Top PDF Original Article Risk factors for early-onset pancreatic cancer patients, and survival analysis

Original Article Risk factors for early-onset pancreatic cancer patients, and survival analysis

Original Article Risk factors for early-onset pancreatic cancer patients, and survival analysis

ed that smoking did not appear to influence the occurrence of pancreatic cancer in young patients, or at least did not play a major role as a risk factor. Therefore, debate continues on the role of smoking in EOPC patients. In this study, smoking frequency was higher than in the general population (34.6 vs. 25.9%), sup- porting the hypothesis that smoking is a predis- posing factor for pancreatic cancer. However, there was no difference in the mean BMI and drinking history of EOPC compared to the NOPC subjects. A role for alcohol intake in EOPC has been indirectly suggested by Raimondi et al. [13]. Other studies showed that obesity (BMI > 30) at a younger age (20 to 49 years) is associ- ated with an earlier onset of pancreatic cancer by 2-6 years [18]. Our criterion for obesity in men is a BMI > 28 according to the Asia Obesity Standard, which is different from the previous study. EOPC occurred more frequently in males; in China, the majority of smokers are men. Our results thus support the hypothesis that tobac- co smoking plays a role in the early onset of pancreatic cancer.
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Original Article Comprehensive analysis of risk factors for hypoparathyroidism in thyroid carcinoma patients

Original Article Comprehensive analysis of risk factors for hypoparathyroidism in thyroid carcinoma patients

It remains controversial whether elective or prophylactic CLND should be performed in patients with T1 and T2 cancer [20, 21]. In cN0 patients, some surgeons prefer to perform pro- phylactic CLND because they consider central lymph node dissection to be incapable of increasing the risk of hypoparathyroidism [22, 23]. However, other researchers have demon- strated that central lymph node dissection is an important factor for increasing the incidence of hypoparathyroidism, and previous studies have reported that lymph node metastasis may only impact recurrence but not survival [24-26]. Our study revealed that a more extensive surgi- cal extent may lead to the incidence of hypo- parathyroidism. The risk of hypoparathyroidism increased when CLND was performed with thy- roidectomy, and there was a greater possibi- lity of bilateral CLND than unilateral CLND. Giordano et al. provided approximate results in 2012 [27]. These studies showed that sur- geons should be alert to hypoparathyroidism during the performance of bilateral CLND. This result showing that unilateral or bilateral CLND may increase the risk of hypocalcemia provid- ed another important reference for hesitation and debate regarding controversial prophylac- tic central neck dissection [20, 28, 29].
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Original Article Systematic lymphadenectomy for survival in patients with early-stage endometrial cancer: a meta-analysis

Original Article Systematic lymphadenectomy for survival in patients with early-stage endometrial cancer: a meta-analysis

Abstract: The efficacy of systematic lymphadenectomy is controversial for improving overall survival in patients with early-stage endometrial cancer. Thus, we performed a meta-analysis comparing the efficacy for overall survival between systematic and unsystematic lymphadenectomies. After an extensive literature search between January 2000 and August 2015, we analyzed nine studies (two randomized controlled trials and seven observational stud- ies) involving 3871 patients with early-stage endometrial cancer. In all nine studies, systematic lymphadenectomy (SL) didn’t improve overall survival (OS), compared with unsystematic lymphadenectomies (USL) (OR, 0.77; 95% CI, 0.52-1.13). Moreover, two RCTs showed no difference in OS between SL and USL (OR, 1.30; 95% CI, 0.94-1.79), whereas seven observational studies demonstrated that SL improved OS, compared with USL (OR, 0.57; 95% CI, 0.42-0.77). In three studies in which patients with low-risk endometrial cancer were included, SL failed to improve OS (OR, 0.96; 95% CI, 0.59-1.55), and two observational studies also showed that there was no difference in OS be- tween SL and USL in the patients (OR, 0.70; 95% CI, 0.37-1.33). On the other hand, three studies in which patients with high-risk endometrial cancer were enrolled showed that SL didn’t increase OS (OR, 0.47; 95% CI, 0.20-1.14), but two observational studies demonstrated that SL improved OS when compared with USL (OR, 0.34; 95% CI, 0.20-0.57). This meta-analysis suggests that SL failed to improve OS in patients in early-stage endometrial cancer, especially those with low-risk disease.
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Original Article Tumor budding and size as risk factors of lymph node metastasis in early colorectal cancer

