Racial Disparities Evident In Early-Stage Liver Cancer Survival

Alliance Medical Foundation Liver and Pancreatic Charitable Trust.
( Govt of India Reg )

We are the only National charity that offers Free Medical Treatment 
support and advice for patients with all forms of Liver & Pancreatic Diseases.

The kindness of supporters like yourself, enables us
to help people with liver & pancreatic disease. 

 

About The Charity Visit : www.amftrust.com

 

Black patients with early-stage liver cancer appear more likely to die of the disease than Hispanic or white patients with the same condition, according to a report in the December issue of Archives of Surgery, one of the JAMA/Archives journals.

Hepatocellular carcinoma, or cancer of the liver, is the fifth leading cause of cancer death worldwide, according to background information in the article. The five-year rate of survival for patients with advanced-stage disease is 5 percent, but those who are diagnosed at an early stage are more likely to be successfully treated. "The available treatment strategies, including tumor ablation, hepatic resection, liver transplant or combined modalities, require highly complex care only available in tertiary referral centers," the authors write. "To obtain care in these centers, patients need to overcome several barriers that may precipitate health care disparities along racial/ethnic lines and may have downstream effects on survival."

Amit K. Mathur, M.D., M.S., and colleagues at the University of Michigan, Ann Arbor, analyzed data from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) registry. They identified a total of 13,244 patients who were diagnosed with stage I or II hepatocellular carcinoma between 1995 and 2006.

Of the patients, 6,316 (47.7 percent) were white, 3,022 (22.8 percent) were Asian, 2,230 (16.8 percent) were Hispanic, 1,397 (10.5 percent) were black and 279 (2.1 percent) were categorized as other. During the study period, a total of 32.8 percent of all patients received invasive therapy for liver cancer. Black and Hispanic patients were less likely to receive such treatments than white, Asian or other patients.

Five-year survival rates were 17.9 percent for all patients, 18.2 percent for white patients, 12.2 percent for black patients, 15.2 percent for Hispanic patients, 22 percent for Asian patients and 17.1 percent for other patients. Median (midpoint) survival times were 15 months for Asians, 10 months for whites and Hispanics and eight months for blacks.

After adjusting for the type of treatment received, black patients had a 12 percent increased rate of death when compared with white patients, Hispanic and white patients had similar rates of death and Asian patients had a 16 percent lower death rate.

"The most notable finding in our study was that racial/ethnic variation in hepatocellular carcinoma outcome is related to access and variable treatment effect from specific therapies," the authors write. "After adjusting for treatment effects, the racial/ethnic disparity in survival between black and white patients decreased but persisted. This finding is linked to two major issues that contribute to health-related disparities in minority populations: black patients have poor access to treatment, and, even after obtaining treatment, they have relatively poor outcomes compared with white patients."

The results have important implications for health policy, they note. "Some evidence suggests that racial/ethnic disparities in access to specialized care may be linked to the providers and facilities that serve minority patients. Further provider education on the importance of hepatocellular carcinoma screening in at-risk groups may be helpful in alleviating these disparities," the authors conclude. "Persistent racial/ethnic disparities in survival even after adjusting for the effects of treatment are of particular concern and may be related to the quality of health care delivered. This variation may require a comprehensive evaluation of centers where minorities receive care to standardize and improve the structure and process of cancer care delivery."

What Does Hypertension Do?

New Study Calls for Greater Awareness of Food Supply for Children With Diabetes

Alliance Medical Foundation Liver and Pancreatic Charitable Trust.
( Govt of India Reg )

We are the only National charity that offers Free Medical Treatment 
support and advice for patients with all forms of Liver & Pancreatic Diseases.

The kindness of supporters like yourself, enables us
to help people with liver & pancreatic disease. 

 

About The Charity Visit : www.amftrust.com

 

 

Managing diabetes in a child requires a careful balance of insulin, diet, and exercise. Buying essential medical supplies, such as needles and testing strips, adds a financial burden to families. According to a new study soon to be published in The Journal of Pediatrics, the resulting food insecurity that arises from the financial burden of diabetes management increases a child's risk of being hospitalized due to complications from diabetes.

