Status and Race Explains much of the Variability in Colorectal Cancer Survival

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Journal of Cancer Therapy 2014年第13期5卷 1223-1233页

作者： Timothy L. Fitzgerald Cary Suzanne Lea Prashanti m. Atluri Jason Brinkley Emmanuel E. Zervos Brody School of medicine Division of Surgical Oncology East Carolina University Greenville USA School of Public Health East Carolina University Greenville USA Division of medical Oncology East Carolina University Greenville USA Department of Biostatistics College of Allied Health Sciences East Carolina University Greenville USA

Health care inequalities exist for patients with colon cancer. We hypothesize that factors such as payers and medical comorbidities may explain much of this inequality. methods: Patients with colon cancer in the NCDB from 2003-2010 were identified in this study. Results: 541,649 patients were identified. median age and survival were 68.6 years and 62.5 months. A majority of them (80.2%) were non-Hispanic white (NHW). African American (AA) and Hispanic (HS) patients were more likely to have medicaid (mD) or be uninsured (ui) and reside in counties with lower socio-economic status (SES). From univariate analysis, it was found that private insurance (PI) had superior survival (98.7 months) compared to mD (46.0 months), medicare (mC) (50.4 months) and ui (54.4 months). Survival was highest for HS (70.9 months) followed by NHW (63.2 months) and AA (53.0 months). Also, survival was linked to comorbidity index (CI), SES, chemotherapy, gender and surgical resection. On multivariate analysis, it was found that male (RR 1.11), SES, surgery (RR 2.29), chemotherapy (RR 1.96), CI, and stage were associated with survival. Race was a predictor of survival, with a survival advantage for HS (RR 0.87) and others (0.87) compared to NHW (1) and AA (1.2). Insurance status was strongly linked to survival. Compared to PI all other groups had poorer survival: mC RR 1.11;mD RR 1.44;and NI RR ***: Inequality in outcomes for colon cancer patients is strongly associated with race and underinsurance.

关键词： Variability Colorectal Cancer Survival

盆腔器官脱垂和尿失禁患者发生的功能性肠病和肛门直肠功能紊乱

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世界核心医学期刊文摘（妇产科学分册） 2006年第5期2卷 6-7页

作者： Jelovsek J.E Barber m.D Paraiso m.F.R Walters m.D. 李奎 Cleveland Clinic Foundation Department of Gynecology and Obstetrics 9500 Euclid Avenue/A81 Cleveland OH 44195 United States

The purpose of this study was 1) to determine the prevalence of functional bowel and anorectal disorders as defined by the Rome Ⅱ criteria in patients with advanced pelvic organ prolapse (POP) and urinary incontinence (ui), and (2) to determine if the extent of prolapse on gynecologic examination is related to the subtypes of constipation or any functional anorectal pain disorder. Study design: Three hundred and two consecutive female subjects presenting to a tertiary urogynecology clinic were enrolled. Demographic, general medical, and physical examination information, including POPQ measurements and a standardized sacral neurologic evaluation, were collected. The prevalence of functional disorders of the bowel, rectum, and anus as defined by the Rome Ⅱ criteria were collected using the Rome Ⅱ modular questionnaire. Relationships of functional disorders to various components of the vaginal examination were reviewed. Results: Thirty six percent (108/302) met the criteria for constipation, including the following subtypes: 19% outlet constipation, 5% functional constipation, 5% constipation predominant irritable bowel syndrome (IBS), and 7% IBS outlet. Nineteen percent (56/302) of subjects had IBS or 1 of its subtypes. Functional diarrhea was seen in 6% (17/302), fecal incontinence in 19% (58/302), and anorectal pain disorders in 25% (77/302). After controlling for age, parity, diabetes, constipating medications, and previous pelvic surgery, there were no differences in the prevalence of constipation or any of its subtypes between patients with ui and those with stage 3 or 4 POP. Fecal incontinence was independently associated with ui (adjusted odds ratio[OR] 6.3; 95% CI 2.6- 19.1), but not advanced POP. Neither overall stage of POP nor stage of posterior vaginal prolapse was significantly associated with any of the functional bowel disorders, including constipation and its subtypes. Perineal body measurement was significantly longer in patients with outlet type co