Original Article Tumor budding and size as risk factors of lymph node metastasis in early colorectal cancer

Abstract: This study was designed to investigate risk factors for lymph node metastasis of the Chinese people with early stage colorectal cancer, which was confirmed to a carcinoma that invaded the submucosa after radical resection. In total, 68 patients revealing submucosal invasive colorectal carcinoma on pathology who underwent curative radical resection from October 2007 to September 2011 were evaluated retrospectively. Tumor size, depth of submucosal invasion, histological grade, lymph-vascular invasion, tumor budding, and microacinar structure were reviewed independently by two pathologists. Student t-test for continuous variables and Chi-square test for categorical variables were used for comparing the clinic-pathological features between two groups (whether lymph node involvement existed or not). Continuous variables are expressed as the mean ± standard error while statisti- cal significance is accepted at P < 0.05. As results, the mean age of the patients was 65.7 ± 9.6 years (range from 47 to 84). The mean tumor size (the largest diameter) was 21.5 ± 1.2 mm (range from 5 to 84 mm). Histologically, 11 patients (16.2%) had metastatic lymph node. The lymph node metastasis was significantly associated with the tumor budding (P = 0.038) and the tumor size (P = 0.031) while other factors were not statistically significant. Tumor budding seems to have a high sensitivity (80.0%) for lymph node metastasis, acceptable specificity (55.6%). There- fore, tumor budding should be performed in order to clarify early colorectal cancer with lymph node metastasis through pathologic analysis.
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Original Article The impact of neuraxial anesthesia on cancer recurrence and survival for patients with prostate cancer: a meta-analysis

Original Article The impact of neuraxial anesthesia on cancer recurrence and survival for patients with prostate cancer: a meta-analysis

Actually, our meta-analysis has its limitations. Firstly, it is subjected to recall or selection bias of retrospective study. Secondly, only published studies could not provide sufficient evidences in this meta-analysis. Finally, our conclusion was checked by crude estimation rather than adjusted data. Therefore, other risk factors su- ch as environmental effects and genetic fac- tors should also be taken into consideration in advanced research. Meanwhile, the heteroge- neity suggested there are potential or undis- covered factors in included publications. De- tailed prospective studies comprising large cohort size are required to confirm our con- clusions.
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Original Article Analysis of risk factors for axillary metastasis in sentinel lymph node positive breast cancer patients

Original Article Analysis of risk factors for axillary metastasis in sentinel lymph node positive breast cancer patients

Breast cancer (BC) is the most common malig- nant tumor in women currently [1]. More than 249,000 people were diagnosed with BC in the United States in 2016, and over 40,000 people die from BC or its complications annually [2]. In recent years, the age of onset is younger with an increasing incidence year by year, which imposes a great threat to both quality of life and life expectancy of patients [3]. Due to the advances in medical technologies, early screen- ing of BC has promoted; therapies for BC are improving constantly. Studies now suggest that, the number of BC patients is increasing on a yearly basis, so does the 5-year survival rate [4].
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Original Article Risk factors for incisional hernia in gynecological cancer patients

Original Article Risk factors for incisional hernia in gynecological cancer patients

Abstract: Purpose: The purpose of this study was to analyze retrospectively the risk factors for incisional hernia (IH) in a group of gynecological cancer patients operated with abdominal midline incisions. Methods: We retrieved retrospectively data of gynecological cancer patients with midline incisions from the clinical database of Kanuni Sultan Suleyman Training and Research Hospital Gynecological Oncology Department, within the time period 2001 to 2015. Patients with IH were analyzed for age, body mass index (BMI), smoking, and the presence of additional medical disorders, previous laparotomies, supraumbilical extension of incision, operative complications, postopera- tive hemoglobin levels, surgical site infections (SSI), adjuvant chemotherapy, abdominal radiotherapy and duration of follow-up. Results: 1369 gynecological cancer patients were operated with midline incisions. 80 patients had IH with a rate of 5.84% (95% CI: 4.56-7.04) incidence. With univariant analysis of demographic findings and risk fac- tors; age, BMI, operative complications, postoperative hemoglobin levels, SSI, adjuvant chemotherapy and duration of follow-up were statistically significant. Multivariate analysis revealed; age [OR: 1.06 (95% CI: 1.02-1.09)], SSI [OR: 2.74 (95% CI: 1.08-7)], adjuvant chemotherapy [OR: 2.67 (95% CI: 1.2-5.9)] and duration of follow-up [OR: 1.03 (95% CI: 1.1-3.5)] as independent predictors of IH. Conclusion: In gynecological cancer patients operated with a midline incision, presence of independent risk factors (i.e.: the patient age, SSI, adjuvant chemotherapy) and prospects for survival may necessitate continued attentiveness to the persisting risk of IH formation in a longer term follow-up. In the presence of risk factors and an expectancy of a prolonged remission; it remains to be further proven in randomized controlled prospective studies, whether prophylactic mesh placement at the time of index procedure, may prevent this unpleasant morbidity.
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Original Article Gender differences of risk factors for early gastric cancer with lymph node metastasis

