The impact of pretreatment absolute lymphocyte count (pALC) and neutrophil-lymphocyte ratio (pNLR) on checkpoint inhibitors (CPIs) response rates in renal cell carcinoma (RCC) and bladder urothelial cancers (BC).

2020 ◽  
Vol 38 (5_suppl) ◽  
pp. 29-29
Author(s):  
Tonjeh Mary Stella Bah ◽  
David Sommerhalder ◽  
Philip A. Haddad
Keyword(s):  
Checkpoint Inhibitors ◽  
Medical Center ◽  
Response Rates ◽  
Neutrophil Lymphocyte Ratio ◽  
Essential Components ◽  
Group A ◽  
Group 2 ◽  
Group B ◽  
The Impact ◽  
Group 1

31 Background: CPIs have been established as essential components of cancer immunotherapy across multiple cancer types with proven clinical benefit, improved outcomes, and less toxicity. Studies in lung and head and neck cancers found that low ALC, a marker of immune exhaustion, was associated with poor response to CPIs and worse progression-free survival. We explored the effect of pALC and pNLR on CPI response rates in patients with RCC and BC. Methods: We retrospectively reviewed every RCC and BC patient that received CPIs at Overton Brooks VA Medical Center and LSUHSC-S between 2015 and 2019. Patients’ pALC and pNLR were calculated. The patients were divided according to pALC into 2 groups: Group A with pALC > 1000 and Group B with pALC < 1000. Similarly, using NLR’s established upper normal limit of 3, 2 groups were created: Group 1 with pNLR < 3 and Group 2 with pNLR > 3. Our primary outcome of interest was defined as the presence or absence of CPI response. Patients who attained stable disease, partial response, and complete response were categorized as responders. Those who progressed on CPIs were labeled as non-responders. The significance of the association between pALC and pNLR groups and the occurrence of any response was analyzed statistically. Results: Twenty patients (13 RCC, 7 BC) were treated with CPIs and had documented responses. Twelve patients had pALC > 1000 (Group A) whereas 8 patients had pALC < 1000 (Group B). Both groups were comparable with respect to age, sex, race, and types of CPIs. Group A had a significantly higher response rate (75% vs 25%, p = 0.027). As to pNLR, 10 patients had pNLR < 3 (Group 1) and another 10 patients had pNLR > 3 (Group 2). Patients with pNLR > 3 had worse response rates to CPIs compared to those with pNLR < 3 (30% vs 80%, p = 0.024). Conclusions: This is the first report from a real-world clinical setting to show a detrimental association between pALC < 1000 and pNLR > 3 and CPI response rates in a retrospective cohort of consecutive non-selected kidney and bladder cancer patients. This association and its clinical utility require further confirmation in a prospective larger cohort.

scholarly journals Congenital pes metatarsus varus: Role of arterial abnormalities in feet and treatment duration and outcome in children

2019 ◽  
Vol 147 (1-2) ◽  
pp. 65-69
Author(s):  
Dragana Cirovic ◽  
Dejan Nikolic ◽  
Tatjana Knezevic ◽  
Vesna Bokan-Mirkovic ◽  
Polina Pavicevic ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Treatment Duration ◽  
Significant Difference ◽  
Group A ◽  
Group 3 ◽  
Group 2 ◽  
Group B ◽  
Prospective Longitudinal ◽  
Group 1 ◽  
Severity Degree

