Dear editor,Patients with supraventricular tachycardia(SVT)commonly present to the emergency department(ED).Current guidelines[1,2]do not recommend routine pathology testing and a report on the topic has questioned th...Dear editor,Patients with supraventricular tachycardia(SVT)commonly present to the emergency department(ED).Current guidelines[1,2]do not recommend routine pathology testing and a report on the topic has questioned their role.A systematic review concluded that troponin testing is commonly performed with a high proportion of positive fi ndings,but these results were not associated with major adverse cardiac events.[3]The conclusions of this review were limited by paucity of data and heterogeneity among studies.展开更多
Epidemiologic studies have suggested a relation between hepatitis C virus (HCV) infection and diabetes mellitus. HCV infection is emerging as a metabolic disease, and diabetes mellitus as a risk factor for HCV infecti...Epidemiologic studies have suggested a relation between hepatitis C virus (HCV) infection and diabetes mellitus. HCV infection is emerging as a metabolic disease, and diabetes mellitus as a risk factor for HCV infection. However, some data on the prevalence of antibodies to HCV in patients with diabetes are conflicting. These seroprevalence data should be interpreted with caution. Some potential bias may occur in those clinic-based studies that target a specif ic disease group. In this letter we explain some reasons for these conflicting studies.展开更多
Object:To determine the extent and impact of upgrading and downgrading among men who underwent radical prostatectomy(RP)according to new grade groupings and to identify predictors of upgrading from biopsy grade Group ...Object:To determine the extent and impact of upgrading and downgrading among men who underwent radical prostatectomy(RP)according to new grade groupings and to identify predictors of upgrading from biopsy grade Group Ⅰ and Ⅱ,and downgrading to grade Group I,in a community setting.Methods:Study participants included 2279 men with non-metastatic prostate cancer diagnosed 2006-2015 who underwent prostatectomy,from the multi-institutional South Australia Prostate Cancer Clinical Outcomes Collaborative registry.Extent of up-or down-grading was assessed by comparing biopsy and prostatectomy grade groupings.Risk of biochemical recurrence(BCR)with upgrading was assessed using multivariable competing risk regression.Binomial logistic regression was used to identify pre-treatment predictors of upgrading from grade Groups Ⅰ and Ⅱ,and risk group reclassification among men with low risk disease.Results:Upgrading occurred in 35%of cases,while downgrading occurred in 13%of cases.Sixty percent with grade Group I disease were upgraded following prostatectomy.Upgrading from grade Group I was associated with greater risk of BCR compared with concordant grading(Hazard ratio:3.1,95%confidence interval:1.7-6.0).Older age,higher prostate-specific antigen levels(PSA),fewer biopsy cores,higher number of positive cores and more recent diagnosis predicted upgrading from grade Group Ⅰ,while higher PSA and clinical stage predicted upgrading from grade Group Ⅱ.No clinical risk factors for reclassification were identified.Conclusion:Biopsy sampling errors may play an important role in upgrading from grade Group I.Improved clinical assessment of grade is needed to encourage greater uptake of active surveillance.展开更多
Objective:To explore immunochemical characterization of antigens of Brucella canis(B. canis),and the use in seroprevalence study of canine brucellosis.Methods:External hot phosphate buffer saline extract(HPBSE) and in...Objective:To explore immunochemical characterization of antigens of Brucella canis(B. canis),and the use in seroprevalence study of canine brucellosis.Methods:External hot phosphate buffer saline extract(HPBSE) and internal sonicated(SA) antigens were prepared from B.canis strain MEX 51 and imniunochemically characterized.These antigens were used to test 527 serum samples of dogs by 2-mercaptoethanol-tubc agglutination test(2 ME-TAT), agar gel immunodiffusion test(AGID).dot-ELISA and indirect enzyme-linked immunosorbent assay(I-ELISA) to assess the seroprevalence of canine brucellosis.Results:The protein content of HPBSE and SA antigens was 0.387 mg/ml.and 0.195 mg/mL,respectively,whereas carbohydrate content was 0.174 mg/mL and 0.150 mg/mL,respectively.The sodium dodecyl sulfate-polyacrylamide gel electrophoresis(12.5%) of HPBSE and SA,revealed 6 and 8 visible peptide bands ranging from 18-80 kDa and 12-45 kDa,respectively.Western blot analysis showed immunodominant bands of MW 12.28.39 and 45 kl)a for HPBSE and 20-24 kl)a for SA. The AGII) revealed HPBSE as more specific antigen than SA but both I-ELISA and dot-ELISA indicated SA antigen to be more specific and reliable than HPBSE.The seroprevalence of canine brucellosis was 2.27%by 2ME-TAT.1.5%by AGID.3.03%by dot-ELISA and 16.12%by I-ELISA. Conclusions:On the basis of the results of present study,we concluded that HPBSE is suitable antigen for AGID,which is more specific:whereas SA antigen is suitable for I-ELISA,which is highly sensitive.Therefore,initial screening of serum samples should be carried out by I-ELISA followed by confirmation with AGID.展开更多
Hydatid disease is considered as an important emerging neglected disease worldwide.Cystic echinococcosis is a neglected disease of public health significance in many low and middle-income countries.The objective of ou...Hydatid disease is considered as an important emerging neglected disease worldwide.Cystic echinococcosis is a neglected disease of public health significance in many low and middle-income countries.The objective of our study was to determine the epidemiological profile of human hydatidosis in Tlemcen.A prospective study was conducted at University Hospital Center(UHC)of Tlemcen,from 2003 to 2018 from the declaration of notifiable diseases.Data entry and analysis was done using Epi-info software 6.One hundred and fifty-eight(158)patients were declared during 16 years of registartion at the UHC of Tlemcen.Ninety three point zero three percent(93.03%)of the reports of cases were received from the surgical services and 6 cases from the pneumology department.A slight female predominance was noted with sex-ratio(Females/Males):1.15.More than half of the patients were subjects over 40 years old.Three cases were noted in children.The average age was 42.38±17.14 years.The liver was the most frequent organ involved in our study followed by pulmonary localization.Fifty one point eight seven(51.87%)of cases were from rural areas and 46.2%from urban areas.Human hydatidosis remains an under-reported and neglected disease in Tlemcen whose fight is essentially based on preventive measures and requires multisectoral collaboration.展开更多
Cutaneous leishmaniasis (CL) is a widespread parasitic disease and a public health problem worldwide. It is an endemic and notifiable disease in Algeria. Our objective was to know the epidemiological characteristics a...Cutaneous leishmaniasis (CL) is a widespread parasitic disease and a public health problem worldwide. It is an endemic and notifiable disease in Algeria. Our objective was to know the epidemiological characteristics and to determine the endemic regions of the CL in the town of Tlemcen. A descriptive study was conducted with a prospective collection over five years, from 2012 to 2016, based on the systematic declaration of CL cases received from the various departments of the University Hospital center (UHC) of Tlemcen. Data entry and analysis was done by Epi-info 6 software. Thirty-four cases of cutaneous leishmaniasis, 27 of which are autochthonous were reported at the UHC of Tlemcen during 5 years with a female predominance;sex ratio (h/f): 0.79. The most affected age group was 40-50 years old. Six cases occurred in children under 16 years, 80% of the reports were received by the dermatology department. The highest peak was recorded in 2013;autumnal predominance was noted in 30% of cases. All patients lived or had been in endemic areas. Vector control campaigns must be reinforced to fight against leishmaniasis in the town of Tlemcen, also, the improvement of habitat conditions for populations at risk.展开更多
