Tag: pubmed

J Clin Oncol. 2023 Apr 25:JCO2201946. doi: 10.1200/JCO.22.01946. Online ahead of print.

ABSTRACT

PURPOSE: In 2006, Children’s Oncology Group (COG) reclassified subgroups of toddlers diagnosed with neuroblastoma from high-risk to intermediate-risk, when the age cutoff for high-risk assignment was raised from 365 days (12 months) to 547 days (18 months). The primary aim of this retrospective study was to determine if excellent outcome was maintained after assigned reduction of therapy.

PATIENTS AND METHODS: Children <3 years old at diagnosis, enrolled on a COG biology study from 1990 to 2018, were eligible (n = 9,189). Assigned therapy was reduced for two cohorts of interest on the basis of the age cutoff change: 365-546 days old with International Neuroblastoma Staging System (INSS) stage 4, MYCN not amplified (MYCN-NA), favorable International Neuroblastoma Pathology Classification (INPC), hyperdiploid tumors (12-18mo/Stage4/FavBiology), and 365-546 days old with INSS stage 3, MYCN-NA, and unfavorable INPC tumors (12-18mo/Stage3/MYCN-NA/Unfav). Log-rank tests compared event-free survival (EFS) and overall survival (OS) curves.

RESULTS: For 12-18mo/Stage4/FavBiology, 5-year EFS/OS (± SE) before (≤2006; n = 40) versus after (>2006; n = 55) assigned reduction in therapy was similar: 89% ± 5.1%/89% ± 5.1% versus 87% ± 4.6%/94% ± 3.2% (P = .7; P = .4, respectively). For 12-18mo/Stage3/MYCN-NA/Unfav, the 5-year EFS and OS were both 100%, before (n = 6) and after (n = 4) 2006. The 12-18mo/Stage4/FavBiology plus 12-18mo/Stage3/MYCN-NA/Unfav classified as high-risk ≤2006 had an EFS/OS of 91% ± 4.4%/91% ± 4.5% versus 38% ± 1.3%/43% ± 1.3% for all other high-risk patients <3 years old (P < .0001; P < .0001, respectively). The 12-18mo/Stage4/FavBiology plus 12-18mo/Stage3/MYCN-NA/Unfav classified as intermediate-risk >2006 had an EFS/OS of 88% ± 4.3%/95% ± 2.9% versus 88% ± 0.9%/95% ± 0.6% for all other intermediate-risk patients <3 years old (P = .87; P = .85, respectively).

CONCLUSION: Excellent outcome was maintained among subsets of toddlers with neuroblastoma assigned to reduced treatment after reclassification of risk group from high to intermediate on the basis of new age cutoffs. Importantly, as documented in prior trials, intermediate-risk therapy is not associated with the degree of acute toxicity and late effects commonly observed with high-risk regimens.

PMID:37098238 | DOI:10.1200/JCO.22.01946

Psychiatr Pol. 2022 Dec 31;56(6):1365-1380. doi: 10.12740/PP/136538. Epub 2022 Dec 31.

ABSTRACT

OBJECTIVES: The study was aimed at finding out whether, and how, changes in dietary habits would be reflected in anthropometric parameters and body composition.

METHODS: Anthropometric measurements (Martin’s technique) were taken on 52 chronically mentally ill patients, twice: before and a year after diet correction. The patients’ body composition was examined, directly after the measurements, by bioelectric impedance analysis (BIA) in tetragonal arrangement, using a Bodystat ®1500MDD device.

RESULTS: Changes in dietary habits were reflected in a significant reduction of body weight, BMI, and waist circumference in schizophrenic women; WHR in men with other diseases increased significantly. BMI analysis showed an increase in the percentage of normal-weight schizophrenic women and men, a decrease in the proportion of underweight women and men, and an increase in the proportion of individuals with normal weight suffering from other diseases. Both groups showed beneficial changes in body composition (increased content and percentage of fatless body weight and water, reduced content and percentage of fat tissue). These changes were statistically significant only in men suffering from other diseases and concerned the increased content of fatless body weight.

