Nevin Manimala

Neuro Oncol. 2021 Oct 5;23(Supplement_3):iii1-iii105. doi: 10.1093/neuonc/noab200.

ABSTRACT

The Central Brain Tumor Registry of the United States (CBTRUS), in collaboration with the CDC and NCI, is the largest population-based registry focused exclusively on primary brain and other central nervous system (CNS) tumors in the United States (US) and represents the entire US population. This report contains the most up-to-date population-based data on primary brain tumors available and supersedes all previous reports in terms of completeness and accuracy and is the first CBTRUS Report to provide the distribution of molecular markers for selected brain and CNS tumor histologies. All rates are age-adjusted using the 2000 US standard population and presented per 100,000 population. The average annual age-adjusted incidence rate (AAAIR) of all malignant and non-malignant brain and other CNS tumors was 24.25 (Malignant AAAIR=7.06, Non-malignant AAAIR=17.18). This overall rate was higher in females compared to males (26.95 versus 21.35) and non-Hispanics compared to Hispanics (24.68 versus 22.12). The most commonly occurring malignant brain and other CNS tumor was glioblastoma (14.3% of all tumors and 49.1% of malignant tumors), and the most common non-malignant tumor was meningioma (39% of all tumors and 54.5% of non-malignant tumors). Glioblastoma was more common in males, and meningioma was more common in females. In children and adolescents (age 0-19 years), the incidence rate of all primary brain and other CNS tumors was 6.21. An estimated 88,190 new cases of malignant and non-malignant brain and other CNS tumors are expected to be diagnosed in the US population in 2021 (25,690 malignant and 62,500 non-malignant). There were 83,029 deaths attributed to malignant brain and other CNS tumors between 2014 and 2018. This represents an average annual mortality rate of 4.43 per 100,000 and an average of 16,606 deaths per year. The five-year relative survival rate following diagnosis of a malignant brain and other CNS tumor was 66.9%, for a non-malignant brain and other CNS tumors the five-year relative survival rate was 92.1%.

PMID:34608945 | DOI:10.1093/neuonc/noab200

Nat Commun. 2021 Oct 4;12(1):5793. doi: 10.1038/s41467-021-26036-x.

ABSTRACT

Household air pollution generated from the use of polluting cooking fuels and technologies is a major source of disease and environmental degradation in low- and middle-income countries. Using a novel modelling approach, we provide detailed global, regional and country estimates of the percentages and populations mainly using 6 fuel categories (electricity, gaseous fuels, kerosene, biomass, charcoal, coal) and overall polluting/clean fuel use – from 1990-2020 and with urban/rural disaggregation. Here we show that 53% of the global population mainly used polluting cooking fuels in 1990, dropping to 36% in 2020. In urban areas, gaseous fuels currently dominate, with a growing reliance on electricity; in rural populations, high levels of biomass use persist alongside increasing use of gaseous fuels. Future projections of observed trends suggest 31% will still mainly use polluting fuels in 2030, including over 1 billion people in Sub-Saharan African by 2025.

PMID:34608147 | DOI:10.1038/s41467-021-26036-x

Retina. 2021 Sep 23. doi: 10.1097/IAE.0000000000003309. Online ahead of print.

ABSTRACT

PURPOSE: To determine the relationship between macular microvascular abnormalities on optical coherence tomography angiography (OCT-A) and silent cerebral infarctions (SCI) on cerebral magnetic resonance imaging (MRI) in sickle cell disease (SCD).

METHODS: Patients (age < 18 years old) from our previous pediatric SCD study cohort who had prior OCT-A and brain MRI were identified. Brain MRI images were compared to macular OCT-A scans to identify macular vascular density differences between patients with SCI and without SCI.

RESULTS: 68 eyes from 34 patients who underwent OCT-A were evaluated, of whom 28 eyes from 14 patients met inclusion criteria for this study. Eight (57%) patients with SCI and 6 (43%) patients without SCI were identified. The mean age (17 years in SCI, 16.3 years in non-SCI) was comparable between groups. There was no statistically significant difference in systemic complications. Deep capillary plexus (DCP) vessel density was lower in the temporal quadrant in patients with SCI (49.3% vs 53.7%, P = 0.014).