Original Article Gender differences of risk factors for early gastric cancer with lymph node metastasis

Age was another crucial risk factor for EGC with LNM, but it also had a gender difference. The mean age of males was (62.40±10.43) years, and the median age was 63. Females had the mean age of 56.72± 13.68 and the median age of 59. The morbidity rate reached maximum at 60-65 years. The median ages of male and female patients with LNM were 62 and 54 years respectively, indicating that LNM occurred in females 8 years earlier than in males, i.e. age had a gender difference. Depth of invasion is the most important risk factor [1, 3]. The LNM rate of the invasion to SM group significantly exceed- ed that of the invasion to M group. Meanwhile, this risk fac- tor affected male and female patients differently, even at the same depth of invasion, i.e. the LNM rate of females significantly surpassed that of males. Univariate analysis showed gen- der, age, location, tumor size, pathological type, Lauren classi- fication and depth of invasion had significant differences. Mu- ltivariate analysis showed only gender, age and depth of inva- sion were independent risk fac- tors for LNM in EGC. However, all the risk fac- tors (gender, age, tumor size, pathological type and depth of invasion) had significant gender differences. Although the subgroups of risk fac- tors including tumor location, macroscopic type and Lauren classification had no significant gender differences, the LNM rate of females was still higher than that of males.
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Original Article A study on related risk factors and prognosis for lymph node metastasis in patients with early gastric cancer

Original Article A study on related risk factors and prognosis for lymph node metastasis in patients with early gastric cancer

Abstract: The aim of this study was to analyze the risk factors and prognosis for lymph node metastasis (LNM) in patients with early gastric cancer (EGC) in order to provide theoretical evidence for establishing a reasonable thera- peutic schedule. This study retrospectively reviewed 112 patients who underwent surgery (open or laparoscopic). Clinical characteristics and pathological features were analyzed by using Chi-square and binary logistic regression. Survival data for the operated patients were analyzed using the Kaplan-Meier method. Logistic regression analysis revealed that age, depth of infiltration, neoplasms by histological type and lymphatic embolus were independent risk factors for LNM. Furthermore, no LNM was observed in patients who had mucousal cancer, were over 60 years old, and had a highly differentiated tumor without lymphatic embolus. However, LNM occurred when neoplasms infil- trated within the submucousal layer. Five-year survival for patients without LNM was 93.9%, which was significantly higher than in patients with LNM. LNM in EGC is related to age, depth of infiltration, tumor histological type and lymphatic embolus. The survival rate with negative lymph nodes was higher than in patients with LNM. Therefore, we believe that endoscopic en bloc dissection may be considered as a surgical treatment for patients who are ≥60 years old and have a highly differentiated tumor invaded the mucous layer without lymphatic embolus. With respect to patients with high risk factors, we recommend an appropriate lymphadenectomy according to the specific situa- tion.
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Original Article An analysis of the chemotherapy efficacy on the survival of advanced gastric cancer patients

Original Article An analysis of the chemotherapy efficacy on the survival of advanced gastric cancer patients

