Nevin Manimala

Rev Esp Salud Publica. 2021 Oct 25;95:e202110182.

ABSTRACT

OBJECTIVE: The COVID-19 pandemic caused by the SARS-CoV-2 virus has generated a great burden on health systems, and healthcare workers have been the most affected. In Spain, the Health Ministry issued common protocols regarding the return-to-work of healthcare workers presenting a negative PCR (Polymerase Chain Reaction) test result and complete resolution of symptoms. Some autonomous communities decided to include a CT (Cycle Threshold) value criterion as well. The aim of this paper was to compare the time intervals required to obtain a negative PCR result by means of both criteria.

METHODS: A multicenter, cross-sectional study was performed from March to September of 2020, in the health areas of Navarra, La Rioja and Vigo (Galicia), managed by their own Occupational Risk Prevention Units. The PCR negativization time intervals were analyzed according to gender, age, professional category and the PCR repetition criteria used (clinical or defined by CT). Mean difference calculation by Student’s t-test and Kaplan-Meier survival analyzes were conducted.

RESULTS: The sample amounted to a total of 1,052 workers: 673 from Navarra, 335 from La Rioja and 44 from Vigo, with an average age of 46 years, and of which 81% were women, 35.48% nursing personnel and 23.65% physicians. No statistically significant differences were found between the PCR negativization time periods with any of the variables, except with the CT criterion, which presented a mean of 6.49 days (95% CI, 4.96-8.02), longer and displaying positively displaced survival curves.

CONCLUSIONS: The CT criterion for carrying out the control PCR test lengthened the reincorporation of essential personnel in the fight against the pandemic.

PMID:34697284

Proc Natl Acad Sci U S A. 2021 Nov 2;118(44):e2107306118. doi: 10.1073/pnas.2107306118.

ABSTRACT

Snow is highly sensitive to atmospheric warming. However, because of the lack of sufficiently long snow avalanche time series and statistical techniques capable of accounting for the numerous biases inherent to sparse and incomplete avalanche records, the evolution of process activity in a warming climate remains little known. Filling this gap requires innovative approaches that put avalanche activity into a long-term context. Here, we combine extensive historical records and Bayesian techniques to construct a 240-y chronicle of snow avalanching in the Vosges Mountains (France). We show evidence that the transition from the late Little Ice Age to the early twentieth century (i.e., 1850 to 1920 CE) was not only characterized by local winter warming in the order of +1.35 °C but that this warming also resulted in a more than sevenfold reduction in yearly avalanche numbers, a severe shrinkage of avalanche size, and shorter avalanche seasons as well as in a reduction of the extent of avalanche-prone terrain. Using a substantial corpus of snow and climate proxy sources, we explain this abrupt shift with increasingly scarcer snow conditions with the low-to-medium elevations of the Vosges Mountains (600 to 1,200 m above sea level [a.s.l.]). As a result, avalanches migrated upslope, with only a relict activity persisting at the highest elevations (release areas >1,200 m a.s.l.). This abrupt, unambiguous response of snow avalanche activity to warming provides valuable information to anticipate likely changes in avalanche behavior in higher mountain environments under ongoing and future warming.

PMID:34697237 | DOI:10.1073/pnas.2107306118

Occup Environ Med. 2021 Oct 25:oemed-2021-107906. doi: 10.1136/oemed-2021-107906. Online ahead of print.

ABSTRACT

INTRODUCTION: The contribution of hazardous noise-a ubiquitous exposure in workplaces-to occupational injury risk is often overlooked. In this ecological study, the fraction of US workplace acute injuries resulting in days away from work in 2019 attributable to hazardous occupational noise exposure was estimated.

METHODS: Using the NoiseJEM, a job exposure matrix of occupational noise, and 2019 Occupational Employment and Wage Statistics data, the proportion of workers experiencing hazardous occupational noise (≥85 dBA) was estimated for every major US Standard Occupational Classification (SOC) group. Population attributable fractions (PAFs) were calculated for each major SOC group using the relative risk (RR) taken from a published 2017 meta-analysis on this relationship.

