Low dose whole lung radiotherapy for older patients with corona virus 19 disease (COVID-19) pneumonitis: practical protocol by the International Geriatric Radiotherapy Group (Preprint)

BACKGROUND Coronavirus disease 19 (COVID-19) carry a high mortality rate among older patients and minorities such as ethnic Africans and Latinos. The chronic baseline systemic inflammation of older patients and minorities may make them more vulnerable to the cytokines storm generated by the viral infection in addition to preexisting co-morbidity. Even though multiple organs failure result from the cytokine storm, pneumonia and respiratory failure often lead to death. OBJECTIVE Low dose whole lung radiotherapy (LDWLRT) may modulate the inflammatory response and may decrease the need for artificial ventilation, thus improving mortality rate. METHODS A phase I-II prospective trials enrolling 500 patients, 65 years old or older from 25 countries will be conducted to investigate the impact of LDWLRT on mortality rate of COVID-19 patients. The patients who will be selected would have developed pneumonias but did not require artificial ventilation. These patients will be followed for a year after receiving this treatment. Their physical activities will be monitored through the ordinal scale and will be correlated with their cytokines status and oxygen saturation rate to assess the impact of the residual inflammation on their daily life. Mortality rates between different ethnic group will be compared and correlated with their cytokines response to the virus and number of co-morbidities. RESULTS We postulate that LDWLRT may improve survival rates of all patients by preventing the need for artificial ventilation which is associated with a high mortality. The inflammatory response between different ethnic groups before and following radiotherapy will be valuable to serve as baseline for future prospective pandemic studies as it has not been reported before. CONCLUSIONS Once the study is complete, we may be able to demonstrate that LDWLRT may improve survival through its anti-inflammatory property CLINICALTRIAL NCT 04493294

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Zinc Depletion Increases Readmission in Older Patients: An Example of Interactions Between Nutrition and Disease

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000275 ◽

2017 ◽

Vol 87 (1-2) ◽

pp. 10-16 ◽

Cited By ~ 1

Author(s):

Salah Gariballa ◽

Awad Alessa

Keyword(s):

Nutritional Status ◽

Inductively Coupled Plasma ◽

Older Patients ◽

Controlled Trial ◽

Prognostic Indicators ◽

Hospitalised Patients ◽

Increased Risk ◽

Co Morbidity ◽

The Impact ◽

Poor Nutrition

Abstract. Background: ill health may lead to poor nutrition and poor nutrition to ill health, so identifying priorities for management still remains a challenge. The aim of this report is to present data on the impact of plasma zinc (Zn) depletion on important health outcomes after adjusting for other poor prognostic indicators in hospitalised patients. Methods: Hospitalised acutely ill older patients who were part of a large randomised controlled trial had their nutritional status assessed using anthropometric, hematological and biochemical data. Plasma Zn concentrations were measured at baseline, 6 weeks and at 6 months using inductively- coupled plasma spectroscopy method. Other clinical outcome measures of health were also measured. Results: A total of 345 patients assessed at baseline, 133 at 6 weeks and 163 at 6 months. At baseline 254 (74%) patients had a plasma Zn concentration below 10.71 μmol/L indicating biochemical depletion. The figures at 6 weeks and 6 months were 86 (65%) and 114 (70%) patients respectively. After adjusting for age, co-morbidity, nutritional status and tissue inflammation measured using CRP, only muscle mass and serum albumin showed significant and independent effects on plasma Zn concentrations. The risk of non-elective readmission in the 6-months follow up period was significantly lower in patients with normal Zn concentrations compared with those diagnosed with Zn depletion (adjusted hazard ratio 0.62 (95% CI: 0.38 to 0.99), p = 0.047. Conclusions: Zn depletion is common and associated with increased risk of readmission in acutely-ill older patients, however, the influence of underlying comorbidity on these results can not excluded.

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Measles outbreak amidst COVID-19 pandemic in Africa: grappling with looming crises

Tropical Medicine and Health ◽

10.1186/s41182-021-00375-3 ◽

2021 ◽

Vol 49 (1) ◽

Author(s):

Abdullahi Tunde Aborode ◽

Abdulhammed Opeyemi Babatunde ◽

Bright-Agbonze Samuel Osayomwanbor ◽

Emmanuel Adebowale Fajemisin ◽

Oko Christian Inya ◽

...

