2,136 research outputs found

    HEALTH VALUE IN FOOD SAFETY SURVEILLANCE INITIATIVES

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    Recognizing the increasing concern about the potential health effects of genetically modified foods, this research provides a framework for economic value of monitoring genetically modified food for their potential long-term human health effects. This is with the view of helping policy makers improve resource allocation decisions in the face of competing public health initiatives. Using a hypothetical population exposed to a hypothetical product, we estimate the health value associated with a post-market surveillance initiative. The analysis indicate that the principal challenge confronting decision makers in the implementation of post-market surveillance initiatives is prioritising products for monitoring given the uncertainty associated with outcomes and effects.Food Consumption/Nutrition/Food Safety,

    Emergency presentation of colorectal cancer in older adults:A retrospective cohort analysis

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    INTRODUCTION: Adults aged 70 years and over account for almost 60% of colorectal cancer (CRC) diagnoses in the United Kingdom. Whilst emergency presentation of CRC is known to be associated with poorer outcomes across all ages, older adults are less likely to be treated with curative intent and have poorer overall survival (OS). We aimed to investigate whether presentation, management, or outcome differed in older (≥70 years) versus younger (&lt;70 years) adults in our population.MATERIALS AND METHODS: The electronic records of patients diagnosed with CRC within the period 2016 to 2019 in National Health Service (NHS) Tayside, Scotland were retrospectively analysed. Patients were grouped by age (&lt;70 years and ≥70 years). Demographics were compared by Chi-squared or t-test, and Kaplan-Meier and Cox proportional hazard regression were used for survival analyses.RESULTS: In total, 1245 patients were diagnosed with CRC (median age 71 years, range 20-98). Of these, 215 patients (17.3%) presented emergently and were included in the analysis. Older adults accounted for 65.1% (n = 140) of emergency presentations. Older adults were less likely to present with classical symptoms of CRC (80.0% vs 90.7%, p = 0.04) and more likely to present via the medical assessment unit (46.4% vs 30.7%, p = 0.03). Additionally, older adults were less likely to receive a histological diagnosis of CRC (71.4% vs 97.3%, p &lt; 0.001) or have complete staging investigations performed (78.6% vs 96.0%, p &lt; 0.001). Fewer older adults underwent surgical management (55.0% vs 86.7%, p &lt; 0.001) and fewer were treated with chemotherapy (14.3% vs 69.3%, p &lt; 0.001). Whilst older adults had poorer median OS than those aged &lt;70 years (12.0 vs 34.4 months, p &lt; 0.001), multivariate Cox proportional hazards regression demonstrated that higher stage (stage III hazard ratio [HR] 2.7, 95% confidence interval [CI] 1.6-4.7, stage IV HR 16.7, 95% CI 9.7-28.8, incomplete HR 8.2, 95% CI 4.6-14.7) and not receiving chemotherapy (HR 2.6, 95% CI 1.7-4.0) were associated with poorer survival, whereas age and sex were not.DISCUSSION: Emergency presentation of colorectal cancer was more common in older adults. Older adults were more likely to present atypically, less likely to have completed staging, and had lower rates of intervention, which were associated with poorer survival outcome.</p

    Emergency presentation of colorectal cancer in older adults:A retrospective cohort analysis

