Updates on larynx cancer epidemiology

Objective: Laryngeal cancer is an important oncologic entity, whose prognosis depends on establishing appropriate preventive and diagnostic measures, especially in populations at higher risk.Methods: Epidemiologic information including worldwide incidence, prevalence, burden of health loss(disability-adjusted life year;DALYs) and mortality of larynx cancer was obtained from the Global Health Data Exchange(GHDx) database.Results: The current incidence, prevalence and mortality of laryngeal cancer are estimated at 2.76 cases/year per 100,000 inhabitants, 14.33 cases/year per 100,000 inhabitants and 1.66 deaths/year per 100,000 inhabitants,respectively, averaging 3.28 million DALYs each year. Incidence and prevalence have increased by 12% and 24%,respectively during the past 3 decades, whilst mortality has declined by around 5%. The epidemiologic burden of this malignancy is approximately 5-fold higher in males and increases in parallel with ageing, peaking after 65 years of age. Both incidence and mortality rates are higher in Europe and lower in Africa, but the ratio between deaths and incidence is the highest in Africa. Incidence has gradually declined in Europe during the past 3 decades, whilst it has increased in South-East Asia and Western Pacific. Cigarette smoking and alcohol abuse contribute for about 90% of overall worldwide mortality for laryngeal cancer.Conclusions: Laryngeal cancer still poses a high clinical and societal burden, with an escalating temporal trend not expected to reverse soon.

Updated overview on interplay between physical exercise,neurotrophins,and cognitive function in humans

The many important benefits of physical exercise also encompass maintenance or improvement of cognitive functions. Among the variousmechanisms underlying the association between physical exercise and brain health, recent evidence attests that neurotrophin receptor signalingmay have an important role, because the activation of this pathway leads to growth and differentiation of new neurons and synapses, supportsaxonal and dendritic growth, fosters synaptic plasticity, and preserves survival of existing neurons. In this review of published evidence, we highlightthat a positive relationship exists between physical exercise and circulating brain-derived neurotrophic factor levels and that the postexercisevariation of this molecule is associated with improvement of neurocognitive functioning. Less clear evidence has instead been published forother neurotrophins, such as nerve growth factor, neurotrophin-3, and neurotrophin-4. Overall, promotion of adequate volumes and intensities ofphysical exercise (i.e., approximately 3 months of moderate-intensity aerobic exercise, with 2—3 sessions/week lasting not less than 30 min)may hence be regarded as an inexpensive and safe strategy for boosting brain-derived neurotrophic factor release, thus preserving or restoringcognitive functions.

Emergency physician's perception of cultural and linguistic barriers in immigrant care:results of a multiple-choice questionnaire in a large Italian urban emergency department

BACKGROUND: A poor communication with immigrants can lead to inappropriate use of healthcare services, greater risk of misdiagnosis, and lower compliance with treatment. As precise information about communication between emergency physicians(EPs) and immigrants is lacking, we analyzed difficulties in communicating with immigrants in the emergency department(ED) and their possible associations with demographic data, geographical origin and clinical characteristics.METHODS: In an ED with approximately 85 000 visits per year, a multiple-choice questionnaire was given to the EPs 4 months after discharge of each immigrant in 2011.RESULTS: Linguistic comprehension was optimal or partial in the majority of patients. Signifi cant barriers were noted in nearly one fourth of patients, for only half of them compatriots who were able to translate. Linguistic barriers were mainly found in older and sicker patients; they were also frequently seen in patients coming from western Africa and southern Europe. Non-linguistic barriers were perceived by EPs in a minority of patients, more frequently in the elderly and frequent attenders. Factors independently associated with a poor f inal comprehension led to linguistic barriers, non-linguistic obstacles, the absence of intermediaries, and the presence of patient's fear and hostility. The latter probably is a consequence, not the cause, of a poor comprehension.CONCLUSION: Linguistic and non-linguistic barriers, although quite infrequent, are the main factors that compromise communication with immigrants in the ED, with negative effects especially on elderly and more seriously ill patients as well as on physician satisfaction and appropriateness in using services.

