Biomedical subjects

Amy Engel

Publications and source records attributed to Amy Engel.

7 recordsLinked to original sources

PubMed2006

The influence of gender on colorectal cancer stage: the state of Ohio, 1996-2001.

PURPOSE: The authors sought to determine if colorectal cancer stage at diagnosis varies by gender in the state of Ohio. METHODS: We conducted a retrospective cohort study. Included in the cohort were patients diagnosed with colorectal cancer from 1996 to 2001 who had their data reported to the State of Ohio Tumor Registry. We collected data on gender, stage of cancer, and three potential confounding variables: age, location of colon cancer, and race. The colorectal cancer was determined to be at one of four stages: (1) carcinoma in situ, (2) local disease, (3) regional disease, and (4) distant disease. In addition, we combined stages 1 and 2 to create a good prognosis category, and we combined stages 3 and 4 to create a bad prognosis category. RESULTS: Our cohort consisted of 27,041 patients [13,807 women (51%) and 13,234 men]. The women with colon cancer were significantly older and had more right-sided colon cancer, (p < 0.05). With the use of logistic regression, the women were significantly less likely to have carcinoma in situ compared with the men (OR = 0.82, 95% CI 0.75-0.89). The women also had a significant decrease in local disease (OR = 0.94, 95% CI 0.89-0.99). In contrast, the women showed significantly more regional disease than men (OR = 1.11, 95% CI 1.05-1.16). The women were less likely to have a good prognostic stage (OR = 0.89, 95% CI 0.85-0.94) and more likely to have a bad prognostic stage (OR = 1.12, 95% CI 1.07-1.18). CONCLUSIONS: In the State of Ohio from 1996 to 2001, women had more advanced colon cancer at diagnosis than men.

Adult↗

PubMed2006

Association of race and breast cancer stage.

PURPOSE: To determine if breast cancer stage exhibits any significant variation between African Americans and white Americans. METHODS: We conducted a retrospective cohort study. Inclusion criteria required a diagnosis of breast cancer that was reported to the TriHealth tumor registry from 1991-2003. For each patient, we collected data on race; American Joint Committee on Cancer stage at diagnosis; and 12 potential confounding variables, including topography, morphology, laterality, age, menopausal age, smoking status, estrogen and progesterone receptor status, marital status, menopausal status, family history of breast cancer in a first-degree relative and insurance status. RESULTS: 5,751 patients (5,119 Caucasians, 632 African Americans) were eligible to be included in the study. African Americans were significantly younger, with a younger age of menopause, less family history of breast cancer, fewer positive estrogen and progesterone receptors, higher rate of cigarette smokers, more Medicaid insured, and more single and divorced individuals compared to Caucasian Americans (p < 0.05). Multivariate analysis found no difference between the races for stage 0, stage 2 and stage 4. African Americans had significantly less stage 1 (RR 0.80, 95% CI: 0.67-0.96), less combined stage 0 and 1 (RR 0.75, 95% CI: 0.63-0.89) and more combined stage 3 (RR 1.50 95% CI: 1.11-2.01). CONCLUSION: Although there was no difference among the races for topography, morphology and laterality of their breast cancers, African-American race is a predictor of more advanced stage at diagnosis.

Black or African American↗

PubMed2005

The influence of ethnicity on patient satisfaction.

OBJECTIVE: To investigate the influence of ethnicity on patient satisfaction with hospitalization care. METHODS: We conducted a random selection, cross-sectional study. Data were collected by telephone interviews over a three-year period utilizing a 16-question survey. Patients were excluded from the study if they were admitted for an obstetric visit, physical rehabilitation, or psychiatric illness or if we were unable to reach them by telephone. We used logistic regression to compare ethnicity with the responses for each of the 16 questions while controlling for three confounders (age, gender, and insurance status). For each question, patient responses of excellent and very good were considered satisfied. Patient responses of good, fair, and poor were considered not satisfied. RESULTS: We surveyed 7,795 patients. Compared to African-Americans, non-Hispanic white Americans were significantly older, included more males, and were insured by Medicaid less often (p < 0.05). Using multivariate analysis, we found that seven of the 16 questions exhibited significant satisfaction differences. African-Americans expressed significantly less satisfaction for two of six questions related to nursing care, two of three questions related to entire staff care, one of two question related to physician care, and one of three questions related to overall satisfaction (p < 0.05). However, African-Americans expressed significantly more satisfaction for one question related to nursing care. There was no difference between the two groups for nine of the 16 questions, including both questions regarding communication and coordination. CONCLUSION: African-Americans reported significantly lower rates of satisfaction compared to non-Hispanic white Americans for six of 16 questions regarding satisfaction during hospitalization care.

Adult↗

PubMed2002

Future time perspective in pathological gamblers.