CONCLUSIONS: Changes in dietary habits enhanced body weight reduction in overweight and obese individuals and resulted in desired changes in BMI, WHR, and body composition. The body fat content was distinctly reduced, with no concurrent changes in the fatless body weight and/or water content. Changes in dietary habits were beneficial for the nutritional status of undernourished patients or those with low body weight.

PMID:37098203 | DOI:10.12740/PP/136538

Psychiatr Pol. 2022 Dec 31;56(6):1327-1344. doi: 10.12740/PP/OnlineFirst/130992. Epub 2022 Dec 31.

ABSTRACT

AIM: The aim of this study was the identification and summary of studies examining the relationship between vitamin D levels and the risk of depression and depressive symptoms severity, published between January 2008 and January 2019.

MATERIAL AND METHODS: A systematic review of literature published within the last 10 years and accessible in PubMed database was conducted by each author separately based on predetermined inclusion criteria.

RESULTS: Out of the 823 studies qualified to the initial abstract analysis, 24 were included into the full-text review and 18 into the meta-analysis. Statistically significant odds ratio was obtained for risk of depression in the course of vitamin D deficiency (OR = 1.51; 95% CI: 1.4-1.62; p < 0.01).

CONCLUSIONS: The analysis of available literature seems to indicate that there is an association between risk of depression and vitamin D deficiency. However, current literature does not give the possibility to state explicitly what is the exact mechanism and direction of this dependency.

PMID:37098201 | DOI:10.12740/PP/OnlineFirst/130992

Psychiatr Pol. 2022 Dec 31;56(6):1237-1251. doi: 10.12740/PP/OnlineFirst/136449. Epub 2022 Dec 31.

ABSTRACT

OBJECTIVES: The aim of the study was to present the characteristics of the convenience sample of the transgender people who registered in one of the sexological outpatient clinics, with particular emphasis on the needs of those seeking assistance. The division into persons with binary and non-binary identities was included.

METHODS: A statistical analysis of the data obtained from the medical records of a group of 49 patients, including 35 patients declaring binary identity and 14 patients declaring non-binary identity, was conducted. The data included, among others, the reported gender identity, the process of its emergence and the range of expectations towards the outpatient clinic (hormone therapy, qualification for gender confirmation procedures, support in obtaining legal recognition of gender reassignment, assistance in the coming-out process, treatment of co-occurring psychiatric problems or psychological assistance).

RESULTS: The results indicate a great diversity of the examined group in terms of the declared gender identity. In the group of non-binary persons, a different than in binary persons course of the emergence and consolidation of gender identity is noticeable. The expectations reported in terms of hormone therapy, surgical treatment, legal recognition, assistance in the coming-out process and mental health indicate that there are differences and heterogeneous needs in the study group. The results indicate that expectations for hormone therapy, gender confirmation surgeries and legal recognition are more common in binary patients.

CONCLUSIONS: Despite the frequent perception of transgender people as a homogeneous group with similar experiences and expectations, the results indicate considerable diversity in the given range.

PMID:37098196 | DOI:10.12740/PP/OnlineFirst/136449

J Oncol Pharm Pract. 2023 Apr 25:10781552231171699. doi: 10.1177/10781552231171699. Online ahead of print.

ABSTRACT

INTRODUCTION: Despite the common occurrence of cetuximab (Cmab)-induced skin toxicity, management strategies are not well established. The traditional mainstay method consists of topical steroids, which, if used excessively, may give rise to other concerns. Alternatively, adapalene can activate epidermal growth factor receptor pathways to potentially alleviate these toxicities.

METHODS: We prospectively studied 31 patients with recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) who were eligible to use adapalene gel as a reactive treatment for topical steroid-refractory skin toxicity. For comparison, we retrospectively reviewed 99 patients with R/M SCCHN (historical control cohort) whose skin toxicity was mainly treated with topical steroids. We compared the frequency and severity of Cmab-induced skin toxicity, Cmab therapy status (e.g., dose modification), side effects caused by topical steroids and adapalene gel itself, and other medical interventions.