CONCLUSION: Patients with SCI were found to have lower vessel density in the DCP compared to those without SCI. This finding suggests that DCP vessel density may have utility as an imaging biomarker to predict the presence of SCI.

PMID:34608107 | DOI:10.1097/IAE.0000000000003309

Transplantation. 2021 Oct 4. doi: 10.1097/TP.0000000000003970. Online ahead of print.

ABSTRACT

BACKGROUND: International travel for transplantation remains a global issue as countries continue to struggle in establishing self-sufficiency. In the United States (US), the United Network for Organ Sharing (UNOS) requires citizenship classification at time of waitlisting to remain transparent and understand to whom our organs are allocated. This study provides an assessment of patients who travel internationally for liver transplantation, and their outcomes, using the current citizenship classification employed by UNOS.

METHODS: Adult liver UNOS data from 2003-2019 was utilized. Patients were identified as citizens, noncitizen, nonresidents (NCNR), or noncitizen residents (NC-R) according to citizenship status. Descriptive statistics compared demographics among the waitlisted patients and demographics and donor characteristics among transplant recipients. A competing risks model was used to examine waitlist outcomes. The Kaplan-Meier method and Cox proportional hazards were used for posttransplant outcomes.

RESULTS: There were significant demographic differences according to citizenship group among waitlisted (n=125 652) and transplanted (n=71 536) patients. Compared with US citizens, NCNR was associated with a 9% increase in transplant (Subdistribution Hazard Ration (SHR) 1.09, 95% CI 1.00-1.18, p=0.04), and NC-R was associated with a 24% decrease transplant (SHR 0.76, 95% CI 0.72-0.79, p<0.0001) and 23% increase in death or removal for too sick (SHR 1.23, 95% CI 1.14-1.33, p<0.0001). US citizens had significantly inferior graft and patient survival (p-values <0.001).

CONCLUSIONS: Though the purpose of the citizenship classification system is transparency, the results of this study highlight significant disparities in access to, and outcomes following, liver transplantation according to citizenship status.

PMID:34608102 | DOI:10.1097/TP.0000000000003970

Dermatol Surg. 2021 Sep 30. doi: 10.1097/DSS.0000000000003251. Online ahead of print.

ABSTRACT

BACKGROUND: Bibliometric studies provide a quantitative statistical analysis of the published literature within a field of interest and allow for easy identification of the major contributing authors, funding sources, and publication trends within the field. To date, no bibliometric studies have been performed pertaining to Merkel cell carcinoma (MCC).

OBJECTIVE: To identify the 100 most frequently cited articles in MCC through a bibliometric analysis of the literature.

METHODS: Web of science was queried to determine the 100 most frequently cited MCC publications published between the years 1970 and 2019. Articles were listed by title, authors and their affiliated institutions, journal title and type, year of publication, country of origin, funding sources, and citation frequency.

RESULTS: Among the 100 most frequently cited MCC publications, articles were cited between 67 and 589 times with a mean of 136.3 times. Articles were cited between 2.0 and 98.2 times per year since publication with a mean of 11.3 times per year. 67% of the articles were published in oncology journals; 33% and 10% of the articles in dermatology and surgery journals, respectively. The most represented journal was Cancer (12%). Paul Nghiem was the most frequently identified author (18%). 36% of the top 100 articles were published out of the University of Washington. The most frequent funding agency was the National Institutes of Health (77%).

CONCLUSION: Through this bibliometric analysis, researchers can easily identify key publications pertaining to MCC, which may in turn enhance their approach to understanding and practicing evidence-based medicine regarding MCC.

PMID:34608096 | DOI:10.1097/DSS.0000000000003251

Dermatol Surg. 2021 Sep 30. doi: 10.1097/DSS.0000000000003238. Online ahead of print.

ABSTRACT

BACKGROUND: The perioral region is highly mobile and subject to multifactorial changes during aging. Resilient Hyaluronic Acid Redensity (RHAR), an RHA filler, was developed with the aim of optimizing outcomes in dynamic facial areas.