AIM:To investigate the prevalence of,and risk factors for,diabetes mellitus(DM) in Algerian patients with chronic hepatitis C virus(HCV) infection and in a control group.METHODS:A cross-sectional study was undertaken....AIM:To investigate the prevalence of,and risk factors for,diabetes mellitus(DM) in Algerian patients with chronic hepatitis C virus(HCV) infection and in a control group.METHODS:A cross-sectional study was undertaken.A total of 416 consecutive patients with viral chronic hepatitis attending the Internal Medicine Department of the University Hospital Center Touhami Benflis in Batna [290 HCV-infected and 126 hepatitis B virus(HBV)-infected patients] were prospectively recruited.RESULTS:The prevalence of DM was higher in HCV-infected patients in comparison with HBV-infected patients(39.1% vs 5%,P < 0.0001).Among patients without cirrhosis,diabetes was more prevalent in HCV-infected patients than in HBV-infected patients(33.5% vs 4.3%,P < 0.0001).Among patients with cirrhosis,diabetes was more prevalent in HCV-infected patients,but the difference was not significant(67.4% vs 20%,P = 0.058).The logistic regression analysis showed that HCV infection [odds ratio(OR) 4.73,95% CI:1.7-13.2],metabolic syndrome(OR 12.35,95% CI:6.18-24.67),family history of diabetes(OR 3.2,95% CI:1.67-6.13) and increased hepatic enzymes(OR 2.22,95% CI:1.1-4.5) were independently related to DM in these patients.CONCLUSION:The high prevalence of diabetes in HCV-infected patients,and its occurrence at early stages of hepatic disease,suggest that screening for glucose abnormalities should be indicated in these patients.展开更多
AIM： To investigate features of Epstein-Barr virus （EBV）associated gastric carcinoma （EBVaGC） among a Mexican population. METHODS： Cases of primary gastric adenocarcinoma were retrieved from the files of the Dep...AIM： To investigate features of Epstein-Barr virus （EBV）associated gastric carcinoma （EBVaGC） among a Mexican population. METHODS： Cases of primary gastric adenocarcinoma were retrieved from the files of the Departments of Pathology at the Instituto Nacional de Cancerologia and the Instituto Nacional de la Nutrición in Mexico City. The anatomic site of the gastric neoplasia was identified, and carcinomas were histologically classified as intestinal and diffuse types and subclassified as proposed by the Japanese Research Society for Gastric Cancer. EBV-encoded small non-polyadenylated RNA-1 （EBER-1） in situ hybridization was conducted to determine the presence of EBV in neoplastic cells. RESULTS： We studied 330 consecutive, non-selected, primary gastric carcinomas. Among these, there were 173 male and 157 female patients （male/female ratio 1.1/1）. EBER-1 was detected in 24 （7.3%） cases （male/ female ratio： 1.2/1）. The mean age for the entire group was 58.1 years （range： 20-88 years）, whereas the mean age for patients harboring EBER-1-positive gastric carcinomas was 65.3 years （range： 50-84 years）. Age and histological type showed statistically significant differences, when EBER-1-positive and -negative gastric carcinomas were compared. EBER-1 was detected in hyperplastic- and dysplastic-gastric mucosa surrounding two EBER-1-negative carcinomas, respectively. CONCLUSION： Among Latin-American countries, Mexico has the lowest frequency of EBVaGC. Indeed, the Mexican population 〉50 years of age was selectively affected. Ethnic variations are responsible for the epidemiologic behavior of EBVaGC among the worldwide population.展开更多
AIM:To clarify the efficiency of the criterion of metabolic syndrome to detecting non-alcoholic fatty liver disease(NAFLD).METHODS:Authors performed a cross-sectional study involving participants of a medical health c...AIM:To clarify the efficiency of the criterion of metabolic syndrome to detecting non-alcoholic fatty liver disease(NAFLD).METHODS:Authors performed a cross-sectional study involving participants of a medical health checkup program including abdominal ultrasonography.This study involved 11 714 apparently healthy Japanese men and women,18 to 83 years of age.NAFLD was defined by abdominal ultrasonography without an alcohol intake of more than 20 g/d,known liver disease,or current use of medication.The revised criteria of the National Cholesterol Education Program Adult Treatment PanelⅢ were used to characterize the metabolic syndrome.RESULTS:NAFLD was detected in 32.2%(95%CI:31.0%-33.5%)of men(n=1874 of 5811)and in 8.7%(95%CI:8.0%-9.5%)of women(n=514 of 5903).Among obese people,the prevalence of NAFLD was as high as 67.3%(95%CI:64.8%-69.7%)in men and 45.8%(95%CI:41.7%-50.0%)in women.Although NAFLD was thought of as being the liver phenotype of metabolic syndrome,the prevalence of the metabolic syndrome among subjects with NAFLD was low both in men and women.66.8%of men and 70.4%of women with NAFLD were not diagnosed with the metabolic syndrome.48.2%of men with NAFLD and 49.8%of women with NAFLD weren't overweight[body mass index(BMI)≥25 kg/m2].In the same way,68.6%of men with NAFLD and 37.9%of women with NAFLD weren't satisfied with abdominal classification(≥90 cm for men and≥80 cm for women).Next,authors defined it as positive at screening for NAFLD when participants satisfied at least one criterion of metabolic syndrome.The sensitivity of the definition"at least 1 criterion"was as good as 84.8%in men and 86.6%in women.Separating subjects by BMI,the sensitivity was higher in obese men and women than in non-obese men and women(92.3%vs 76.8%in men,96.1%vs 77.0%in women,respectively).CONCLUSION:Authors could determine NAFLD effectively in epidemiological study by modifying the usage of the criteria for metabolic syndrome.展开更多
Background Little is known about the prevalence oforthostatic hypertension （OHT） and its effect on long-term mortality in the eld- erly. We evaluated the prevalence of OHT and its effect on mortality in hospitalized...Background Little is known about the prevalence oforthostatic hypertension （OHT） and its effect on long-term mortality in the eld- erly. We evaluated the prevalence of OHT and its effect on mortality in hospitalized elderly patients. Methods Out of 1852 patients admit- ted between 31/12/1999 and 31/12/2000 to an acute geriatric ward, 474 patients （48% males） with a mean age of 81.5 ±6.8 years were en- rolled in this study. Blood pressure （BP） was measured three times during the day in a supine and standing position. Patients with at least one increase in systolic or diastolic BP levels upon standing were diagnosed with OHT. Medical history, physical examination and laboratory parameters were retrieved from the medical records. Mortality data until 18th June 2014 were retrieved from the computerized system of the Ministry of the Interior. Results Four hundred and seven patients （86%） were diagnosed with OHT. Those without OHT had a lowerbody mass index and were more likely males, smokers, had a higher rate of Parkinson＇s disease and less congestive heart failure compared with those with OHT. Patients with OHT had a better survival rate than those without OHT （P = 0.024）. Hazard ratios （HRs） for mortality in those with OHT adjusted to age and multiple risk factors were： 0.67 [95% confidence interval （CI）： 0.51-0.87] and 0.73 （95% CI： 0.55-0.97）, respectively; a similar tendency was noticed in a sensitivity analysis by gender. Conclusion Hospitalized elderly patients with OHT had a better survival rate than those without OHT.展开更多
AIM： To examine the presence of human papillomavirus （HPV） in esophageal squamous cell carcinoma （ESCC） specimens collected from Colombia and Chile located in the northern and southern ends of the continent, resp...AIM： To examine the presence of human papillomavirus （HPV） in esophageal squamous cell carcinoma （ESCC） specimens collected from Colombia and Chile located in the northern and southern ends of the continent, respectively.METHODS： We examined 47 and 26 formalin-fixed and paraffin-embedded ESCC specimens from Colombia and Chile, respectively. HPV was detected using GP5＋/GP6＋ primer pair for PCR, and confirmed by Southern blot analysis. Sequencing analysis of L1 region fragment was used to identify HPV genotype. In addition, P16^INK4A protein immunostaining of all the specimens was conducted.RESULTS： HPV was detected in 21 ESCC specimens （29%）. Sequencing analysis of L1 region fragment identified HPV-16 genome in 6 Colombian cases （13%） and in 5 Chilean cases （19%）. HPV-18 was detected in i0 cases （21%） in Colombia but not in any Chilean case. Since Chilean ESCC cases had a higher prevalence of HPV-16 （without statistical significance）, but a significantly lower prevalence of HPV-18 than in Colombian cases （P = 0.011） even though the two countries have similar ESCC incidence rates, the frequency of HPV-related ESCC may not be strongly affected by risk factors affecting the incidence of ESCC. HPV-16 genome was more frequently detected in p16 positive carcinomas, although the difference was not statistically significant. HPV-18 detection rate did not show any association with p16 expression. Well-differentiated tumors tended to have either HPV-16 or HPV-18 but the association was not statistically significant. HPV genotypes other than HPV-16 or 18 were not detected in either country.CONCLUSION： HPV-16 and HPV-18 genotypes can be found in ESCC specimens collected from two South American countries. Further studies on the relationship between HPV-16 presence and p16 expression in ESCC would aid understanding of the mechanism underlying the presence of HPV in ESCC.展开更多
