AIM: To evaluate the prevalence and characteristics of colorectal adenoma and carcinoma in an inner city Hispanic population.METHODS: We reviewed the reports of 1628 Hispanic patients who underwent colonoscopy at Howa...AIM: To evaluate the prevalence and characteristics of colorectal adenoma and carcinoma in an inner city Hispanic population.METHODS: We reviewed the reports of 1628 Hispanic patients who underwent colonoscopy at Howard University from 2000 to 2010. Advanced adenoma was defined as adenoma ≥ 1 cm in size,adenomas with villous histology,high grade dysplasia and/or invasive cancer. Statistical analysis was performed using χ2 statistics and t-test.RESULTS: The median age of the patients was 54 years,64.2% were females. Polyps were observed in 489(30.0%) of patients. Adenoma prevalence was 16.8%(n = 273),advanced adenoma 2.4%(n = 39),and colorectal cancer 0.4%(n = 7). Hyperplastic polyps were seen in 6.6% of the cohort(n = 107). Adenomas predominantly exhibited a proximal colonic distribution(53.7%,n = 144); while hyperplastic polyps were mostly located in the distal colon(70%,n = 75). Among 11.7%(n = 191) patients who underwent screening colonoscopy,the prevalence of colorectal lesions was 21.4% adenoma,2.6% advanced adenoma; and 8.3% hyperplastic polyps.CONCLUSION: Our data showed low colorectal cancer prevalence among Hispanics in the Washington DC area. However,the pre-neoplastic pattern of colonic lesions in Hispanics likely points toward a shift in this population that needs to be monitored closely through large epidemiological studies.展开更多
BACKGROUND The coronavirus disease 2019(COVID-19)disproportionately affected African Americans(AA)and Hispanics(HSP).AIM To analyze the significant effectors of outcome in African American patient population and make ...BACKGROUND The coronavirus disease 2019(COVID-19)disproportionately affected African Americans(AA)and Hispanics(HSP).AIM To analyze the significant effectors of outcome in African American patient population and make special emphasis on gastrointestinal(GI)symptoms,laboratory values and comorbidities METHODS We retrospectively evaluated the medical records of 386 COVID-19 positive patients admitted at Howard University Hospital between March and May 2020.We assessed the symptoms,including the GI manifestations,comorbidities,and mortality,using logistic regression analysis.RESULTS Of these 386 COVID-19 positive patients,257(63.7%)were AAs,102(25.3%)HSP,and 26(6.45%)Whites.There were 257(63.7%)AA,102(25.3%)HSP,26(6.45%)Whites.The mean age was 55.6 years(SD=18.5).However,the mean age of HSP was the lowest(43.7 years vs 61.2 for Whites vs 60 for AAs).The mortality rate was highest among the AAs(20.6%)and lowest among HSP(6.9%).Patients with shortness of breath(SOB)(OR2=3.64,CI=1.73-7.65)and elevated AST(OR2=8.01,CI=3.79-16.9)elevated Procalcitonin(OR2=8.27,CI=3.95-17.3),AST(OR2=8.01,CI=3.79-16.9),ferritin(OR2=2.69,CI=1.24-5.82),and Lymphopenia(OR2=2.77,CI=1.41-5.45)had a high mortality rate.Cough and fever were common but unrelated to the outcome.Hypertension and diabetes mellitus were the most common comorbidities.Glucocorticoid treatment was associated with higher mortality(OR2=5.40,CI=2.72-10.7).Diarrhea was prevalent(18.8%),and GI symptoms did not affect the outcome.CONCLUSION African Americans in our study had the highest mortality as they consisted of an older population and comorbidities.Age is the most important factor along with SOB in determining the mortality rate.Overall,elevated liver enzymes,ferritin,procalcitonin and C-reactive protein were associated with poor prognosis.GI symptoms did not affect the outcome.Glucocorticoids should be used judiciously,considering the poor outcomes associated with it.Attention should also be paid to monitor liver function during COVID-19,especially in AA and HSP patients with higher disease severity.展开更多
Multi-speed economic recovery,with risksThe scale of U.S.fiscal stimulus and the speed of vaccine rollout have significantly lifted global economic prospects.We raise our 2021 global growth forecast to 5.7%from 4.8%.G...Multi-speed economic recovery,with risksThe scale of U.S.fiscal stimulus and the speed of vaccine rollout have significantly lifted global economic prospects.We raise our 2021 global growth forecast to 5.7%from 4.8%.Growth optimism has driven markets since we made our initial forecast in December of 2020,contributing to commodity gains and new infla-tion concerns.However,we maintain a cautious outlook given the uneven nature of the economic recovery.展开更多
We examine whether business groups' influence on cash holdings depends on ownership. Group affiliation can increase firms' agency costs or benefit firms by providing an internal capital market, especially in t...We examine whether business groups' influence on cash holdings depends on ownership. Group affiliation can increase firms' agency costs or benefit firms by providing an internal capital market, especially in transition economies characterized by weak investor protection and difficult external capital acquisition. A hand-collected dataset of Chinese firms reveals that group affiliation decreases cash holdings, alleviating the free-cash-flow problem of agency costs.State ownership and control of listed firms moderate this benefit, which is more pronounced when the financial market is less liquid. Group affiliation facilitates related-party transactions, increases debt capacity and decreases investmentcash-flow sensitivity and overinvestment. In transitional economies, privately controlled firms are more likely to benefit from group affiliation than statecontrolled firms propped up by the government.展开更多