Blockchain Implications in the Management of Patient Complaints in Healthcare

Blockchain is an emerging technology that has recently been the focus for many researchers who have highlighted its diverse applications including healthcare. Transparency in managing unsolicited patient complaints is important in healthcare for both patients and healthcare providers;in addition, patient complaints analysis is significant to the continued quality improvement. Accordingly, the purpose of this study is to understand the nature of patient complaints management in the healthcare settings, explore the implications of blockchain on the management of patient complaints, and identify limitations in the usage of blockchain. Structured qualitative review and content analysis of the literature methods were used through multiple inclusion and exclusion phases for the scope of this research. Blockchain technology characteristics have been analyzed and approximated with desired features in the patients’ complaint management. Patient complaints provide valuable information to drive continuous improvements in healthcare. Blockchain is described as transparent, decentralized, immutable and anonymous. Results of this research found that a complaint Management system that is built on blockchain technology might have desired features that involve data integrity, security and transparency. Blockchain does have certain limitations that involve cybersecurity, scalability, confidentiality, readiness to adopt it, and is uncertainty about its impact. As a conclusion, implementing a system to manage patient complaints that is based on blockchain technology is promising, due to its desired possible features.

Mortality from chronic liver disease:Recent trends and impact of the COVID-19 pandemic

Prepandemic time trends in mortality from chronic liver disease(CLD)differed according to specific cause of death(decreasing for liver cirrhosis,stable or increasing for liver cancer),etiology(increasing for nonalcoholic fatty liver disease,generally decreasing for other etiologies),and world region(decreasing in areas with the highest burden of hepatitis B virus,increasing in Eastern Europe and other countries).The coronavirus disease 2019(COVID-19)pandemic affected mortality of patients with CLD both directly,with a higher risk for severe illness and death depending on age,stage and etiology of the disease,and indirectly,through social isolation and loss of support,harmful drinking,and difficulties in access to care.Nevertheless,only sparse data are available on variations in CLD as a cause of death during the pandemic.In the USA,in 2020-2021 a growth in mortality was registered for all liver diseases,more marked for alcoholic liver disease,especially among young people aged 25-44 years and in selected ethnic groups.COVID-19 related deaths accounted only for a minor part of the excess.Further data from mortality registers of other countries are warranted,preferably adopting the so-called multiple cause-of-death approach,and extended to deaths attributed to viral hepatitis and liver cancer.

The Pubic Arch Angle： A Study on the Predictability of Labor and Delivery

Study objective： to verify if the PAA （angle of the pubic arch） is a predictive data for the mode of delivery, the duration of labour and the expulsion period. Methods： we chose to measure the PAA in 100 women recruited, chosen from the 38th to the 42th week of gestation. The method involves the use of two-dimensional transperineal ultrasound. Data collection took place over a period of time from May to September 2015. The ante-partum data taken into consideration were the patient’s name and surname, PAA, parity, age, height; those acquired in the post-partum provide for the calculation in minutes of the active phase of labor, the duration of the expulsion period, the execution of the amniorrhexis and the use of the synthetic oxytocin, the fetal cranial circumference, the fetal weight and the position of the presented part. Results： results discovered ultrasoundly 100 PAA, with an average value of 115.5° and we proceeded by evaluating 90 vaginal births. Infants at birth had a CC with an average value of 34.5 mm. By relating the two variables PAA and CC for the dependent variable “period expulsion in minutes”, confirming that the expulsive period depends on the relationship between PAA and CC. The average of the minutes of the expulsion period is 50＇ in women with a PAA 〉 111.5° and a CC 〉 34.5 mm while in women with an PAA 〉 111.5° the media time is 30＇ regardless of the CC. It has been shown that oxytocin and amniorrhexis reduce the minutes of the expulsion period only in a case of PAA 〉 111.5° and a CC 〉 34.5 mm bringing them from 60＇ to 23＇. Conclusion： the duration of the active phase of labor is not influenced by the PAA but it depends on external factors. In the case of the expulsion period, a predictability of the PAA on its duration is shown if the CC is taken into consideration; as regards the influence of the PAA on the method of delivery, it was not possible to carry out any analysis since all the useful cases had vaginal delivery.

