Top PDF Attributable causes of esophageal cancer incidence and mortality in China.

Attributable causes of esophageal cancer incidence and mortality in China.

Attributable causes of esophageal cancer incidence and mortality in China.

obesity, tooth loss and poor oral health, and consumption of hot drinks. BMI has been inversely associated with esophageal squamous cell carcinoma in various countries, including China [35]. At least two prospective studies in China have also shown that tooth loss increases risk of developing upper gastrointestinal cancers [36,37]. And in the Golestan Case-Control Study in Iran, drinking hot and very hot tea were associated with 2-fold and 8- fold elevated risks of esophageal cancer, respectively [38]. Therefore, there is a need for additional studies to evaluate the contribution of these and other risk factors to the burden of esophageal cancer in China. Second, there were some sources of uncertainty in the relative risks we used in making our PAF estimates. The RRs of alcohol drinking and of low vegetable and fruit intake were obtained from meta-analyses, and some of the original studies included in these meta-analyses may not have been adjusted for confounding factors. Moreover, the RRs of low vegetable and fruit intake were derived from non-Chinese Asian studies, and there was uncertainty in the extrapolation of these RR to the Chinese population. It was difficult to evaluate the direction and potential magnitude of these potential biases. Also, RRs in men were used for both genders because of a lack of available data among women or the statistical instability of risk estimates in women, but RRs for men and women might be different. Third, we were not able to collect information on the amount and duration of smoking or alcohol drinking in the Chinese population at large, and epidemiological studies have demonstrated that these variables are important to fully assess the impact of these exposures on esophageal cancer [39,40]. Fourth, we did not adjust our estimates of PAF for the possible interaction because too little data are available in studies from China to provide valid estimates of the ORs of interaction between different risk factors. Finally, another potential limitation was the lack of measured esophageal cancer incidence data in China, which meant that we had to estimate these numbers from mortality data and a mortality- to-incidence ratio. This M/I ratio was calculated by Poisson regression models, adjusted for age, gender and cancer registry site, but it was not adjusted for other relevant factors such as socioeconomic status because of a lack of available data.
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Arq. Gastroenterol.  vol.53 número1

Arq. Gastroenterol. vol.53 número1

Given the important participation of esophageal cancer in incidence and mortality rates and the observed changes regarding the prevalence of EA, this study aims to describe both clinically and epidemiologically the population of pa- tients with diagnosis of EC treated in a quaternary attention institute for cancer from January, 2009 to December, 2011, in Sao Paulo, Brazil, in order to establish a proile of these patients and compare it with data of other services.
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Association between Postoperatively Developed Atrial Fibrillation and Long-Term Mortality after Esophagectomy in Esophageal Cancer Patients: An Observational Study.

Association between Postoperatively Developed Atrial Fibrillation and Long-Term Mortality after Esophagectomy in Esophageal Cancer Patients: An Observational Study.

the atrial excitation waveform [25,26]. The use of preoperative CCB medication also showed an unfavourable effect on the development of AF after esophagectomy in the present study. Dihydropyridine, a type of CCB that exclusively acts on the vasculature, results in vasodilation. The harmful effects of preoperative CCB medication on the development of AF observed in our present analysis might be partly attributable to the prevalent use of dihydropyridine-type CCBs, although we did not confirm this due to the lack of data in the postoperative period. Eso- phagectomy is usually a long surgery, and is often accompanied by unstable hemodynamics. Patients who receive preoperative dihydropyridine-type CCBs might be at a greater risk of developing hypotensive events. To resolve this promptly, fluid might be administered quickly, and thereafter, acute atrial dilation, which is a mechanism associated with the development of AF [27,28], might follow. Our results suggest that the CCB medication might be considered to be discontinued before esophagectomy, and if necessary, vasopressor should be considered to be administered to reverse hypotension during surgery in patients who had been taking CCB medication, especially for elderly patients.
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Socio-demographic and geographical factors in esophageal and gastric cancer mortality in Sweden.

Socio-demographic and geographical factors in esophageal and gastric cancer mortality in Sweden.

