Epidemiology of Pancreatic Cancer

Epidemiology of Pancreatic Cancer Introduction Pancreatic cancer is the most lethal and hard to diagnose type of cancer and thus often called the â€Å"silent killer†. Currently, no early detection method and no effective treatment are available for pancreatic cancer. Moreover, out of all patients diagnosed with pancreatic cancer, 75% will die within the first year where most within 3-6 months (Klein, 2013). While it is practically impossible to tell what person will develop this type of cancer the essential pathophysiology of cancers can help with understanding the origins and reasons for pancreatic cancer development. Like most cancers, pancreatic cancer is caused by damage to DNA leading to its mutation. These mutations can be originated from different sources which can be categorized according to the nature of the occurrence. Three main categories of mutations have been universally recognized: inherited mutation, age-related, carcinogen caused or due to human behavior (Klein, 2013). The outcome of the exposure to one or multiple DNA mutation causes may be the formation of the neoplasms in the pancreatic tissue which may progress to actual pancreatic cancer where initial growth of the tumor is silent; therefore, symptoms are usually a sign of advanced disease. The objective of the present research paper is to highlight the epidemiological facts related to pancreatic cancer (i.e frequency, distribution and determinants of health) and identify the public health authorities’ approaches towards management and control of this devastating health condition. Frequency, Distribution And Determinants of Health According to Canadian Cancer Registry age-standardized incidence rated (ASIR) of pancreatic cancer has been declined for men by 0.46% on the course from 1991 to 2007 with 11.2 case per 100,000 population in 1991 and 10.5 cases in 2007 respectively. However, during the same period of time the ASIR of pancreatic cancer for women per 100,000 population remained steady with a slight fluctuation hovering around 8.5 case. The prevalence rate in United States and Europe has been calculated to be about 99,901 cases before 2012 with an incidence of 37,685 new cases in 2012. Despite the fact that some significant progress in cancer survival rate has been attained the projected 5-year rate of survival remained persistent slightly rising to 5.4% since 1975. Such poor outcomes are mostly due to the fact of the nature of the cancer where more than 80% of the patients presenting with already advanced stage and metastatic aetiology (Klein, 2013). However, despite the poor prognosis of 5 years that has been shared by researches conducted both in US, Europe and Canada the age-standardized mortality rate (ASMR) in Canadian men has declined substantially by 0.61 percent since 1992 lingering around 8.9 cases per 100,000 in 2009 (95% confidence interval). With regards to women ASMR the data from Statistics Canada claims the decrease of 0.2% for the same period of time which attests to the stability of rates in women (Zaheer Gallinger, 2013). Determinant of Health The most commonly recognized carcinogen related to pancreatic cancer is cigarettes. Smoking remains the most associated risk to cancer development having odds ratio (OR) of 1.74, 95% confidence interval (CI). Thus, the cessation is the main recommendation being disease specific (Zaheer Gallinger, 2013). Less putative risks associated with this type of cancer include: body mass index (BMI) over 35 (OR of 1.55 and 95% CI) and alcohol consumption of over 6 beverages a day is seen to be associated (OR 1.46, 95% CI) (Borgida et al., 2011). Original Epidemiological Studies Management of pancreatic adenocarcinoma in Ontario, Canada: a population-based study using novel case ascertainment This uses prospective case-control and cross-sectional survey observational study design. The study population is pancreatic adenocarcinoma (PA) patients in Canada with data sources from diagnosed patients of PA between 2003 and 2006 who were identified using electronic pathology reporting (E-path) of the Pathology Information Management System (PIMS). For more information questionnaires were mailed to patients. The main results showed a low participation rate of 26% (351 out of 1325). Nonresponders were mostly over 70 years old and more likely to have had treatment in non-academic centres. While, 54% of responders had a potentially curative operation with 77% being 70 years or younger (p=0.03). Academic centres had higher resection rates and less