Introduction/Objective. The aim of this paper was to examine proportion of patients with arterial abnormalities of feet due to age and severity degree of pes metatarsus varus (PMV), and to evaluate the treatment duration and outcome. Methods. The prospective longitudinal study included 240 patients with congenital PMV classified into three age groups: group < 3 months of life (Group 1), group 3?9 months (Group 2), and group 9?12 months (Group 3). Three categories of PMV were analyzed: mild/moderate/severe. Groups with arterial anomalies (Group A) and without (Group B) were analyzed. Clinical outcome was graded as: good/satisfactory/poor. Results. There is statistically significant difference in distribution of children regarding age and severity degree on first visit and presence of feet arterial abnormalities (p < 0.01). For Group A, younger children had longer physical therapy, while for Group B, older children had longer duration of physical therapy. Same trend applies as severity degree of foot deformity increase. In Group A, the most frequent treatment outcome was poor (for Group 1 ? 46.7%; Group 2 ? 60%; Group 3 ? 62%), while in Group B for Group 1 and Group 2 it was frequently good (Group 1 ? 90%; Group 2 ? 40%), and for Group 3 frequently satisfactory (Group 3 ? 53.3%). Conclusion. In children with PMV it might be advisable to perform ultrasound evaluation of arterial structure of feet, and particularly in cases were such deformity is more severe.

scholarly journals AML-CM Score Predicts Prognosis in Hemato-Geriatric Patients with New-Onset Acute Myeloid Leukemia (AML) Who Receive Hypomethylating Agents (HMA)

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 2617-2617
Author(s):  
Giovanni Marconi ◽  
Roberta di Nicola ◽  
Chiara Sartor ◽  
Mariachiara Abbenante ◽  
Jacopo Nanni ◽  
...  
Keyword(s):  
Adverse Events ◽  
Board Of Directors ◽  
Advisory Committees ◽  
Group 4 ◽  
Group A ◽  
Group 3 ◽  
Group 2 ◽  
Group B ◽  
Idh2 Mutation ◽  
Group 1

