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  • Bortezomib (PS-341) In this meta analysis the correlation be

    2019-08-11

    In this meta-analysis, the correlation between the prevalence of H. pylori and the HDI was not significant. However, visual inspection of the graphic revealed a reduction in prevalence with the increase in income per capita, in seven studies. It is known that there is an association between worse sanitary conditions and low socioeconomic levels with high prevalence of H. pylori. [44] Despite these limitations, the present work traces an overview of H. pylori infection for LAC. The findings presented here indicate that the prevalence is high, in men and women, for all age groups. The findings presented evidence that the prevalence of H. pylori remained highin LAC and that an increase in the HDI did not reduce this prevalence. Effective actions are therefore required to reduce the prevalence of this agent in LAC.
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    Introduction Meningiomas are the most common central nervous system tumor with an incidence rate of 8.14/100,000 population from 2010 to 2014 in the United States [1]. Most meningiomas are benign, slow-growing, but with a consistent pattern of increasing incidence [2]. Meningiomas are classified based on morphologic criteria by the World Health Organization (WHO) into three groups (grade I-III) [3]. Tissue confirmation may be deferred in some patients, as meningiomas can be diagnosed by imaging [4,5], and are frequently diagnosed incidentally. In those cases, magnetic resonance imaging may be used to differentiate benign and atypical meningioma, based on tumor margins, edema, bone destruction, and Bortezomib (PS-341) coefficient [6,7]. Population-based studies estimate that around 90% are grade I (benign), 10% are grade II (borderline), and less than 3% are grade III (malignant) [1,8]. Treatment approaches for meningiomas include either observation alone, radiation alone, or surgical Bortezomib (PS-341) resection with or without radiation, and rarely, in cases with progression, a trial of systemic treatment, although there are no FDA approved therapies. Patients may be treated conservatively in small, asymptomatic tumors, whereas radiation therapy is reserved to prevent further growth in high grade lesions or in cases where a complete resection cannot be performed [9], with limited level 1 evidence on treatment recommendations. An early investigation using the National Cancer Database (NCDB) included cases from 1985 to 1988 and 1990 to 1992 [10]. Subsequent analyses of the NCDB focused on discussions of high-grade meningiomas [9,[11], [12], [13]] and limited their cohorts to patients with surgical or histological confirmation; these investigations may not be representative of treatment or decision estimates of all patients with diagnosis of meningioma. In addition, a recent NCDB analysis focused on grade I intracranial meningiomas that included cases without WHO grade as grade I [14]. Data on the accuracy of imaging alone in determining WHO grade is limited [6,7], and many of the patients without WHO grade reported may have had grade II or III disease, inconclusive pathology reports, contraindications, or refused to undergo biopsy or surgery. We provide an overall estimate on initial treatment decisions along with survival estimates for meningiomas in the United States.
    Methods We analyzed the NCDB from 2004 to 2014, for patients with diagnosis of meningioma using International Classification of Disease for Oncology (ICD-O-3) codes 9530–9534 and 9537-9539. The NCDB prospectively collects cancer patient data from over 1500 American College of Surgeons Commission on Cancer (CoC) accredited institutions in the United States [[15], [16], [17], [18]]. Data in our analysis includes age at diagnosis, sex, race, Hispanic origin, comorbidities based on Charlson-Deyo score (CDS) [19], primary payer status, median income, education status (percentage of non-High school graduates), and residency area, as defined by the United States Department of Agriculture Economic Research Service based on the patient’s residential zip code. Facility type was included as available, with community facilities defined as centers without graduate medical education.