Keyword(s):

Mortality Rate ◽

High Mortality ◽

Health Sector ◽

Community Leaders ◽

Double Burden ◽

Vaccination Programs ◽

Health And Wellbeing ◽

Measles Outbreak ◽

African Health ◽

The Impact

AbstractCoronavirus disease 2019 (COVID-19) and measles are major threats to the health and wellbeing of Africans. Measles is an endemic disease in Africa with a high mortality rate especially in children despite available vaccines. This letter aims to discuss the impact of the COVID-19 pandemic on prevention and management of measles in Africa. The emergence of COVID-19 has exacerbated the morbidities of measles due to multi-factors like the disruption of mass measles routine vaccination, a monopolistic focus on COVID-19 eradication, malnutrition, and poor surveillance. Currently, the COVID-19 pandemic and looming measles epidemic pose a double burden on the African health sector. We recommend urgent interventions from government and other stakeholders including community leaders to strengthen measles research and vaccination programs in Africa amidst the pandemic.

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Does Risk Calculator by Nationwide Survey Match The Postoperative Outcome in Patients Who Underwent Major Hepatectomy?

10.21203/rs.3.rs-76187/v1 ◽

2020 ◽

Author(s):

Atsushi Nanashima ◽

Naoya Imamura ◽

Masahide Hiyoshi ◽

Koichi Yano ◽

Takeomi Hamada ◽

...

Keyword(s):

Mortality Rate ◽

Hospital Mortality ◽

High Mortality ◽

Major Hepatectomy ◽

Nationwide Survey ◽

Hospital Death ◽

Risk Calculator ◽

Biliary Malignancy ◽

Co Morbidity ◽

Hepatobiliary Diseases

Abstract Background: To clarify significance of the present National Clinical Database risk calculator (NCD-RC) for hepatectomy in Japan, relationship between perioperative parameters or outcomes in major hepatectomy and the mortality rate by NCD-RC was examined. Methods: Patient demographics, co-morbidity, surgical records, postoperative morbidity or mortality were examined and compared to the 30 days- or in-hospital-mortality rate among 55 patients with hepatobiliary diseases who underwent hemi- or more-extended hepatectomy and central (segment 458) hepatectomy. The cut-off percent for high risk mortality before hepatectomy was set at 5% in this period. Results: In-hospital morbidity over CD III was 17 (28%), The 30-day mortality and in-hospital mortality was nil and two (3%), respectively. Male patient showed significantly higher in-hospital mortality rate (p<0.01). In the 37 patients (group woML), mean age was 67.8±8.7 years old ranging 45 and 84. Others included A) with severe complications or mortality in whom low mortality rate (group wML, n=13), B) without severe complications neither mortality in whom high mortality rate (group woMH, n=7), and C) with severe complications or mortality in whom high mortality rate (group wMH, n=4 (6.5%)). Age, distribution of elderly patients, gender, the hepatobiliary diseases and the prevalence of preoperative co-morbidity were not significantly different between groups. In the group wML, the bile leakage was dominant and, however, the in-hospital death was not observed. In the group wMH, all operations were right hepatectomy with bile duct resection (RH-BDR) for biliary malignancy and two died of hepatic failure and, however, the prevalence of RH-BDR was not significantly higher in comparison with other groups. Conclusions: Predictive mortality rate by risk calculator under nationwide survey did not always match with patient outcomes in the actual clinical setting and further improvement will be required. In case of RH-BDR for biliary malignancy with high predictive rate, the careful perioperative managements is important under the present nationwide database.

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The impact of age on outcome after surgery for colorectal adenocarcinoma

Annals of The Royal College of Surgeons of England ◽

10.1308/003588411x587154 ◽

2011 ◽

Vol 93 (6) ◽

pp. 445-450 ◽

Cited By ~ 16

Author(s):

AL Widdison ◽

S Wienand Barnett ◽

N Betambeau

Keyword(s):