The hypothesis that pathological gambling is associated with shortened time horizons was investigated by administering the Zimbardo Time Perspective Inventory (ZTPI) and the Future Time Perspective Inventory (FPTI) to a group of pathological gamblers and two comparison groups, psychiatric day patients and social gamblers. The South Oaks Gambling Screen (SOGS) was used to assess the severity of the participants' gambling. Sixty-six participants were recruited, of which 35 were women. The mean age of participants was 39 years. Results showed significantly shorter time horizons in pathological versus social gamblers but few differences between pathological gamblers and psychiatric patients. These results suggest that shortened time horizons are not a unique feature of addicted populations. The role of psychological distress as a possible explanatory variable is discussed.

Adult↗

PubMedDate not supplied

Stimulating resident research in a general surgery residency community program.

OBJECTIVE: Resident research teams were established at this community hospital in the 1997 academic year. Research productivity, including publications and presentations in the years before establishing research teams and the 8 years subsequent to establishment of research teams with faculty mentors, was reviewed. METHODS: Each team is supported by a research specialist who provides assistance with project design, data evaluation, statistical analysis, manuscript editing, and preparation of research presentations. Every resident is assigned to a research team that meets monthly. The teams consist of a 4th- or 5th-year resident, 2nd- or 3rd-year resident, surgical intern, research team mentor, and research specialist. The resident is required to be an active contributing co-investigator on 1 team project per year, contributing to the development and performance of the study, participating in writing the manuscript, and must be able to defend the study. By the end of the third year, the resident is required to complete 1 individual project that is submitted to the postgraduate competition for residents. In addition, a completed manuscript must be ready to submit to a peer-reviewed journal. Promotion can be denied if the appropriate time has not been devoted to research. Minimum completion requirements include a case report and a presentation at a national or regional meeting. The research registry was reviewed for all presentations and publications given by the surgical residents during the 8 years before the teams were established and the 8 years after the teams were formed. RESULTS: In the 8 years before the establishment of research teams, 60 papers were published. After the establishment of research teams, 77 papers were published. During the 8 years before research teams were being established, 69 presentations were given. During the subsequent 8 years with the use of mentoring and research teams, 92 presentations were given. The research teams resulted in a 33% increase in presentations and a 13% increase in publications. CONCLUSIONS: Establishment of research teams and mentoring can help stimulate research interest and activity. Continuity on research teams throughout the 5-year residency is also crucial for the progression and development, duration, and completion of projects. Continuity of the mentor and research specialists also helps facilitate productivity and completion of the task. This method has been highly successful in improving the research presentations and publications in a community-based hospital residency.

Community Medicine↗

PubMedDate not supplied

The influence of gender on colon cancer stage.

OBJECTIVE: To determine if colon cancer stage at diagnosis varies by gender. METHODS: We conducted a retrospective cohort study comprising of patients diagnosed with colon cancer from 1990 to 2002 and had their data reported to the TriHealth Tumor Registry, Cincinnati, OH. We classified the colon cancer into one of four stages: carcinoma in situ (CIS), local, regional, and distant disease. RESULTS: Our cohort consisted of 2891 patients (1467 women and 1424 men). The women with colon cancer were significantly older and more likely to be single or widowed; in addition, more of them were African American (p < 0.05). The men with colon cancer were more likely to smoke tobacco and consume alcohol (p < 0.05). There was no difference between the genders for family history of colon cancer (8.5% vs. 9.6%). We found that women were significantly less likely to have CIS compared with men (OR = 0.51, 95% CI 0.09-0.85). Women also possessed a nonsignificant decrease in local disease. In contrast, the women showed significantly more regional disease than men (OR = 1.19, 95% CI 1.06-1.30) and had a non-significant increase in distant disease. CONCLUSION: After controlling for multiple variables, at diagnosis and staging of colon cancer, women had more advanced disease than men.

Adult↗

PubMedDate not supplied

Large uterine fibroids causing mechanical obstruction of the inferior vena cava and subsequent thrombosis: a case report.

A 35-year-old woman presented with severe left leg swelling and pain after a spontaneous abortion of a 20-week fetus. Duplex ultrasound imaging confirmed venous thrombosis of the left iliac, common femoral, superficial femoral, deep femoral, greater saphenous, posterior tibial, and popliteal, peroneal, and soleal veins. A computed tomography scan showed large uterine fibroids that were completely compressing the distal inferior vena cava and both ureters, with associated hydronephrosis. A magnetic resonance venography showed the inferior vena cava proximal to the mechanical obstruction was free of thrombosis but was dilated at 27 mm in the suprarenal location. A hysterectomy was performed and an 8-pound uterus was removed. Intraoperative ultrasound of the inferior vena cava showed a patent crescent shaped vein with no thrombus and adequate venous blood flow. Pathology of the uterus showed a large leiomyoma with necrosis. Her lower extremity symptoms resolved.

Adult↗