frequently aborted resections with curative intent. Low rates showed 43% of responders received chemotherapy and 7% participated in clinical trials (Borgida et al., 2011). Diagnosis and management of pancreatic cancer This uses case-control and prospective observational study design. The study population is Canada with data sources from Cochrane for systematic reviews, reference lists from prior studies, Medline, PubMed and Google Scholar using MeSH terms. The main results shows the diagnosis and treatment relevant to the general clinician includes screening via Triphasic abdominal contrast computed tomography is most preferred for diagnosis, smoking cessation as the sole preventative measure, curative potential remains with surgery, adjuvant chemotherapy, and survival benefit from FOLFIRINOX, gemcitabine alone and plus for advanced cases (Zaheer Gallinger, 2013). Identifying people at a high risk of developing pancreatic cancer This uses cohort, case-control and prospective observational study design. The study population is North America with data sources from familial pancreatic cancer registry and other registries (Klein, 2012). The main results was that through relatives of pancreatic cancer patients there has been demonstrated in relation to pancreatic cancer a familial aggregation of 1.5–1.3-fold increased risk, quantified risk of this cancer and other cancers, identification of susceptibility genes in these high risk families and initiation of screening trials (Klein, 2012). Public Health Approaches Electronic Pathology Reporting System Electronic Pathology Reporting System (E-path) is an approach used to identify pancreatic adenocarcinoma (PA) patients across Ontario. It is implemented to provide the fastest source of cancer information. Ontario Cancer Registry uses Pathology Information Management System (PIMS), which relies on E-path. The E-path system is a database used for collecting electronic pathology information from laboratories in Ontario that process tumour specimens. E-path provides reports in a timelier manner than paper-based reports and has shown an increase in report’s completeness. This has great advantage when studying patients that have fast and progressive disease such as PA. In this system, electronic pathology reports come from each laboratory and are queued in a database by health record technicians for on-screen review. This process occur daily in most laboratories and weekly in some low-volume laboratories. If the health record technician see the report findings useful, the report wi ll be coded and consolidated with the OCR database. Reports of particular cancers like PA are filtered and printed by study personnel for review (Borgida et al., 2011). Educational Events and Symposia Organizations such as Pancreatic Cancer Canada host some series educational events for Pancreatic Cancer (PC) patients, their families, relatives, and friends in places across Canada. These events give opportunity for patients learn more about the topics related to pancreatic cancer. Also, there are meetings or conferences held by leaders in the PC field to talk about different topics and bring mutual trust and friendship to survivors and those touched by the disease (Pancreatic Cancer Canada, 2011). Research Established partnerships with leading research hospitals to raise the profile of the disease. Funding is being provided by organization like PCC to continue the fight for cancer (Pancreatic Cancer Canada, 2011). References Borgida, A. E., Ashamalla, S., Wigdan, A-S., Rothenmund, H., Urbach, D., Moore, M., Gallinger, S. (February 2011). Management of pancreatic adenocarcinoma in Ontario, Canada: A population-based study using novel case ascertainment. U.S. National Library of Medicine National Institutes of Health, 54(1), 54-60. doi: 10.1503/cjs.026409 Klein, A. P. (December 6, 2012). Identifying people at a high risk of developing pancreatic cancer. U.S. National Library of Medicine National Institutes of Health, 13(1), 66-74. doi: 10.1038/nrc3420 Pancreatic Cancer Canada. (2011) Educational Events and Symposia. Retrieved from: http://www.pancreaticcancercanada.ca/site/PageNavigator/facingpancreaticcancer_educational_events.html Pancreatic Cancer Canada. (2011) Research. Retrieved from: http://www.pancreaticcancercanada.ca/ site/PageServer?pagename=research_main Zaheer K. S., Gallinger, S. (2013). Diagnosis and management of pancreatic cancer. Pancreatic Cancer Canada. Retrieved from: http://www.pancreaticcancercanada.ca/site/DocServer/Steven_Gallinger_report_April_23_2012.pdf?docID=1361