Background Although much efforts have been made to precisely define fitness of AML patients, in patients who are not candidate to chemotherapy, there is no prognostic model and the respective weight of AML biology and patient fitness are not well established. Here we test AML-CM score (Sorror, JAMA 2018), that is validated in fit population, in a set of old AML patients who received HMAs. Methods We retrospectively collected data of consecutive patients who received HMAs in our institution from 1st Jan 2008 with an age > 65 years at AML diagnosis. AML-CM score was applied to all the patients. Patients were divided in 4 groups (score 1-4: group 1, score 5-6: group 2; score 7-9: group 3, score > 9: group 4) and in 2 macro-groups (score 1-6: group A and score > 6 group B) for the analyses. Descriptive data are presented as median with interquartile ranges (IQR). Adverse events are graded according to CTCAE v4.03. Survival analysis was conducted with Kaplan-Meyer and are presented as 95% confidence intervals (C.I.) and differences in overall survival (OS) were tested with 2-side log rank test. Fisher exact test and Person's chi squared test were used whenever appropriate. Results At data cut-off, 1st Jan 2019, 60 consecutive patients received decitabine or azacytidine as 1st line therapy for AML. Median age of the population was 75.94 years (IQR 72.53-80.38). Most of the patients (37/62, 59.7%) had de novo AML, 19/62 (30.6%) had AML secondary to previous myeloid disorders and 6/62 (9.7%) had AML secondary to chemotherapy or radiotherapy. Most of the patients were smokers (19/33, 57.57%, 29 no data), and few were usual drinkers (4/16, 25.00%, 46 no data). In our set, out of 62 patients, 2 patients (3.2%) had inv(3), 1 (1.6%) a translocation involving 11q23, 1 (1.6%) del(5q), 4 (6.4%) mon(7) or del (7q), 1 (1.6%) del(17p), 15 (24.2%) complex karyotype, 27 (43.5%) normal karyotype, 4 (6.5%) other alterations and 5 were not evaluable; 3/17 (17.65%, 45 no data) harbored IDH2 mutation, 1/16 (6.25%) IDH2 mutation, 2/33 FLT3 mutation (6.06%, 29 no data), 1/24 (4.17%, 38 no data), 2/15 (13.33%, 47 no data) TP53 mutation. According to ELN 2017, 3/62 patients (4.83%) had low risk, 34/62 (54.84%) intermediate risk and 23/62 (37.10%) high risk AML. According to AML-CM score, 13/62 patients (20.97%) were in group A, 20/62 (32.36%) in group B, 21/62 (33.87%) in group C, 6/62 (9.68%) in group D, 2/62 (3.23%) were not allocated for incomplete AML-CM score. There was no difference in term of age, ELN risk, secondary AML prevalence, HMA administered, or response to HMA according to ELN criteria between group 1, 2, 3, 4 or between macro-group A and B. Cardiovascular comorbidity, diabetes mellitus, obesity, previous tumor, hypoalbuminemia, elevated LDH were prevalent in higher risk AML-CM groups (3-4) and in macro-group B. Median OS was 658 days (95% C.I. 316-1000) in group 1, 556 days (95% C.I. 463-649 in group 2, 243 days (95% C.I. 153-353) in group 3, 107 days (95% C.I. 47-167) in group 4 (p=.021, figure 1A). Furthermore, we observed a median OS of 589 days (95% C.I. 328-850) in macro-group A and 219 days (95% C.I. 96-342) in macro-group B (p=.003, figure 1B). Reduced survival was correlated with a non-statistical trend toward augmented incidence of infections and adverse events in higher risk AML-CM groups (3-4). Conclusions AML-CM is a useful indicator of prognosis in old patients that receive HMAs. Prognosis in our set is influenced by comorbidity (measured with AML-CM, a quantitative score) more than by disease biology. We identified a group of patients (macro-group A) that has median OS after HMAs outlying OS reported in literature. This brilliant result can be due to lower comorbidity. AML-CM could help in defining candidate patients for therapy intensification and care utilization or for team comorbidity management. GM and RDN equally contributed Figure 1 Disclosures Martinelli: Roche: Consultancy; Novartis: Consultancy; ARIAD: Consultancy; BMS: Consultancy; Pfizer: Consultancy. Baccarani:Novartis: Consultancy, Speakers Bureau; Incyte: Consultancy, Speakers Bureau; Takeda: Consultancy. Papayannidis:Pfizer: Honoraria; Teva: Honoraria; Shire: Honoraria; Novartis: Honoraria; Amgen: Honoraria; Incyte: Honoraria. Cavo:janssen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: travel accommodations, Speakers Bureau; bms: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; sanofi: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: travel accommodations, Speakers Bureau; AbbVie: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; novartis: Honoraria; takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; amgen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau.

scholarly journals The Importance of Disease Burden after Induction and Prior to Transplantation in Patients with Acute Myeloid Leukaemia Receiving Allogeneic Transplantation

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 3931-3931
Author(s):  
Claudia Nunez-Torron ◽  
Carlos Jimenez Chillon ◽  
Fernando Martin Moro ◽  
Alejandro Luna ◽  
Adolfo Saez ◽  
...  
Keyword(s):  
Disease Burden ◽  
Allogeneic Transplantation ◽  
High Risk Group ◽  
Post Transplant ◽  
Best Response ◽  
Group 3 ◽  
Group 2 ◽  
Group B ◽  
The Impact ◽  
Group 1

