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Objective To assess the association between patterns of distant metastases and overall survival in metastatic ovarian cancer and identify prognostic factors for site-specific distant metastases. Methods Data was obtained from the SEER database between 2010 and 2014. Univariate and multivariate Cox proportional hazard models were used to identify variables associated with overall survival. Survival times between different groups were compared using Kaplan-Meier analysis and log-rank tests. Results We analyzed 1481 patients. The most common distant metastatic site was liver, followed by distant lymph nodes, lung, bone, and brain. The site of distant metastases was an independent prognostic factor for overall survival. Using liver metastases as reference, overall survival was lower for lung metastases ( p  = 0.0297) and higher for distant lymph node metastases ( p  = 0.0006). Using distant lymph nodes as reference, distant metastases to the liver ( p  = 0.0006), lung ( p  < 0.0001), brain ( p  = 0.0455), and bone ( p  = 0.0138) were all associated with worse overall survival. The number of metastatic sites did not affect overall survival. We also found that surgery and chemotherapy affected overall survival for patients with distant lymph node metastases only; age, histological subtype, surgery, and chemotherapy affected overall survival for patients with liver metastases only, while histological subtype and chemotherapy affected overall survival for patients with lung metastases only. Conclusions The site of distant metastases affected overall survival in metastatic ovarian cancer. Patients with specific distant metastatic sites should receive special treatment and management. The identified prognostic factors can help clinician evaluate the prognosis for ovarian cancer patients with distant metastases. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study aims to evaluate the association between folic acid (FA) supplementation and congenital heart defects (CHDs). METHODS: This hospital-based case-control study initiated in 2010 in China analyzed 358 cases and 422 controls. The adjusted odds ratio (AOR) calculated using a logistic model was used to assess the association between FA supplementation and CHDs. RESULTS: Compared with a mother who reported no FA supplementation, mothers who reported FA supplementation were less likely to have offspring with isolated CHD(s) (AOR=0.52, 0.34-0.78) and multiple complex conditions (AOR=0.27, 0.14-0.55). However, mothers who reported FA supplementation for less than 1month regardless of the start time of supplementation, did not have a significantly lower risk of having an offspring with isolated or multiple complex conditions. Mothers who reported FA supplementation for 3months beginning before conception had a significantly lower risk of having children with isolated CHD(s) (AOR=0.31, 0.18-0.54). CONCLUSION: FA-supplementation is associated with reduced risk of CHDs. The earlier FA supplementation begins before pregnancy and the longer supplementation lasts, the lower the risk of CHDs is. [ABSTRACT FROM AUTHOR]

Abstract: Objective: This study aims to evaluate the association between folic acid (FA) supplementation and congenital heart defects (CHDs). Methods: This hospital-based case–control study initiated in 2010 in China analyzed 358 cases and 422 controls. The adjusted odds ratio (AOR) calculated using a logistic model was used to assess the association between FA supplementation and CHDs. Results: Compared with a mother who reported no FA supplementation, mothers who reported FA supplementation were less likely to have offspring with isolated CHD(s) (AOR=0.52, 0.34–0.78) and multiple complex conditions (AOR=0.27, 0.14–0.55). However, mothers who reported FA supplementation for less than 1month regardless of the start time of supplementation, did not have a significantly lower risk of having an offspring with isolated or multiple complex conditions. Mothers who reported FA supplementation for ≧3months beginning before conception had a significantly lower risk of having children with isolated CHD(s) (AOR=0.31, 0.18–0.54). Conclusion: FA-supplementation is associated with reduced risk of CHDs. The earlier FA supplementation begins before pregnancy and the longer supplementation lasts, the lower the risk of CHDs is. [Copyright &y& Elsevier]