Survival nasopharyngeal cancer,survival equipment jobs in uk,survival gear and weapons - Review

admin | Category: Electile Dysfunction 2016 | 09.06.2015
Epstein-Barr virus, nasopharyngeal carcinoma, nasophargeal carcinoma at Libya, ">  Background and objectiveLibya is one of the North African countries with an endemic of nasopharyngeal carcinoma, particularly in the northern part of Libya as compared with its southern part.
In this type, the condition usually originates in the squamous cells that line the middle part of the pharynx called oropharynx.
The keratinizing cells that arise from the epithelial basal layer of the nasopharynx become cancerous in this condition. This form is represented by malignancy arising in the non-keratinized squamous epithelium and observed in most number of patients. The malignant condition starts with the formation of abnormal cells found in the lining of the nasopharynx.
The malignant cells undergo rapid proliferation and gradually reach the oropharynx, affecting the soft palate, tongue and tonsils. The cancerous cells can be found in the lymph nodes on one side of the neck, besides the nasopharynx. On further multiplication, the cancer cells spread beyond the primary site to the cranial nerves, posterior throat, ocular bone, and areas surrounding the skull or jawbone.
The cancer extensively spreads to lymph nodes above the collar bone, which is located between the ribcage and shoulder blade. The pharynx starts behind the nose and ends at the top of the trachea, a membranous tube which makes its entry directly into the lungs. The possibility of a genetic mutation as well as intake of food contaminated with carcinogenic nitrosamines in causing cancer of the nasopharynx cannot be entirely ruled out. Proper diagnostic information can be obtained from the process of staging, which helps healthcare providers to know the current stage of the disorder. In this procedure, nasoscope, a thin, lighted tube-like instrument fitted with a lens, is inserted into the nasal cavity to look for abnormal areas.
Affected patients can be checked for antibodies produced against the nuclear antigens associated with EBV.
The method does not involve any deeper investigation of the neurological system, but includes a superficial determination of the sensory neurons and motor reflexes.
Radiographic studies of the head produce a series of images of the nose, sinuses, and facial bones for detecting both minor and minor growths in the respective regions. The imaging techniques are the ideal modalities to detect the disorders of the bone and other organs as well.
This highly specialized imaging technique is normally used to find the presence of malignant cells in the bones. In this process, the malignant cells are subjected to high-energy x-rays in order to destroy or delay its growth.
Younger patients as well females seem to respond better to the treatment than the older population. Aside from direct effects on survival, severe comorbidity can also have a prognostic impact by altering therapy. We assessed the prognostic impact of comorbidity in a group of patients with cancer of the larynx and used a statistical techniques called conjunctive consolidation to include comorbidity in a staging system.
The cohort of 196 patients with laryngeal cancers consisted of 151 men and 42 women whose median age was 62 years.
To incorporate comorbidity into the TNM staging system and maintain the four category system, a statistical technique known as conjunctive consolidation, or targeted-cluster analysis, was used. In conjunctive consolidation, prognostic variables are combined, based on biologic and statistical criteria, to produce composite variables. Prognostic Information Provided by Comorbidity-Utilizing the conjunctive consolidation techniques, we demonstrated the unique prognostic information provided by comorbidity within TNM. Three Composite Stages-Because both prognostic comorbidity and TNM stages were distinctively important, we combined the categories, using the conjunctive consolidation strategy. The purpose of staging is to divide a large, usually heterogeneous group into smaller subgroups that are externally disparate but internally homogeneous with respect to outcome. When evaluating different staging systems or the same staging system in different populations, one must keep in mind that the level of "performance" of the system depends largely on the variance of the predictors and the rate of development of the outcome event in each study population.
Monotonicity of Survival Gradient--The survival gradient is monotonic if each of the successive subgroups has a consistently lower (or higher) survival rate than the preceding group. The range of survival gradient is the difference between the highest and lowest survival rates in the staging system. Proportionate Reduction in Predictive Errors--A staging system divides a population into unique prognostic strata. Proportionate Reduction in Variance-The proportionate reduction in variance refers to the proportion of group variance in the original population that was later reduced by the division into stages. Chi-Square for Linear Trend-This score represents a test of the linear monotonicity of the survival rates within ordered categories. The c-statistic is derived from measures of sensitivity and specificity and is equal to the area under the receiver operating characteristic (ROC) curve.
The results of the quantitative evaluation of the TNM and composite staging systems are shown in Table 6.
Prospective collection of data from a different cohort of patients is crucial to demonstrate the validity of the proposed composite staging system.
The widespread use of the TNM staging system has helped standardize the classification of human cancers. Taxonomies exist to classify comorbidity, and statistical techniques are available to include multiple variables into a single staging system.

