Improved stage and survival for patients in the Aotearoa New Zealand colorectal cancer screening program 2012-2019.

BACKGROUND: Colorectal cancer (CRC) screening was introduced in Aotearoa New Zealand at Waitemata District Health Board (WDHB) in late 2011. This study reviewed patterns of disease, treatment received, and survival of patients with national bowel screening program (NBSP)-detected CRC versus non-NBSP patients at WDHB 2012-2019. METHODS: Data collected retrospectively for all patients with adenocarcinoma of the colon or rectum at WDHB 2012-2019. Patient records were manually reviewed. Chi-square, Fisher's exact test and the Mann Whitney U-test used as appropriate. Kaplan-Meier and Cox proportional hazards regression modelling for survival analysis. RESULTS: 1667 patients included (360 NBSP and 1307 non-NBSP). 863 (51.8%) were male. Median age at diagnosis 73 years (range 21-100); NBSP patients were younger (median 68 vs. 76 years, P < 0.001). NBSP patients had significantly lower T, N, M and overall TNM stage than non-BSP patients. Median survival estimate on Kaplan-Meier analysis was 94 months for all patients. Statistically significant (P < 0.05) predictors of mortality on multi-variate regression analysis included increasing overall TNM stage compared with stage I (stage II HR 1.63 (95% CI 1.14-2.34), stage III HR 2.86 (95% CI 2.03-4.03), stage IV HR 7.73 (95% CI 5.59-10.68)), diagnosis within NBSP (HR 0.51 (95% CI 0.37-0.71)), increasing age in years (HR 1.03 (95% CI 1.02-1.03)), urgent/emergency surgery (HR 1.66 (95% CI 1.36-2.01)) and formal resection of primary tumour (HR 0.31 (95% CI 0.25-0.38)). CONCLUSION: Patients diagnosed within the Aotearoa New Zealand NBSP were found to be younger and have earlier stage CRC. Diagnosis within the NBSP is an independent predictor of survival for patients with CRC.

Early onset colorectal cancer: Challenges across the cancer care continuum.

Early Onset Colorectal cancer (EOCRC) incidence is increasing at an alarming pace. An increase of 90% in colon cancer and 124% in rectal cancer is expected by 2030. Patients with EOCRC are not receiving additional attention compared to older patients despite having a unique molecular pattern, majority of cases are sporadic, and related short- and long-term treatment and disease complications. The current management and screening guidelines have been constructed from studies on late onset CRC. Plethora of studies are ongoing to understand this disease entity in order to construct a tailored prevention, detection and management plans. While waiting for a better understanding of the disease, efforts should be directed toward improving the quality of care across the cancer continuum. Here we aim to address the challenges faced by EOCRC patients across the cancer continuum. This will facilitate directing future efforts and research toward construction of a personalized and precise guidelines.

A search for novel thermoluminescent radiation dosimeter media.

We describe two example pilot efforts to help define new thermoluminescent dosimeter media. The first concerns ZnS:Mn nanophosphors, prepared by chemical precipitation using zinc and sodium sulfate, doped with manganese sulfate at concentrations varying from 1 to 3mol. The second concerns chemical vapor deposited diamond, produced as a thin film or as amorphous carbon on a single-crystal silicon substrate, each deposited under the same conditions, use being made of the hot filament-chemical vapor deposition (HFCVD) technique. The gas concentrations used were 1% CH4 in 99% H2 and 25% CH4 in 75% H2. Characterization of formations used FESEM, XRD and EDX. The nanophosphors consisted of particles of sizes in the range 85-150nm, the thermoluminescence (TL)-based radiation detection medium giving rise to a single peaked glow curve of maximum yield at a temperature of 250°C at a heating rate of 5°C/s. The TL response increased linearly with radiation dose, ZnS doped to 2mol of Mn being found the most sensitive. Regarding chemical vapor deposited (CVD) carbon, inappreciable TL was found for the resultant ball-like amorphous carbon films, graphite, and the silicon substrate, whereas CVD diamond films showed a promising degree of linearity with dose. For both the ZnS and diamond samples, TL signal fading was appreciable, being some 40% per day for ZnS and>50% per day for CVD films even under storage in the dark at room temperature, making it apparent that there is need to adjust parameters such as the size of nanoparticles.