Abstract: Objective: This research is to investigate the chemotherapy effiacy in advanced gastric cancer patients and prognostic factors so that to provide a basis for improving the diagnosis and treatment of advanced gastric cancer. Methods: A retrospective analysis was performed on the efficacy of chemotherapy with advanced gastric cancer (GC) diagnosed as well as survival data. The survival rate was estimated by Kaplan-Meier and compared by Log-rank test. Factors influencing the prognosis of patients were analyzed by Cox proportional hazard regression model. Results: The overall response rate (ORR) was 36.2% in 102 patients with advanced GC after chemotherapy. The incidences of grade III-IV hematological toxicity and grade III-IV nausea and vomiting in SOX group (14.9% and 0.0%) were lower than that in FOLFOX6 group (30.9% and 10.9%) (P<0.05). Our result showed that the survival rates among patients with different ECOG score, tumor status, histological grade, the number of organs involved in metastasis and chemotherapy efficacy were statistically significant (P<0.05). Multivariate cox regression analysis showed that ECOG score ≥2 points, poorly differentiated/undifferentiated histological grade and SD/PD of chemo- therapy efficacy were prognostic risk factors. Conclusion: Adverse reactions are milder in the SOX group. And the long-term prognosis of patients with advanced GC is poor. Patients with ECOG score ≥2 points, poorly differentiated/ undifferentiated histological grade, or SD/PD of chemotherapy efficacy are more likely to undergo bad prognosis.
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Original Article Impact of primary tumor location on the overall survival of patients with stage IV colorectal cancer: a propensity score analysis of data from the surveillance epidemiology and end results program data

Original Article Impact of primary tumor location on the overall survival of patients with stage IV colorectal cancer: a propensity score analysis of data from the surveillance epidemiology and end results program data

We would like to acknowledge the limitations of the present study. One limitation of the pres- ent study is the lack of information regarding microsatellite instability (MSI) in the SEER da- tabase. According to the literature, colorectal cancer with MSI has a better prognosis [13, 14]. Second, whether or not subjects recei- ved chemotherapy is not recorded in the SEER database. Third, the models that were applied are simplified and used available and accept- ed measures; they clearly do not adequately account for all variables associated with sub- ject outcomes. Fourth, while we performed a risk adjustment for known confounders, poten- tial bias due to unknown confounding factors cannot be excluded. Finally, although propensi-
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Original Article Postoperative prognosis and risk factors in patients with early cervical cancer

Original Article Postoperative prognosis and risk factors in patients with early cervical cancer

with previous studies. The different clinical stage of the studies may be attributed to the controversial results. Furthermore, patients in this study were treated with an individualized comprehensive therapy, which can also cause the different results. In addition, previous stud- ies have showed that clinical stage, depth of invasion, vascular invasion were risk factors associated with the prognosis of patients with cervical cancer [13, 14]. The findings were basi- cally consistent with the previous studies, indi- cating that tumor size (>4 cm), deep invasion (>1/2 muscular layer) and vascular invasion predicted a poor prognosis. Therefore, in clini- cal practice, patients at high risk should be monitored and followed up closely, in order to improve the clinical prognosis. Additionally, this study also showed that lymph node metastasis was an independent risk factor in early cervical cancer. At present, lymph node metastasis is widely recognized as a major risk factor in cervi- cal cancer. Fang et al. reported that the inci- dence of pelvic lymph node metastasis in early cervical cancer was 23.35%, which was associ- ated with the prognosis of the patients [18]. Cheng and his colleagues’ study showed that the 5-year OS was 31.96% in patients with 2 or more lymph node metastasis, which was signifi- cantly lower than those without lymph node metastasis, the 5-year OS was 79.33% [19]. A retrospective study by Zhu et al. showed a neg- ative correlation between the number of lymph node metastasis and the survival rate of patients [20]. Therefore, after radical surgery, attention should be paid on patients with lymph node metastasis, and postoperative radiother- apy and chemotherapy was an effective strate- gy to reduce the recurrence and metastasis of cervical cancer and improve the long-term survival.
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Original Article Analysis of survival-related factors in elderly patients following glioma operation

Original Article Analysis of survival-related factors in elderly patients following glioma operation