The clinical and histopathological presentation reveals no uniquely specific pattern of appearance; however, there is high deficiency in the data that confirm the possible predisposing factors that may play a role in the development of this common variety of head and neck cancer in this country, and whether these factors affect the patients' response to treatment. Effect of Epstein-Barr virus infection on predisposition and postradiotherapeutic prognostic value among Libyan patients with nasopharyngeal cancer. Detection of low level of human papilloma virus type 16 DNA sequences in cancer cell lines derived from two well-differentiated nasopharyngeal cancers. Epstein-Barr virus-associated malignancies: epidemiologic patterns and etiologic implications. Volatile nitrosamine levels in common foods from Tunisia, south China and Greenland, high-risk areas for nasopharyngeal carcinoma (NPC).
Effect of nickel sulfate on cellular proliferation and Epstein-Barr virus antigen expression in lymphoblastoid cell lines.
Nasopharyngeal carcinoma in Malaysian Chinese: occupational exposures to particles, formaldehyde and heat.
Traditional Cantonese diet and nasopharyngeal carcinoma risk: a large-scale case-control study in Guangdong, China.
Environmental and dietary risk factors for nasopharyngeal carcinoma: A case-control study in Zangwu County, Guangxi, China.
Adulthood consumption of preserved and nonpreserved vegetables and the risk of nasopharyngeal carcinoma: a systematic review. Cantonese-style salted fish as a cause of nasopharyngeal carcinoma: report of a case-control study in Hong Kong.
Evaluation of nonviral risk factors for nasopharyngeal carcinoma in a high-risk population of Southern China. Nasopharyngeal cancer in a low-risk population: defining risk factors by histological type.
In other cases, the cancer may spread to the area surrounding the nasopharynx as well as to the lymph nodes in a unilateral direction. About 18% of cases are reported from Guangdong, a province on the south sea coast of the People’s Republic of China. Abnormal count of white blood cells is a warning sign of a possible malignant condition in the body. For this, a plain physical examination and evaluation of a patient’s medical history is needed to identify problems related to the brain, coordination of muscles and movement. The procedure involves intravenous administration of a small quantity of radioactive glucose.
Some anticancer drugs are orally administered to the patients while the remaining ones are given through the vein or muscle. The method uses laboratory-prepared substances that may boost or restore the body’s natural defense system and negate the effects of cancer. This is more often seen in the advanced stages of the disorder where the lymph nodes and other tissues of the neck get involved. A patient who is "too sick" to tolerate a preferred treatment may be given a less aggressive or even palliative therapy.
The illustrative data derived from a study of patients with biopsy-proven squamous cell carcinomas of the larynx first treated between 1975 and 1983 at Yale-New Haven Hospital, New Haven, Connecticut [16]. This form of multivariate analysis can be used to incorporate prognostic variables into an existing staging system without relying on cryptic mathematical regression equations or the exponential expansion of stage groupings [26,37-39]. The system can maintain a discrete number of stages (usually three or four), and is more relevant and meaningful to clinicians than are the results of regression equations [39].
Thus, the eight comorbidity-TNM stage groups were consolidated into three composite stages: alpha, beta, and gamma (Table 4). Among the 166 patients without prognostic comorbidity, the beta group consisted of TNM stages III and IV and the alpha group, TNM stages I and II. The qualitative comparison of different staging systems is best done with "face validity" or "common sense" [40], whereas statistical scores and tests are used for the quantitative evaluation of each system's mathematical accomplishments [41]. When the outcome of interest is a dichotomous event, all the members of a stratum are "predicted" to have attained or not attained the target event, depending on whether the stratum rate is above or below 50%. The score ranges from 0 to 1, and higher values represent better achievements for staging systems having the same number of categories. Both systems produced a monotonic survival gradient and distributed the entire population into the various stages fairly equally. In addition, the unique prognostic impact of comorbidity demonstrated in laryngeal cancer must be separately assessed in other anatomic subsites within the head and neck region before a comprehensive comorbidity-anatomic staging system for head and neck cancer can be proposed. Nevertheless, clinical factors, such as comorbidity, which are important for classification, prognostication, and evaluation of treatment effectiveness, remain excluded. The continued exclusion of important clinical factors perpetuates an imprecise cancer classification system, and the inclusion of these variables should be a top priority of clinical researchers. Denoix PF, Schwartz D: Regeles generales de classification des cancers et de presentation des resultats therapeutics.
A scanner is made to revolve around the body to produce three-dimensional images of organs that have utilized the maximum amount of glucose. Surgical removal of these diseased tissues may prevent the cancer from spreading to the other regions. NPC has a 5-year survival rate, which means that affected patients live for at least 5 years after the diagnosis of the disorder. The risk factors associated with the condition must be kept at bay to prevent it from occurring.