Themes Presented in Goblin Market by Christina Rossetti Essay -- Gobli

Themes Presented in Goblin Market by Christina Rossetti Christina Rossetti's used her poetry to express herself; her work exhibits many autobiographical elements and from it the reader can discern Rossetti's emotions, beliefs and her comments on the society she lived in. As a female poet it would have been improper for Rossetti to deal directly with these issues though and so her ideas are masked through appearing to be children's poetry and having simple meanings. 'Goblin Market' superficially appears to a moral story about two sisters one of whom gives way to the temptation of the goblins forbidden fruits but through her poetic techniques Rossetti manages to embody her fears and desires. One of the desires Rossetti appears to have in this poem is for a relationship similar to that of Lizzie and Laura; the closing lines of the poem express the joys of having a sister "To fetch one if one goes astray", but Rossetti had only brothers. This theme of friendship is crucial to the plot of the poem and maybe Rossetti yearns for someone she can feel close to. Rossetti shows the difference between the love Laura has for the goblins fruits and the love between the sisters through the use of parallelism. While Laura "sucked" the goblins' fruits "until her lips were sore" showing Laura's greed as she gives way to temptation and gives a strongly physical image, Lizzie calling "Hug me, kiss me, suck my juices / Squeezed from goblin fruits for you" brings to mind Lizzie's self-sacrifice - the difference of Laura's lust for the juices and Lizzie's love for her sister is apparent. The image by Rossetti describing the sisters "Like two pigeons in one nest" creates a strong impression of the closeness between the two s... ...n coming before love in Rossetti's life. 'Goblin Market' contains many of the key themes that appear throughout Rossetti's poetry. In typical Rossettian style it appears almost superfluous on first reading but subtexts hidden within it. The casual rhyming scheme suggests that the work is a aimed at being children's poetry but the issues it deals with are distinctly adult. Early in the poem Laura is described as "rearing her glossy head" and much later on Lizzie is referred to as being stubborn as a "horse"; this demonstrates that through repetition and subtle parallels Rossetti manages to show how both sisters are so similar and yet so far apart. Christina Rossetti's use of poetic devices allows 'Goblin Market' to work on several levels allowing her to write poetry both acceptable to the society she lived in while also allowing her to express herself.

Combining Vinegar and Baking Soda- Lab Report

The second trial displayed similar results of a weak presence of carbon dioxide. The solution bubbled up, the cork stayed stationary in the top of the bottle, but the solid did not dissolve completely. A third trial was performed in which we decided to increase the amount of vinegar used. The indicator which triggered this decision was the resulting solid at the bottom of vessel. In the third trial we kept the baking soda our constant at % TTS. ND deed 2 ounces of vinegar. The results remained similar to trial two. The solution bubbled, the cork remained stationary In the top of the bottle, and there remained solid In the bottom of the vessel. A fourth trial was performed In which we again Increased the amount of vinegar added to dissolve the solid. In the fourth trial we kept the baking soda our constant at % TTS. And added 3 ounces of vinegar. The results Improved slightly as we saw that, although the cork remained stationary, the solution bubbled substantially higher In the bottle displaying a stronger presence of arbor dioxide.It was also noted that the solid that remained was much less than In past trials. A fifth trial was performed in which we again increased the amount of vinegar added to dissolve the solid. In the fifth trial we kept the baking soda our constant at TTS. And added 4 ounces of vinegar. The results dramatically changed. The solution bubbled almost immediately and so quickly that the solution overflowed that there was more than enough baking soda, there may have been too much vinegar added and that the technique of the pour may have been too slow or the exults may have been different.A sixth and final trial was done in which we kept the baking soda our constant at % TTS. And reduced the amount of vinegar poured to approximately 3 h ounces. The pour was done more quickly and the bubbling reaction took place almost immediately. The cork was placed in the bottle after the overflowing had started to occur so the reaction of the cork popping st ill was not quite achieved, however the last trial did show a large amount of carbon dioxide present. The data from each trial is recorded in the table below on the following page.In order to study he reaction we created trials which would allow the chemicals to combine within a vessel. The movement or lack of movement from the cork allowed us to measure the amount of carbon dioxide present in each experiment. My results showed the trial with the greatest reaction was the final trial because the solution bubbled almost more than the other trials. If the cork had been placed inside of the bottle quicker or if the pour had been slightly slower the cork would have popped with stronger force.The trial with the least reaction was trial one because the solution bubbled the least wowing a weak presence of carbon dioxide, the solid dissolved completely and the cork remained completely stationary showing there was very little pressure within the vessel. While observing the experiment, I noti ced that the more vinegar added and the quicker the pour the greater the reaction and the more the solution bubbled. In order to further investigate the experiment, next time I would try the experiment utilizing only one student performing the pour to keep consistency of the control of the pour and the pressure being applied to the cork.