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    Introduction: Adults aged 70 years and over account for almost 60% of colorectal cancer (CRC) diagnoses in the United Kingdom. Whilst emergency presentation of CRC is known to be associated with poorer outcomes across all ages, older adults are less likely to be treated with curative intent and have poorer overall survival (OS). We aimed to investigate whether presentation, management, or outcome differed in older (≥70 years) versus younger (&lt;70 years) adults in our population.Materials and Methods: The electronic records of patients diagnosed with CRC within the period 2016 to 2019 in National Health Service (NHS) Tayside, Scotland were retrospectively analysed. Patients were grouped by age (&lt;70 years and ≥70 years). Demographics were compared by Chi-squared or t-test, and Kaplan-Meier and Cox proportional hazard regression were used for survival analyses.Results: In total, 1245 patients were diagnosed with CRC (median age 71 years, range 20–98). Of these, 215 patients (17.3%) presented emergently and were included in the analysis. Older adults accounted for 65.1% (n = 140) of emergency presentations. Older adults were less likely to present with classical symptoms of CRC (80.0% vs 90.7%, p = 0.04) and more likely to present via the medical assessment unit (46.4% vs 30.7%, p = 0.03). Additionally, older adults were less likely to receive a histological diagnosis of CRC (71.4% vs 97.3%, p &lt; 0.001) or have complete staging investigations performed (78.6% vs 96.0%, p &lt; 0.001). Fewer older adults underwent surgical management (55.0% vs 86.7%, p &lt; 0.001) and fewer were treated with chemotherapy (14.3% vs 69.3%, p &lt; 0.001). Whilst older adults had poorer median OS than those aged &lt;70 years (12.0 vs 34.4 months, p &lt; 0.001), multivariate Cox proportional hazards regression demonstrated that higher stage (stage III hazard ratio [HR] 2.7, 95% confidence interval [CI] 1.6–4.7, stage IV HR 16.7, 95% CI 9.7–28.8, incomplete HR 8.2, 95% CI 4.6–14.7) and not receiving chemotherapy (HR 2.6, 95% CI 1.7–4.0) were associated with poorer survival, whereas age and sex were not.Discussion: Emergency presentation of colorectal cancer was more common in older adults. Older adults were more likely to present atypically, less likely to have completed staging, and had lower rates of intervention, which were associated with poorer survival outcome

    Emergency presentation of colorectal cancer in older adults:A retrospective cohort analysis

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    INTRODUCTION: Adults aged 70 years and over account for almost 60% of colorectal cancer (CRC) diagnoses in the United Kingdom. Whilst emergency presentation of CRC is known to be associated with poorer outcomes across all ages, older adults are less likely to be treated with curative intent and have poorer overall survival (OS). We aimed to investigate whether presentation, management, or outcome differed in older (≥70 years) versus younger (&lt;70 years) adults in our population.MATERIALS AND METHODS: The electronic records of patients diagnosed with CRC within the period 2016 to 2019 in National Health Service (NHS) Tayside, Scotland were retrospectively analysed. Patients were grouped by age (&lt;70 years and ≥70 years). Demographics were compared by Chi-squared or t-test, and Kaplan-Meier and Cox proportional hazard regression were used for survival analyses.RESULTS: In total, 1245 patients were diagnosed with CRC (median age 71 years, range 20-98). Of these, 215 patients (17.3%) presented emergently and were included in the analysis. Older adults accounted for 65.1% (n = 140) of emergency presentations. Older adults were less likely to present with classical symptoms of CRC (80.0% vs 90.7%, p = 0.04) and more likely to present via the medical assessment unit (46.4% vs 30.7%, p = 0.03). Additionally, older adults were less likely to receive a histological diagnosis of CRC (71.4% vs 97.3%, p &lt; 0.001) or have complete staging investigations performed (78.6% vs 96.0%, p &lt; 0.001). Fewer older adults underwent surgical management (55.0% vs 86.7%, p &lt; 0.001) and fewer were treated with chemotherapy (14.3% vs 69.3%, p &lt; 0.001). Whilst older adults had poorer median OS than those aged &lt;70 years (12.0 vs 34.4 months, p &lt; 0.001), multivariate Cox proportional hazards regression demonstrated that higher stage (stage III hazard ratio [HR] 2.7, 95% confidence interval [CI] 1.6-4.7, stage IV HR 16.7, 95% CI 9.7-28.8, incomplete HR 8.2, 95% CI 4.6-14.7) and not receiving chemotherapy (HR 2.6, 95% CI 1.7-4.0) were associated with poorer survival, whereas age and sex were not.DISCUSSION: Emergency presentation of colorectal cancer was more common in older adults. Older adults were more likely to present atypically, less likely to have completed staging, and had lower rates of intervention, which were associated with poorer survival outcome.</p