Consequently, the presence of severe comorbidity, rather than the TNM stage, may sometimes determine the selection of treatment [33-35] and the patient's eventual outcome [7,17,36]. The methods of research included retrospective review of the medical records and use of a standard medical record data extraction form, coding form, and coding criteria handbook. Table 2 shows the 5-year survival results according to eight baseline variables for the 193 patients for whom 5-year survival data were available. Some quantitative scores and tests used for dichotomous outcomes (ie, survival) are described below. For instance, if the survival rate for a particular stage were higher than 50%, each member of this stratum would be predicted to survive.
The total improvement in congruent fit can be expressed as the proportionate reduction in predictive errors. For each of the quantitative tests, the composite staging system performed better than the TNM system.
The life-threatening disorder has been attributed to Epstein-Barr virus (EBV), which belongs to the herpes family. Since cancer cells are highly active, the rate of metabolic process in the affected areas of the body is rapid. Nevertheless, comorbidity data are not currently collected or included in cancer statistics.
Age, symptom status, TNM stage, and prognostic comorbidity were the variables that provided important prognostic information. Within that stage group, however, the 71 patients without prognostic comorbidity have a survival rate of 83%, whereas the 6 patients with prognostic comorbidity have a rate of 17%. The results were statistically significant, and adjacent stages showed a chi-square for linear trend value of 42.2 with P less than 0001. This commonly found infectious agent generally causes a host of malignant ailments, including Burkitt’s lymphoma and NPC. As demonstrated in Table 1 and the previously cited reports, this omission continues to produce major imprecision in the classification of patients and the subsequent interpretation of both 5-year survival rates and therapeutic effectiveness.
Likewise, within TNM stages II, III, and IV, the presence of prognostic comorbidity defines unique prognostic subgroups that would not have been identified by TNM stage alone. The larger the proportionate reduction in predictive error, the better is the staging system.
Pathological studies of type 2 and 3 of the disease have shown that the virus can severely infect the epithelial cells by undergoing multiple transformations.  The manner in which the virus enters the body has not been determined because the natural reservoir of this minute living particle is still unknown. All patients with lymphoepithelioma showed significant response to concomitant radiochemotherapy (100%) with high survival rate exceeding 5 years.ConclusionThe EBV infection can be considered one of the main predisposing factors to nasopharyngeal carcinoma in the Libyan population.
Many medical investigators agree that NPC follows a complex process and apart from its ethnic susceptibility, the involvement of several carcinogens triggers the formation of the malignant cells. It was noted from this study that the induction of cancer by EBV is mainly by chronic infection rather than by acute infection; this was confirmed by significant elevation in serum IgG rather than IgM. Clemens JD, Feinstein AR, Holabird N, et al: A new clinical-anatomic staging system for evaluating prognosis and treatment of prostatic cancer. Peipert JF, Wells CK, Schwartz PE, et al: The impact of symptoms and comorbidity on prognosis in stage IB cervical cancer.
Bennett CL, Greenfield S, Aronow H, et al: Patterns of care related to age of men with prostrate cancer. Boyd NF, Clemens JD, Feinstein AR: Pretherapeutic morbidity in the prognostic staging of acute leukemia. Wells CK, Stoller JK, Feinstein AR, et al: Comorbid and clinical determinants of prognosis in endometrial ca. Adami HO, Malker B, Holmberg L, et al: The relationship between survival and age at diagnosis in breast cancer. Sigurdsson H, Baldetrop B, Borg A, et al: Indicators of prognosis in node-negative breast cancer. Burke HB, Henson DE: Criteria for prognostic factors and for an enhanced prognostic system. Kaplan MH, Feinstein AR: The importance of classifying initial comorbidity in evaluating the outcome of diabetes mellitus.
Satariano WA: Comorbidity and functional status in older women with breast cancer implications for screening, treatment, and prognosis.
Concato J, Horwitz RI, Feinstein AR, et al: Problems of comorbidity in mortality after prostatectomy.
Greenfield S, Bianco DM, Elashoff RM, et al: Patterns of care related to age of breast cancer patients.
Satariano WA, Ragland DR: The effect of comorbidity on 3-year survival of women with primary breast cancer. Gordon TJ: Hazards in the use of the logistic function with special reference to data from prospective cardiovascular studies. Concato J, Schwartzman D, Feinstein AR: A comparison of logistic regression and conjunctive consolidation as methods of multivariable analysis (abstract).
Harrell FE, Lee KL, Califf RM, et al: Regression modeling strategies for improved prognostic prediction.

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