RESULTS: Adapalene gel was used by eight patients (25.8%) in the prospective cohort. Patients in the historical control cohort more frequently required escalation of topical steroid potency (34.3% vs. 12.9%, p = 0.022). Although there was no statistically significant difference in the frequency of grade ≥3 facial skin rash and paronychia between the two cohorts, the prospective cohort showed a significantly shorter time to complete recovery from grade 2/3 paronychia (16 vs. 47 days, p = 0.017). Further, while no skin infections were observed in the prospective cohort, 13 patients in the historical control cohort developed skin infections, especially periungual infection (0% vs. 13.1%, p = 0.024). In addition, no patients in the prospective cohort received a dose reduction of Cmab due to skin toxicities, compared to 20 patients in the historical control cohort (0% vs. 20.2%, p = 0.003). No apparent adapalene gel-related side effects were observed.

CONCLUSIONS: Adapalene gel may be an effective management option for topical steroid-refractory Cmab-induced skin toxicities and could improve compliance with Cmab therapy.

PMID:37098185 | DOI:10.1177/10781552231171699

Environ Sci Technol. 2023 Apr 25. doi: 10.1021/acs.est.2c09299. Online ahead of print.

ABSTRACT

Acrolein is an identified high-priority hazardous air pollutant ubiquitous in daily life and associated with cardiometabolic risk that attracts worldwide attention. However, the etiology role of acrolein exposure in glucose dyshomeostasis and type 2 diabetes (T2D) is unclear. This repeated-measurement prospective cohort study included 3522 urban adults. Urine/blood samples were repeatedly collected for determinations of acrolein metabolites (N-acetyl-S-(3-hydroxypropyl)-l-cysteine, N-acetyl-S-(2-carboxyethyl)-l-cysteine; acrolein exposure biomarkers), glucose homeostasis, and T2D at baseline and a three-year follow-up. We found that each 3-fold increment in acrolein metabolites was cross-sectionally associated with 5.91-6.52% decrement in homeostasis model assessment-insulin sensitivity (HOMA-IS) and 0.07-0.14 mmol/L, 4.02-4.57, 5.91-6.52, 19-20, 18-19, and 23-31% increments in fasting glucose (FPG), fasting insulin (FPI), HOMA-insulin resistance (HOMA-IR), risks of prevalent IR, impaired fasting glucose (IFG), and T2D, respectively; longitudinally, participants with sustained-high acrolein metabolite levels had increased risks of incident IR, IFG, and T2D by 63-80, 87-99, and 120-154%, respectively (P < 0.05). In addition, biomarkers of heme oxygenase-1 activity (exhaled carbon monoxide), lipid peroxidation (8-iso-prostaglandin-F2α), protein carbonylation (protein carbonyls), and oxidative DNA damage (8-hydroxy-deoxyguanosine) mediated 5.00-38.96% of these associations. Our study revealed that acrolein exposure may impair glucose homeostasis and increase T2D risk via mediating mechanisms of heme oxygenase-1 activation, lipid peroxidation, protein carbonylation, and oxidative DNA damage.

PMID:37098180 | DOI:10.1021/acs.est.2c09299

Breastfeed Med. 2023 Apr 25. doi: 10.1089/bfm.2023.0043. Online ahead of print.

ABSTRACT

Background: Donor human milk (DHM) is the recommended feeding for preterm infants when mother’s own milk is unavailable or insufficient. DHM macronutrient’s variability may have significant implications on preterm growth. Different pooling strategies could be used to improve the macronutrient content, facilitating the achievement of nutritional requirements of preterm. Objective: The aim was to compare the impact of random pooling (RP) and target pooling (TP) strategies on the macronutrient content of DHM and to identify which RP practice allows the achievement of a macronutrient composition as similar as possible to that achievable with TP. Methods: The macronutrient content of 1,169 single-donor pools was analyzed, and a TP strategy combining 2,3,4, or 5 single-donor pools was adopted. On the bases of single-donor pools’ analyses, a simulation of 10,000 randomly selected pools for each configuration of donor considered and for different milk volume proportions was performed. Results: Regardless of the type of strategy and milk volume, as the number of donor per pool increases, the percentage of pools with a macronutrient content equal or higher than the reference values for human milk increases. Conclusion: When a TP strategy is not feasible, a RP strategy combining at least five donors should be performed to obtain a better macronutrient content of DHM.

PMID:37098175 | DOI:10.1089/bfm.2023.0043

R I Med J (2013). 2023 May 1;106(4):35-39.