According to study author Dr. Elizabeth Cummings, "A household is food secure when all members have access to food that is safe and varied enough to meet their nutritional needs. Families who are hungry, who use food banks or food stamps, or those who worry about affording food are considered food insecure."
Dr. Cummings and colleagues interviewed 183 Canadian families with at least one child with diabetes over a 16 month period. They completed a survey that assessed their food security, demographic information (e.g., income, education levels), and strategies used to mitigate the financial burden of their child's diabetes.
The researchers found that 22% of the families they interviewed were food insecure, a significantly higher percentage than the national Canadian rate of 9.2%. Food security is not just a problem in Canada, however. A report released by the U.S. Department of Agriculture's Economic Research Service states that 17.4 million households had difficulty providing enough food due to lack of resources in 2009.1 According to Dr. "Children from food insecure families had poorer diabetes control and were 3.7 times more likely to require hospitalization for diabetes within the past year."
Almost all the families interviewed received some financial support for their diabetes supplies. However, many reported that someone in the family ate less so that the child with diabetes would have enough. "A small number of families reported that they tested their child's blood sugar less often than recommended," co-author Dr. Stacey Marjerrison reports, "or used needles more than once to help manage the cost of their child's diabetes."
Dr.believes that health professions should be more aware of this issue. "A review of financial support available to families is needed," she asserts. "Improvement of support may result in fewer hospitalizations and thus lower health care costs."

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of AMF Trust or Dr.Alacc

Anti-Microbials Are a Common Cause of Drug-Induced Liver Injury and Failure?

Alliance Medical Foundation Liver and Pancreatic Charitable Trust.
( Govt of India Reg )

We are the only National charity that offers Free Medical Treatment 
support and advice for patients with all forms of Liver & Pancreatic Diseases.

The kindness of supporters like yourself, enables us
to help people with liver & pancreatic disease. 

 

About The Charity Visit : www.amftrust.com

 

 New research shows that anti-microbial medications are a common cause of drug-induced liver injury (DILI) leading to acute liver failure (ALF), with women and minorities disproportionately affected. While ALF evolves slowly, once it does occur a spontaneous recovery is unlikely; however liver transplantation offers an excellent survival rate. 

Full findings of this ten-year prospective study are published in the December issue of Hepatology, a journal of the American Association for the Study of Liver Diseases.
Patients with liver failure resulting from DILI may experience deep jaundice, fluid retention, advanced coagulopathy and coma. More than 1100 drugs, herbal remedies, natural products, vitamins, minerals, dietary supplements, and recreational and illicit compounds are known to cause liver injury, which reportedly affect 1 in 100,000 to 1 in 10,000 patients. Prior research shows DILI is a frequent cause of hepatitis, and accounts for 5%-10% of hospitalizations for jaundice and 12% of all cases of ALF (excluding acetaminophen).
In the current study, researchers investigated liver injury and failure caused by drugs other than acetaminophen. Detailed case reports were collected from 1,198 subjects with ALF enrolled at 23 sites participating in the National Institutes of Health-funded Acute Liver Failure Study Group, led by Principal Investigator, William M. Lee, M.D., from the University of Texas Southwestern Medical Center in Dallas, TX. Researchers identified 133 patients with DILI with 71% of those cases in women.

"Our findings confirm prior medical evidence that found a high female predominance in DILI ALF, suggesting that women may be more susceptible to liver injury or use more prescription drugs than men," said Dr. Adrian Reuben, Professor of Medicine at the Medical University of South Carolina and lead study author.

Furthermore, the research team documented a disproportionately high number of minorities with DILI ALF, including African-American (16%), Hispanic (15%) and other minority groups (12%). "We observed inexplicably high numbers of minority patients with DILI ALF. This racial disparity is atypical for acetaminophen-induced ALF in the U.S. and further studies should explore this discrepancy," commented Dr. Reuben.