Analysis Of The Necklace Novel - Free Essay Example

Sample details Pages: 2 Words: 549 Downloads: 4 Date added: 2019/08/02 Category Literature Essay Level High school Tags: The Necklace Essay Did you like this example? Mathilde Loisel lives in a level with her better half, who fills in as a representative for the Minister of Edification. Their lives are not lavish, but rather they are not impecunious, just basic. Mathilde, be that as it may, yearns to be lavish. Don’t waste time! Our writers will create an original "Analysis Of The Necklace Novel" essay for you Create order She begrudges her companion Jeanne who has a gigantically goliath house and bunches of adornments. One day her significant other conveys home a solicitation to a ball. He commends his better half will be invigorated to go to such an extravagant gathering, however rather she is vexed. She repines that she has nothing compatible to wear to such an excessive event. Her kind spouse agrees to give her the four hundred francs that he had been saving to purchase an early rifle to get herself an outfit. The seven day stretch of the gathering, Mathilde appears to be thoughtful once more. At the point when her better half asks her for what reason, she worries that she has no adornments to wear with her dress. He recommends that maybe she could obtain something from her companion Jeanne Forestier. Mathilde goes to Jeannes home and chooses a shimmering jewel jewelry to get. She and her better half go to the celebration and have an impressive time. She hovers astounding and moves throughout the night. Determinately, they head home in the small hours of the morning. When they arrive home, Mathilde understands that the jewelry is absent. They think about whether it tumbled off in the carriage that they brought home, however neither of them depicted the number. Her significant other goes out to test the lanes yet returns with next to nothing. To slow down for time, Mathilde prosecutes to her companion that she broke the fasten and is having it restored. Meanwhile, they discover another jewe lry that matches the missing one, however it costs thirty-six thousand francs. Her better half randomly acquired eighteen thousand francs from his dad, however they will require to get whatever remains of the mazuma. Convincingly, they have enough to buy the supersession jewelry and Mathilde offers it to Jeanne who doesnt even optically solicit it. The following ten years Mathildes life changes significantly. They peregrinate to a more moment residence where she needs to cook and clean for herself. She moreover works as an afterthought while her better half maintains numerous sources of income to pay back all the mazuma they acquired. After the ten years, the mazuma is altogether paid back, yet Mathilde has matured a lot. One day she optically observes Jeanne Forestier in the city. She chooses to reveal to her reality about the jewelry. Jeanne is staggered by Mathildes unpleasant appearance. Mathilde elucidates that it is in a roundabout way in light of Jeanne since she lost the jewelry she obtained from her and needed to pay for a supersession. Stunned, Jeanne admits that the neckband Mathilde acquired was an invented unauthentic, made out of glue, worth close to five hundred francs. Pellucidly, the enlightenment of the story is that veracity is the best strategy. On the off chance that Mathilde had been veracious with her com panion from the initiation, she would have discovered that the accessory wasnt made out of bona fide precious stones and would not have squandered ten years paying for a supersession.