Abstract Introduction: Response to chemotherapy treatment both by cytology and by more sensitive techniques such as cytometry is one of the most influential parameters in the survival of patients with Acute Myeloid Leukaemia (AML). Patients with detectable minimal residual disease (MRD) or those with active disease (AD) after induction or prior to allogeneic transplantation (HCST) represent a high-risk group. Objectives: to analyse the impact of disease burden before HSCT in terms of Overall Survival (OS) and Event Free Survival (EFS) in a group of patients who received HSCT in a single institution. We also analysed the influence of disease burden at the end of induction (considering best response after 1 or 2 cycles) and its impact on those patients in Cytological Remission (CR) with MRD &lt;0.1% prior to transplantation. Methods: We analysed 103 patients who received HSCT in one centre between 2008 and 2020 in whom we knew disease status after induction and before HSCT. We divided the cohort into three groups according to preHSCT disease: Group 1) Patients in CR with MRD &lt;0.1% by cytometry, Group 2) CR with MRD ≥0.1% and Group 3) patients with AD (≥5% blasts by cytology). We analysed post-transplant EFS and OS using the Kaplan Meier method and the Cumulative Incidence of Relapse (CIR) using Gray's test. Results: The baseline characteristics of the population are reflected in table 1. Median follow-up was 13 months (0-140). One-year EFS (1y-EFS) was 49%. One-year OS (1y-OS) was 57.5%, with a 1y-IAR of 27%. We first analysed the impact on post-transplant survival according to the different groups. Group 1 had significantly better EFS than Group 2 (p=0.04) and Group 3 (p&lt;0.001) (Figure 1A). Regarding OS there was no difference between Group 1 and Group 2 (p=0.2) although it was significantly better than Group 3 (p&lt;0.001) (Image 1B). IAR-1 was 14% vs 48% vs 50% (p&lt;0.001) respectively. We subsequently analysed the impact on post-transplant survival according to the response to induction. Post-transplant EFS and OS were better in those in CR MRD- after induction compared to patients in CR with MRD+ (p=0.05 and p=0.002) as well as in patients with AD at the end of induction (p=0.002 and p=0.008). We stratified Group 1 according to the best response to induction (MRD- or MRD+/EA) and we performed an analysis according to the following groups: A) Patients with MRD- after induction and also before HSCT, B) Patients with MRD+/EA after induction achieving MRD- before HSCT. Comparing both groups there were no differences in either EFS (1y-EFS Group A 69% vs Group B 54%, p=0.5) or OS ( Group A 69% vs Group B 61%, p=0.8). Conclusions: Patients with pre-transplant AD or MRD+ are a high-risk group due to a high incidence of post-HSCT relapse. Although patients with AD or CR with MRD+ after induction have a worse prognosis, those who achieve MRD- before HSCT have a similar survival to the MRD- group from the start of chemotherapy. Figure 1 Figure 1. Disclosures Garcia-Gutiérrez: Pfizer: Research Funding; Bristol-Myers Squibb: Consultancy; Incyte: Consultancy; Novartis: Consultancy.

scholarly journals A retrospective comparative study to evaluate the efficacy and safety of mifepristone with misoprostol over misoprostol alone in induction in labor

2018 ◽  
Vol 7 (12) ◽  
pp. 5140
Author(s):  
Reena Sharma ◽  
B. R. Sharma ◽  
Poojan Dogra
Keyword(s):  
Comparative Study ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Efficacy And Safety ◽  
Group A ◽  
The Mean ◽  
Group 2 ◽  
Group B ◽  
Retrospective Comparative Study ◽  
Group 1

Background: The aim is to compare the improvement in pre-induction Bishop’s score, proportion of patients going in labor and induction–delivery interval after using the Misoprostol versus Mifepristone and Misoprostol as cervical ripening and labor inducing agent.Methods: It is retrospective comparative study conducted on 110 women. Women were randomized in group A and in group B of 55 patients in each group. Group A received tab Mifepristone 200 mg orally on day 1 followed by Misoprostol 25 ug after 48 hours and continued 6 hourly till maximum four tablets and group B patients received tablet Misoprostol 25ug and continued 25ug 6hrly maximum 4 doses. Women observed for improvement in Bishop‟s score, induction-delivery interval and requirement of subsequent doses of Misoprostol.Results: Present study concluded that tablet Mifepristone is an efficient cervical ripening and inducing agent of labor as pre-induction Bishop’s score was improved. 36.4%patients went into labor only with tablet Mifepristone. The mean induction-delivery interval was,19±12.2hrs in Group 1 as compare to 13.1±13.0 hrs in Group 2. Mean Bishop’s score observed in Group 1 were 2.5±1.78 and 1.67±1.25 in Group 2. It was observed that there was significant improvement in the Bishop’s score after giving Mifepristone to the patients; mean Bishop’s 24hrs after mifepristone were 4.03±1.80. Repeated dose of Misoprostol required in Group 1 was observed to be higher than group 2 as shown in table 8. Mean misoprostol doses required in group 1 was 2.56±1.15 as compared to 1.71±1.58 in group 2.Conclusions: Mifepristone with Misoprostol reduce the induction delivery interval and more potent in combination for induction of labour as compared to Misoprostol alone.