AIM： To examine the role of E-cadherin and betacatenin in carcinogenesis and to assess their prognostic implication in Epstein-Barr virus-associated gastric carcinomas （EBV-GCs）. METHODS： We compared the frequency...AIM： To examine the role of E-cadherin and betacatenin in carcinogenesis and to assess their prognostic implication in Epstein-Barr virus-associated gastric carcinomas （EBV-GCs）. METHODS： We compared the frequency of E-cadherin and beta-catenin expression in 59 EBV-GCs and 120 non-EBV-GCs, and examined the association between patients＇ prognosis and the expressions of these proteins. RESULTS： Neither the cellular-membranous nor the cytoplasmic E-cadherin expression showed any difference between EBV-GCs and non-EBV-GCs. On the other hand, loss of membranous expression of beta- catenin occurred more frequently in non-EBV-GCs than EBV-GCs [odds ratio = 0.41; 950 confidence interval （CI）, 0.19-0.90]. Furthermore, the nuclear and/or cytoplosmic expression of beta-catenin was seen more frequently in EBV-GCs than non-EBV-GCs （odds ratio = 2.23; 95% CI, 0.97-5.09）, and was observed in a larger proportion of carcinoma cells of EBV-GCs than non-EBV-GCs （P = 0.024）. Survival analysis for non-EBV-GC revealed that lymph node metastasis was significantly associated with poor prognosis （P 〈 0.001）. Among EBV- GCs, the depth of invasion （P = 0.005）, lymph node metastasis （P = 0.004） and an intestinal type by Lauren classification （hazard ratio = 9.47; 95% CI, 2.67-33.6） were significantly associated with poor prognosis. On the other hand, nuclear and/or cytoplasmic expression of beta-catenin was associated with a better prognosis in patients with EBV-GC （hazard ratio = 0.32; 95% CI, 0.11-0.93）. CONCLUSION： We observed more frequent preservation of beta-catenin in cell membrane and accumulation in nuclei and/or cytoplasm in EBV-GCs than in non-EBV- GCs. Factors involved in the prognosis of EBV-GCs and non-EBV-GCs are different in the two conditions.展开更多
AIM:To investigate the presence of high-risk human papilloma virus (HPV) in esophageal squamous cell carcinomas (ESCCs) in a non-selected Mexican population.METHODS: Cases with a pathological diagnosis of squamous cel...AIM:To investigate the presence of high-risk human papilloma virus (HPV) in esophageal squamous cell carcinomas (ESCCs) in a non-selected Mexican population.METHODS: Cases with a pathological diagnosis of squamous cell carcinoma of the esophagus were obtained from Department of Pathology files, at the National Cancer Institute in Mexico City during the period between 2000 and 2008. Slides from each case were reviewed and cases with sufficient neoplastic tissue were selected for molecular analysis. DNA was extracted from paraffin-embedded tissue samples for polymerase chain reaction analysis to detect HPV DNA sequences. Demographic and clinical data of each patient were retrieved from corresponding clinical records.RESULTS: HPV was detected in 15 (25%) of ESCCs. HPV-16 was the most frequently observed genotype, followed by HPV-18; HPV-59 was also detected in one case. Unfortunately, HPV genotype could not be established in three cases due to lack of material for direct sequencing, although universal primers detected the presence of HPV generic sequences. No low-risk HPV genotypes were found nor was HPV-16/18 co-infection. HPV presence in ESCC was not significantly associated with gender, age, alcohol consumption, smoking, anatomic location, or histologic grade. All patients belonged to low and very low socioeconomic strata, and were diagnosed at advanced disease stage. Male patients were most commonly affected and the male:female ratio in HPV-positive ESCC increased two- fold in comparison with HPV-negative cases (6.5:1 vs 3.1:1).CONCLUSION: High prevalence of high-risk HPV in ESCC in Mexico does not support the hypothesis that HPV-associated ESCC is more common in areas with higher ESCC incidence rates.展开更多
BACKGROUND Given most patients with distal malignant biliary obstruction present in the nonresectable stage,palliative endoscopic biliary drainage with fully covered metal stent(FCMS)or uncovered metal stent(UCMS)is t...BACKGROUND Given most patients with distal malignant biliary obstruction present in the nonresectable stage,palliative endoscopic biliary drainage with fully covered metal stent(FCMS)or uncovered metal stent(UCMS)is the only available measure to improve patients’quality of life.Half covered metal stent(HCMS)has been recently introduced commercially.The adverse effects and stent function between FCMS and UCMS have been extensively discussed.AIM To study the duration of stent patency of HCMS and compare it with FCMS and UCMS to optimize biliary drainage in inoperable patients with distal malignant obstruction.Secondary aims in our study included evaluation of patients’survival and the rates of adverse events for each type of stent.METHODS We studied 210 patients and randomized them into three equal groups;HCMS,FCMS and UCMS were inserted endoscopically.RESULTS Stent occlusion occurred in(18.6%,17.1%and 15.7%in HCMS,FCMS and UCMS groups,respectively,P=0.9).Stent migration occurred only in patients with FCMS(8.6%of patients).Cholangitis and cholecystitis occurred in 11.4%and 5.7%of patients,respectively,in FCMS.Tumor growth occurred only in 10 cases among patients with UCMS after a median of 140 d,sludge occurred in nine,seven and one patients in HCMS,FCMS and UCMS,respectively(P=0.04).CONCLUSION Given the prolonged stent functioning time,the use of HCMS is preferred over the use of UCMS and FCMS for optimizing biliary drainage in patients with distal malignant biliary obstruction.展开更多
Metabolic syndrome(MetS),a cluster of modifiable metabolic conditions(including abdominal obesity,dyslipidemia,elevated blood pressure,and hyperglycemia),has become an essential contributor to the global health burden...Metabolic syndrome(MetS),a cluster of modifiable metabolic conditions(including abdominal obesity,dyslipidemia,elevated blood pressure,and hyperglycemia),has become an essential contributor to the global health burden and public health challenges worldwide.展开更多
Objective:Treatment delays in prostate cancer have been characterised,although not explicitly in men undergoing transperineal prostate biopsies.We aimed to determine if delays to radical prostatectomy correlate with a...Objective:Treatment delays in prostate cancer have been characterised,although not explicitly in men undergoing transperineal prostate biopsies.We aimed to determine if delays to radical prostatectomy correlate with adverse outcomes using a contemporary population-based cohort of men diagnosed by transperineal biopsies.Methods:This study analysed men with prostate cancer of the International Society for Urological Pathology grade group≥2,diagnosed by transperineal prostate biopsies who underwent prostatectomy,using the prospectively data from 1 January 2014 to 30 June 2018 Prostate Cancer Outcomes Registry-Victoria.Data were analysed according to stratified demographic and disease characteristics.Time intervals from biopsy(28,60,90,120,and 270 days)were compared using odds ratios and regression analyses for proportion of upgrading,early biochemical recurrence,pT3 disease at prostatectomy,and positive surgical margins.Results:In total,2008 men were analysed.There were 306(16.7%)men with upgrading,151(8.4%)with biochemical recurrence,1068(54.1%)with pT3 disease,and 464(23.1%)with positive surgical margins(percentages excluded patients with missing data).All adverse outcomes studied were significantly associated with higher prostate-specific antigen and grade at diagnosis.Delays of 120-270 days did not adversely alter the incidence of Gleason upgrading,pT3,or recurrence.Delays(most frequent 60-89 days,28%)were associated with positive surgical margins but not monotonically.Regression modelling demonstrated no increased likelihood of most adverse outcomes for up to 270 days.Conclusion:Men with prostate cancer of grade group≥2 diagnosed through transperineal biopsy may wait up to 270 days for a prostatectomy without a greater likelihood of upgrading,pT3 disease,positive surgical margins,or biochemical recurrence.展开更多
