Nevin Manimala

Cancer. 2022 Mar 21. doi: 10.1002/cncr.34157. Online ahead of print.

ABSTRACT

BACKGROUND: Cancer-related deaths over the next decade are expected to increase due to cancer screening deficits associated with the coronavirus disease 2019 (COVID-19) pandemic. Although national deficits have been quantified, a structured response to identifying and addressing local deficits has not been widely available. The objectives of this report are to share preliminary data on monthly screening deficits in breast, colorectal, lung, and cervical cancers across diverse settings and to provide online materials from a national quality improvement (QI) study to help other institutions to address local screening deficits.

METHODS: This prospective, national QI study on Return-to-Screening enrolled 748 accredited cancer programs in the United States from April through June 2021. Local prepandemic and pandemic monthly screening test volumes (MTVs) were used to calculate the relative percent change in MTV to describe the monthly screening gap.

RESULTS: The majority of facilities reported monthly screening deficits (colorectal cancer, 80.6% [n = 104/129]; cervical cancer, 69.0% [n = 20/29]; breast cancer, 55.3% [n = 241/436]; lung cancer, 44.6% [n = 98/220]). Overall, the median relative percent change in MTV ranged from -17.7% for colorectal cancer (interquartile range [IQR], -33.6% to -2.8%), -6.8% for cervical cancer (IQR, -29.4% to 1.7%), -1.6% for breast cancer (IQR, -9.6% to 7.0%), and 1.2% for lung cancer (IQR, -16.9% to 19.0%). Geographic differences were not observed. There were statistically significant differences in the percent change in MTV between institution types for colorectal cancer screening (P = .02).

CONCLUSION: Cancer screening is still in need of urgent attention, and the screening resources made available online may help facilities to close critical gaps and address screenings missed in 2020.

LAY SUMMARY: Question: How can the effects of the coronavirus disease 2019 pandemic on cancer screening be mitigated?

FINDINGS: When national resources were provided, including methods to calculate local screening deficits, 748 cancer programs promptly enrolled in a national Return-to-Screening study, and the majority identified local screening deficits, most notably in colorectal cancer. Using these results, 814 quality improvement projects were initiated with the potential to add 70,000 screening tests in 2021. Meaning: Cancer screening is still in need of urgent attention, and the online resources that we provide may help to close critical screening deficits.

PMID:35307815 | DOI:10.1002/cncr.34157

Int Ophthalmol. 2022 Mar 21. doi: 10.1007/s10792-021-02131-2. Online ahead of print.

ABSTRACT

PURPOSE: We performed a systematic review and meta-analysis to assess the role of prophylactic laser retinopexy in preventing rhegmatogenous retinal detachment (RRD) in acute retinal necrosis (ARN).

METHODS: Pubmed, Embase and Cochrane databases were searched for eligible studies from inception to July 2020. Comprehensive clinical demographics were extracted from each study by two independent investigators. A random effects model was selected to analyze the OR of RRD risk and visual outcome with 95%CI. Subsequent subgroup and sensitivity analysis were conducted to evaluate the source of heterogeneity.

RESULTS: A total of eight studies and 247 eyes (111 prophylactic laser retinopexy eyes and 136 eyes receiving antiviral treatment) were included in this analysis. There was moderate statistical heterogeneity across all studies. When compared with routine antiviral treatment alone, RRD risk decreased in patients receiving prophylactic laser retinopexy, however, this was not statistically significant (P = 0.09, OR = 0.42, 95%CI: 0.15-1.15). There was significant improvement in BCVA during the follow-up period in the prophylactic laser retinopexy subgroup (P = 0.01, WMD = – 0.98, 95%CI: – 1.74, – 0.22).

CONCLUSION: Based on current analysis, our results did not support convincing evidence of prophylactic laser in preventing RRD. Future studies featuring high-quality, multicenter trials will be required to correct baseline characteristics.

TRIAL REGISTRATION: This meta-analysis has been retrospectively registered in Prospero (registration number: CRD42020201008).