Older Patients ◽

Operative Mortality ◽

Relative Proportion ◽

The Elderly ◽

Medical Complications ◽

Related Factors ◽

Percentage Points ◽

Age Related ◽

Co Morbidity ◽

The Impact

INTRODUCTION The incidence of colorectal cancer (CRC) increases with age. The aim of this study was to investigate the impact of age and age-related factors on post-operative mortality and survival following CRC resections. METHODS A prospectively collected database of 459 CRC resections was analysed. RESULTS The mean age of the patients was 70 years (range: 25–95 years) and 54% were male. The relative proportion of female patients increased with age so that for patients aged over 77 more women were treated than men. The probability of undergoing an emergency resection (25%) did not change with age. In older patients the proportion of rectal cancers resected decreased and the proportion of hemicolectomies and Hartmann's operations performed increased. The 30-day mortality rate was 4% after elective and 11% after emergency resections. Most deaths were caused by medical complications, reflecting increased co-morbidity in the elderly. Post-operative mortality was 1% in patients under the age of 59. This increased by 3 percentage points every 10 years after elective resections and by 8 percentage points every 10 years after emergency resections. CRC-specific survival was independent of age whereas overall survival decreased so the likelihood of dying from CRC decreased with age: at age 50 half the deaths were from CRC, at age 70 a third and at age 80 a quarter. CONCLUSIONS CRC stage and the probability of presenting as an emergency did not change with age but older patients were more likely to be female and have colon cancer. Post-operative mortality progressively increased with age. Most deaths were caused by medical complications, reflecting increased co-morbidity. Older patients were less likely to die from CRC.

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PERFORMANCE OF THE NURSE IN FRONT OF THE USER VICTIM OF TRAUMA CAUSED BY FIREARMS PROJECTILES: AN EXPERIENCE REPORT

Health and Society ◽

10.51249/hes01.01.2021.169 ◽

2021 ◽

Keyword(s):

Mortality Rate ◽

High Mortality ◽

Experience Report ◽

Morbidity And Mortality ◽

Nursing Process ◽

Qualitative And Quantitative ◽

Type Study ◽

New Research ◽

The Impact ◽

Nursing Course

Firearm trauma is considered one of the main reasons for morbidity and mortality in Brazil. In view of its destructive capacity of organs and tissues that come into contact with the fragments of the bullet. This work aims to report the experience of three students of the nursing course, facing the care of a patient with a firearm. This is a descriptive, qualitative, experience report type study. In the present study, it was possible to envision the application of the nursing process in its entirety, which allowed us to think of a plan based on the process of rehabilitation and healing of the patient. Going up a discussion about the violence in the country, since it is taking a high mortality rate between 15 to 24 years. Based on the construction of this work, it is suggested to create new research that addresses in a qualitative and quantitative way the impact of cases of violence in today's society.

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FACTORS RELATED TO ADOLESCENT DELAY IN PANEMBONG GIRANG CIANJUR

International Journal of Social Science ◽

10.53625/ijss.v1i3.407 ◽

2021 ◽

Vol 1 (3) ◽

pp. 151-158

Author(s):

Helvy Yunida

Keyword(s):

Mortality Rate ◽

Juvenile Delinquency ◽

High Mortality ◽

Death Rate ◽

Causes Of Death ◽

Drunk Driving ◽

Drinking Alcohol ◽

Juvenile Mortality ◽

The Impact ◽

Very High

The juvenile delinquency rate in Panembong girang has long been very high. The environment is not good. For parents who have teenagers, they will be very worried if their teenagers are released to hang out with teenagers in such an environment. Many behaviors that lead to juvenile delinquency. The teenager's acquaintance with the Panembong Girang teenager has led to a legal case, which has ended at the court. These include being involved in drug abuse, beating other people until they are seriously injured and sentenced to prison, drinking alcohol, promiscuity, stealing, and others. The impact of juvenile delinquency The juvenile mortality rate in Panembong Girang is very high, compared to the death rate of adults and parents. The cause of the high mortality rate of adolescents in Panembong girang indirectly is the lack of control of adolescents in managing themselves. Often gather, in groups with peers, who incidentally have bad behavior. So that teenagers do what they should not do. Having an uncontrollable personality, causing the teenager to fall into drinking liquor or alcohol. One of the causes of death in adolescents worldwide due to accidents. in Panembong Girang the number of causes of death for adolescents is directly due to alcohol and accidents. The purpose of the study was to determine the cause of death of adolescents and to determine the lifestyle of panembong happy adolescents. The research method is a qualitative descriptive research design. The informants were taken by 3 neighbors next door to the meatball seller's house, teenagers and members of the Youth Organization. Results and Discussion: the cause of the death rate of adolescents due to alcohol died immediately and when drunk driving a motor vehicle an accident. Conclusion: the factors of the high mortality rate of adolescents in Panembong Girang are due to alcohol and accidents after drinking alcohol