In the world,digestive cancers represent a major public health problem by their frequency and severity.Digestive tract cancers are very common malignant tumors worldwide and are an important cause of cancer-related de...In the world,digestive cancers represent a major public health problem by their frequency and severity.Digestive tract cancers are very common malignant tumors worldwide and are an important cause of cancer-related death.The objective of our study was to determinate the survival of digestive cancers in the province of Tlemcen over a period of 5 years.This is a prognostic historical-prospective study with an exhaustive collection data,which consists of studying the 5-year survival of digestive cancers in the province of Tlemcen,of all patients with digestive cancers whatever the stage,diagnosed between 2011 and 2012 and histologically confirmed in subjects residing in the province of Tlemcen at the moment of diagnosis.The subjects of our study were identified from the cancer registry of Tlemcen.In total,408 cases of digestive cancers were diagnosed over 2 years in Tlemcen province.Most digestive cancers were characterized by a predominance of men except for cancer of the liver,gallbladder and bile ducts but whatever the sex,these cancers occur mainly in subjects whose age is greater than or equal to 45 years.Topographically,for both sexes combined,the colorectum followed by the stomach were the organs most affected by digestive cancers.Histopathologically,a predominance of adenocarcinoma has been noted.The 5-year global survival rate of all digestive cancers was 55.4%,depending on the localization;colorectal cancer,small bowel cancer,gallbladder and bile ducts cancer,stomach and esophagus cancers are cancers of intermediate prognosis whose survival in 5 years is between 40%and 80%.Liver cancer and pancreatic cancer remain poor prognosis cancers with 5-year survival rates of 23.08%and 33.3%respectively.The survival of digestive cancers must be improved by adequate care and surveillance of patients.The prevention of colorectal cancers which occupy the first place among the digestive cancers is based essentially on the knowledge of the risk factors and the screening allowing the improvement of the survival rate.The registry of cancer remains a fundamental tool of any cancer control program;it constitutes a starting source for the analysis of survival.展开更多
Background: Human migration facilitate the spread of tuberculosis(TB).Migrants face an increased risk of TB infection.In this study,we aim to explore the spatial inequity of sputum smear-positive pulmonary TB(SS+PTB)i...Background: Human migration facilitate the spread of tuberculosis(TB).Migrants face an increased risk of TB infection.In this study,we aim to explore the spatial inequity of sputum smear-positive pulmonary TB(SS+PTB)in China;and the spatial heterogeneity between SS+PTB and internal migration.Methods:: Notified SS+PTB cases in 31 provinces in China's Mainland were obtained from the national web-based PTB surveillance system database.Internal migrant data were extracted from the report on China’s migrant population development.Spatial autocorrelations were explored using the global Moran’s statistic and local indicators of spatial association.The spatial variation in temporal trends was performed using Kulldorff’s scan statistic.Fixed effect and spatial autoregressive models were used to explore the spatial inequity between SS+PTB and internal migration.Results: A total of 2380233 SS+PTB cases were reported in China between 2011 and 2017,of which,1716382(72.11%)were male and 663851(27.89%)were female.Over 70%of internal migrants were from rural households and had lower income and less education.The spatial variation in temporal trend results showed that there was an 9.9%average annual decrease in the notification rate of SS+PTB from 2011 to 2017;and spatial clustering of SS+PTB cases was mainly located in western and southern China.The spatial autocorrelation results revealed spatial clustering of internal migration each year(2011–2017),and the clusters were stable within most provinces.Internal emigration,urban-to-rural migration and GDP per capita were significantly associated with SS+PTB,further,internal emigration could explain more variation in SS+PTB in the eastern region in mainland.However,internal immigration and rural-to-urban migration were not significantly associated with SS+PTB across China.Conclusions: Our study found the spatial inequity between SS+PTB and internal migration.Internal emigration,urban-to-rural migration and GDP per capita were statistically associated with SS+PTB;the negative association was identified between internal emigration,urban-to-rural migration and SS+PTB.Further,we found those migrants with lower income and less education,and most of them were from rural households.These findings can help stakeholders to implement effective PTB control strategies for areas at high risk of PTB and those with high rates of internal migration.展开更多
Background: The 2 most cited sports injury prevention research frameworks incorporate intervention development, yet little guidance is available in the sports science literature on how to undertake this complex proces...Background: The 2 most cited sports injury prevention research frameworks incorporate intervention development, yet little guidance is available in the sports science literature on how to undertake this complex process. This paper presents a generalizable process for developing implementable sports injury prevention interventions, including a case study applying the process to develop a lower limb injury prevention exercise training program(Footy First) for community Australian football.Methods: The intervention development process is underpinned by 2 complementary premises:(1) that evidence-based practice integrates the best available scientific evidence with practitioner expertise and end user values and(2) that research evidence alone is insufficient to develop implementable interventions.Results: The generalizable 6-step intervention development process involves(1) compiling research evidence, clinical experience, and knowledge of the implementation context;(2) consulting with experts;(3) engaging with end users;(4) testing the intervention;(5) using theory; and(6)obtaining feedback from early implementers. Following each step, intervention content and presentation should be revised to ensure that the final intervention includes evidence-informed content that is likely to be adopted, properly implemented, and sustained over time by the targeted intervention deliverers. For Footy First, this process involved establishing a multidisciplinary intervention development group, conducting 2targeted literature reviews, undertaking an online expert consensus process, conducting focus groups with program end users, testing the program multiple times in different contexts, and obtaining feedback from early implementers of the program.Conclusion: This systematic yet pragmatic and iterative intervention development process is potentially applicable to any injury prevention topic across all sports settings and levels. It will guide researchers wishing to undertake intervention development.展开更多
文摘Dear editor,Patients with supraventricular tachycardia(SVT)commonly present to the emergency department(ED).Current guidelines[1,2]do not recommend routine pathology testing and a report on the topic has questioned their role.A systematic review concluded that troponin testing is commonly performed with a high proportion of positive fi ndings,but these results were not associated with major adverse cardiac events.[3]The conclusions of this review were limited by paucity of data and heterogeneity among studies.