the lesions while minimizing the impact on brain function of patients [6]. In traditional craniotomy for brain glioma, positioning of the tumor and normal brain tissues mainly depends on the surgeon’s direct vision. However, the unclear operated area and the complex structure of brain tissues will affect the accurate identification. As a result, surgeons fail to com- pletely remove the diseased tissues during operation, or may even cause damage to normal tissues [7]. A study has confirmed that exces- sive brain tissue resection will lead to brain dysfunction and neurological impair- ment in patients, and seri- ous sequelae may be left even if the patients undergo operation successfully [8]. Microsurgical treatment can accurately excise the tumor under the microscope while minimizing the exposure and damage to normal brain tissues, so it has a higher safety [9]. However, current studies and reports have shown that the postopera- tive survival rate of patients with glioma is low with un- satisfactory prognosis [10]. In this study, the 1-, 2- and 3-year survival rates of pa- tients were 81.41%, 63.46% and 33.97%, respectively, indicating that the long-term survival rate of patients is low after operation. There- fore, understanding relevant factors affecting the postop- erative prognosis of patients and making appropriate intervention measures have important clinical value in improving the postoperative survival rate of patients. Figure 7. The effect of de-
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The epidemiology of herpes zoster and its complications in Medicare cancer patients

The epidemiology of herpes zoster and its complications in Medicare cancer patients

Results from the analysis of risk factor for HZ are pre- sented in Table 3. Age, gender, race, and immunocompro- mising conditions and/or medications were statistically significant risk factors for HZ. Conditional on cancer sta- tus, estimates from the sample that included hematologic cancer patients indicate that patients 75 to 85 years old ran a higher risk of developing HZ compared with patients ≥85 years (IRR = 1.12, p < 0.001). Males were at lower risk of developing HZ than females (IRR = 0.83, p < 0.001). Black patients were less likely to develop HZ than white patients (IRR = 0.64, p < 0.001). Patients who had immu- nocompromising conditions other than HIV ran a higher risk of developing HZ (IRR = 1.25, p < 0.001). Finally, re- ceipt of autologous or allogeneic stem cell transplants was associated with a higher risk of developing HZ (IRRs of 2.07, p < 0.001; and 1.92, p = 0.024, respectively). Results from the sample that included solid cancer patients were largely similar. Radiotherapy recipients ran a slightly lower risk of developing HZ compared to solid cancer patients who did not receive radiotherapy (IRR = 0.94, p < 0.001) while patients with stage III/IV cancer at diagnosis ran a higher risk of developing HZ (IRR = 1.20, p < 0.001).
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Original Article Genome-wide analysis of differential methylation in pancreatic cancer

Original Article Genome-wide analysis of differential methylation in pancreatic cancer

Abstract: Pancreatic cancer as a fatal malignant tumor is difficult in diagnosis and treatment. Effective biomarkers are demanded in clinical practice. Up to now, there is little known about the DNA methylation signatures across the whole genome scale in pancreatic cancer. In this study, comparison of differential mathylation sites was performed between pancreatic cancer tissues and pericarcinous tissues using Infinium Human Methylation 450 Beadchips. A total of 24,417 CpG sites representing 9,589 genes were identified between two cohorts. Of the 24,417 CpG sites, 14,721 (60%, 14,721 of 24,417) CpG sites were hypomethylated and 9,705 (40%, 9,705 of 24,417) CpG sites were hypermethylated. GO (Gene Ontology) and KEGG analysis were implemented to systematically characterize the significant differential methylated genes between pancreatic cancer tissues and pericarcinous tissues. In addition, we further screened 51 genes with aberrant methylation, which were the most likely candidate methylation markers within the scale of global differential methylation profiling. GO and KEGG analysis indicated these genes owning a wide range of functions. The identification of differential methylated genes in this study provides information valu- able to the in-depth study of pancreatic cancer.
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Risk Factors and Complications of Acute Ischaemic Stroke Patients at Hospital Universiti Kebangsaan Malaysia (HUKM)

Risk Factors and Complications of Acute Ischaemic Stroke Patients at Hospital Universiti Kebangsaan Malaysia (HUKM)

Risk Factors and Complications of Acute Ischaemic Stroke Patients at Hospital Universiti Kebangsaan Malaysia (HUKM) ORIGINAL ARTICLE Risk Factors and Complications of Acute Ischaemic Stroke Patients'[.]

