66 research outputs found
Contemporary incidence and mortality rates of kidney cancer in the united states
No full textMethods: Relying on the Surveillance, Epidemiology, and End Results (SEER) database, we computed age-adjusted incidence, mortality rates and 5-year cancer-specific survival (CSS) for patients with histologically confirmed kidney cancer between 1975 and 2009. Long-term (1975â2009) and short-term (2000â2009) trends were examined by joinpoint analysis, and quantified using the annual percent change (APC). The reported findings were stratified according to disease stage.Results: Age-adjusted incidence rates of RCC increased by +2.76%/year between 1975 and 2009 (from 6.5 to 17.1/100 000 personyears, p < 0.001), and by +2.85%/year between 2000 and 2009 (p < 0.001). For the same time points, the corresponding APC for the incidence of localized stage were +4.55%/year (from 3.0 to 12.2/100 000 person years, p < 0.001), and +4.42%/year (p < 0.001), respectively. The incidence rates of regional stage increased by +0.88%/year between 1975 and 2009 (p < 0.001), but stabilized in recent years (2000â2009: +0.56%/year, p = 0.4). Incidence rates of distant stage remained unchanged in long-and short-term trends. Overall mortality rates increased by +1.72%/year between 1975 and 2009 (from 1.2 to 5.0/100 000 person-years, P<0.001), but stabilized between 1994 and 2004 (p = 0.1). Shortterm mortality rates increased in a significant fashion by +3.14%/year only for localized stage (p < 0.001).Interpretation: In contemporary years, there is a persisting upward trend in incidence and mortality of localized RCC.Introduction: This is a timely update of incidence and mortality for renal cell carcinoma (RCC) in the United States
Benefit in regionalisation of care for patients treated with radical cystectomy: A nationwide inpatient sample analysis
No full textObjective To quantify in absolute terms the potential benefit of regionalisation of care from low- to high-volume hospitals. Patients and Methods Patients with a primary diagnosis of bladder cancer treated with radical cystectomy (RC) were identified within the Nationwide Inpatient Sample, a retrospective observational population-based cohort of the USA, between 1998 and 2009. Intraoperative and postoperative complications, blood transfusions, prolonged length of stay, and in-hospital mortality rates represented the outcomes of interest. Potentially avoidable outcomes were calculated by subtracting predicted rates (i.e. estimated outcomes if care was delivered at a high-volume hospital) from observed rates (i.e. actual observed outcomes after care delivered at a low-volume hospital). Multivariable logistic regression models and number needed to treat were generated. Results Patients treated at high-volume hospitals had lower odds of complications during hospitalisation than those treated in low-volume hospitals. Potentially avoidable intraoperative complications, postoperative complications, blood transfusions, prolonged hospitalisation, and in-hospital mortality rates were 0.6, 7.4, 2.8, 9.4, and 2.0%, respectively. This corresponds to a number needed to redirect from low- to high-volume hospitals in order to avoid one adverse event of 166, 14, 36, 11 and 50, respectively. Conclusion This is the first report to quantify the potential benefit of regionalisation of RC for muscle-invasive bladder cancer to high-volume hospitals. © 2013 The Authors. BJU International © 2013 BJU International
Customer relationship management systems for the SME’s – is this a perfect marriage made in the cloud?
No full textThe purpose of this research is to identify the key evaluation criteria to be considered by the Small and Medium Enterprises before the selection of CRM deployment model and secondly, to build a practical guide for clear understanding which CRM deployment model will suits better for Small businesses in future considering those critical criteria. A review of the literature concerning CRM in-house / cloud CRM study found the area to be a topic of major concern for decision makers in small organizations because of the budget and risk constraints and Cloud CRM is comparatively a new innovation under study. Moreover there is no existing research which identify the key criteria for CRM model selection and describe which CRM model is better on those criteria. The research also focuses on identifying if subscription pricing model is better than ownership model for the small and medium organizations. The research also discusses the different concepts such as Customer Relationship Management, CRM in the cloud and cloud computing, especially in relation to SMEs, in order to have a great insight that gives the opportunity to successfully research this topic.