These lifestyle risk factors are more common among individuals in low socioeconomic positions. However, the construct of social stratification in society is of public health importance, and these lifestyle factors could be regarded as being mediating factors on the pathway from social adversity to development of cancer. Hence, if regarded as mediating factors they should not be adjusted for. Factors related to survival from these cancers, like tumor stage, treatment and co –morbidities, would confound the analyses to a very little extent as the mortality in these cancers is very high and the cancer is thus recorded as the cause of death. Thirdly, and finally, the Causes of Death Register contains no information on histological type of the tumors and cannot differentiate between adenocarcinoma and squamous cell carci- noma of the esophagus. With regard to known socio-demographic risk factors, they are however very similar between these two types of esophageal cancer.[8–11]
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Knowledge about cervical cancer and barriers of screening program among women in Wufeng County, a high-incidence region of cervical cancer in China.

Knowledge about cervical cancer and barriers of screening program among women in Wufeng County, a high-incidence region of cervical cancer in China.

This is the first study to provide insight into the factors that affect women’s participation in cervical cancer screenings in rural areas of China. The study showed that women in rural areas lacked knowledge about cervical cancer and the importance of cervical screening for early cancer diagnosis. Cervical cancer education is needed to provide accurate information and to raise public awareness about cervical cancer screenings. Health providers should assume an active role in the provision of appropriate information about the importance of screenings to women’s health. This study draws our attention to the fact that the provision of knowledge about cervical cancer could reduce the anxiety and stigma associated with screenings and thus encourage participation. However, not all women who are willing to participate in screenings actually do participate in them. In-depth interviews are also warranted to determine how women’s willingness transfers to actual participation in screenings [29,30].
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The Impact of E-Commerce Securi ty, and National Environment  on Consumer adoption of Intern et Banking in Malaysia and  Singapore

The Impact of E-Commerce Securi ty, and National Environment on Consumer adoption of Intern et Banking in Malaysia and Singapore

The research model is designed to examine the impact of customers’ perception of e- commerce security, and national environmental factors on their acceptance of Internet banking in Malaysia and Singapore. Several models have been used to explain factors determining consumer acceptance of Internet banking (Straub et. al., 1997; Liao et. al., 1999; Sathye, 1999; Tan & Teo, 2000; Pavlou, 2003; Suh & Han, 2003; Brown et. al., 2003; Venkatesh et. al., 2003). For example: technology acceptance model (TAM) devices by Davis (1986) was used by Suh and Han (2003). According to Suh and Han (2003), one of the most widely used models for explaining the factors that affects user acceptance of information systems or information technology is TAM. Another model is Fishbein and Ajzen’s (1989) theory of reasoned action (TRA), which is based on Davis’s (1986) technology acceptance model (TAM). TRA model asserts that attitude towards a behavior is determined by relevant beliefs (Davis et. al., 1989). Other theories are the theory of planned behavior (TPB), the decomposed theory of planned behavior (DTPB) by Taylor and Todd (1995) and the diffusion of innovation theory, Rogers (1983). The decomposed TPB model, according to Tan and Teo (2000), uses constructs from the innovation literature such as relative advantage, compatibility, subjective norms, and perceived behavioral control by decomposing them into more specific dimensions. While, Venkatesh et. al.’s (2003) unified theory of acceptance and use of technology (UTAUT) on the other hand posits four core determinants (performance expectancy, effort expectancy, social influence and facilitating condition) and four moderators (gender, age, experience and voluntariness of use) of the key relationships of intention and usage of information technology.
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Explicit and implicit approach of sensitivity analysis in numerical modelling of solidification

Explicit and implicit approach of sensitivity analysis in numerical modelling of solidification

Keywords: Application of Information Technology to the Foundry Industry: Solidification Process: Numerical Tcchniqucs: Sensitivity Analysis; Borzndary Elcmcnt Mcthod.. Introd[r]

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Sao Paulo Med. J.  vol.120 número6

Sao Paulo Med. J. vol.120 número6

the survival for the general population of the city of São Paulo because of the sources of their cases, i.e. two hospitals that treat patients from the highest social stratum of the population. Such a variable may have important implica- tions on cancer survival, since this population has easier ac- cess to healthcare and those hospitals are renowned for their highly differentiated healthcare quality.