文摘Epidemiologic studies have suggested a relation between hepatitis C virus (HCV) infection and diabetes mellitus. HCV infection is emerging as a metabolic disease, and diabetes mellitus as a risk factor for HCV infection. However, some data on the prevalence of antibodies to HCV in patients with diabetes are conflicting. These seroprevalence data should be interpreted with caution. Some potential bias may occur in those clinic-based studies that target a specif ic disease group. In this letter we explain some reasons for these conflicting studies.
基金This project was funded by the Movember Foundation as part of their Australian and New Zealand prostate cancer outcomes registry initiative(PCOR-ANZ)which aims to develop a binational clinical registry for outcomes monitoring and research to inform practice and improve outcomes for men with prostate cancer.Dr.Beckmann is supported by an NHMRC Early Career Researcher Fellowship.
文摘Object:To determine the extent and impact of upgrading and downgrading among men who underwent radical prostatectomy(RP)according to new grade groupings and to identify predictors of upgrading from biopsy grade Group Ⅰ and Ⅱ,and downgrading to grade Group I,in a community setting.Methods:Study participants included 2279 men with non-metastatic prostate cancer diagnosed 2006-2015 who underwent prostatectomy,from the multi-institutional South Australia Prostate Cancer Clinical Outcomes Collaborative registry.Extent of up-or down-grading was assessed by comparing biopsy and prostatectomy grade groupings.Risk of biochemical recurrence(BCR)with upgrading was assessed using multivariable competing risk regression.Binomial logistic regression was used to identify pre-treatment predictors of upgrading from grade Groups Ⅰ and Ⅱ,and risk group reclassification among men with low risk disease.Results:Upgrading occurred in 35%of cases,while downgrading occurred in 13%of cases.Sixty percent with grade Group I disease were upgraded following prostatectomy.Upgrading from grade Group I was associated with greater risk of BCR compared with concordant grading(Hazard ratio:3.1,95%confidence interval:1.7-6.0).Older age,higher prostate-specific antigen levels(PSA),fewer biopsy cores,higher number of positive cores and more recent diagnosis predicted upgrading from grade Group Ⅰ,while higher PSA and clinical stage predicted upgrading from grade Group Ⅱ.No clinical risk factors for reclassification were identified.Conclusion:Biopsy sampling errors may play an important role in upgrading from grade Group I.Improved clinical assessment of grade is needed to encourage greater uptake of active surveillance.
基金The financial support provided to the first author in the form of Junior Fellowship by ICAR,New Delhi is duly acknowledged
文摘Objective:To explore immunochemical characterization of antigens of Brucella canis(B. canis),and the use in seroprevalence study of canine brucellosis.Methods:External hot phosphate buffer saline extract(HPBSE) and internal sonicated(SA) antigens were prepared from B.canis strain MEX 51 and imniunochemically characterized.These antigens were used to test 527 serum samples of dogs by 2-mercaptoethanol-tubc agglutination test(2 ME-TAT), agar gel immunodiffusion test(AGID).dot-ELISA and indirect enzyme-linked immunosorbent assay(I-ELISA) to assess the seroprevalence of canine brucellosis.Results:The protein content of HPBSE and SA antigens was 0.387 mg/ml.and 0.195 mg/mL,respectively,whereas carbohydrate content was 0.174 mg/mL and 0.150 mg/mL,respectively.The sodium dodecyl sulfate-polyacrylamide gel electrophoresis(12.5%) of HPBSE and SA,revealed 6 and 8 visible peptide bands ranging from 18-80 kDa and 12-45 kDa,respectively.Western blot analysis showed immunodominant bands of MW 12.28.39 and 45 kl)a for HPBSE and 20-24 kl)a for SA. The AGII) revealed HPBSE as more specific antigen than SA but both I-ELISA and dot-ELISA indicated SA antigen to be more specific and reliable than HPBSE.The seroprevalence of canine brucellosis was 2.27%by 2ME-TAT.1.5%by AGID.3.03%by dot-ELISA and 16.12%by I-ELISA. Conclusions:On the basis of the results of present study,we concluded that HPBSE is suitable antigen for AGID,which is more specific:whereas SA antigen is suitable for I-ELISA,which is highly sensitive.Therefore,initial screening of serum samples should be carried out by I-ELISA followed by confirmation with AGID.
文摘Hydatid disease is considered as an important emerging neglected disease worldwide.Cystic echinococcosis is a neglected disease of public health significance in many low and middle-income countries.The objective of our study was to determine the epidemiological profile of human hydatidosis in Tlemcen.A prospective study was conducted at University Hospital Center(UHC)of Tlemcen,from 2003 to 2018 from the declaration of notifiable diseases.Data entry and analysis was done using Epi-info software 6.One hundred and fifty-eight(158)patients were declared during 16 years of registartion at the UHC of Tlemcen.Ninety three point zero three percent(93.03%)of the reports of cases were received from the surgical services and 6 cases from the pneumology department.A slight female predominance was noted with sex-ratio(Females/Males):1.15.More than half of the patients were subjects over 40 years old.Three cases were noted in children.The average age was 42.38±17.14 years.The liver was the most frequent organ involved in our study followed by pulmonary localization.Fifty one point eight seven(51.87%)of cases were from rural areas and 46.2%from urban areas.Human hydatidosis remains an under-reported and neglected disease in Tlemcen whose fight is essentially based on preventive measures and requires multisectoral collaboration.
文摘Cutaneous leishmaniasis (CL) is a widespread parasitic disease and a public health problem worldwide. It is an endemic and notifiable disease in Algeria. Our objective was to know the epidemiological characteristics and to determine the endemic regions of the CL in the town of Tlemcen. A descriptive study was conducted with a prospective collection over five years, from 2012 to 2016, based on the systematic declaration of CL cases received from the various departments of the University Hospital center (UHC) of Tlemcen. Data entry and analysis was done by Epi-info 6 software. Thirty-four cases of cutaneous leishmaniasis, 27 of which are autochthonous were reported at the UHC of Tlemcen during 5 years with a female predominance;sex ratio (h/f): 0.79. The most affected age group was 40-50 years old. Six cases occurred in children under 16 years, 80% of the reports were received by the dermatology department. The highest peak was recorded in 2013;autumnal predominance was noted in 30% of cases. All patients lived or had been in endemic areas. Vector control campaigns must be reinforced to fight against leishmaniasis in the town of Tlemcen, also, the improvement of habitat conditions for populations at risk.
