Medulloblastoma (MB) is a brain malignancy, which commonly occurs in children, but is rare in adults. The Surveillance, Epidemiology, and End Results (SEER) database was used to compare survival, clinical features, and prognostic factors of children and adults with MB from 1992 to 2013. Overall survival estimates were compared using the Kaplan–Meier method, and Cox Proportion Hazard Regression modeling was used to evaluate prognostic variables. We identified 616 children (63.8%) and 349 adults (36.2%) with diagnosis of MB. The estimated survival rates for children diagnosed with MB for 2, 5, and 10 years were 85.6%, 75.5%, and 67.9%, respectively; the corresponding estimates for adults were 84.9%, 74.2%, and 67.3%. Radiotherapy was the only identical prognostic factor observed in the two groups. Children MB patients were more likely to experience distal metastases that was associated with increased hazard of mortality, and be diagnosed after 2003. Among adult MB patients, gross total resection (GTR) was a favorable prognostic factor, while large cell/anaplastic (LC/A) histology was correlated with decreased survival. Our analysis highlighted that both groups had similar overall survival time, but the prognostic factors were not comparable, except radiotherapy which was associated with better survival.
Objectives
The association of C‐reactive protein (CRP) and serum 25‐hydroxyvitamin D [25(OH)D] and cardiovascular disease (CVD) remains unknown.
Methods
We performed a cross‐sectional analysis on 3848 participants by using the data from the National Health and Nutrition Examination Surveys (2007 to 2008). CVD was defined as a compromise of stroke, myocardial infarction, heart failure, and coronary heart disease. High CRP was defined as ≥0.2 mg/dL, and vitamin D status were categorized as severe deficiency, <25 nmol/mL; deficiency, 25 to 49.9 nmol/mL; insufficiency, 50 to 74.9 nmol/mL; and normal, ≥75 nmol/mL. Statistical analysis was performed using logistic regression models.
Results
We found that both high CRP and low 25(OH)D levels were associated with CVD. Participants with high CRP levels and severe vitamin D deficiency had a higher likelihood of having CVD than those with neither risk factor (odds ratio = 2.69, 95% confidence interval = 1.45‐4.98,
P
= .0017). In stratified analysis, a significant positive association between vitamin D level and CVD was observed only in the high CRP group. However, in the absence of high CRP, even with severe vitamin D deficiency, no association was found with an increasing risk of CVD (
P
= .6416).
Conclusion
Within a cross‐sectional, nationally representative sample, these findings suggest that vitamin D status evaluation, or vitamin D supplement may be especially important for individuals with high CRP levels.
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