scholarly journals 51. Sustained Impact of an Antimicrobial Stewardship (AS) Initiative Targeting Asymptomatic Bacteriuria and Pyuria in the Emergency Department (ED)

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S145-S146
Author(s):  
Mary Catherine Cash ◽  
Garrett Hile ◽  
James Johnson ◽  
Tyler Stone ◽  
Vera Luther ◽  
...  
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Inappropriate Prescribing ◽  
Asymptomatic Bacteriuria ◽  
Secondary Outcome ◽  
Indwelling Catheter ◽  
Inappropriate Treatment ◽  
Group 2 ◽  
The Impact ◽  
Group 1

Abstract Background The sustainability of unique AS initiatives are largely unstudied. A multi-faceted initiative to reduce inappropriate treatment of asymptomatic pyuria (ASP) and asymptomatic bacteriuria (ASB) in the ED was implemented at our institution in 2016. A pre-post intervention analysis demonstrated reduction in the inappropriate treatment (tx) of ASP/ASB from 100% to 32% (p&lt; 0.001) following the intervention. The purpose of this present study was to determine the sustained impact of the initiative and determine if re-education provided in Oct 2020 could further reduce inappropriate tx. Methods This was a retrospective, interrupted time series study conducted at an 885 bed academic medical center. Patients (pts) discharged from the ED in Nov 2019 – Feb 2020 (group 1) and Nov 2020 – Feb 2021 (group 2) were retrospectively screened in chronologic order until 50 pts in each group met study criteria. Similar to the 2016 study, pts were included if they were ≥ 18 years old and had a positive urine culture or pyuria. Pts were excluded if they had symptoms of a urinary tract infection (UTI), another infection requiring antibiotics (ABX), indwelling catheter, ureteral stent, or nephrostomy tube, or if pregnant or immunocompromised. The primary outcome was the proportion of pts prescribed ABX within 72 hrs of ED discharge. The secondary outcome was the number of pts returning to the ED with symptomatic UTI within 30 days of discharge. Group 1 was compared to the 2016 study’s post group to determine the sustained impact of the initial initiative; group 2 was compared to group 1 to determine the impact of re-education, which involved a presentation to ED providers and a posted algorithm and fact sheet. Results Results from all time periods are summarized in Table 1. Improvement in inappropriate tx was still noted 3 years after the intervention (28% vs 32%; p = NS). Re-education did not further improve inappropriate prescribing, with 28% of group 2 pts still receiving tx. Table 1. Conclusion The decrease in inappropriate use of ABX for ASP/ASB was still noted 3 years after implementation of a multi-faceted AS initiative. Re-education did not result in further improvement. Disclosures James Johnson, PharmD, FLGT (Shareholder) Vera Luther, MD, Nothing to disclose

scholarly journals Is robotic radical nephroureterectomy a safe alternative to open approach: The first prospective analysis

2021 ◽  
Vol 93 (4) ◽  
pp. 408-411
Author(s):  
Panagiotis Mourmouris ◽  
Omer Burak Argun ◽  
Lazaros Tzelves ◽  
Mustafa Bilal Tuna ◽  
Maria Gourtzelidou ◽  
...  
Keyword(s):  
Upper Urinary Tract ◽  
Open Approach ◽  
Radical Nephroureterectomy ◽  
Drain Removal ◽  
Estimated Blood Loss ◽  
Group A ◽  
The Mean ◽  
Group 2 ◽  
Group B ◽  
Group 1