The deductive research uses quantitative approaches for data collection and analysis. The evaluation criteria for CRM systems at general level were proposed via a researcher through intensive literature review. In primary research, the general criteria were refined via collecting data from CRM in house / Cloud CRM experts and users in SMEs by structured questionnaires by that researcher analyze the key criteria for selecting CRM deployment model. This research provides valuable insight for managers in SMEs when selecting CRM delivery model for their companies. Furthermore, the academicians who are interested in cloud computing or CRM could adapt it further to different cases. Author keywords: Customer relationship management, cloud computing, SME’s, cloud CRM, in–house CR
A meta-analysis of patient outcomes with subcentimeter disease after chemotherapy for metastatic nonseminomatous germ cell tumor (NSGCT).
No full text 324 Background: Around a quarter of men with metastatic nonseminatous germ cell tumor (NSGCT) have a residual mass, typically in the retroperitoneum, after chemotherapy. While post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) is accepted to be the best way to manage large retroperitoneal masses, the treatment of small residual masses (≤1cm) is controversial. Both PC-RPLND and surveillance produce good outcomes for men in this situation, and we sought to review our experience of surveillance and synthesize the cumulative findings in the form of a meta-analysis. Methods: We searched PubMed and abstracts from ASCO and AUA to identify relevant, English language studies. Inclusion criteria was the presence of a subcentimeter post-chemotherapy retroperitoneal mass. The Dana-Farber Cancer Institute cohort was constructed from a database of men undergoing cisplatin-based chemotherapy for metastatic NSGCT. The outcomes of interest were the proportion with necrosis, teratoma or active cancer on histology at PC-RPLND, and the total number of relapses, retroperitoneal (RP)-only relapses and overall survival in men undergoing surveillance. Results: A total of 47 men formed our surveillance cohort and three relapsed with a median follow-up of 5.4 years and median time to relapse of 12.7 months. All three were alive at a median of 4.2 years after relapse with salvage therapy. On meta-analysis, the pooled estimates of necrosis, teratoma and active cancer in the 588 men who underwent PC-RPLND were 71%, 24% and 4% respectively. Of the combined 455 men who underwent surveillance, the pooled estimate of relapse rate was 5%, with an RP-only relapse rate of 3%. Overall, of the 15 men who suffered an RP-only relapse on surveillance, two died of disease. Conclusions: Surveillance is an alternative strategy for managing men with minimal residual RP disease after chemotherapy and avoids an RPLND in about 95% of men who are cured with chemotherapy alone. </jats:p
Response to 'Evolving M-protein pattern in patients with smoldering multiple myeloma: impact on early progression'
No full textNovel Therapeutic Approaches and the Evolution of Drug Development in Advanced Kidney Cancer
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BUDGETTICKS A MUST FOR THE GOVERNMENT
No full textSYNOPSIS The D.Litt Thesis herewith submitted, namely 'Budgetticks - A must for the Government'. This nature of research comes under the purview of the subject Public Administrations, which happens to be mine own discovery. Presently, there are huge problems in chalking out the yearly budget of the different countries in the present day world. Moreover, the countries which are in the arena of third world and underneath nations, this problem of framing of yearly budget has become a misnomer. The different Governments pertaining to such third world and underneath arena find the same, quite difficult in order to present their budget in thier respective Parliaments, or, before the Assemblies. In fact, there are no relevancies observed to-day, in between the different budgetary provisions (i.e. monetary provisions) and the resultant effects. Here, the Governments are meeting with their drastic failures in providing the people, which are very akin to maintain their lives and livelihoods towards, achieving a conducive sustenance. Here, Budget and its effects make no systematic impact in providing the people, their day to day necessities. Presently, most of the 3rd world and underneath nations are adopting the type of budget which are basically borrowed from the Britishers. During the colonial rule of the Britishers, they have imposed their ideas, their authority, responsibility, accountability, in the shape of forming the Governments, up to their own tastes. Unfortunately such Governments are not finding an outlet to be away from such unsuitable procedural ways as set up towards framing of the budget as made by the Britishers. Of course, partly the British system may have, some help to the capitalistic nations like U.S.A., U.K. and other European countries, but for the people of 3rd world and the underneath nations, this system only provides a distorted, hazy as well as quite an unsuitable order, in consideration to their geographical, social, political and anthropological behavioural orders.
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