PMID:35307785 | DOI:10.1007/s10792-021-02131-2

J Neurol. 2022 Mar 21. doi: 10.1007/s00415-022-11079-x. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: With aging population, there is an increase of atrial fibrillation (AF) and other vascular risk factors. We investigated trends in stroke severity at hospital admission with respect to AF and other risk factors in a prospective national stroke registry from 2005 to 2020.

METHODS: Data from the prospective Austrian Stroke Unit Registry were used to study demographic and clinical factors associated with the change in admission stroke severity over years. Time trends in admission stroke severity of patients with pre-stroke modified Rankin Score ≤ 3 were investigated with respect to clinical variables and predefined age groups 18-54, 55-64, 65-74, 75-84 and ≥ 85 years. Time trends were studied using robust generalized linear models assuming normal distribution with a log link. Stroke severity on admission was assessed according to the National Institutes of Health Stroke Scale Score (NIHSS).

RESULTS: In total, 140,312 patients with acute ischemic stroke were included in the analysis. Within the study period, mean patients’ age increased from 70 to 72 years (p < 0.001) and median NIHSS at admission decreased from 4 to 3 (p < 0.001). The frequency of AF increased from 25 to 32% (p < 0.001). The decrease in median admission NIHSS was evident in all relevant subgroups but more pronounced in patients with risk factors including AF, diabetes, hypercholesterolemia, smoking, elderly patients and those with pre-stroke disability.

CONCLUSION: Despite an aging population and generally increasing AF frequency, we observed a consistent trend towards less disabling strokes on admission.

PMID:35307755 | DOI:10.1007/s00415-022-11079-x

Med Sci Monit. 2022 Mar 21;28:e935366. doi: 10.12659/MSM.935366.

ABSTRACT

BACKGROUND The purpose of this study was to determine the safety and efficacy of enteral nutrition in combination with microbial preparations for bowel preparation in elderly patients with colorectal cancer. MATERIAL AND METHODS Were divided 160 patients diagnosed with colorectal cancer into a control group (n=80) and an experimental group (n=80) by random number table method. The control group took the traditional intestinal preparation, and the experimental group took oral enteral nutrition combined with microbial preparations. Both groups were treated by the same medical team. The postoperative recovery, complications, nutritional status, inflammation, and other indicators of the 2 groups were compared. RESULTS The nutritional status of the experimental group was significantly better than that of the control group, the incidence of tissue inflammation and postoperative complications was significantly lower than that of the control group, and the stool test results of patients with postoperative diarrhea were better than those of the control group, and the difference between groups was statistically significant. CONCLUSIONS The intestinal preparation using enteral nutrition combined with microbial preparations can alleviate the systemic inflammatory response in elderly patients, improve the nutritional status, reduce the occurrence of postoperative complications, and facilitate rapid postoperative recovery.

PMID:35307727 | DOI:10.12659/MSM.935366

Eur J Cancer Prev. 2022 Mar 8. doi: 10.1097/CEJ.0000000000000749. Online ahead of print.

ABSTRACT

OBJECTIVE: Cancer of unknown primary (CUP) is a metastatic malignancy with an unidentifiable primary tumour origin. Previous studies suggest that type 2 diabetes mellitus (T2DM) and CUP risk are associated. This study examines the association in greater depth by investigating T2DM status, T2DM duration, T2DM age at diagnosis, and medication that was being used in relation to CUP.

METHODS: Data were utilized from the Netherlands Cohort Study, a prospective cohort that includes 120 852 participants aged 55-69 years at baseline in 1986. All participants completed a self-administered questionnaire on cancer risk factors. CUP cases were identified through record linkage with the Netherlands Cancer Registry and Dutch Pathology Registry. After 20.3 years of follow-up, 963 incident CUP cases and 4288 subcohort members were available for case-cohort analyses. Proportional hazards models were employed to estimate multivariable-adjusted hazard ratios (HRs).

RESULTS: Overall, we observed a nonsignificant positive association between T2DM status and CUP risk [HR, 1.35; 95% confidence interval (CI), 0.92-1.99], which increased in women after stratification for sex (HR, 1.55; 95% CI, 0.90-2.64). For participants who were aged less than 50 years at diagnosis of T2DM, a statistically significant positive association was found in relation to CUP (HR, 2.42; 95% CI, 1.26-4.65), compared with participants without T2DM.