OBJECTIVE: This randomized, blinded, multicenter clinical study aimed to demonstrate superiority of RHAR over no-treatment control for correction of moderate-to-severe dynamic perioral rhytides.

MATERIALS AND METHODS: Blinded live evaluator assessments of efficacy included improvement in perioral rhytides severity using a proprietary scale (Perioral Rhytids Severity Rating Scale [PR-SRS]) and the Global Aesthetic Improvement Scale. Subjects self-assessed their results with FACE-Q, a validated patient-reported outcome measure, and satisfaction scales. Safety was monitored throughout the study based on common treatment responses (CTRs) and adverse events (AEs).

RESULTS: The primary efficacy end point was achieved, with the treatment group showing statistically significant superiority over the control group at Week 8 (80.7% vs 7.8% responder rate by PR-SRS, p < .0001). Most patients (66%) were still responders at Week 52 (study completion). Most AEs were CTRs after perioral injection of a dermal filler, and none was a clinically significant treatment-related AE.

CONCLUSION: Resilient Hyaluronic Acid Redensity is effective and safe for the correction of dynamic perioral rhytides in all Fitzpatrick phototypes, with marked durability.

PMID:34608092 | DOI:10.1097/DSS.0000000000003238

Asia Pac J Ophthalmol (Phila). 2021 Sep 28. doi: 10.1097/APO.0000000000000439. Online ahead of print.

ABSTRACT

PURPOSE: This study compared the extended depth of focus (EDOF) intraocular lens (IOL) (ZXR00; Tecnis Symfony, Johnson & Johnson Vision, Santa Ana, CA, US) to a novel, higher-order aspheric monofocal IOL (ICB00; Tecnis Eyhance, Johnson & Johnson Vision, Santa Ana, CA, US) which uses the same platform and material.

METHODS: Medical records of patients undergoing cataract surgery with ZXR00 or ICB00 implantation between March 2020 and January 2021 and with the data available for the 3-month visit were reviewed. The uncorrected near, intermediate, and distance visual acuity (VA); corrected distance VA; and optical quality parameters were the main outcome measures.

RESULTS: Among the 174 enrolled patients, 72 and 102 received the ZXR00 and ICB00, respectively. The average patient ages were 59.6 ± 10.6 (range: 49 to 70) and 65.2 ± 8.2 (range: 45 to 82) years in the ZXR00 and ICB00 groups, respectively, with significantly older patients in the ICB00 group. The other baseline parameters were not different for the 2 groups. Compared to the ICB00 group, the ZXR00 group showed markedly superior near VA (P < 0.05) at 3 months postoperatively. In terms of optical quality, ICB00 was, statistically, significantly superior to ZXR00.

CONCLUSIONS: The ZXR00 showed remarkable near vision and defocus curve smoothness, while the ICB00 achieved better optical quality. The 2 IOLs had comparable distance and intermediate vision.

PMID:34608065 | DOI:10.1097/APO.0000000000000439

Cancer Nurs. 2021 Sep 30. doi: 10.1097/NCC.0000000000001027. Online ahead of print.

ABSTRACT

BACKGROUND: Glioblastoma multiforme (GBM) is an aggressive brain tumor. Patients commonly rely on family caregivers for physical and emotional support. We previously demonstrated that caregiver mastery measured shortly after diagnosis was predictive of GBM patient survival, corrected for known predictors of survival (n = 88).

OBJECTIVE: The aims of this study were to verify the contribution of caregiver mastery and investigate the added value of mastery over other predictors to predict 15-month survival.

METHODS: Data collected for a longitudinal study (NCT02058745) were used. Multivariable Cox regression analyses were performed for models with known clinical predictors (patient age, Karnofsky Performance Status, type of surgery, O6-methylguanine-DNA-methyltransferase promotor methylation status), with and without adding caregiver mastery to predict mortality. The added value of each model in discriminating between patients with the lowest and highest chances of survival at 15 months was investigated through Harrell’s concordance index.

