IntroductionWhile mortality following primary cervical cancers (PCCs) continues to decline due to advancements in screening and treatment, a small subset of women who developed PCCs will develop second malignancies after their initial diagnosis. Little is known about these women. ObjectiveThis study aims to determine the common second malignancies among patients with primary cervical cancers and the factors associated with improved overall survival. MethodologyWe conducted a retrospective analysis of all PCCs in the SEER database between 1975 and 2016. We identified a subset of patients who subsequently developed secondary malignancies after a primary cervical cancer diagnosis. We then determined the factors associated with a prolonged latency interval, defined as the time between the PCC diagnosis and a subsequent secondary malignancy diagnosis. In a sub-analysis, we also determined the commonest secondary malignancies following a PCC diagnosis. ResultsA total of 1,494 patients with cervical cancers developed a second malignancy during the study period. The mean age at diagnosis of the PCCs was 56.0 ± 14.0 years. The mean latency interval between PCC and a subsequent secondary malignancy was 9.6 ± 9.3 years. Cytoreductive surgery (odds ratio (OR) = 1.40; 95% confidence interval (CI) = 1.05-1.86) and radiotherapy (OR = 1.52; 95% CI = 1.14-2.03) during the PCC are associated with a prolonged latency interval.Patients who received chemotherapy (OR = 0.23; 95% CI = 0.16-0.33) or those of Hispanic ethnicity (OR = 0.63; 95% CI = 0.44-0.90) were more likely to develop second malignancies within 10 years after a PCC diagnosis. The most common second malignancies were abdominal malignancies with rectal cancers (12.2%), pancreatic cancers (10.1%), stomach cancers (9.2%), cecum cancers (8.4%), and sigmoid colon cancers (8.3%). ConclusionThere is a significant association between Hispanic ethnicity and a shorter latency interval among patients with PCC. The findings from this study may help optimize screening for secondary cancers among cervical cancer survivors.

Introduction Although disparities in cancer survival exist across different races/ethnicity, the underlying factors are not fully understood. Aim To identify the interaction between race/ethnicity and insurance type and how this influences survival among non-Hodgkins lymphoma (NHL) patients. Methods We utilized the SEER (Surveillance, Epidemiology, and End Results) Registry to identify patients with a primary diagnosis of NHL from 2007 to 2015. Our primary outcome of interest was the hazard of death following a diagnosis of NHL. In addition, we utilized the Cox regression model to explore the interaction between race and insurance type and how this influences survival among NHL patients. Results There were 44,609 patients with NHL who fulfilled the study criteria. The mean age at diagnosis was 50.9 ± 10.8 years, with a mean survival of 49.8± 34.5 months. Among these patients, 64.8% were non-Hispanic Whites, 16% were Hispanics, and 10.8% were Blacks. In addition, 76.5% of the study population had private insurance, 16.6% had public insurance, and 6.9% were uninsured. Blacks had the worst survival (HR=1.66; 95% = 1.55-1.78). Patients on private insurance had better survival compared to those with public insurance (HR=2.11; 95% CI=2.00-2.24) Conclusion The racial and socioeconomic disparity in survival outcomes among patients with NHL persisted despite controlling for treatment modalities, age, and disease stage.

Psychogenic vomiting is defined as recurrent vomiting without any known discernible organic reasons, or functional vomiting occurring from psychological stress. The overall clinical presentation of psychogenic vomiting suggests a wide range of disability levels, such as stress disorders, mood changes, depression, sexual problems, personality disorders, learned responses, conversion disorders, and illness problems. Non-pharmacological treatment modalities are important as medication for psychogenic vomiting such as individual and group psychotherapy, supportive and behavioral therapy, and family and marital therapy. In this case report, a 25-year-old male with schizophrenia on medication presented to an outpatient clinic with the primary complaint of recurrent vomiting. After ruling out pathologic and physiologic causes of vomiting. It was classified as psychogenic vomiting.

Introduction: Fetal macrosomia is defined as a fetal weight of more than 4kg or 4.5 kg irrespective of gestational age at delivery. The mode of delivery is usually left to the surgeon's discretion, but fetal macrosomia increases the risk of cesarean delivery among women worldwide. In addition, the role of social determinants of health such as maternal race, educational level, and insurance in managing fetal macrosomia cannot be overemphasized.Aim: To determine the interaction between maternal race, insurance, and education level and how this affects the management of fetal macrosomia in the United States.