文摘AIM:To investigate the prevalence of,and risk factors for,diabetes mellitus(DM) in Algerian patients with chronic hepatitis C virus(HCV) infection and in a control group.METHODS:A cross-sectional study was undertaken.A total of 416 consecutive patients with viral chronic hepatitis attending the Internal Medicine Department of the University Hospital Center Touhami Benflis in Batna [290 HCV-infected and 126 hepatitis B virus(HBV)-infected patients] were prospectively recruited.RESULTS:The prevalence of DM was higher in HCV-infected patients in comparison with HBV-infected patients(39.1% vs 5%,P < 0.0001).Among patients without cirrhosis,diabetes was more prevalent in HCV-infected patients than in HBV-infected patients(33.5% vs 4.3%,P < 0.0001).Among patients with cirrhosis,diabetes was more prevalent in HCV-infected patients,but the difference was not significant(67.4% vs 20%,P = 0.058).The logistic regression analysis showed that HCV infection [odds ratio(OR) 4.73,95% CI:1.7-13.2],metabolic syndrome(OR 12.35,95% CI:6.18-24.67),family history of diabetes(OR 3.2,95% CI:1.67-6.13) and increased hepatic enzymes(OR 2.22,95% CI:1.1-4.5) were independently related to DM in these patients.CONCLUSION:The high prevalence of diabetes in HCV-infected patients,and its occurrence at early stages of hepatic disease,suggest that screening for glucose abnormalities should be indicated in these patients.
基金Supported by a Grant No. 12218231 from Grants-in-Aid for Scientific Research of the Ministry of Education, Science, Sports,and Culture of Japan
文摘AIM： To investigate features of Epstein-Barr virus （EBV）associated gastric carcinoma （EBVaGC） among a Mexican population. METHODS： Cases of primary gastric adenocarcinoma were retrieved from the files of the Departments of Pathology at the Instituto Nacional de Cancerologia and the Instituto Nacional de la Nutrición in Mexico City. The anatomic site of the gastric neoplasia was identified, and carcinomas were histologically classified as intestinal and diffuse types and subclassified as proposed by the Japanese Research Society for Gastric Cancer. EBV-encoded small non-polyadenylated RNA-1 （EBER-1） in situ hybridization was conducted to determine the presence of EBV in neoplastic cells. RESULTS： We studied 330 consecutive, non-selected, primary gastric carcinomas. Among these, there were 173 male and 157 female patients （male/female ratio 1.1/1）. EBER-1 was detected in 24 （7.3%） cases （male/ female ratio： 1.2/1）. The mean age for the entire group was 58.1 years （range： 20-88 years）, whereas the mean age for patients harboring EBER-1-positive gastric carcinomas was 65.3 years （range： 50-84 years）. Age and histological type showed statistically significant differences, when EBER-1-positive and -negative gastric carcinomas were compared. EBER-1 was detected in hyperplastic- and dysplastic-gastric mucosa surrounding two EBER-1-negative carcinomas, respectively. CONCLUSION： Among Latin-American countries, Mexico has the lowest frequency of EBVaGC. Indeed, the Mexican population 〉50 years of age was selectively affected. Ethnic variations are responsible for the epidemiologic behavior of EBVaGC among the worldwide population.
基金Supported by Young Scientists(B)(23790791)from Japan Society for the Promotion of Science
文摘AIM:To clarify the efficiency of the criterion of metabolic syndrome to detecting non-alcoholic fatty liver disease(NAFLD).METHODS:Authors performed a cross-sectional study involving participants of a medical health checkup program including abdominal ultrasonography.This study involved 11 714 apparently healthy Japanese men and women,18 to 83 years of age.NAFLD was defined by abdominal ultrasonography without an alcohol intake of more than 20 g/d,known liver disease,or current use of medication.The revised criteria of the National Cholesterol Education Program Adult Treatment PanelⅢ were used to characterize the metabolic syndrome.RESULTS:NAFLD was detected in 32.2%(95%CI:31.0%-33.5%)of men(n=1874 of 5811)and in 8.7%(95%CI:8.0%-9.5%)of women(n=514 of 5903).Among obese people,the prevalence of NAFLD was as high as 67.3%(95%CI:64.8%-69.7%)in men and 45.8%(95%CI:41.7%-50.0%)in women.Although NAFLD was thought of as being the liver phenotype of metabolic syndrome,the prevalence of the metabolic syndrome among subjects with NAFLD was low both in men and women.66.8%of men and 70.4%of women with NAFLD were not diagnosed with the metabolic syndrome.48.2%of men with NAFLD and 49.8%of women with NAFLD weren't overweight[body mass index(BMI)≥25 kg/m2].In the same way,68.6%of men with NAFLD and 37.9%of women with NAFLD weren't satisfied with abdominal classification(≥90 cm for men and≥80 cm for women).Next,authors defined it as positive at screening for NAFLD when participants satisfied at least one criterion of metabolic syndrome.The sensitivity of the definition"at least 1 criterion"was as good as 84.8%in men and 86.6%in women.Separating subjects by BMI,the sensitivity was higher in obese men and women than in non-obese men and women(92.3%vs 76.8%in men,96.1%vs 77.0%in women,respectively).CONCLUSION:Authors could determine NAFLD effectively in epidemiological study by modifying the usage of the criteria for metabolic syndrome.
文摘Background Little is known about the prevalence oforthostatic hypertension （OHT） and its effect on long-term mortality in the eld- erly. We evaluated the prevalence of OHT and its effect on mortality in hospitalized elderly patients. Methods Out of 1852 patients admit- ted between 31/12/1999 and 31/12/2000 to an acute geriatric ward, 474 patients （48% males） with a mean age of 81.5 ±6.8 years were en- rolled in this study. Blood pressure （BP） was measured three times during the day in a supine and standing position. Patients with at least one increase in systolic or diastolic BP levels upon standing were diagnosed with OHT. Medical history, physical examination and laboratory parameters were retrieved from the medical records. Mortality data until 18th June 2014 were retrieved from the computerized system of the Ministry of the Interior. Results Four hundred and seven patients （86%） were diagnosed with OHT. Those without OHT had a lowerbody mass index and were more likely males, smokers, had a higher rate of Parkinson＇s disease and less congestive heart failure compared with those with OHT. Patients with OHT had a better survival rate than those without OHT （P = 0.024）. Hazard ratios （HRs） for mortality in those with OHT adjusted to age and multiple risk factors were： 0.67 [95% confidence interval （CI）： 0.51-0.87] and 0.73 （95% CI： 0.55-0.97）, respectively; a similar tendency was noticed in a sensitivity analysis by gender. Conclusion Hospitalized elderly patients with OHT had a better survival rate than those without OHT.