Researchers identified 61 different agents that, alone or in combination, could cause liver injury and failure in the study population. Anti-microbial agents were found to be the most common cause of DILI ALF cases and included anti-tuberculosis drugs (25), sulphur-containing drugs (12), nitrofurantoin (12), other antibiotics (7), antifungal agents (6), and anti-retroviral drugs (4). Patients who develop ALF after taking these drugs typically do not experience a spontaneous recovery -- the transplant-free survival rate in this study was 27%.
There were 56 eligible subjects who underwent liver transplantation of whom all but four survived, giving an overall survival for the entire cohort 66.2%. The authors highlight that the 23.3% of transplantation waitlist deaths attest to the urgent need for donor organs in this setting. "Liver transplantation offers excellent survival for ALF patients, however further investigation should include more detail on drug use duration, and the impact of alcohol use and diabetes, to provide additional understanding of idiosyncratic drug-induced liver injury and failure," Dr. Reuben concluded.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of AMF Trust or Dr.Alacc

Make A Donation Today...

My corresponding to you is to request for a generous donation for the Alliance Medical Foundation Liver & Pancreatic  Trust. www.amftrust.com 
We are running short of funds.

Any help from your side is welcome and will be thoroughly recognized by our society.

We are the only National charity that offers Free Medical Treatment support and advice for adults with all forms of Liver & Pancreatic Diseases. The kindness of supporters like yourself, enables us to help people with liver & pancreatic disease.

Also we assure you that your help will not be misused.

"To the World you might be one person,

But to one person you might be the world"
 

Only you can make a change 

 Make A Donation Today...

 

Alliance Medical Foundation,

A/C No: - SB 01003300

CORPORATION BANK, Thiruvalla
SWIFT CODE: - CORPINBB 485
RTGS IFSC CODE: - CORO 0000485

Other areas of charity operations

1.      Provide medical assistance

To provide treatment to poor and needy patients irrespective of their Irrespective of their Religion, Caste and Community or Locality  make them maximum self-dependent on health base.

2.      Scholarship to children of dependents

To provide educational assistance to their children during the course of treatment.

3.      Provide food, clothing and housing

To provide food clothing and shelter to the family members of the dependent if we can,

During the course of treatment.

4.      Conduct Medical camps

To conduct Medical Camps in different parts.

If you have any further inquiries please feel free to contact us.

Or you can also know more about our humanitarian work by visiting our website
 www.amftrust.com

Registered Office: 
Polachiriyil Building | Near Y.M.C.A |T.K Road

Thiruvalla | Pathanamthitta Dist. | Kerala | India |Pin : 689101

Tel : 91-469- 2604587, 2734342 |Res : 91-469-2618816

Mob : 9497812636, 9495509461, 9387121349 |
Fax : 91-469-2734342

Email : info@amftrust.com | web : www.amftrust.com

Facebook  www.facebook.com/alliance.medical.foundation

Twitter   www.twitter.com/amftrust 

Blog   www.alliancemedicalfoundation.blogspot.com

Dr.Alacc personal blog  www.alacc.posterous.com

DAILY HEALTH NEWS   www.healthwatchnews.wordpress.com      

Official Web Site   www.amftrust.com

TMC435 Works Well in Treatment-experienced Hepatitis C

Alliance Medical Foundation Liver and Pancreatic Charitable Trust.
( Govt of India Reg )

We are the only National charity that offers Free Medical Treatment 
support and advice for patients with all forms of Liver & Pancreatic Diseases.

The kindness of supporters like yourself, enables us
to help people with liver & pancreatic disease. 

About The Charity Visit : www.amftrust.com

Medivir last week announced interim data from the Phase 2b ASPIRE trial, demonstrating that its investigational once-daily HCV protease inhibitor TMC435 (being developed jointly with Tibotec), when combined with pegyalted interferon plus ribavirin, increased the likelihood that treatment-experienced chronic hepatitis C patients would achieve undetectable HCV viral load at 4, 12, and 24 weeks, compared with standard therapy alone. Rates of undetectable HCV RNA at week 24 ranged from 78% for prior null responders to 94% for prior relapsers.