An unusual presentation of metabolic cardiomyopathy due to Pompe's disease.

An Omani infant boy who presented in the neonatal period with cardiac failure secondary to hypertrophic cardiomyopathy is reported. He subsequently progressed to show features of a metabolic disorder with multisystem involvement and was diagnosed to have Type II glycogenosis (Pompe's disease). The differential diagnosis and management of metabolic cardiomyopathy are outlined.

A profile of childhood neuropathies at a university hospital in Oman.

OBJECTIVE: To analyze all cases of childhood neuropathies (under 14 years of age) and report on their profile, pattern, clinical features and management. METHODS: Children with acute flaccid paralysis, longstanding weakness of extremities, neuroregression and children receiving anti cancer drugs with symptoms suggestive of neuropathy were evaluated for evidence of peripheral neuropathy. The evaluation of children with acute flaccid paralysis was a prospective study from January 1992 through to December 2000. The rest of the patients were studied retrospectively from the hospital medical records, pediatric neurology outpatient clinic and the neurophysiology laboratory, Sultan Qaboos University Hospital, Al-Khod, Oman RESULTS: Eighty-two (39 Male: 43 Female) children were found to have peripheral neuropathy. Acute Guillain-Barré [corrected] syndrome was the most common with 37 children (45.1%), followed by genetic neuropathies [hereditary motor and sensory neuropathy with 17 (20.7%), hereditary sensory and autonomic neuropathy with 2 (2.4%), hereditary spastic paraplegia associated neuropathy with 9 (11%) and metachromatic leucodystrophy with 9 (11%)]. Chronic inflammatory demyelinating neuropathy was seen in 5 (6.1%) and vincristine induced neuropathy in 3 (3.5%) children. CONCLUSION: Acute Guillain-Barré [corrected] syndrome is the most common neuropathy amongst the acquired neuropathies. The treatable neuropathies constituted 54.7% (45 children) and the preventable genetic neuropathies accounted for the remaining 45.3% (37 children)

A profile of childhood neuropathies at a university hospital in Oman.

OBJECTIVE: To analyze all cases of childhood neuropathies (under 14 years of age) and report on their profile, pattern, clinical features and management. METHODS: Children with acute flaccid paralysis, longstanding weakness of extremities, neuroregression and children receiving anti cancer drugs with symptoms suggestive of neuropathy were evaluated for evidence of peripheral neuropathy. The evaluation of children with acute flaccid paralysis was a prospective study from January 1992 through to December 2000. The rest of the patients were studied retrospectively from the hospital medical records, pediatric neurology outpatient clinic and the neurophysiology laboratory, Sultan Qaboos University Hospital, Al-Khod, Oman RESULTS: Eighty-two (39 Male: 43 Female) children were found to have peripheral neuropathy. Acute Guillain-Barre syndrome was the most common with 37 children (45.1%), followed by genetic neuropathies [hereditary motor and sensory neuropathy with 17 (20.7%), hereditary sensory and autonomic neuropathy with 2 (2.4%), hereditary spastic paraplegia associated neuropathy with 9 (11%) and metachromatic leucodystrophy with 9 (11%)]. Chronic inflammatory demyelinating neuropathy was seen in 5 (6.1%) and vincristine induced neuropathy in 3 (3.5%) children. CONCLUSION: Acute Guillain-Barre syndrome is the most common neuropathy amongst the acquired neuropathies. The treatable neuropathies constituted 54.7% (45 children) and the preventable genetic neuropathies accounted for the remaining 45.3% (37 children).