关键词：盆腔器官脱垂功能性肠病肛门直肠阴道后壁膨出罗马Ⅱ标准盆腔手术史痉挛性肛部痛统计学资料

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Solid State Vaginal Laser for the Treatment of Genitourinary Syndrome of menopause: A Preliminary Report

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Open Journal of Obstetrics and Gynecology 2018年第2期8卷 113-121页

作者： D. Dodero F. Frascani m. Angelucci G. Bernabei E. merlo F. Locatelli F. murina Villa maris Clinic Genova Italy Casa di Cura Santa Famiglia Rome Italy Blu mar Clinic Milan Italy Studio Locatelli Modena Italy Lower Genital Tract Disease Unit V. Buzzi Hospital-University of Milan Milan Italy

Background: Genitourinary syndrome of menopause (GSm) is the new term for vulvovaginal atrophy (VVA). The condition is relevant in more than 50% of women, having an adverse impact on quality of life and sexual relationships. Objective: To assess the efficacy and safety of a new type of non-ablative laser, Solid State Vaginal Laser (SSVL), for vaginal tissue regeneration and rejuvenation. method: Eighty participants with GSm symptoms were treated with a total of 4 treatments in about two months (every 15 - 20 days) of a non-ablative SSVL (LASEmaR 1500Tm-EUFOTON). A cumulative intensity of GSm symptoms using a 10-cm VAS (dryness and/or burning and/or dyspareunia), the vaginal health index (VHI), the Female Sexual Function Index (FSFI) were evaluated. Urinary Incontinence Short Form (ICIQ-ui SF) and vaginal bioptic samples were also collected. Results: Improvement following the SSVL was observed on VHIS, VVA symptoms and sexual female function. This finding was also ratified by the improvement of vaginal histological features. After the SSVL treatment, almost all patients (91%) affected by urinary incontinence obtained the complete remission of symptoms. Conclusion: The objective evaluation of VHIS, FSFI and ICIQ-ui SF scores and the histological results indicates a real favorable effect of SSVL on GSm and on urinary incontinence.

关键词： Atrophic Vaginitis Genitourinary Syndrome of menopause Urinary Incontinence Fractional Laser

The Psycho-Social Impact of Urinary Incontinence on the Quality of Life among kuwaiti Women with Type 2 Diabetes mellitus

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Open Journal of Nursing 2020年第7期10卷 716-729页

作者： Florence E. Omu Sanaa m. Taghaddom Chitra Vellolikalam Fawzeyah S. H. S. Alharbi Samiha I. A. Dwaib Gifta Jeevakumari College of Nursing The Public Authority for Applied Education & Training Kuwait Sabah Al Ahmad Urology Centre Kuwait

This study was conducted to determine the psycho-social impact of urinary incontinence (ui) on the quality of life of 250 kuwaiti women with type 2 diabetic mellitus (Dm). A survey method, using a 33-item 5-point Likert scale Arabic questionnaire adapted from the king’s Health Questionnaire (kHQ), was employed for data collection from February to may, 2014 while all the participants were receiving treatment for ui at a specialized urology center in kuwait. Participants with ui and a co-morbidity of type 2 Dm and obesity were 20 to 65 years old. Results showed the following variables were statistically significant for frequency of urine leak: Age was (m>χm>2 = 36.877, df = 3, P ≤ 0.000). Parity showed nulliparous women reported less urine leak compared to parous women: Chi-square was (m>χm>2 = 24.83, df = 12, P ≤ 0.016). Type 2 Dm for more than 3 years duration had the highest incidence of several leaks per day. BmI of above 25 kg/m2 caused daily urine leak: Chi-square (m>χm>2 = 17.912, df = 9, P ≤ 0.036). Participants’ self reports of good general health were those who leaked urine either 2 - 3 times weekly or occasionally. Finally, the impact of incontinence on their lifestyle was reported as extreme by 128 (51.2%), and 6 (2.4%) reported little or no impact on their quality of life: Chi-square was (m>χm>2 = 52.392, df = 18, P ≤ 0.000). In conclusion, this study showed a clear correlation between ui and reduced quality of life. midwives are well positioned to correct the myth that ui is an inevitable byproduct of childbearing. midwives should explain to all pregnant women how childbirth can be a risk factor and provide anticipatory guidance by teaching preventive measures like pelvic floor exercises before and after delivery. Family members should assist sufferers in coping with their challenges by dispelling any form of stigmatization, joining them in practicing pelvic floor exercises, and encouraging,