    Emergency presentation of colorectal cancer in older adults:A retrospective cohort analysis

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    Introduction: Adults aged 70 years and over account for almost 60% of colorectal cancer (CRC) diagnoses in the United Kingdom. Whilst emergency presentation of CRC is known to be associated with poorer outcomes across all ages, older adults are less likely to be treated with curative intent and have poorer overall survival (OS). We aimed to investigate whether presentation, management, or outcome differed in older (≥70 years) versus younger (&lt;70 years) adults in our population.Materials and Methods: The electronic records of patients diagnosed with CRC within the period 2016 to 2019 in National Health Service (NHS) Tayside, Scotland were retrospectively analysed. Patients were grouped by age (&lt;70 years and ≥70 years). Demographics were compared by Chi-squared or t-test, and Kaplan-Meier and Cox proportional hazard regression were used for survival analyses.Results: In total, 1245 patients were diagnosed with CRC (median age 71 years, range 20–98). Of these, 215 patients (17.3%) presented emergently and were included in the analysis. Older adults accounted for 65.1% (n = 140) of emergency presentations. Older adults were less likely to present with classical symptoms of CRC (80.0% vs 90.7%, p = 0.04) and more likely to present via the medical assessment unit (46.4% vs 30.7%, p = 0.03). Additionally, older adults were less likely to receive a histological diagnosis of CRC (71.4% vs 97.3%, p &lt; 0.001) or have complete staging investigations performed (78.6% vs 96.0%, p &lt; 0.001). Fewer older adults underwent surgical management (55.0% vs 86.7%, p &lt; 0.001) and fewer were treated with chemotherapy (14.3% vs 69.3%, p &lt; 0.001). Whilst older adults had poorer median OS than those aged &lt;70 years (12.0 vs 34.4 months, p &lt; 0.001), multivariate Cox proportional hazards regression demonstrated that higher stage (stage III hazard ratio [HR] 2.7, 95% confidence interval [CI] 1.6–4.7, stage IV HR 16.7, 95% CI 9.7–28.8, incomplete HR 8.2, 95% CI 4.6–14.7) and not receiving chemotherapy (HR 2.6, 95% CI 1.7–4.0) were associated with poorer survival, whereas age and sex were not.Discussion: Emergency presentation of colorectal cancer was more common in older adults. Older adults were more likely to present atypically, less likely to have completed staging, and had lower rates of intervention, which were associated with poorer survival outcome

    Colon capsule endoscopy investigation based on faecal haemoglobin concentration in symptomatic patients to detect bowel disease

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    We would like to thank the biochemistry laboratory staff at Raigmore and Ninewells Hospital for processing and analysing FIT samples, and all the patients who participated in the ScotCap evaluation.Peer reviewe

    Blood polymorphonuclear leukocyte chemotaxis during experimental escherichia-coli bovine mastitis.

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    The relationship between the severity of experimental Escherichia coli mastitis and the chemotactic response of blood polymorphonuclear leukocytes was investigated before and during mastitis. Experimental E. coli mastitis was induced in 10 healthy cows by inoculation of the rear right quarters with 10(3) cfu of E. coli. Cows were classified into two groups based on the severity of the mastitis. Bacterial growth in the inoculated quarter was used as parameter that indicated severity. Before and during experimental mastitis, the chemotactic response and the number of circulating polymorphonuclear leukocytes were greater for the moderately diseased cows than for the severely diseased cows. During the first 24 h of the experimental mastitis, the chemotactic response of polymorphonuclear leukocytes decreased in both groups. Recovery of the chemotactic response of white blood cells was more rapid in moderately diseased cows than in severely diseased cows. Possibly, the larger proportion of band neutrophils (the less chemotactically active band neutrophils) partially accounts for the lower chemotactic response of the circulating polymorphonuclear leukocytes during experimental mastitis in the severely diseased cows
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