Purpose: To test the efficacy and safety profile of robotic radical nephroureterectomy compared to the open approach. Methods: We enrolled 45 consecutive patients who suffered from non-metastatic, upper urinary tract urothelial carcinoma from September 2019 to March 2021 and underwent radical nephroureterectomy. Patients were divided in two groups: group A consisted of 29 patients (open approach) and group B consisted of 16 patients (robotic approach). The factors which were taken into consideration were age, sex, body mass index, tumour size, side and grade, cancer stage, ASA score, operation time, drain removal time, foley time, hospitalization time, estimated blood loss, surgical margins, preoperative and postoperative creatinine, Hct and bladder recurrences. Statistical analysis was performed with the use of SPSS version 26 and p < 0.05 was the cut-off for reaching statistical significance. Results: The mean age in group 1 was 67.12 years and in group 2 68.12 years, whereas the mean body mass index (BMI) in group 1 was 26.54 kg/m2 and in group 2 25.20 kg/m2. Operative time was better in group A (124 vs 186 mins p < 0.001) and estimated blood loss were better in group B compared to group A (137 vs 316 ml p < 0.001). Length of stay (LOS) was significantly less in the robotic group (5.75 vs 4.3 days p = 0.003) and the same applied for time required for drain removal (4.5 vs 3.3 days p = 0.006). Conclusions: Robotic radical nephroureterectomy is a safe and efficient alternative to open approach. It provides a favorable perioperative profile in patients suffering from upper urinary tract carcinoma without metastasis.

The role of previous radical local treatment (RLT) on the outcome of immune checkpoint inhibitors (ICI) in patients (pts) with metastatic urothelial carcinoma (mUC).

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 496-496
Author(s):  
Rafael Morales-Barrera ◽  
Natalia Vidal Casinello ◽  
Montserrat Domenech ◽  
Teresa Bonfill ◽  
Javier Puente ◽  
...  
Keyword(s):  
Checkpoint Inhibitors ◽  
Local Treatment ◽  
Rank Test ◽  
True Value ◽  
Kaplan Meier ◽  
Group A ◽  
Control Disease ◽  
Primary Bladder ◽  
Group B ◽  
The Impact

496 Background: There is a growing interest in local treatment for metastatic solid tumors. Recently, retrospective studies have reported the potential benefit of RLT to primary bladder cancer in pts with metastatic disease. We tested the impact of previous RLT in pts with mUC treated with ICI. Methods: Data from pts with mUC treated with ICI collected between May 2013 and May 2019 using a multi-institutional database was evaluated. Stratification was made according to previous RLT with ICI versus no RLT with ICI. We defined RLT as radical surgery (RS) or ≥50 Gy of radiotherapy (RT) delivered to the bladder. The X2 test was used to determine differences in rates. Overall survival (OS) between previous RLT plus ICI (group A) versus no RLT plus ICI (group B) generated using Kaplan-Meier method was compared by log-rank test. OS was calculated from the date of initiation of ICI to the date of death. Analyses were performed using SPSS v21. Results: A total of 115 pts with mUC were treated with ICI, 62 (53.9%) previously were treated with RS, 7(6.1%) RT and 46 (40%) no received RLT. ICI prescribed were atezolizumab (55.7%), pembrolizumab (16.5%), durvalumab (11.3%), durvalumab/tremelimumab (7.8%), nivolumab (5.2%) and avelumab (3.5%). The disease control rate (CR [6.9%] +PR [9.6%] +SD [14.1%]) was higher for pts with previous RLT compared to those pts who did not receive RLT (CR [3.2%] + PR [5.8%] + SD [6.4%](P=0.325). Median OS was 11.23 mo (95% CI; 6.02-16.44) and 7.95 mo (95%IC; 5.15-10.75) for group A and group B, respectively (P=0.481). Conclusions: This multicenter cohort suggests that previous RLT might play an impact for control disease in pts with mUC treated with ICI. Although this is hypothesis generating, the true value of this approach remains to be demonstrated in prospective studies.