RESULTS: About 20.3 million workers (13.8%) are exposed to hazardous levels of occupational noise. Nearly 3.4% of acute injuries resulting in days away from work in 2019 (95% CI 2.4% to 4.4%) were attributable to hazardous occupational noise, accounting for roughly 14 794 injuries (95% CI 10 367 to 18 994). The occupations with the highest and the lowest PAFs were production (11.9%) and office and administrative support (0.0%), respectively.

DISCUSSION: Hazardous noise exposure at work is an important and modifiable factor associated with a substantial acute occupational injury burden.

PMID:34697222 | DOI:10.1136/oemed-2021-107906

In Vivo. 2021 Nov-Dec;35(6):3603-3612. doi: 10.21873/invivo.12666.

ABSTRACT

BACKGROUND/AIM: Conjunctival malignant melanoma (CMM) is a rare, but very aggressive tumor with a high metastasis rate. Not much is known about the CMM metastasis mechanisms. So far, epidermal growth factor (EGF) and its receptor (EGF-R) as well as macrophages and matrix metalloproteinase 9 (MMP-9) have been reported to lead to metastasis by epithelial-mesenchymal-transition and tumor migration in different solid tumors. Therefore, we evaluated whether EGF and EGF-R, CD68 and MMP-9 are altered in CMM samples in comparison to conjunctival nevi and healthy conjunctiva.

PATIENTS AND METHODS: EGF, EGF-R, the macrophage marker CD68 and MMP-9 expression were analyzed in human conjunctival melanoma (CMM, n=16), human conjunctival nevi (n=13) and disease-free human conjunctiva (controls, n=14) by immunohistology. Staining of each sample was evaluated using a standardized score ranging from negative (0) to triple positive (3). The groups were then compared by ANOVA, followed by Tukey’s post-hoc test.

RESULTS: A statistically significant increase of EGF was seen in CMM samples in comparison to conjunctival nevi (p=0.03). In contrast, no statistically significant differences in EGF-R expression were noted between the three groups. A statistically significant increase of CD68 was only seen in conjunctival nevi compared to controls (p=0.04). MMP-9 expression was similar in all groups.

CONCLUSION: In CMM, the study data demonstrated an up-regulation of EGF in comparison to conjunctival nevi. Hence, EGF might promote proliferation of CMM cells and induce the epithelial-mesenchymal transition. Therefore, our data suggest that an interplay between EGF and CMM might have a critical role in the developing CMM tumors and metastasis.

PMID:34697202 | DOI:10.21873/invivo.12666

In Vivo. 2021 Nov-Dec;35(6):3495-3499. doi: 10.21873/invivo.12651.

ABSTRACT

BACKGROUND/AIM: COVID-19 may lead to progressive respiratory failure as a consequence of alveolar damage, resulting in death. The aim of this study was to evaluate cytogenetic damage in oral cells of COVID-19 patients by micronucleus assay.

PATIENTS AND METHODS: A total of 11 COVID-19 patients aged 40.7±9.3 years (5 men and 6 women) were included in this study. For the control group, a total of 15 participants not infected with SARS-CoV-2 virus were included. The mean age was 41.6±6.2 years (5 men and 10 women).

RESULTS: The results showed statistically significant differences (p<0.05) in micronucleated buccal mucosa cells of COVID-19 patients. In addittion, a statistically significant increase in karyolysis and karrhyorexis (p<0.05) was observed in COVID-19 patients compared to control.

CONCLUSION: SARS-CoV-2 virus can induce mutagenesis and cytotoxicity in oral cells.

PMID:34697187 | DOI:10.21873/invivo.12651

In Vivo. 2021 Nov-Dec;35(6):3483-3488. doi: 10.21873/invivo.12649.