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Synthesis of nanoparticeles in ductile iron with small additions of vanadium and niobium and its mechanical properties

Synthesis of nanoparticeles in ductile iron with small additions of vanadium and niobium and its mechanical properties

Ductile iron is a modern construction material and offers wide range of mechanical properties with simultaneous high wear resistance and dumping capacity [1]. From foundry practice result that in many cases production of ductile iron ensure fulfillment the Standard regarding tensile strength as well as elongation but not always yield strength archives required value. Investigations enabling affirm whether the foregoing problem can be resolve by means of small additions of vanadium, niobium and nitrogen and heat treatment are the aim of this work.
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Hospital-acquired infections: a cost estimation for CLABSI in Portugal

Hospital-acquired infections: a cost estimation for CLABSI in Portugal

This inefficiently used resources are even larger since they should this study did not account for all costs attributable to the morbidity (in particular none of the indirect costs). The public insurer should consider this waste of resources as a potential gain in efficiency of provision. In order to achieve a higher level of production, respecting the current financial constraints, different approaches are possible: positive (negative) trends may be prized (punished); or prevention campaigns financed. A new remuneration system may take into account the progress in the preventable HAIs’ control, incentivizing the progressive reduction of this morbidity or penalizing the increase of the same. If this is the case, the provider may create negative incentive: such as misreporting the onset of nosocomial infections (by reporting community infections); preventive over-administration of antibiotics or selection of less at- risk patients. 30 These incentive scheme would be applicable only if accounting mechanisms are feasible: if physicians’ behavior is verifiable. By financing prevention campaigns, the
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Arq. Gastroenterol.  vol.46 número4

Arq. Gastroenterol. vol.46 número4

ABSTRACT – Context - Although endoscopic esophageal variceal sclerotherapy has been largely supplanted by variceal band ligation, it is still performed routinely in many institutions, especially in developing countries. Intramural esophageal hematoma has been described as a rare complication of sclerotherapy. Risk factors have not been completely established. Objective - To demonstrate the incidence of post-sclerotherapy intramural esophageal hematoma in our hospital and discuss the possible factors involved. Methods - This is a retrospective observational study made at the “Hospital Universitário Clementino Fraga Filho”, Rio de Janeiro, RJ, Brazil, reviewing the medical records of all esophageal variceal sclerotherapy procedures performed from April 2000 to November 2005. The evaluation of the clinical, laboratorial and endoscopic features in our patients and those reported in the literature was also done. Review of literature was performed through MEDLINE search. Results - A total of 1,433 esophageal variceal sclerotherapy procedures were performed in 397 patients, with an intramural esophageal hematoma incidence of 4 cases (0.28%). Three of our patients developed additional complications, and one death was a direct consequence of a rupture of the hematoma. Nineteen well described cases were reported in the literature. Intramural esophageal hematoma occurred mostly after the forth esophageal variceal sclerotherapy session. Coagulation disturbances were present in the majority of cases. Conclusion - Intramural esophageal hematoma is a rare complication of esophageal variceal sclerotherapy and its incidence in our institution was similar to those observed in the literature. Our study suggests that this complication occurs as a result of a fragile esophageal mucosa after previous esophageal variceal sclerotherapy sessions. Impaired coagulation, although not essential, could contribute to hematoma formation and extension through esophageal submucosa.
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Antiplatelet Therapy in Breast Cancer Patients Using Hormonal Therapy: Myths, Evidence and Potentialities – Systematic Review

Antiplatelet Therapy in Breast Cancer Patients Using Hormonal Therapy: Myths, Evidence and Potentialities – Systematic Review