Hygienic characteristics of the cosmetologists' lifestyle

2020 ◽  
Vol 60 (12) ◽  
pp. 958-963
Author(s):  
Natalia I. Latyshevskaya ◽  
Tatyana L. Yatsyshena ◽  
Elena L. Shestopalova ◽  
Irina Yu. Krainova
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Information And Communication Technologies ◽  
Health Risks ◽  
Healthy Lifestyle ◽  
Personal Hygiene ◽  
Risk Category ◽  
Essential Components ◽  
Group A ◽  
Group B

Modern trends in the deterioration of health and the growth of non-communicable diseases among the adult working-age population, including medical workers, actualize the importance of a healthy lifestyle for maintaining health and professional longevity. There were almost no studies related to cosmetologists' experienced group as representatives of aesthetic medicine. There is no scientific evidence on behavioral risks of this group. It justifies the relevance of this study. The study aims to analyze the essential components of the cosmetologists' lifestyle depending on age and the argumentation of priority behavioral health risk factors for preventive and recreational work justification. Sixty women (practicing cosmetologists in Volgograd at the age of 28-39 years (group A) and 40-53 (group B)) took part in the study. Lifestyle assessment included a modified questionnaire. The questionnaire consists of 5 blocks (block 1 - nutrition; 2 - physical activity, including hardening and active rest; 3 - daily regimen; 4 - personal hygiene; 5 - bad habits). It allows the analysis of the adherence to a healthy lifestyle based on the provision of quantitative data. Statistical data processing was carried out using the Excel package. The authors identified the essential and statistically significant differences in the cosmetologists' lifestyle depending on age. The respondents of group B demonstrated hygienically rational indicators in all blocks of the lifestyle more often. They had a more formed adherence to a healthy lifestyle: 504 answers in the category "insignificant risk" of respondents in group B versus 354 in group A. Distribution of answers in the "high risk" category: 119 responses in group B and 185 in group A. The lifestyle of 46.7% of the respondents in group B refers to a healthy lifestyle. 3.3% of the group B respondents have an anxious lifestyle, 50% have health risks. 10% of Group A respondents' lifestyle refers to a healthy lifestyle. 13.3% of Group A respondents' lifestyle refers to an anxious lifestyle; 76.7% of this group have health risks. There was almost no complex hygienic research profession of medical cosmetologists. Cosmetologists of the older age group (40-53 years old) are more conscious of maintaining a hygienically rational lifestyle. The most significant defects among cosmetologists aged 28-39 years are low physical activity, nutritional defects, insufficient duration of night rest, and excessive use of information and communication technologies for rest, accompanied by manifestations of neurotization and signs of pronounced fatigue. The obtained results argue the need to develop and implement informational and educational measures to prevent risk behavior patterns, taking into account the age of cosmetologists and the priority of the identified behavioral risk factors.

CD34 immunostain increases sensitivity of the diagnosis of fetal vascular malperfusion in placentas from ex-utero intrapartum treatment

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Jerzy Stanek
Keyword(s):  
Statistical Significance ◽  
Treatment Procedure ◽  
Fetal Survival ◽  
Ex Utero Intrapartum Treatment ◽  
Life Threatening ◽  
Group 2 ◽  
Cd34 Immunostain ◽  
The Impact ◽  
Diaphragmatic Hernias ◽  
Group 1