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Age-dependent vulnerability to endotoxemia is associated with reduction of anticoagulant factors activated protein C and thrombomodulin

Blood ◽

10.1182/blood-2009-10-246678 ◽

2010 ◽

Vol 115 (23) ◽

pp. 4886-4893 ◽

Cited By ~ 40

Author(s):

Marlene E. Starr ◽

Junji Ueda ◽

Hitoshi Takahashi ◽

Hartmut Weiler ◽

Charles T. Esmon ◽

...

Keyword(s):

Mortality Rate ◽

High Mortality ◽

Protein C ◽

Low Dose ◽

Activated Protein C ◽

Aged Mice ◽

Fibrin Formation ◽

Pathway Activation ◽

Age Dependent ◽

Young Mice

AbstractThe protein C (PC) pathway is an important anticoagulant mechanism that prevents thrombosis during the systemic inflammatory response. Thrombomodulin (TM), an endothelial cell membrane receptor, accelerates the conversion of PC to activated protein C (APC), which leads to the down-regulation of thrombin production and fibrin formation. Induction of acute endotoxemia in young and aged mice with a low dose of bacterial endotoxin lipopolysaccharide (LPS, 2.5 mg/kg) caused a high mortality rate in aged (80%) but not young (0%) mice. After injection with this dose of LPS, fibrin formation was significantly elevated only in aged mice, plasma APC levels were increased only in young mice, and TM expression was profoundly depressed in the aged. The increased thrombosis, suppressed APC level, and decreased TM expression were not observed in young mice receiving a higher dose of LPS (20 mg/kg), which resulted in a mortality rate (78%) equivalent to that seen in aged mice with the low-dose LPS. Mutant mice with reduced TM showed significantly less plasma APC and increased fibrin formation compared with wild-type mice after LPS. These results demonstrate that PC pathway activation is suppressed with aging and is partly responsible for age-associated thrombosis and high mortality during endotoxemia.

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Low-Dose-Whole-Lung Radiotherapy for Older Patients with Coronavirus Disease (Covid-19) Pneumonia: A Phase I-II Prospective Non-Randomized Protocol by the International Geriatric Radiotherapy Group

Archives of Clinical and Biomedical Research ◽

10.26502/acbr.50170160 ◽

2021 ◽

Vol 05 (02) ◽

Author(s):

Nam P Nguyen ◽

Meritxell Arenas ◽

Te Vuong ◽

Alice Zamagni ◽

Vincent Vinh-Hung ◽

...

Keyword(s):

Phase I ◽

Older Patients ◽

Low Dose ◽

Radiotherapy Group ◽

Lung Radiotherapy ◽

Randomized Protocol

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Business Incubation Initiatives Impact on Entrepreneurs and SMEs

International Journal of E-Entrepreneurship and Innovation ◽

10.4018/ijeei.290820 ◽

2022 ◽

Vol 12 (1) ◽

pp. 0-0

Keyword(s):

Mortality Rate ◽

Incubation Period ◽

High Mortality ◽

Exploratory Study ◽

Qualitative Data ◽

Policy Implications ◽

Business Incubation ◽

Methodological Triangulation ◽

The Impact

Business incubation (BI) is a strategic tool that helps a country to grow its entrepreneurial base and reduce the high mortality rate of SMEs. Kingdom of Eswatini adopted the business incubation initiatives to promote entrepreneurship and SME development. To date, no data exist on the impact made by business incubation initiatives. Adopting methodological triangulation of both quantitative and qualitative data collected through questionnaires and interviews where the participants consisted of SME owners, BI managers, and BI trainers, this exploratory study aims to investigate business incubation initiatives' impact on entrepreneurs and SMEs. Findings reflect that BIs measure their impact by seeing an increase in revenue, increase in the number of people employed, and SME survival post the incubation period. Though SMEs agreed that the BI effects positively, the study also revealed that some SMEs remained in the incubation for more than 10 years. Policy implications emerging are the need to introduce graduation policy and proper determination of requirements for incubation.

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