CONCLUSION: Our findings indicate that there is a nonsignificant positive association between T2DM and CUP risk and that the association became stronger in women in stratified analyses.

PMID:35307714 | DOI:10.1097/CEJ.0000000000000749

Simul Healthc. 2022 Mar 18. doi: 10.1097/SIH.0000000000000646. Online ahead of print.

ABSTRACT

INTRODUCTION: Recent work has highlighted communication difficulties when wearing personal protective equipment (PPE) in the clinical setting, but currently, there are little objective data on its effects. We assessed the impact of PPE on verbal communication in a simulated operating room and evaluated use of an audio communication device.

METHODOLOGY: Frontline health professionals across specialties including surgery, anesthetics, and nursing undertook speech discrimination testing with and without standardized levels of PPE in a simulated operating room environment. Background noise (30- and 70-a-weighted decibel multitalker babble) at 2 distances (2 and 4 m) were selected representative of operating room environments. Bamford-Kowal-Bench (BKB) scoring (192 sentences per participant) was performed. A Digital Multichannel Transceiver System (DMTS) was evaluated. We assessed the effects of PPE use, distance, and use of the DMTS with pairwise comparisons, using a Bonferroni correction, and assessed participant experience via Likert scales.

RESULTS: Thirty-one healthcare professionals were tested. Without PPE in 70-a-weighted decibel “babble,” median BKB sentence scores were 90% and 76% at 2 and 4 m (adjusted P < 0.0005). The median BKB sentence scores dropped to 8% and 4% at 2 and 4 m in PPE (adjusted P < 0.0005). Improved speech discrimination was achieved with DMTS use to 70% and 76% at 2 and 4 m. Personal protective equipment led to a statistically significant reduction in BKB scores across all conditions compared with baseline. Overall participant confidence in PPE clinical communication was low.

CONCLUSIONS: Addition of PPE dramatically impairs speech discrimination and communication in high levels of background noise characteristic of clinical environments, which can be significantly improved using DMTS. Measures should be taken by teams through both through reduction of background noise and consideration of assistive technologies maximizing patient safety. This may be further rehearsed in a simulation environment.

PMID:35307712 | DOI:10.1097/SIH.0000000000000646

Wiad Lek. 2022;75(2):533-540.

ABSTRACT

OBJECTIVE: The aim: Objective of the research is to determine the effect of NOS3 and AGTR1 genotypes of patients with arterial hypertension and high body mass index in the course of the disease.

PATIENTS AND METHODS: Materials and methods: 58 patients (22 men and 36 women) with AH and high BMI were examined. The average age of the examined patients was 53.6±8.7 years. The analysis of rs1799983 polymorphisms of the NOS3 gene (localization 7q36.1; 7:150999023) and AGTR1 (type 1 receptor for angiotensin 2 1166 A>C) was performed using TaqMan assay (Thermo Fisher Scientific, USA) by real-time PCR (Applied Biosystems, USA) using TaqMan probe amplification products. Genomic DNA samples were isolated from stabilized blood using a Genomic DNA Mini Kit reagent (Invitrogen, USA). The Statistica 10 program (StatSoft Inc.) was used for statistical processing of the obtained data, USA). The independent samples were compared using the Mann-Whitney (U) criterion. In all cases of statistical evaluation, the reliability of differences was taken into account at a value of p<0.05.

CONCLUSION: Results and conclusions: Polymorphism of the NOS3 and AGTR1 genes is associated with early development and complicated course of cardiovascular pathology. The combination of NOS3 and AGTR1 gene polymorphism in patients with the high body mass index increases the risk of complications in hypertension. Using a mathematical model to predict the probability (95%) of genetic mutations in two genes (NOS3 and AGTR1) increases the effectiveness of diagnosis for patients with the high risk of developing cardiovascular complications.

PMID:35307690

Wiad Lek. 2022;75(2):514-519.

ABSTRACT

OBJECTIVE: The aim: Was to study the state of the nitric oxide system, LPO and antioxidant system in the body of experimental animals in simulated metabolic syndrome. The aim of the study was to study the state of the nitric oxide system, lipid peroxidation and antioxidant system in the body of experimental animals in simulated MS.

