RESUMEN
Barrett's esophagus (BE) is a well-known premalignant condition that can be associated with the development of dysplasia and adenocarcinoma. In the past, esophagectomy was the standard treatment for patients with BE with high grade dysplasia (HGD) and early cancer (EC). However, esophagectomy is not necessarily the only treatment response to HGD and EC anymore. Over the past decade, a number of endoscopic therapies have been developed for management of BE. These include endoscopic mucosal resection, thermal ablation techniques that use laser irradiation, multipolar electrocoagulation, argon plasma coagulation, photodynamic therapy, and the recently developed cryotherapy and radiofrequency ablation.
Asunto(s)
Esófago de Barrett/terapia , Esofagoscopía , Coagulación con Plasma de Argón , Crioterapia , Humanos , Terapia por Láser , FotoquimioterapiaAsunto(s)
Negro o Afroamericano , Enfermedades Inflamatorias del Intestino/complicaciones , Prueba de Papanicolaou , Neoplasias del Cuello Uterino/complicaciones , Frotis Vaginal , Adulto , Estudios de Casos y Controles , Estudios de Cohortes , Femenino , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Neoplasias del Cuello Uterino/diagnósticoRESUMEN
INTRODUCTION: Less hygienic use of blood glucose monitoring equipment such as blood glucose meters, lancets, finger stick devices or other diabetes-care equipment such as syringes or insulin pens by self-administration often exposes the diabetic patient to Hepatitis B infection. This study evaluates hepatitis B vaccination among individuals with diabetes. METHODS: The study used data from the 2000-2013 National Health Interview Survey (NHIS). Vaccination rates among adult individuals with diabetes of various ethnic backgrounds was accessed and compared using chis-square tests. Multivariable logistic regression model was used to compare factors affecting hepatitis B vaccination among individuals with diabetes. RESULTS: The crude rate of diabetes in this population was 5.4%. The rate of vaccination among individuals with diabetes differed across racial groups (Asians 31.8% vs. blacks 30.7%; and whites 26.5%; p<0.01). After multivariate regression, the leading factors affecting hepatitis B vaccination included Age (40-60 years) (OR=0.51, 95% CI=0.47-0.57, p<0.01), lack of college education (OR=0.71,95% CI=0.64-0.79, p<0.01), foreign birth (OR=0.83, 95% CI=0.72-0.95, p<0.01), and Hispanic ethnicity (OR=0.88, 95% CI=0.78-1.00, P<0.05). CONCLUSION: Social and economic factors-education, insurance status, age, poverty level, and place of birth affect rates of vaccination among individuals with diabetes.