AbstractShort CommunicationsEXIT (ex-utero intrapartum treatment) procedure is a fetal survival-increasing modification of cesarean section. Previously we found an increase incidence of fetal vascular malperfusion (FVM) in placentas from EXIT procedures which indicates the underlying stasis of fetal blood flow in such cases. This retrospective analysis analyzes the impact of the recently introduced CD34 immunostain for the FVM diagnosis in placentas from EXIT procedures.Objectives and MethodsA total of 105 placentas from EXIT procedures (48 to airway, 43 to ECMO and 14 to resection) were studied. In 73 older cases, the placental histological diagnosis of segmental FVM was made on H&E stained placental sections only (segmental villous avascularity) (Group 1), while in 32 most recent cases, the CD34 component of a double E-cadherin/CD34 immunostain slides was also routinely used to detect the early FVM (endothelial fragmentation, villous hypovascularity) (Group 2). 23 clinical and 47 independent placental phenotypes were compared by χ2 or ANOVA, where appropriate.ResultsThere was no statistical significance between the groups in rates of segmental villous avascularity (29 vs. 34%), but performing CD34 immunostain resulted in adding and/or upgrading 12 more cases of segmental FVM in Group 2, thus increasing the sensitivity of placental examination for FVM by 37%. There were no other statistically significantly differences in clinical (except for congenital diaphragmatic hernias statistically significantly more common in Group 2, 34 vs 56%, p=0.03) and placental phenotypes, proving the otherwise comparability of the groups.ConclusionsThe use of CD34 immunostain increases the sensitivity of placental examination for FVM by 1/3, which may improve the neonatal management by revealing the increased likelihood of the potentially life-threatening neonatal complications.

scholarly journals The negative effects of COVID-19 and national lockdown on emergency surgery morbidity due to delayed access

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Francesco A. Ciarleglio ◽  
Marta Rigoni ◽  
Liliana Mereu ◽  
Cai Tommaso ◽  
Alessandro Carrara ◽  
...  
Keyword(s):  
Emergency Department ◽  
Blood Transfusion ◽  
Emergency Surgery ◽  
Surgical Care ◽  
Close Correlation ◽  
Negative Effects ◽  
Group 2 ◽  
Retrospective Comparative Study ◽  
The Impact ◽  
Group 1

Abstract Background The aim of this retrospective comparative study was to assess the impact of COVID-19 and delayed emergency department access on emergency surgery outcomes, by comparing the main clinical outcomes in the period March–May 2019 (group 1) with the same period during the national COVID-19 lockdown in Italy (March–May 2020, group 2). Methods A comparison (groups 1 versus 2) and subgroup analysis were performed between patients’ demographic, medical history, surgical, clinical and management characteristics. Results Two-hundred forty-six patients were included, 137 in group 1 and 109 in group 2 (p = 0.03). No significant differences were observed in the peri-operative characteristics of the two groups. A declared delay in access to hospital and preoperative SARS-CoV-2 infection rates were 15.5% and 5.8%, respectively in group 2. The overall morbidity (OR = 2.22, 95% CI 1.08–4.55, p = 0.03) and 30-day mortality (OR = 1.34, 95% CI 0.33–5.50, =0.68) were significantly higher in group 2. The delayed access cohort showed a close correlation with increased morbidity (OR = 3.19, 95% CI 0.89–11.44, p = 0.07), blood transfusion (OR = 5.13, 95% CI 1.05–25.15, p = 0.04) and 30-day mortality risk (OR = 8.00, 95% CI 1.01–63.23, p = 0.05). SARS-CoV-2-positive patients had higher risk of blood transfusion (20% vs 7.8%, p = 0.37) and ICU admissions (20% vs 2.6%, p = 0.17) and a longer median LOS (9 days vs 4 days, p = 0.11). Conclusions This article provides enhanced understanding of the effects of the COVID-19 pandemic on patient access to emergency surgical care. Our findings suggest that COVID-19 changed the quality of surgical care with poorer prognosis and higher morbidity rates. Delayed emergency department access and a “filter effect” induced by a fear of COVID-19 infection in the population resulted in only the most severe cases reaching the emergency department in time.

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