Breast cancer is the most frequently diagnosed tumor in women worldwide, with a significant impact on morbidity and mortality. Chemotherapy and hormone therapy have significantly reduced mortality; however, the adverse effects are significant. Aspirin has been incorporated into clinical practice for over 100 years at a low cost, making it particularly attractive as a potential agent in breast cancer prevention and as an adjunct treatment to endocrine therapy in the prophylaxis of cardiovascular complications. The objective of this study was to evaluate the role of aspirin in reducing the incidence of breast cancer and to evaluate the impact of its use on morbidity and mortality and reduction of cardiovascular events as adjuvant therapy during breast cancer treatment with selective estrogen receptor modulators. A systematic review was performed using the PRISMA methodology and PICO criteria, based on the MEDLINE, EMBASE and LILACS databases. The original articles of clinical trials, cohort, case-control studies and meta-analyses published from January 1998 to June 2017, were considered. Most studies showed an association between the use of selective estrogen receptor modulators and the increase in thromboembolic events. The studies suggest a protective effect of aspirin for cardiovascular events during its concomitant use with selective estrogen receptor modulators and in the prevention of breast cancer. This systematic review suggests that aspirin therapy combines the benefit of protection against cardiovascular events with the potential reduction in breast cancer risk, and that the evaluation of the benefits of the interaction of endocrine therapy with aspirin should be further investigated.
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Trends in cervical cancer mortality in the Americas

Trends in cervical cancer mortality in the Americas

It is difficult to document the Moreover, an independent study on causes cervical cancer burden in the least- of mortality among Honduran women 15- developed geogr[r]

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Epidemiological and histopathological aspects of primary cutaneous melanoma in residents of Joinville, 2003-2014

Epidemiological and histopathological aspects of primary cutaneous melanoma in residents of Joinville, 2003-2014

Currently, despite the existence of a pioneering state com- pulsory cancer notification system (Sistema Estadual de Registro de Câncer no Estado de Santa Catarina – SISCAN), its database is un- fortunately incomplete due to underreporting of CM cases, mak- ing it impossible to conduct an actual population-based study. 35,36

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N-acetyltransferase 2 polymorphisms and risk of esophageal cancer in a Chinese population.

N-acetyltransferase 2 polymorphisms and risk of esophageal cancer in a Chinese population.

Previous case-control reports have yielded inconsistent results regarding the association of NAT2 SNPs with cancers, possibly because of the small number of subjects, which would compromise the power of the statistical analyses in these studies. In the esophagus, the slow NAT2 acetylator genotype was more susceptible to esophageal cancer in Japan [12]. However, in another study in Taiwan, NAT2 polymorphisms did not affect the risk of esophageal cancer, irrespective of environmental factors [13]. In a more recent study in India, NAT2 acetylator genotypes did not influence susceptibility to esophageal cancer. NAT2 polymorphisms did not significantly modulate the cancer risk after interaction with environmental factors, such as tobacco, alcohol or occupational exposure [14]. In another study in the Kashmir Valley, none of the three NAT2 polymorphic alleles (rs1799929, rs1799930 and rs1799931) was found to be indepen- dently associated with risk of esophageal and gastric cancers [15], which was also in accordance with our results. Meta analysis also suggested that NAT2 genotypes are not associated with lung cancer [16], gastric cancer [17], breast cancer [18], prostate cancer [19] and oral cancer [20]. NAT2 rs1565684 T.C is in linkage disequilibrium with another important SNP NAT2 rs4345600 A.G (NS 12, 29306 A.G) (r 2 = 0.845) in Chinese Han Beijing population. Although NAT2 rs1565684 T.C SNP is functional using SNP function prediction websites (http://snpinfo.niehs.nih. gov/snpinfo/snpfunc.htm and http://www.regulomedb.org/). The etiology of NAT2 rs1565684 T.C SNP is still not well known and need further investigation.
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Clinics  vol.63 número2

Clinics vol.63 número2

As already indicated by other authors, relative risks from the CPS II, used in the current paper, are also ques- tionable. The information found in CPS II is based on non- representative population samples, in which married, white, higher-income, and more educated individuals were over- represented, thus limiting the generalization of the results. It must be noted that these are national estimates, adjusted by age without accounting for other potential confounders like alcohol consumption, schooling, hypertension, and prevalence of diabetes mellitus. 33,34 However, in the absence
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	Field Cancerisation of the Upper Aerodigestive Tract: Screening for Second Primary Cancers of the Oesophagus in Cancer Survivors

Field Cancerisation of the Upper Aerodigestive Tract: Screening for Second Primary Cancers of the Oesophagus in Cancer Survivors