基金Supported by Grants-in-Aid for Scientific Research on Priority Areas of the Ministry of Education, Culture, Sports, Science and Technology, Japan, No. 12218231 and 17015037
文摘AIM： To examine the presence of human papillomavirus （HPV） in esophageal squamous cell carcinoma （ESCC） specimens collected from Colombia and Chile located in the northern and southern ends of the continent, respectively.METHODS： We examined 47 and 26 formalin-fixed and paraffin-embedded ESCC specimens from Colombia and Chile, respectively. HPV was detected using GP5＋/GP6＋ primer pair for PCR, and confirmed by Southern blot analysis. Sequencing analysis of L1 region fragment was used to identify HPV genotype. In addition, P16^INK4A protein immunostaining of all the specimens was conducted.RESULTS： HPV was detected in 21 ESCC specimens （29%）. Sequencing analysis of L1 region fragment identified HPV-16 genome in 6 Colombian cases （13%） and in 5 Chilean cases （19%）. HPV-18 was detected in i0 cases （21%） in Colombia but not in any Chilean case. Since Chilean ESCC cases had a higher prevalence of HPV-16 （without statistical significance）, but a significantly lower prevalence of HPV-18 than in Colombian cases （P = 0.011） even though the two countries have similar ESCC incidence rates, the frequency of HPV-related ESCC may not be strongly affected by risk factors affecting the incidence of ESCC. HPV-16 genome was more frequently detected in p16 positive carcinomas, although the difference was not statistically significant. HPV-18 detection rate did not show any association with p16 expression. Well-differentiated tumors tended to have either HPV-16 or HPV-18 but the association was not statistically significant. HPV genotypes other than HPV-16 or 18 were not detected in either country.CONCLUSION： HPV-16 and HPV-18 genotypes can be found in ESCC specimens collected from two South American countries. Further studies on the relationship between HPV-16 presence and p16 expression in ESCC would aid understanding of the mechanism underlying the presence of HPV in ESCC.
基金Supported by Grants-in-Aid for Scientific Research on Priority Areas (12218231, 17015037, and 18014024) of the Ministry of Education, Culture, Sports, Science and Technology, Japan
文摘AIM： To examine the role of E-cadherin and betacatenin in carcinogenesis and to assess their prognostic implication in Epstein-Barr virus-associated gastric carcinomas （EBV-GCs）. METHODS： We compared the frequency of E-cadherin and beta-catenin expression in 59 EBV-GCs and 120 non-EBV-GCs, and examined the association between patients＇ prognosis and the expressions of these proteins. RESULTS： Neither the cellular-membranous nor the cytoplasmic E-cadherin expression showed any difference between EBV-GCs and non-EBV-GCs. On the other hand, loss of membranous expression of beta- catenin occurred more frequently in non-EBV-GCs than EBV-GCs [odds ratio = 0.41; 950 confidence interval （CI）, 0.19-0.90]. Furthermore, the nuclear and/or cytoplosmic expression of beta-catenin was seen more frequently in EBV-GCs than non-EBV-GCs （odds ratio = 2.23; 95% CI, 0.97-5.09）, and was observed in a larger proportion of carcinoma cells of EBV-GCs than non-EBV-GCs （P = 0.024）. Survival analysis for non-EBV-GC revealed that lymph node metastasis was significantly associated with poor prognosis （P 〈 0.001）. Among EBV- GCs, the depth of invasion （P = 0.005）, lymph node metastasis （P = 0.004） and an intestinal type by Lauren classification （hazard ratio = 9.47; 95% CI, 2.67-33.6） were significantly associated with poor prognosis. On the other hand, nuclear and/or cytoplasmic expression of beta-catenin was associated with a better prognosis in patients with EBV-GC （hazard ratio = 0.32; 95% CI, 0.11-0.93）. CONCLUSION： We observed more frequent preservation of beta-catenin in cell membrane and accumulation in nuclei and/or cytoplasm in EBV-GCs than in non-EBV- GCs. Factors involved in the prognosis of EBV-GCs and non-EBV-GCs are different in the two conditions.
文摘AIM:To investigate the presence of high-risk human papilloma virus (HPV) in esophageal squamous cell carcinomas (ESCCs) in a non-selected Mexican population.METHODS: Cases with a pathological diagnosis of squamous cell carcinoma of the esophagus were obtained from Department of Pathology files, at the National Cancer Institute in Mexico City during the period between 2000 and 2008. Slides from each case were reviewed and cases with sufficient neoplastic tissue were selected for molecular analysis. DNA was extracted from paraffin-embedded tissue samples for polymerase chain reaction analysis to detect HPV DNA sequences. Demographic and clinical data of each patient were retrieved from corresponding clinical records.RESULTS: HPV was detected in 15 (25%) of ESCCs. HPV-16 was the most frequently observed genotype, followed by HPV-18; HPV-59 was also detected in one case. Unfortunately, HPV genotype could not be established in three cases due to lack of material for direct sequencing, although universal primers detected the presence of HPV generic sequences. No low-risk HPV genotypes were found nor was HPV-16/18 co-infection. HPV presence in ESCC was not significantly associated with gender, age, alcohol consumption, smoking, anatomic location, or histologic grade. All patients belonged to low and very low socioeconomic strata, and were diagnosed at advanced disease stage. Male patients were most commonly affected and the male:female ratio in HPV-positive ESCC increased two- fold in comparison with HPV-negative cases (6.5:1 vs 3.1:1).CONCLUSION: High prevalence of high-risk HPV in ESCC in Mexico does not support the hypothesis that HPV-associated ESCC is more common in areas with higher ESCC incidence rates.
文摘BACKGROUND Given most patients with distal malignant biliary obstruction present in the nonresectable stage,palliative endoscopic biliary drainage with fully covered metal stent(FCMS)or uncovered metal stent(UCMS)is the only available measure to improve patients’quality of life.Half covered metal stent(HCMS)has been recently introduced commercially.The adverse effects and stent function between FCMS and UCMS have been extensively discussed.AIM To study the duration of stent patency of HCMS and compare it with FCMS and UCMS to optimize biliary drainage in inoperable patients with distal malignant obstruction.Secondary aims in our study included evaluation of patients’survival and the rates of adverse events for each type of stent.METHODS We studied 210 patients and randomized them into three equal groups;HCMS,FCMS and UCMS were inserted endoscopically.RESULTS Stent occlusion occurred in(18.6%,17.1%and 15.7%in HCMS,FCMS and UCMS groups,respectively,P=0.9).Stent migration occurred only in patients with FCMS(8.6%of patients).Cholangitis and cholecystitis occurred in 11.4%and 5.7%of patients,respectively,in FCMS.Tumor growth occurred only in 10 cases among patients with UCMS after a median of 140 d,sludge occurred in nine,seven and one patients in HCMS,FCMS and UCMS,respectively(P=0.04).CONCLUSION Given the prolonged stent functioning time,the use of HCMS is preferred over the use of UCMS and FCMS for optimizing biliary drainage in patients with distal malignant biliary obstruction.
基金supported by the Foundation of National Key Program of Research and Development of China[grant No.2016YFC0900803]Science and Technology Innovation Team Support Plan of Colleges and Universities in Henan Province[grant No.21IRTSTHN029]+4 种基金National Natural Science Foundation of China[grant No.81573243 and 81602925]Henan Natural Science Foundation of China[grant No.182300410293]Science and Technology Foundation for Innovation Talent of Henan Province[grant No.164100510021]Science and Technology Innovation Talents Support Plan of Henan Province Colleges and Universities[grant No.14HASTIT035]High-level Personnel Special Support Project of Zhengzhou University[grant No.ZDGD13001]。
文摘Metabolic syndrome(MetS),a cluster of modifiable metabolic conditions(including abdominal obesity,dyslipidemia,elevated blood pressure,and hyperglycemia),has become an essential contributor to the global health burden and public health challenges worldwide.
基金The Prostate Cancer Outcomes Registry-Victoria is supportedby the Movember Foundation (HREC/17/Alfred/33).