ABSTRACT

BACKGROUND: Resection of the primary lesion with radical lymph node dissection is the most promising treatment avenue for patients with cancer. On the other hand, these procedures often induce excessive intraoperative blood loss (IBL) and require perioperative blood transfusion. The influence of IBL on the long-term postoperative outcomes of patients with digestive cancer is controversial. We investigated the impact of IBL on survival and recurrence after curative surgery in patients with colorectal cancer (CRC) in a single study group.

PATIENTS AND METHODS: In total, 1,597 patients who underwent radical resection for CRC at three group hospitals between 2000 and 2019 were reviewed. Patients were classified into a group with high IBL (≥200 ml) or low IBL (<200 ml). The risk factors for disease-free (DFS) and overall (OS) survival were analyzed.

RESULTS: A total of 489 and 1,108 patients were classified into the high and low IBL groups, respectively. The OS and DFS rates at 5 years after surgery were 89.3% and 63.4%, respectively, for the high IBL group and 96.9% and 77.8% for the low IBL group; these differences were statistically significantly (p<0.001). The multivariate analysis demonstrated that IBL was a significant independent risk factor for OS and DFS.

CONCLUSION: The amount of IBL was associated with significant differences in the OS and DFS of patients with stage II/III CRC who received curative resection. The surgical procedure, surgical strategy, and perioperative care should be carefully planned to avoid causing IBL.

PMID:34697185 | DOI:10.21873/invivo.12649

In Vivo. 2021 Nov-Dec;35(6):3459-3466. doi: 10.21873/invivo.12646.

ABSTRACT

BACKGROUND/AIM: Neoadjuvant or perioperative chemotherapy is the standard treatment for locally advanced gastric cancer. However, in Eastern countries this is still debated. The aim of our study was to evaluate the survival impact of neoadjuvant chemotherapy.

PATIENTS AND METHODS: A total of 60 patients who underwent preoperative chemotherapy were compared to patients with locally advanced gastric cancer that underwent upfront surgery.

RESULTS: Median survival of the entire group curatively treated was 41 months with a median progression-free survival of 38 months. By excluding patients with stage IV disease from the neoadjuvant group, a statistically significant difference was reached both in terms of overall survival and disease-free survival. By subdividing patients according to pTNM stages, neoadjuvant patients showed better survival in stage I and II.

CONCLUSION: Neoadjuvant chemotherapy could be an effective treatment for locally advanced disease. However, randomized studies are still needed to fully understand its role and identify patients that will benefit from it.

PMID:34697182 | DOI:10.21873/invivo.12646

In Vivo. 2021 Nov-Dec;35(6):3233-3243. doi: 10.21873/invivo.12618.

ABSTRACT

BACKGROUND: Expression of kallikrein-11 (KLK11) has been found to be related to the prognosis of various human cancer types but its physiological functions in the steps of breast cancer (BC) progression are still unknown.

MATERIALS AND METHODS: BC and adjacent normal breast tissue samples were collected from 28 patients. KLK11 expression levels were determined by real-time polymerase chain reaction for each sample and associations with known prognostic features were statistically analyzed.

RESULTS: Although there was slight up-regulation in tumor tissues overall, significant down-regulation of KLK11 expression in tumor tissue was observed in the elderly and in patients with perineural invasion. Furthermore, tumor size, grade, mitotic score, necrosis, calcification, lymphatic invasion, hormone receptor status and Ki67 expression were associated with altered KLK11 level.

CONCLUSION: Changes in expression levels of KLK11, associated with patient characteristics, might be used as complementary data in order to predict clinical outcome and prognosis in BC.

PMID:34697154 | DOI:10.21873/invivo.12618

Lupus Sci Med. 2021 Oct;8(1):e000534. doi: 10.1136/lupus-2021-000534.

ABSTRACT

OBJECTIVES: To evaluate the risk of psychiatric disorders and all-cause mortality associated with belimumab therapy in patients with SLE.