关键词： Urinary Incontinence mixed Incontinence Stress Incontinence Urge Incontinence Overactive Bladder Quality of Life Diabetes mellitus Obesity

Activation of PAR1 increases cardiac action potential duration through stimulation of the late Na current.

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Activation of PAR1 increases cardiac action potential durati...

REDESCRIPTION OF THE EARLY CAmBRIAN TRILOBITE ART HRICOCEP HALUS CHAUVEAui BERGERON, 1899

第十五届国际药理学大会

作者： S. Sablayrollesl R. Letienne C. Pinet A. Coulombe m. Perez B.Le Grand Centre de Recherche Pierre Fabre Castres Centre de Recherche Pierre Fabre Castres INSERm U-621 CHU Pitié Salpétrière Paris France INSERm U-621 CHU Pitié Salpétrière Paris France Centre de Recherche Pierre Fabre Castres Centre de Recherche Pierre Fabre Castres

＜正＞ Thrombin constitue the main activator of the protease activated receptor PAR1, however, to date only few informations are available on the pathophysiological relevance of PAR1 in the heart. The main goal of the present study was to investigate the affect of PAR1 activation on the action potential duration of guinea-pig papillary. Firstly, an immunochemistry study using monoclonal mouse antibody to thrombin demonstrate the presence of PAR1 with a great density on the endocardium. Using the patch-clamp technique on freshly isolated cardiomyocytes, we demonstrate activation of PAR1 with thrombin 32ui/ml increase the amplitude of the late sodium current （2.2±0.5pA/pF）. In addition, the action potential duration were significantly increase APD50 in a concentration dependent manner both by thrombin 32ui/ml （max van 14.80% ） and by SFLLR 100μm （max van 13, 09% ）. In each case, these PAR1 activations were fully block by TTX 1μm confirming the involvement of the late sodium current in the action potential prolongation. Similarly, the PAR1 induced an increase of APD50 was concentration de-pendently block by two PAR1 antagonist compounds, SCH 203099 and ER 112787.

关键词： PAR1 APD Late Sodium Current.

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古生物学报 1988年第5期 557-560+671页

作者： P. D. Lane m. R. Blaker Department of Geology University keele Siaffs ST5 5BG U. k. Department of Geology University keele Siaffs ST5 5BG U. k.

The type series of Arthricocephalus chauvea-ui Bergeron, 1899 is redescribed and figured, anda lectotype selected. The genus is referable to theOryctocephalidae. Arthricocephalus was described by Bergeron(1899, P. 514) from a small number of specimenson a slab of shale collected, and presented to Ber-geron, by m. Chauveau. The provenance of theslab was said to be the mountain chain to the nor-th of Toung-yen-Fou, i. e. in Tongren Countywhich is located in northeastern Guizhou. south-

关键词： REDESCRIPTION OF THE EARLY CAmBRIAN TRILOBITE ART HRICOCEP HALUS CHAUVEAui BERGERON 早寒武世下寒武世寒武纪 PI

口服双磷酸盐对囊性纤维化和低骨矿物质密度患者的影响

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世界核心医学期刊文摘（儿科学分册） 2005年第5期1卷 30-31页

