Background: Evidence suggests that cancer patients with increased travel burden to treatment centers may have limited treatment options. Purpose: To investigate the association between travel distance to a treatment f...Background: Evidence suggests that cancer patients with increased travel burden to treatment centers may have limited treatment options. Purpose: To investigate the association between travel distance to a treatment facility and initial treatment choice among young men with low-risk prostate cancer in a rural state. Methods: A retrospective medical charts review was conducted of young men (65 years or younger) newly diagnosed with low-risk prostate cancer from January 1, 2005 through December 31, 2014 who were treated with either active surveillance, radical prostatectomy, or brachytherapy at either of the two major hospital systems in Bismarck, ND, USA. Results: Information on a random sample of 242 patients was studied. The majority of patients (66%) received radical prostatectomy. Patients who received radical prostatectomy were significantly younger (p-value 0.001). PSA at diagnosis, clinical stage, and Gleason score were not associated with treatment choice (p-value = 0.06;p-value = 0.1794;and p-value = 1.00;respectively). Adjusting for age at diagnosis, PSA at diagnosis, and treatment facility, treatment choice was not associated with travel distance (p-value = 0.309). Patients treated at St. Alexius facility were more likely to undergo radical prostatectomy than Sanford health patients (p-value Conclusions: We found no association between travel distance and treatment choice for low-risk prostate cancer. Treatment choice was associated with institution which may suggest institutional bias in patterns of care.展开更多
Background: Trauma is major public health problem in developing countries where they are associated with many factors, mainly such as lack of road safety, poverty and inadequate urban planning. We aim to highlight the...Background: Trauma is major public health problem in developing countries where they are associated with many factors, mainly such as lack of road safety, poverty and inadequate urban planning. We aim to highlight the epidemiology of the fractures limbs bones in a rural area where people live in a context of low economy, low education and insecurity. Methods: We conducted a cross-sectional, retrospective study involving all patients admitted for fracture in the surgical department of FOMULAC-KATANA General Reference Hospital from 1<sup>st</sup> January 2011 to 31<sup>st</sup> December 2014. The patients whose medical records were not completed were excluded. Results: Among 136 patients included in our study, 140 bones limbs were registered. Most of them (60.1%) were aged between 15 - 44 years and the average age is 30, 1 year. Male predominance is noticed (72.8%) with a male/female ratio of 2.7/1, and informal professionals are the most found in our patients (67.6%). The main circumstances of fracture occurrence are, respectively, road traffic accidents (57.4%), falls (22.3%) and firearms (10.3%). The leg bones (33.6%) and forearm bones (20%) are the most concerned bones. Open fractures are recorded in 40.7% of patients. The supporting treatment is mainly orthopedic (64.5%) but also surgical (35.5). The mortality rate is 3.6%. Conclusion: The fractures of the limbs bones in Katana General Reference Hospital mainly affect young male which is informal professional. The road traffic accidents are the first circumstance leading to fractures followed by falls. The leg bones are the most fractured body part and fractures are commonly opened.展开更多
文摘Background: Evidence suggests that cancer patients with increased travel burden to treatment centers may have limited treatment options. Purpose: To investigate the association between travel distance to a treatment facility and initial treatment choice among young men with low-risk prostate cancer in a rural state. Methods: A retrospective medical charts review was conducted of young men (65 years or younger) newly diagnosed with low-risk prostate cancer from January 1, 2005 through December 31, 2014 who were treated with either active surveillance, radical prostatectomy, or brachytherapy at either of the two major hospital systems in Bismarck, ND, USA. Results: Information on a random sample of 242 patients was studied. The majority of patients (66%) received radical prostatectomy. Patients who received radical prostatectomy were significantly younger (p-value 0.001). PSA at diagnosis, clinical stage, and Gleason score were not associated with treatment choice (p-value = 0.06;p-value = 0.1794;and p-value = 1.00;respectively). Adjusting for age at diagnosis, PSA at diagnosis, and treatment facility, treatment choice was not associated with travel distance (p-value = 0.309). Patients treated at St. Alexius facility were more likely to undergo radical prostatectomy than Sanford health patients (p-value Conclusions: We found no association between travel distance and treatment choice for low-risk prostate cancer. Treatment choice was associated with institution which may suggest institutional bias in patterns of care.
文摘Background: Trauma is major public health problem in developing countries where they are associated with many factors, mainly such as lack of road safety, poverty and inadequate urban planning. We aim to highlight the epidemiology of the fractures limbs bones in a rural area where people live in a context of low economy, low education and insecurity. Methods: We conducted a cross-sectional, retrospective study involving all patients admitted for fracture in the surgical department of FOMULAC-KATANA General Reference Hospital from 1<sup>st</sup> January 2011 to 31<sup>st</sup> December 2014. The patients whose medical records were not completed were excluded. Results: Among 136 patients included in our study, 140 bones limbs were registered. Most of them (60.1%) were aged between 15 - 44 years and the average age is 30, 1 year. Male predominance is noticed (72.8%) with a male/female ratio of 2.7/1, and informal professionals are the most found in our patients (67.6%). The main circumstances of fracture occurrence are, respectively, road traffic accidents (57.4%), falls (22.3%) and firearms (10.3%). The leg bones (33.6%) and forearm bones (20%) are the most concerned bones. Open fractures are recorded in 40.7% of patients. The supporting treatment is mainly orthopedic (64.5%) but also surgical (35.5). The mortality rate is 3.6%. Conclusion: The fractures of the limbs bones in Katana General Reference Hospital mainly affect young male which is informal professional. The road traffic accidents are the first circumstance leading to fractures followed by falls. The leg bones are the most fractured body part and fractures are commonly opened.
基金教育部"新世纪优秀人才支持计划"(NCET-07-0668NCET-08-0451)+6 种基金教育部长江学者和创新团队发展计划(IRT0855)国家自然科学基金(7067108371071128)教育部留学回国人员科研启动基金霍英东教育基金会高等院校青年教师基金基础性研究课题(121093)美国Santa Fe Institute国际项目基金斯坦福大学联合资助项目等项目资助