METHODS: A literature search of four electronic bibliographic databases, including PubMed, EMBASE, Scopus and Cochrane databases, was conducted for randomised controlled trials (RCTs) reporting adverse reactions between belimumab and placebo. OR and 95% CI were calculated using the Mantel-Haenszel method with fixed-effects or random-effects model, depending on the heterogeneity test.

RESULTS: In total, 11 eligible RCTs including 8824 patients with SLE were randomised into belimumab (5160 patients with 5552 patient-years) and placebo (3664 patients with 3985 patient-years) groups, respectively. Overall, no increased risk was identified with belimumab therapy at all dosages compared with placebo in patients with SLE regarding all psychiatric disorders (OR 0.89, 95% CI 0.64 to 1.23, I²=58%) and all-cause mortality (OR 1.10, 95% CI 0.64 to 1.89, I²=0%). The subgroup analysis of psychiatric disorders also revealed no statistically elevated risks in serious psychiatric disorders (OR 1.15, 95% CI 0.77 to 1.70, I²=47%), non-serious psychiatric disorders (OR 0.83, 95% CI 0.60 to 1.16, I²=52%), suicidal ideation or behaviour (OR 0.87, 95% CI 0.57 to 1.33, I²=0%), and depression (OR 1.29, 95% CI 0.90 to 1.85, I²=15%). Secondary analysis restricting belimumab at approved dose of 10 mg/kg only yielded similar results.

CONCLUSION: Belimumab therapy overall does not increase psychiatric events and all-cause mortality risks, whereas the results from Belimumab Assessment of Safety in SLE Study are suggestive of increased risk of psychiatric adverse events with belimumab exposure. Consequently, post-marketing data are needed to ascertain its psychiatric safety, especially serious mental disorders.

PMID:34697129 | DOI:10.1136/lupus-2021-000534

BMJ Open. 2021 Oct 25;11(10):e055125. doi: 10.1136/bmjopen-2021-055125.

ABSTRACT

OBJECTIVE: To assess the magnitude of dietary diversity and associated factors among pregnant women in the rural communities of Jimma Zone, south-west Ethiopia.

DESIGN: A community-based cross-sectional study was conducted from 1 June to 30 June 2020.

SETTINGS: The study was conducted in Seka Chekorsa and Mana districts. From a total of 63 listed kebeles, 21 were randomly selected.

PARTICIPANTS: Three hundred sixty first-trimester pregnant women have participated in this study. We used a systematic random sampling method to select the participants after a home-to-home census.

PRIMARY AND SECONDARY OUTCOMES: Dietary diversity was assessed using a 24 hours dietary recall method. Descriptive statistics were computed to describe the study subjects. Bivariate and multivariable logistic regression was run to control for all possible confounding effects and measure the strength of association between the outcome of interest and predictor.

RESULTS: The overall magnitude of adequate dietary diversity was found to be 186 (51.7%); 95% CI 46.1% to 56.4%). Having attended elementary education (adjusted OR (AOR)=2.45; 95% CI 1.33 to 4.51), completed grade 8 (AOR=6.05; 95% CI 2.65 to 13.80), attended high school (AOR=11.69; 95% CI 3.76 to 36.27), completed high school and above (AOR=2.92; 95% CI 1.16 to 7.32), husbands attended high school (AOR=2.92; 95% CI 1.15 to 7.47), family size of less than five (AOR=3.44; 95% CI to 1.77-6.66) were positively significantly associated with adequate dietary diversity. On the other hand, not had additional meal during pregnancy (AOR=0.42; 95% CI 0.21 to 0.83) was negatively associated with adequate dietary diversity.

CONCLUSIONS: We observed that the adequate dietary diversity score of pregnant women was low compared with the pooled proportion of dietary diversity conducted in Ethiopia. Therefore, strengthening and promoting female education through intersectoral collaborations and additional meal counselling during pregnancy is indispensable.

PMID:34697127 | DOI:10.1136/bmjopen-2021-055125