文摘Objective:Treatment delays in prostate cancer have been characterised,although not explicitly in men undergoing transperineal prostate biopsies.We aimed to determine if delays to radical prostatectomy correlate with adverse outcomes using a contemporary population-based cohort of men diagnosed by transperineal biopsies.Methods:This study analysed men with prostate cancer of the International Society for Urological Pathology grade group≥2,diagnosed by transperineal prostate biopsies who underwent prostatectomy,using the prospectively data from 1 January 2014 to 30 June 2018 Prostate Cancer Outcomes Registry-Victoria.Data were analysed according to stratified demographic and disease characteristics.Time intervals from biopsy(28,60,90,120,and 270 days)were compared using odds ratios and regression analyses for proportion of upgrading,early biochemical recurrence,pT3 disease at prostatectomy,and positive surgical margins.Results:In total,2008 men were analysed.There were 306(16.7%)men with upgrading,151(8.4%)with biochemical recurrence,1068(54.1%)with pT3 disease,and 464(23.1%)with positive surgical margins(percentages excluded patients with missing data).All adverse outcomes studied were significantly associated with higher prostate-specific antigen and grade at diagnosis.Delays of 120-270 days did not adversely alter the incidence of Gleason upgrading,pT3,or recurrence.Delays(most frequent 60-89 days,28%)were associated with positive surgical margins but not monotonically.Regression modelling demonstrated no increased likelihood of most adverse outcomes for up to 270 days.Conclusion:Men with prostate cancer of grade group≥2 diagnosed through transperineal biopsy may wait up to 270 days for a prostatectomy without a greater likelihood of upgrading,pT3 disease,positive surgical margins,or biochemical recurrence.
文摘In the world,digestive cancers represent a major public health problem by their frequency and severity.Digestive tract cancers are very common malignant tumors worldwide and are an important cause of cancer-related death.The objective of our study was to determinate the survival of digestive cancers in the province of Tlemcen over a period of 5 years.This is a prognostic historical-prospective study with an exhaustive collection data,which consists of studying the 5-year survival of digestive cancers in the province of Tlemcen,of all patients with digestive cancers whatever the stage,diagnosed between 2011 and 2012 and histologically confirmed in subjects residing in the province of Tlemcen at the moment of diagnosis.The subjects of our study were identified from the cancer registry of Tlemcen.In total,408 cases of digestive cancers were diagnosed over 2 years in Tlemcen province.Most digestive cancers were characterized by a predominance of men except for cancer of the liver,gallbladder and bile ducts but whatever the sex,these cancers occur mainly in subjects whose age is greater than or equal to 45 years.Topographically,for both sexes combined,the colorectum followed by the stomach were the organs most affected by digestive cancers.Histopathologically,a predominance of adenocarcinoma has been noted.The 5-year global survival rate of all digestive cancers was 55.4%,depending on the localization;colorectal cancer,small bowel cancer,gallbladder and bile ducts cancer,stomach and esophagus cancers are cancers of intermediate prognosis whose survival in 5 years is between 40%and 80%.Liver cancer and pancreatic cancer remain poor prognosis cancers with 5-year survival rates of 23.08%and 33.3%respectively.The survival of digestive cancers must be improved by adequate care and surveillance of patients.The prevention of colorectal cancers which occupy the first place among the digestive cancers is based essentially on the knowledge of the risk factors and the screening allowing the improvement of the survival rate.The registry of cancer remains a fundamental tool of any cancer control program;it constitutes a starting source for the analysis of survival.
基金ACKNOWLEDGEMENTS This study was supported by the following science foundation： 1. EU FP7 Program： UroSense. 201 I 2. ISN Research Committee grant. 2007 3. ISN Reseat ch Committee grant. 2004.
文摘Background: Human migration facilitate the spread of tuberculosis(TB).Migrants face an increased risk of TB infection.In this study,we aim to explore the spatial inequity of sputum smear-positive pulmonary TB(SS+PTB)in China;and the spatial heterogeneity between SS+PTB and internal migration.Methods:: Notified SS+PTB cases in 31 provinces in China's Mainland were obtained from the national web-based PTB surveillance system database.Internal migrant data were extracted from the report on China’s migrant population development.Spatial autocorrelations were explored using the global Moran’s statistic and local indicators of spatial association.The spatial variation in temporal trends was performed using Kulldorff’s scan statistic.Fixed effect and spatial autoregressive models were used to explore the spatial inequity between SS+PTB and internal migration.Results: A total of 2380233 SS+PTB cases were reported in China between 2011 and 2017,of which,1716382(72.11%)were male and 663851(27.89%)were female.Over 70%of internal migrants were from rural households and had lower income and less education.The spatial variation in temporal trend results showed that there was an 9.9%average annual decrease in the notification rate of SS+PTB from 2011 to 2017;and spatial clustering of SS+PTB cases was mainly located in western and southern China.The spatial autocorrelation results revealed spatial clustering of internal migration each year(2011–2017),and the clusters were stable within most provinces.Internal emigration,urban-to-rural migration and GDP per capita were significantly associated with SS+PTB,further,internal emigration could explain more variation in SS+PTB in the eastern region in mainland.However,internal immigration and rural-to-urban migration were not significantly associated with SS+PTB across China.Conclusions: Our study found the spatial inequity between SS+PTB and internal migration.Internal emigration,urban-to-rural migration and GDP per capita were statistically associated with SS+PTB;the negative association was identified between internal emigration,urban-to-rural migration and SS+PTB.Further,we found those migrants with lower income and less education,and most of them were from rural households.These findings can help stakeholders to implement effective PTB control strategies for areas at high risk of PTB and those with high rates of internal migration.
基金funded by an National Health and Medical Research Council (NHMRC) Partnership Project Grant (ID: 565907) which included additional support (both cash and in-kind) from the following project partner agencies: the Australian Football League Victorian Health Promotion Foundation+7 种基金 New South Wales Sporting Injuries Committee JLT Sport, a division of Jardine Lloyd Thompson Australia Pty Ltd. Sport and Recreation Victoria, Department of Transport, Planning and Local Infrastructure and Sports Medicine Australia- National and Victorian Branchessupported by an NHMRC Principal Research Fellowship (APP1058737)supported by an NHMRC Career Development Fellowship (APP1048731)supported by a NHMRC Practitioner fellowship (APP1058493)Research Fellowships funded through the major NHMRC Partnership Project Grant
文摘Background: The 2 most cited sports injury prevention research frameworks incorporate intervention development, yet little guidance is available in the sports science literature on how to undertake this complex process. This paper presents a generalizable process for developing implementable sports injury prevention interventions, including a case study applying the process to develop a lower limb injury prevention exercise training program(Footy First) for community Australian football.Methods: The intervention development process is underpinned by 2 complementary premises:(1) that evidence-based practice integrates the best available scientific evidence with practitioner expertise and end user values and(2) that research evidence alone is insufficient to develop implementable interventions.Results: The generalizable 6-step intervention development process involves(1) compiling research evidence, clinical experience, and knowledge of the implementation context;(2) consulting with experts;(3) engaging with end users;(4) testing the intervention;(5) using theory; and(6)obtaining feedback from early implementers. Following each step, intervention content and presentation should be revised to ensure that the final intervention includes evidence-informed content that is likely to be adopted, properly implemented, and sustained over time by the targeted intervention deliverers. For Footy First, this process involved establishing a multidisciplinary intervention development group, conducting 2targeted literature reviews, undertaking an online expert consensus process, conducting focus groups with program end users, testing the program multiple times in different contexts, and obtaining feedback from early implementers of the program.Conclusion: This systematic yet pragmatic and iterative intervention development process is potentially applicable to any injury prevention topic across all sports settings and levels. It will guide researchers wishing to undertake intervention development.