文摘AIM: To evaluate the prevalence and characteristics of colorectal adenoma and carcinoma in an inner city Hispanic population.METHODS: We reviewed the reports of 1628 Hispanic patients who underwent colonoscopy at Howard University from 2000 to 2010. Advanced adenoma was defined as adenoma ≥ 1 cm in size,adenomas with villous histology,high grade dysplasia and/or invasive cancer. Statistical analysis was performed using χ2 statistics and t-test.RESULTS: The median age of the patients was 54 years,64.2% were females. Polyps were observed in 489(30.0%) of patients. Adenoma prevalence was 16.8%(n = 273),advanced adenoma 2.4%(n = 39),and colorectal cancer 0.4%(n = 7). Hyperplastic polyps were seen in 6.6% of the cohort(n = 107). Adenomas predominantly exhibited a proximal colonic distribution(53.7%,n = 144); while hyperplastic polyps were mostly located in the distal colon(70%,n = 75). Among 11.7%(n = 191) patients who underwent screening colonoscopy,the prevalence of colorectal lesions was 21.4% adenoma,2.6% advanced adenoma; and 8.3% hyperplastic polyps.CONCLUSION: Our data showed low colorectal cancer prevalence among Hispanics in the Washington DC area. However,the pre-neoplastic pattern of colonic lesions in Hispanics likely points toward a shift in this population that needs to be monitored closely through large epidemiological studies.
基金the National Institute on Minority Health and Health Disparities of the National Institutes of Health,No.G12MD007597.
文摘BACKGROUND The coronavirus disease 2019(COVID-19)disproportionately affected African Americans(AA)and Hispanics(HSP).AIM To analyze the significant effectors of outcome in African American patient population and make special emphasis on gastrointestinal(GI)symptoms,laboratory values and comorbidities METHODS We retrospectively evaluated the medical records of 386 COVID-19 positive patients admitted at Howard University Hospital between March and May 2020.We assessed the symptoms,including the GI manifestations,comorbidities,and mortality,using logistic regression analysis.RESULTS Of these 386 COVID-19 positive patients,257(63.7%)were AAs,102(25.3%)HSP,and 26(6.45%)Whites.There were 257(63.7%)AA,102(25.3%)HSP,26(6.45%)Whites.The mean age was 55.6 years(SD=18.5).However,the mean age of HSP was the lowest(43.7 years vs 61.2 for Whites vs 60 for AAs).The mortality rate was highest among the AAs(20.6%)and lowest among HSP(6.9%).Patients with shortness of breath(SOB)(OR2=3.64,CI=1.73-7.65)and elevated AST(OR2=8.01,CI=3.79-16.9)elevated Procalcitonin(OR2=8.27,CI=3.95-17.3),AST(OR2=8.01,CI=3.79-16.9),ferritin(OR2=2.69,CI=1.24-5.82),and Lymphopenia(OR2=2.77,CI=1.41-5.45)had a high mortality rate.Cough and fever were common but unrelated to the outcome.Hypertension and diabetes mellitus were the most common comorbidities.Glucocorticoid treatment was associated with higher mortality(OR2=5.40,CI=2.72-10.7).Diarrhea was prevalent(18.8%),and GI symptoms did not affect the outcome.CONCLUSION African Americans in our study had the highest mortality as they consisted of an older population and comorbidities.Age is the most important factor along with SOB in determining the mortality rate.Overall,elevated liver enzymes,ferritin,procalcitonin and C-reactive protein were associated with poor prognosis.GI symptoms did not affect the outcome.Glucocorticoids should be used judiciously,considering the poor outcomes associated with it.Attention should also be paid to monitor liver function during COVID-19,especially in AA and HSP patients with higher disease severity.
文摘Multi-speed economic recovery,with risksThe scale of U.S.fiscal stimulus and the speed of vaccine rollout have significantly lifted global economic prospects.We raise our 2021 global growth forecast to 5.7%from 4.8%.Growth optimism has driven markets since we made our initial forecast in December of 2020,contributing to commodity gains and new infla-tion concerns.However,we maintain a cautious outlook given the uneven nature of the economic recovery.
基金financial support from the National Natural Science Foundation of China (Project No. 71402005)Social Science Foundation of Beijing (Project No. 15JGC155)
文摘We examine whether business groups' influence on cash holdings depends on ownership. Group affiliation can increase firms' agency costs or benefit firms by providing an internal capital market, especially in transition economies characterized by weak investor protection and difficult external capital acquisition. A hand-collected dataset of Chinese firms reveals that group affiliation decreases cash holdings, alleviating the free-cash-flow problem of agency costs.State ownership and control of listed firms moderate this benefit, which is more pronounced when the financial market is less liquid. Group affiliation facilitates related-party transactions, increases debt capacity and decreases investmentcash-flow sensitivity and overinvestment. In transitional economies, privately controlled firms are more likely to benefit from group affiliation than statecontrolled firms propped up by the government.