The Journal of the Oklahoma State Medical Association最新文献

Answer: No. A randomized controlled trial of patients with heart failure and an ejection fraction > 45% showed that spironolactone did not significantly reduce the incidence of the primary composite outcome of death from cardiovascular causes, aborted cardiac arrest, or hospitalization for the management of heart failure. Level of Evidence for the Answer: ALimits: English, Adults, Randomized Controlled Trials, Meta-analysis, and Systematic review. Date Search Was Conducted: December 2015. Inclusion criteria: All randomized controlled trials, meta-analyses, and systematic reviews in patients with congestive heart failure with preserved ejection fractions, who were taking spironolactone, and published in the past 5 years. Exclusion criteria:; Age less than eighteen years, Eplerenone .

OBJECTIVE: To assess patient opinion on the Patient Protection and Affordable Care Act (PPACA) in an Otolaryngology practice and the factors that influence those opinions. STUDY DESIGN: Observational study. METHODS: An anonymous survey assessing patient opinion on the PPACA, demographic information, political affiliation, medical diagnosis, and insurance status was distributed to patients in three separate Otolaryngology clinics (General, cancer, and Low-income/Indigent) from April to June 2014. A total of 300 surveys were distributed and 207 were used for final analysis. The primary study outcome measures were patient opinion of the PPACA and statistically significant variables affecting that opinion. The association of Support for the PPACA and variables were tested using the Chi-square test. RESULTS: The only variables that showed a significant association with support for the PPACA were Political Party (p<0.0001) and Ethnicity (p=0.0050). Specifically, a higher proportion of Democrats support the PPACA than Republicans and a higher proportion of African Americans and Hispanic/Latinos support the PPACA than Whites and Native Americans. CONCLUSION: Our survey of current Otolaryngology patients mirrors national findings of the division between Republicans and Democrats in their attitudes towards the Affordable Care Act. Political party appears to be the most significant factor in shaping patient opinion on this controversial subject regardless of insurance status or cancer diagnosis and a higher proportion of African Americans and Hispanic/Latinos support the PPACA than Whites and Native Americans. LEVEL OF EVIDENCE: IV.

Background: Cancer is the second-leading cause of death in the United States (US) and Oklahoma ranks near the top with the highest rates of mortality from cancer. The top four major sites of cancer were prostate, female breast, lung and bronchus, and colon and rectum.

Methods: Joinpoint software was used to examine the incidence and mortality for the four cancers over time from 1999-2012 for both the US and Oklahoma.

Results: Incidence and mortality rates declined from 1999-2012 for the four cancer sites. The average annual, age-adjusted incidence rate was higher in the US than Oklahoma for prostate cancer, but higher in Oklahoma for female breast, lung and bronchus, and colon and rectum cancer sites.

Conclusions: Over the course of 14 years from 1999-2012, the age-adjusted incidence and mortality rates of prostate cancer, female breast cancer, lung and bronchus cancer, and colon and rectum cancer decreased over time nationally and in Oklahoma.

Recent studies have shown an apparent increase in thyroid cancer in the United States. Whether is due to an actual increase or increased screening is disputed. We analyzed thyroid cancer incidence and mortality across age and racial groups in Oklahoma (using data from the Oklahoma Central Cancer Registry) against Surveillance, Epidemiology, and End Results (SEER) program national data - using SEER*Stat software for mortality. In the US and Oklahoma, females had a higher AAIR compared to males, but it was lower in Oklahoma than in the US (Females: US 15.5 per 100,000, OK 10.9 per 100,000; Males: US 5.4 per 100,000, OK 3.8 per 100,000). Overall, five-year relative survival was lower, yet still high, for Oklahoma than in the US (92.1% v. 97.1%). Survival by stage was lower in Oklahoma compared to the United States for localized (97.8% v. 99.8%), regional (92.0% v. 97.0%), and distant (36.6% v. 55.3%) stage cancers.