RESULTS: In total, 41 caregiver-patient dyads were included. When evaluating solely clinical predictors, Karnofsky Performance Status and patient age were significant predictors of mortality (hazard ratio [HR], 0.974; 95% confidence interval [CI], 0.949-1.000; and HR, 1.045; 95% CI, 1.002-1.091, respectively). Adding caregiver mastery, these clinical predictors remained statistically significant, and mastery showed an HR of 0.843 (95% CI, 0.755-0.940). The discriminative value improved from C = 0.641 (model with known clinical predictors) to C = 0.778 (model with mastery), indicating the latter is superior.

CONCLUSIONS: We confirm that caregiver mastery is associated with GBM patient survival.

IMPLICATIONS FOR PRACTICE: Incorporating support and guidance for caregivers into standard care could lead to benefits for caregiver well-being and patient outcomes.

PMID:34608049 | DOI:10.1097/NCC.0000000000001027

Cancer Nurs. 2021 Sep 30. doi: 10.1097/NCC.0000000000001012. Online ahead of print.

ABSTRACT

BACKGROUND: Complex survivorship cancer care requires nurse-led interventions. Therefore, a nurse-led patient navigation intervention was developed in which trained cancer nurses gave advice and referred to other professionals during the process of recovery and rehabilitation of hematopoietic stem cell transplantation (HSCT) patients.

OBJECTIVE: The aim of this study was to understand the nature and effect of this nurse-led information and referral intervention.

METHODS: Of the 199 included patients in the intervention group, 75 completed the quality of life, quality of care, self-efficacy, and self-management behavior questionnaires at baseline and at 6 and 12 months after HSCT. A historical control group of 62 patients completed the same questionnaires 12 months after HSCT. In addition, patients’ experiences with the intervention were evaluated in 2 focus groups.

RESULTS: Patients emphasized the holistic approach of the cancer nurses and the opportunity to discuss psychosocial domains of life. Within the intervention group, a statistically significant effect on quality of life was demonstrated over time. The differences in quality of life, self-efficacy, and self-management were not significant between the intervention group and control group.

CONCLUSION: The holistic focus of this nurse-led intervention proved to be acceptable to the HSCT patients and promising in supporting the (complex) challenges that these patients face during their process of recovery and rehabilitation.

IMPLICATIONS FOR PRACTICE: Nurse-led patient navigation interventions with a holistic approach when included in the daily practice of complex survivorship cancer care can support HSCT patients’ information and referral needs during their rehabilitation.

PMID:34608045 | DOI:10.1097/NCC.0000000000001012

Cancer Nurs. 2021 Oct 1. doi: 10.1097/NCC.0000000000001014. Online ahead of print.

ABSTRACT

BACKGROUND: Preparedness for caregiving could balance the negative impacts of caregiving. The interventions aimed at increasing readiness among the caregivers are important during the illness period for both patients and their caregivers.

OBJECTIVES: The aims of this study were to review the interventions applied to the caregivers of cancer patients and to examine the effects of these interventions on the preparedness to care.

METHODS: The ScienceDirect, Scopus, CENTRAL, Web of Science, MEDLINE, and PubMed were searched for relevant studies published between 2000 and 2020. The methodological quality was assessed using the Quality Assessment Tool for Quantitative Studies. The statistical analyses were performed using the Comprehensive Meta-Analysis software version 3.0. The publication bias was assessed using the Egger test, for funnel plots.

RESULTS: Eleven studies were selected for the meta-analysis, including those about psychoeducation programs (n = 5), education programs (n = 3), supportive programs (n = 2), and a self-care support program for the caregivers (n = 1). The methodological quality assessment revealed 2 studies as “strong.” The results indicated an increase in the caregivers’ preparedness to care after the interventions. The subgroup analysis revealed that the programs with higher ratios of female caregivers were more effective.

CONCLUSION: The interventions applied to the family caregivers can exert beneficial effects on caregivers’ preparedness to care. Nonetheless, future studies should focus on methodological issues, such as randomization and blinding.

IMPLICATIONS FOR PRACTICE: Nurse-driven interventions may be used as a useful strategy to improve the preparedness to care among the caregivers of cancer patients. The male caregivers should be closely followed by healthcare professionals for knowledge and support needs.

PMID:34608043 | DOI:10.1097/NCC.0000000000001014