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Introduction Appropriate antibiotic prescription practices for pharyngitis slow anti-microbial resistance. Unnecessary antibiotic prescribing and non-adherence to practice guidelines remain a clinical problem. The objective of this study was to examine the relationship between group A Streptococcus (GAS) throat culture testing and antibiotic prescriptions at 10 free clinics in the Tampa Bay Area serving the uninsured population. Methods A retrospective cohort study was conducted using data from patient charts from January 2018 to December 2019. We obtained data regarding a chief complaint related to strep pharyngitis: sore throat, enlarged tonsils, pharyngeal erythema, and/or cervical lymphadenopathy. The frequency and relative proportions of throat swab administration and antibiotic prescription were also analyzed. Results Of the 12,005 patients serviced during the study period, 245 (2.0%) reported one or more of the chief complaints related to strep pharyngitis. Of the patients reporting pharyngitis, the mean age was 40.2 years, with 66% being female. Of the patients receiving antibiotics for pharyngitis symptoms, 93 (91.2%) did not receive a throat swab. Patients receiving a throat swab showed a significantly increased odds of antibiotic prescription (OR=3.4, 95% CI: 1.1-12.7). Patients reporting symptoms of pharyngitis commonly had other comorbidities, including smoking (14.7%) and diabetes (13.5%). Conclusion The large proportion of patients receiving antibiotics for pharyngitis symptoms reveals the need for provider counseling on current recommendations of antibiotic prescription practices, which state that a throat swab with a rapid antigen detection test and/or culture should be performed for all patients where bacterial symptoms of rhinorrhea, cough, and/or oral ulcers are present. Another potential area of improvement indicated by this study may be providing additional supplies of throat swabs for these underserved clinics. Further research is needed to understand the root causes of providers' non-compliant prescribing patterns in the free clinics and to assess the role of the uninsured population in reducing anti-microbial resistance.
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Introduction Substance use disorders occur in about 5% of the cancer population and can decrease treatment adherence, impede pain management, and undermine a cancer survivor's network of social support. Although current literature demonstrates substance use is associated with socioeconomic disparity, there is limited research on the prevalence of alcohol, tobacco, and illicit drug use among uninsured cancer survivors in the United States. Our multicenter cross-sectional study describes the prevalence of substance use in uninsured cancer survivors in the Tampa Bay Area. Methods A comprehensive retrospective chart review of electronic medical records and paper charts was conducted at nine free clinics in the Tampa Bay Area of Florida between January 1, 2016, and December 31, 2017. Substance use prevalence was compared between uninsured cancer survivors and uninsured patients without reported cancer history after adjusting for available demographic risk factors. Results There were 222 patients with a history of cancer and 6,768 patients without a history of cancer included for analysis. Cancer survivors had a median age of 55 years (interquartile range 48-61 years), were mostly female (n = 146, 66.1%), and of Hispanic ethnicity (n = 94, 52.5%). Cancer survivors were more likely to be current smokers (n = 42, 25.1%) compared to patients without a cancer history (n = 759, 16.1%). Patients with a history of cancer were more likely to be current drinkers (n = 34, 26%) compared to non-cancer patients (n = 942, 22.9%). There was no significant difference in illicit drug use history between the two groups. Conclusions Our study demonstrates that uninsured cancer survivors are more likely to be smokers and alcohol consumers than uninsured patients without a history of cancer. There was no significant difference in illicit drug use in cancer survivors and patients without a history of cancer. Future educational interventions should target substance use among uninsured cancer survivors.
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Melanoma is the deadliest form of skin cancer. Despite recent advances in medicine and the development of new treatments for melanoma, cures remain elusive as acquired resistance to both targeted and immunotherapies are becoming common. Therefore, more studies are conducted to dissect underlying molecular mechanisms that drive melanoma growth in order to provide better therapeutic option. Here, employing a comprehensive and unbiased analysis of different RNA modification regulatory proteins using various publicly available databases we identify the most relevant RNA modifying proteins that plays crucial role in melanoma development. Our study started with the analysis of various genetic alterations (amplifications, mutations/deletion) as well as RNA overexpression of these RNA modification regulatory proteins in The Cancer Genome Atlas melanoma database. We then analyzed their expression in The Human Protein Atlas data. The result of analysis revealed that only a subset of RNA modification regulatory proteins are overexpressed in >75% of melanoma patient cases as compared to normal skin. However, when examined in Oncomine dataset we found only two genes (METTL4 and DNMT3A) were significantly overexpressed in melanoma samples versus normal skin samples and matched with the results of The Human Protein Atlas data. Therefore, we functionally validated METTL4 and DNMT3A using shRNA-mediated knockdown and found that their knockdown in melanoma cells led to melanoma cells growth inhibition. Collectively, in this study, we investigated the epitranscriptomic landscape of melanoma using various publicly available database and identified DNMT3A and METTL4 as the most relevant potential regulators of melanoma growth.