PATIENTS AND METHODS: Materials and methods: The study was performed on 20 white male Wistar rats. Male control rats (n = 10) were fed a normal control diet. Male rats of the main group (n = 10) were fed a diet high in fat (over 60 % energy from fats) for 16 weeks, thus modeling the development of MS. The indicators of the prooxidant and antioxidant system, as well as the nitric oxide system were determined by photospectrographic method.

RESULTS: Results: In animals with simulated MS, intensification of lipoperoxidation (statistically significantly higher level of TBA-active products 1.84 times), depletion of antioxidant protection (statistically significantly lower level of superoxide dismutase 2 times), activation of nitric oxide system (statistically significantly higher NO-synthase level 2.15 times) were found compared with intact animals.

CONCLUSION: Conclusions: In animals with simulated MS, activation of lipid peroxidation processes, depletion of antioxidant protection and increased.

PMID:35307687

Wiad Lek. 2022;75(2):499-503.

ABSTRACT

OBJECTIVE: The aim: To examine the effect of the developed wellness program on hemodynamic indices and psychological state of perimenopausal women.

PATIENTS AND METHODS: Materials and methods: The study involved 27 women aged 39 to 47 years. Inclusion criteria: recorded perimenopause, climacteric syndrome, history of episodic increase in blood pressure up to 140/85 or 150/90 mmHg. Exclusion criteria: primary hypertension, diabetes mellitus, chronic contagious, systemic, oncology diseases, and mental illnesses. Research procedure comprised tracing of the heart rate, blood pressure registration, and pulse pressure calculation. Robinson index, the coefficient of endurance according to A. Kvas formula were calculated. The assessment of psychological state was made using the Spielberger-Khanin Inventory.

RESULTS: Results: Multidisciplinary professionals gave classes upon wellness program at “Women’s Health” school. The program included educational conversations, healthy walking, massage, psycho-corrective exercises. The dynamics of the studied parameters was analyzed after 12 weeks. Based on the anthropometric measures findings the tested women showed improvement of 6,76% weight loss; and their body mass index decreased by 6,77%. Initial numbers of Robinson index and the coefficient of endurance were above normal values. After working under the program statistically significant dynamics was observed (р <0,05), although there were still signs of cardiovascular disorders. There were statistically significant positive changes Spielberger-Khanin Inventory on State Anxiety (-9,09%) and Personal Anxiety Scales (-6,96%) (p <0,05).

CONCLUSION: Conclusions: Early detection of risk factors and physical activity will help to bring a vast improvement to prognosis and quality of life of perimenopausal women with hypertension onset.

PMID:35307684

Wiad Lek. 2022;75(2):494-498.

ABSTRACT

OBJECTIVE: The aim: To study the clinical and laboratory characteristics of measles, as well as to compare the course of this disease in vaccinated and unvaccinated children in the Poltava region (Ukraine).

PATIENTS AND METHODS: Materials and methods: 104 inpatients with measles were examined: vaccinated (n=27) and unvaccinated (n=77). The patient examination program included: assessment of complaints and anamnestic data obtained by questioning (during admission to hospital treatment, during treatment and after discharge) and detailed analysis of medical records (Form № 003/γ), physical examination, general clinical study of peripheral blood. Statistical processing of the study results was carried out by methods of variation statistics using the program «SPSS 17.0».

RESULTS: Results: The clinical and laboratory picture of measles in the examined patients is typical for this disease. Measles vaccinated children are significantly less likely to have fever (р=0.001) and Koplik’s spots (χ2=3.80, р=0.051), the duration of fever (р=0.001), cough (р=0.000), and the length of hospital stay (р=0.000), as well as 3.0 times less often leukopenia is detected (р=0.043) and 2.0 times less often – acceleration of ESR (р=0.023).

CONCLUSION: Conclusions: The obtained data raise the question of expanding the explanatory work on the importance of a full course of preventive vaccination among children, as well as increasing the volume of public procurement of necessary drugs to increase public access to free vaccination.

PMID:35307683