Tobacco, alcohol, and betel quid are the main causes of squamous cell cancers of the upper aerodigestive tract. These substances can cause multifocal carcinogenesis leading to multiple synchronous or metachronous cancers of the oesophagus, head and neck region, and lungs (‘ield cancerisation’). Globally there are several million people who have survived either head and neck squamous cell cancer (HNSCC) or lung cancer (LC). HNSCC and LC survivors are at increased risk of developing second primary malignancies, including second primary cancers of the oesophagus. The risk of second primary oesophageal squamous cell cancer (OSCC) ranges from 8-30% in HNSCC patients. LC and HNSCC survivors should be ofered endoscopic surveillance of the oesophagus. Lugol chromoendoscopy is the traditional and best evaluated screening method to detect early squamous cell neoplasias of the oesophagus. More recently, narrow band imaging combined with magnifying endoscopy has been established as an alternative screening method in Asia. Low-dose chest computed tomography (CT) is the best evidence- based screening technique to detect (second primary) LC and to reduce LC-related mortality. Low-dose chest CT screening is therefore recommended in OSCC, HNSCC, and LC survivors. In addition, OSCC survivors should undergo periodic pharyngolaryngoscopy for early detection of second primary HNSCC. Secondary prevention aims at quitting smoking, betel quid chewing, and alcohol consumption. As ield cancerisation involves the oesophagus, the bronchi, and the head and neck region, the patients at risk are best surveilled and managed by an interdisciplinary team.
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Epidemiology of acute myocardial infarction in Salvador, Brazil: Incidence, lethality, and mortality

Epidemiology of acute myocardial infarction in Salvador, Brazil: Incidence, lethality, and mortality

The purpose of the work being partially reported here was to define the role of acute myocardial in- farction as a health problem in the city of Salvador, Bahia, Br[r]

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Sudden death and cardiac arrest in marathon runners: incidence rates and causes

Sudden death and cardiac arrest in marathon runners: incidence rates and causes

Background: The marathon race is an aerobic sport that requires high training volume. Marathon runners may eventually be exposed to unfavorable environmental conditions associated with changes in blood volume and hydration level that may increase the risk of cardiac arrhythmias that can cause cardiac ar- rest and sudden death. Objective: To identify the existing life risks for marathon runners related to the occurrences of sudden death and cardiac arrest and the most prevalent causes of these events. Methods: Integrative literature review of descriptive-qualitative nature in the databases: Google, Academic Google, Medline, Scielo and Pubmed. Results: Sudden death incidence rates ranged from 0.58 to 2.0 per 100.000 runners while cardiac arrest rates ranged from 1.01 to 2.6 per 100.000 runners being men most suscepti- ble to these events. Among the causes of sudden death and cardiac arrest, studies indicate that in older athletes (age > 45 years) coronary artery disease (CAD) is the most prevalent and in younger athletes (age < 45 years) structural and congenital causes are the most common as hypertrophic cardiomyopathy. Most of the events of sudden death and cardiac arrest occurred in the last quartile of the race or after the finish line. Conclusion: The risks of sudden death and cardiac arrest in marathons are low and higher in men being coronary artery disease and hypertrophic cardiomyopathy the most prevalent causes of these events.
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Cancer incidence in eighteen cities of the State of São Paulo, Brazil

Cancer incidence in eighteen cities of the State of São Paulo, Brazil

when the likeness of genetic and environmental forces involved in cancer causation in both populations is taken into account. However, a closer look at the indi- vidual cities reveals that, for both sexes, in places such as Santos and Ribeirão Preto, the incidence was higher than for other state capital, while in others, such as Barretos, São José dos Campos, Santa Bárbara d’Oeste, São João da Boa Vista, and Itapeva, the incidence was lower than that for the city of São Paulo city. The higher incidence rates found in Santos and Ribeirão Preto could be explained by the higher availability of resources for cancer management in these two regional centers, at- tracting the population living in smaller neighboring towns, and resulting in an overestimation of rates, de- spite their relatively larger population size and the ef- forts to exclude non-residents. However, cities with simi- lar population sizes and good cancer management fa- cilities, such as São José dos Campos and Sorocaba, showed much lower rates. There is a need to find other explanations for the higher cancer incidence in Santos and Ribeirão Preto. Further exploratory studies with a broader geographic reach can contribute to that, rais- ing questions to be addressed in more detailed, risk factor-oriented local studies. 9
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