作者： Ringuier B. Leboucher B. Leblanc m. 郭战宏

Disturbances in bone mineralization are frequent in cystic fibrosis but few st udies have focused on the use of biphosphonates in this indication, and none on the use of oral etidronate. We report our experience using this latter treatment . methods. -The study was retrospective and included five children and three ad ults with cystic fibrosis (six males and two females) aged seven to 30:years wit h Z-scores for lumbar bone density lower than-2:SD after one year of calcium ( 1:g/day) and vitamin D (900:ui/day and 300:000:ui/6:months) supplementation. All were treated during one year with etidronate: four courses of 15:days (one cour se per trimester) with doses ranging from 4 to 8:mg/kg per day. Calcium and vita min D supplementation was continued between the etidronate treatment course. Tot al body and lumbar bone mineral density (BmD) were measured three times: at the beginning and the end of the year of calcium and vitamin D supplementation and at the end of the year of supplementation plus the four courses of etidronate treatment. Resu lts. -The increase in BmD in absolute value (g/cm2) and in Z-score was signifi cantly higher (P mbined supplementation and etidron ate treatment (total body g/cm2: 3 ±1%, Z-score: 2 ±1%and lumbar spine g/cm 2: 6 ±5%, Z-score: 3 ±4%) than after supplementation alone (total body g/cm 2:-1 ±3%, Z-score:-4 ±3%and lumbar spine g/cm2:-1 ±3%, Z-score:-4 ± 4%). Supplementation alone improved the total BmD in only one patient and the l umbar BmD in three, whereas after etidronate treatment the total and lumbar BmD were improved in the eight patients. None of the patients presented with side ef fects that could be attributed to the treatment. Conclusion. -Oral etidronate t reatment is well-tolerated and capable of improving bone mineralization in pati ents with cystic fibrosis. Further work will be necessary to determine the optim al dosage and the optimal frequency for the treatment series.

关键词：骨矿物质密度囊性纤维化腰椎骨密度双磷酸盐囊肿性纤维化最佳剂量给药频率骨矿化

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综述：一些证据显示盆底肌训练可减少分娩12个月内的孕妇尿失禁

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英国医学杂志中文版 2010年第4期13卷 238-239页

作者： Hay-Smith J mφrkved S Fairbrother kA 卫茂玲(译) 方芳(校) Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women 四川大学华西医院中国循证医学中心四川大学华西二院妇产科

问题：盆底肌肉训练（PFmT）预防和（或）治疗怀孕或产后妇女尿失禁（u1）和大便失禁（F1）是否有效？研究范围纳入研究的包括随机对照试验（RCTs）或半随机对照试验，评估盆底肌肉训练（PFmT）减少怀孕或产后妇女泌尿系（ui）和大便失... 详细信息

问题：盆底肌肉训练（PFmT）预防和（或）治疗怀孕或产后妇女尿失禁（u1）和大便失禁（F1）是否有效？研究范围纳入研究的包括随机对照试验（RCTs）或半随机对照试验，评估盆底肌肉训练（PFmT）减少怀孕或产后妇女泌尿系（ui）和大便失禁（FI）。见PFmT进一步细节的补充数据。主要结果是自我报告的ui或FI.

关键词：尿失禁盆底肌训练半随机对照试验盆底肌肉训练孕妇分娩证据综述

Health Promotion to Patients with Pelvic Floor Dysfunction: An Integrative Review

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Open Journal of Obstetrics and Gynecology 2015年第3期5卷 155-162页

作者： karine C.Bezerra José A.Vasconcelos Neto Leonardo R.P.S.Bezerra Sara A.L.karbage Isabella P.R.Frota Camila T.m.Vasconcelos monica O.B.Oriá Department of Nursing Federal University of CearáFortalezaBrazil

Introduction and Hypothesis: The Pelvic Floor Dysfunction (PFD) is a common gynecological condition that causes significant morbidity in the affected population, increasing clinical and financial challenge for the Public Health Services. methods: This study aimed to review the available evidence and interventions to promote the health of women with PFD. We used the following databases to select papers for this review: Scopus, Pubmed, CINAHL, LILACS and Cochrane. The sample consists of seven articles, with evidence levels 1 and 2. Results: The results of the articles point out to a greater number of activities related to the management of Urinary Incontinence (ui) behavioral support to the patient and physical therapy of the pelvic floor muscles. They were both beneficial to ui prevention and treatment. Conclusions: The physical therapy approach, when associated with cognitive and behavioral strategies, leverages ui outcomes in patients.

关键词： Evidence-Based Practice Health Promotion Intervention Studies Pelvic Organ Prolapse Urinary Incontinence