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Original Article Analysis of high-risk factors and effect of early intervention on preterm infant neurodevelopment

Original Article Analysis of high-risk factors and effect of early intervention on preterm infant neurodevelopment

Another fundamental question is whether these children would benefit from being identi- fied earlier and receiving specific, early inter- vention. Various early intervention (EI) strate- gies have been developed to improve long-term outcomes. Fredrik Serenius observed 1,011 infants born before 27 completed gestational weeks, and found that among children born extremely preterm and receiving active perina- tal care, 73% of them had mild or no disability, and neurodevelopmental outcome improved with each week of gestational age [8]. In ano- ther study, Arne Ohlsson assessed the effec- tiveness of the Newborn Individualized Deve- lopmental Care and Assessment Program (NIDCAP) through a systematic review and meta-analyses of randomized controlled trials that included 627 preterm infants; and revealed that there was no evidence to prove that NIDCAP improved long-term neurodevelopmen- tal or short-term medical outcomes [9]. Hence, in this study, we analyzed 1,337 pre- term infants at the prenatal, perinatal and post- natal periods to determine the relationship between certain potential risk factors and the incidence of abnormal neurodevelopmental outcomes. At the same time, we focused on the role of early intervention on the neurodevelop- mental outcome of preterm infants with certain risk factors to provide precise evidence for the promotion of the neurodevelopment of preterm infants.
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Toward the precision breast cancer survival prediction utilizing combined whole genome-wide expression and somatic mutation analysis

Toward the precision breast cancer survival prediction utilizing combined whole genome-wide expression and somatic mutation analysis

Breast cancer is the most commonly occurring female cancer in developed countries. Over 40,000 breast can- cer deaths and approximately 250,000 new cases were reported in 2016 [1]. The survival rate in HER2+ breast cancer patients [2] has been remarkably increased through targeted therapies including tyrosine kinase in- hibitors. Adjuvant treatments such as chemotherapy also improved the 5-year survival rate of the breast patients [3, 4]. However, the significant side effects of chemother- apy can shorten the lifespan of cancer patients in some cases [5]. Additionally, due to potential metastasis and invasion of cancer, the overall outcome for breast cancer patients remains bleak. An effective survival predictor, which is capable of helping cancer treatment and fore- seeing the clinical outcomes, can improve life quality and lifespan of cancer patients. Thus, better prognostic biomarkers of survival risk prediction are needed.
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Maternal and neonatal risk factors for early-onset group B streptococcal disease: a case control study

Maternal and neonatal risk factors for early-onset group B streptococcal disease: a case control study

Results: A total of 99 cases and 200 controls were included. The majority of cases presented in the first 72 hours of life (62/99 [63.9%]), of which 87/99 (89.7%) had at least one clinical risk factor for the development of EOGBS disease. Mothers of neonates with EOGBS disease were more likely to have GBS bacteriuria (odds ratio [OR] 10.76, 95% confidence interval [CI] 1.24–93.42), infection in the peripartum period (OR 8.92, CI 2.87–27.68), and tem- perature $38°C (OR 7.10, CI 2.50–20.17). GBS disease was associated with premature rupture of membranes and fetal tachycardia (P,0.01 for both). Neonates with EOGBS disease were more likely to have respiratory distress disease and convulsions, require tube feeding, and have longer hospital stays compared with the controls (P,0.01 for all). Stepwise multiple logistic regression has identified three risk factors that were associated with the highest tendency for the development of EOGBS disease. These were lack of antenatal attendance (OR =0.30 and CI 0.98–0.88), rupture of membranes (OR =9.62 and CI 3.1–29.4), and antibiotic use in labor (OR =0.16 and CI 0.38–0.67).
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As the bell tolls: a foundation study on pancreatic cancer consumer's research priorities

As the bell tolls: a foundation study on pancreatic cancer consumer's research priorities

The ethical and practical issues of inquiries with people with advanced cancer need to be carefully planned and appropriate safeguards implemented. Facilitated tele- phone discussion groups supported by trained counsel- lors allowed us to reliably and suitably canvass the views of a highly vulnerable consumer group. The approach provided PC patients and carers the opportunity to become involved in the research priority-setting process in a manner that created minimal disruption to their lives, and took into account varying levels of pain, mobility and psychological distress. It was a welcomed opportunity for these groups to express their needs in terms of research. One of the difficulties of engaging PC consumers in research is the relatively short time between disease diag- nosis and death. Time-economy was a fundamental con- sideration in the planning and implementation of the current research. PC develops and spreads silently, and closes in swiftly. Engaging with people who suffer from this highly lethal, time limited disease is challenging as there is often only a small window of opportunity availa- ble. Capturing those affected early via established mecha- nisms such as targeted projects, patient advice lines or clinician referrals are likely to be the best avenues to pro- vide those interested with the opportunity for research involvement.
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