ABSTRACT

Hospital-associated delirium is common in older adults, especially those with dementia, and is associated with high morbidity and mortality. We performed a feasibility study in the emergency department (ED) to examine the effect of light and/or music on the incidence of hospital- associated delirium. Patients aged ≥ 65 who presented to the ED and tested positive for cognitive impairment were enrolled in the study (n = 133). Patients were randomized to one of four treatment arms: music, light, music and light, and usual care. They received the intervention during their ED stay. In the control group, 7/32 patients developed delirium, while in the music-only group, 2/33 patients developed delirium (RR 0.27, 95% CI 0.06-1.23), and in the light-only group (RR 0.41, 95% CI 0.12-1.46), 3/33 patients developed delirium. In the music + light group, 8/35 patients developed delirium (RR 1.04, 95% CI 0.42–2.55). Providing music therapy and bright light therapy to ED patients was shown to be feasible. Although this small pilot study did not reach statistical significance, there was a trend towards less delirium in the music-only and light-only groups. This study lays the groundwork for future investigation into the efficacy of these interventions.

PMID:37098145

J Appl Gerontol. 2023 Apr 25:7334648231169130. doi: 10.1177/07334648231169130. Online ahead of print.

ABSTRACT

Neighborhood support can improve aging in place for older adults, but research on the role of public housing staff in supporting older tenants is lacking. Twenty-nine participants (janitors, n = 11; maintenance staff, n = 18) collected data about critical situations among older tenants residing in apartments in Sweden. Modifying the Critical Incident Technique (CIT) and applying a mixed-methods design, quantitative and qualitative data were collected and analyzed with descriptive statistics and thematic analysis, integrated through narrative. We found that older tenants asked staff for help with daily tasks. The staff identified CI management dilemmas in meeting older tenants’ support needs while following the housing company’s regulations, maintaining professional responsibilities, respecting individual work attitudes and preferences, and experienced a lack of competencies in some situations. Staff members were responsive to offering support in simple, practical, and emotional situations and in addressing matters they perceived as deficits in social and health services.

PMID:37098132 | DOI:10.1177/07334648231169130

Cornea. 2023 Apr 25. doi: 10.1097/ICO.0000000000003293. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to determine the barriers to accessing the crosslinking service in Auckland, New Zealand.

METHODS: This was a prospective 1-year study of patients at Auckland District Health Board. Studied parameters included age, sex, body mass index, ethnicity, New Zealand Deprivation (NZDep; an area-based measure of socioeconomic status, 1 = low deprivation-10 = high deprivation) score of residence, disease severity (maximum keratometry and thinnest corneal thickness), attendance, distance travelled, car ownership, employment status, and visual outcomes. Statistical analysis was performed using independent t tests, Pearson correlation, independent samples ANOVA, MANCOVA, and binomial logistic regression.

RESULTS: Four hundred fifty-four patients with keratoconus were analyzed and had a mean age of 24.1 ± 0.8 years, mean body mass index of 33.0 ± 9.7 kg/m2, and 43% were female. Pacific Peoples consisted 40.2% of the population; Māori 27.2%; Europeans 21.2%; Asian 9.9%; and Middle Eastern, Latin American, and African (MELAA) 1.3%. The mean distance travelled was 12.5 ± 9.5 km, NZDep score was 6.8 ± 2.6, and attendance was 69.0 ± 42.5%. The lowest attendance was observed in Pacific Peoples (58.9%) and the highest was in Asians (90%) (P = 0.019). The mean worst-eye visual acuity at attendance was 0.75 ± 0.47 logMAR (6/35). Unemployment was associated with worse best-eye visual acuity at FSA (P = 0.01) and follow-up (P < 0.05). Māori and Pacific Peoples had the highest NZDep (P < 0.001), were younger at presentation (P = 0.019), had higher disease severity (P < 0.001), and worse visual acuity (P < 0.001).

CONCLUSIONS: Poor attendance was seen in this cohort. Pacific Peoples and Māori presented younger with worse disease severity and visual acuity but also had the highest nonattendance. These results suggest that deprivation, factors associated with ethnicity, and unemployment are potential barriers to attendance.

PMID:37098115 | DOI:10.1097/ICO.0000000000003293