Search

This study documents the number of ambulatory visits associated with gastroesophageal reflux disease (GERD) in the United States. Sample data from nearly 80,000 patients captured by the National Ambulatory Medical Care Survey (NAMCS; 1998-2001) were analyzed. Basic demographics of patients with GERD and factors associated with each visit were assessed. Approximately 38.53 million of 2.653 billion adult outpatient visits made in the United States during the study period were GERD-related. GERD-related visits increased by 46.5% from 1998 to 2001. Most GERD-related visits were by women (54.7%) with an average age of 56.0 years, compared with patients without GERD, who were even more likely to be women (62.2%) and younger (52.6 years). Patients with GERD were more likely to have multiple reasons (50.5%) and multiple diagnoses (79.3%) per medical visit versus non-GERD patients (37.6% and 48.4%, respectively). Utilization of data from the NAMCS reveals that GERD-related visits increased annually during the study period. Patients with GERD are more likely to see a physician if they have concomitant medical conditions, making GERD a condition that is very likely untreated in a high percentage of individuals. [ABSTRACT FROM AUTHOR]

Discusses the surgical treatment of early-stage endometrial cancer in the U.S. Role of adjuvant radiation therapy; Standard treatment of endometrial cancer; Controversy on the management of endometrial cancer.

This cross-sectional study reports associations between anthropometric measures, serum antioxidant concentrations, and present diet with measures of elevated cell proliferation in 51 patients with Barrett's esophagus. Cell proliferation was assessed as fractions of cells in the S and G2 phases, measured in biopsies of Barrett's tissue and analyzed by DNA content flow cytometry. Elevated proportions in the S and G2 phases predict progression to adenocarcinoma. The percentage of cells in the S phase was positively associated with waist-to-hip ratio (r = 0.33, p <> . [ABSTRACT FROM AUTHOR]

Objectives. The purpose of this study was to examine whether youth participation in tobacco promotion campaigns is associated with susceptibility to tobacco use. Methods. Data were collected from telephone interviews of a national random sample of 1047 adolescents 12 to 17 years of age. Results. A proportional odds model was used to estimate the effects of age, gender, presence of a tobacco user in the household, awareness of tobacco promotions, knowledge of a young adult or adolescent friend owning a promotional item, participation in tobacco promotions, and receipt of free tobacco samples or direct mail from tobacco companies on susceptibility to tobacco use. All of the covariates, except for receiving direct mailings and knowing a young adult friend who owned a promotional item, were significantly associated with susceptibility. Conclusions. There is a strong association between an awareness of and involvement with tobacco promotions and being susceptible to tobacco use of a user of tobacco products. [ABSTRACT FROM AUTHOR]

The tobacco industry remains a formidable influence in thwarting tobacco control efforts, in pan because industry leaders have raised policymaker and public concern about how tobacco control might negatively impact tobacco farmers. In this study, we interviewed a random, stratified sample of 528 tobacco farmers in the Southeast and 991 U.S. residents about issues related to tobacco farmers. We found that a majority of the U.S. public expressed the belief that U.S. taxpayers subsidized tobacco farmers. This belief combined with the strong opposition to tobacco farmer subsidies (15 percent thought there should be subsidies), likely play a role in public attitudes toward tobacco farmers. At the same time, however, we found reasonably strong public support for efforts to help tobacco farmers transition to new enterprises, although the public underestimates tobacco farmer interest in diversification. For example, two of three Americans believe that the government should help farmers make a living other than growing tobacco and over half thought that taxpayers should help pay for such programs. These data illustrate potential common ground for elected officials to consider as they attempt to concomitantly address the needs of farmers and the interests of the public. Ultimately, if the interests of tobacco farmers can be made clearly to the general public, and vice versa, pro- health and pro -farmer policies might well become a reality [ABSTRACT FROM AUTHOR]

The article examines the developmental correlation of tobacco and alcohol use among elementary school children in the United States. Applied to the present study, the socialization model posits an inverse association between competence and the risk of early use of tobacco and alcohol. Although competence has been widely studied, and has been linked to risk behaviors among adolescents, the relation between competence and early substance use by children requires investigation. The researchers examine the association between competence and early use of tobacco and alcohol. The researchers hypothesize inverse associations between measures of children's personal, social, and academic competence and their risk of early use of alcohol and tobacco. The results of the study indicate that use of tobacco and alcohol during childhood has a strong inverse association with several measures of child competence, both self-reported and teacher rated. Early use was also inversely associated with perceived effective parenting and positively associated with parental modeling of use.

The authors present their thoughts on "Ovarian Cancers: Evolving Paradigms in Research and Care," a report from the U.S. National Academies of Sciences, Engineering, and Medicine that explores gaps in the evidence base of ovarian cancer research. They discuss the need for expanded screening and prevention research, stating that treatments should be standardized and disseminated.

Recently, ovarian cancer research has evolved considerably because of the emerging recognition that rather than a single disease, ovarian carcinomas comprise several different histotypes that vary by etiologic origin, risk factors, molecular profiles, therapeutic approaches and clinical outcome. Despite significant progress in our understanding of the etiologic heterogeneity of ovarian cancer, as well as important clinical advances, it remains the eighth most frequently diagnosed cancer in women worldwide and the most fatal gynecologic cancer. The International Agency for Research on Cancer and the United States National Cancer Institute jointly convened an expert panel on ovarian carcinoma to develop consensus research priorities based on evolving scientific discoveries. Expertise ranged from etiology, prevention, early detection, pathology, model systems, molecular characterization and treatment/clinical management. This report summarizes the current state of knowledge and highlights expert consensus on future directions to continue advancing etiologic, epidemiologic and prognostic research on ovarian carcinoma., (Published by Oxford University Press 2021.)

Background: Studies have consistently indicated that the majority of individuals meeting the US Prevention Services Task Force guidelines for genetic testing have not had genetic counseling or testing. Despite increased availability and lower costs of multiplex cancer gene panels, there remains a gap in genetics services that has not been addressed by the current care delivery models. Lower cost of DNA sequencing with online patient-initiated ordering could increase test availability, but the ideal quantity and delivery method of patient education is not known. We hypothesized that online genetic education and testing with access to board certified genetic counselors could improve access to genetic testing while maintaining test quality and clinical utility. The MAGENTA (MAking GENetic Testing Accessible) trial is a nationwide randomized study designed to compare the effectiveness of online genetic education with pre- and post-test telephone genetic counseling to three potentially more accessible alternative approaches: online genetic education with optional telephone counseling, online genetic education with required pre-test telephone genetic counseling, and online genetic education with required post-test telephone genetic counseling., Methods: 3000 women nationwide will undergo genetic testing for 19 hereditary cancer genes. This is a randomized four-arm non-inferiority study with equal randomization. The four study arms were selected to independently assess the delivery of genetic information both before and after genetic testing (pre-test and post-test) by either requiring telephone genetic counseling or providing only online education with optional telephone counseling. Patients have post-test telephone counseling when testing positive for a pathogenic inherited mutation in all four arms. Surveys measuring psychological, behavioral and cognitive state are completed online at baseline, 3 months, 12 months and 24 months post-results disclosure. The primary study outcome is cancer-risk distress at 3 months post-result disclosure., Discussion: This trial will assess the use of a genetic service model using online access and electronic education, while evaluating the need for personal pre- and post-test genetic counseling. Data from this study may lead to increased options for delivery of genetic testing and possibly increase access to genetic testing. Identifying more individuals with inherited cancer susceptibility will allow targeted cancer prevention., Trial Registration: Clinicaltrials.gov: NCT02993068 (registered December 14, 2016).