Retrospective analysis of early COVID-19 vaccine efficacy in older individuals receiving primary cycle, first booster and second booster

Background:We analysed data garnered during the ongoing Italian nationwide coronavirus disease 2019(COVID-19)vaccination campaign for comparing early COVID-19 monovalent vaccine efficacy in older persons who received the primary vaccination cycle,the first vaccine booster,and the second vaccine booster.Methods:We conducted a retrospective analysis of early COVID-19 monovalent vaccine efficacy(i.e.,within 120 days)against COVID-19 related hospitalizations,intensive care unit(ICU)admissions and deaths in older persons(i.e.,aged≥80 years),by accessing official data of the COVID-19 national integrated surveillance program instituted by the Italian National Institute of Health.Vaccine efficacy was compared(odds ratio;OR)among cohorts receiving the primary vaccination cycle,the first vaccine booster,and the second vaccine booster.Results:A consistent decline could be seen in the rate of COVID-19 hospitalizations,ICU admissions and deaths with increasing number of monovalent immunizations.Within 120 days of administration,the first and second vaccine boosters had superior efficacy compared to the primary vaccination cycle,reducing the odds of all endpoints between 62%-71%and 69%-84%,respectively.A modestly superior early efficacy could also be noted for the second versus the first monovalent vaccine booster(ORs of all endpoints further reduced by 18%-48%).Conclusion:Since an increasing number of immunizations is associated with a lower risk of unfavourable COVID-19 outcomes,vaccine boosters may be useful for limiting the clinical burden of this infectious disease in elderly populations.

The impact of COVID-19 pandemic on teeth grinding in the US and UK

Background:Preliminary evidence suggests that the burden of stress and anxiety may have considerably increased during the coronavirus disease 2019(COVID-19)pandemic.Since these two mental health-related factors are important causes of teeth grinding,we carried out an infodemiological analysis to define whether the burden of teeth grinding may have increased as a consequence of COVID-19.Methods:We conducted an electronic search in Google Trends,with the term“teeth grinding”,setting the geographical area to“US”or“UK”and the search period between July 2017 and July 2022.The weekly Google Trends score for“teeth grinding”was downloaded,and the difference in the volume Google searches for“teeth grinding”was compared between the pre-COVID-19 and COVID-19 periods in both countries.Results:The median value of weekly Google Trends score for“teeth grinding”was found to be significantly increased after emergence of the COVID-19 pandemic both in the UK(57 with interquartile range[IQR]51-64 vs.48 with IQR 42-53;+19%and P<0.001)and the US(78 with IQR 73-83 vs.70 with IQR 66-74;+11%and P<0.001),compared to the homologous period before.Conclusion:The results of this infodemiological analysis reveal that the volume of Web searches for“teeth grinding”in both the UK and US has considerably increased after emergence of the COVID-19 pandemic,thus probably reflecting an increased burden of this condition in the general population.

Pooled analysis of efficacy of the fourth mRNA-based COVID-19 vaccine dose in eliciting anti-SARS-CoV-2 serum antibody response in the general immunocompetent population

Objective:Since the opportunity of widespread administration of the fourth mRNA-based coronavirus disease 2019(COVID-19)vaccine dose remains controversial,this article provides a pooled analysis of the efficacy of the second COVID-19 mRNA-based homologous vaccine booster in eliciting anti-SARS-CoV-2 serum antibody response in general immunocompetent populations.Methods:We conducted a digital search in Medline using the keywords"fourth dose"or"second booster"and"antibodies"and"COVID-19"or"SARS-CoV-2"and"BNT162b2"or"mRNA-1273",to identify all clinical studies which evaluated the anti-SARS-CoV-2 serum antibody response after the fourth mRNA-based COVID-19 homologous vaccine dose administration in general immunocompetent populations compared to the response seen before its administration and after the first booster.Results:Four studies totaling 571 recipients of the second mRNA-based COVID-19 vaccine booster were finally included in our analysis.The weighted mean difference(WMD)ratio of anti-SARS-CoV-2 serum antibodies levels measured after and before administration of the fourth vaccine dose was 9.7(95%CI,6.5-12.9)in those receiving BNT162b2 and 12.0(95%CI,5.8-18.2)in those receiving mRNA-1273,respectively.The WMD ratio of anti-SARS-CoV-2 serum antibodies levels measured at the peak of the fourth and third vaccine doses was 1.4(95%CI,1.2-1.7)in those receiving BNT162b2 and 1.9(95%CI,1.5-2.4)in those receiving mRNA-1273,respectively.Conclusion:Our data confirm the efficacy of the fourth mRNA-based COVID-19 vaccine dose in restoring a satisfactory level of anti-SARS-CoV-2 serum antibodies,though such effectiveness seems only marginally superior to that of the first booster.

Global variation in skin injures and skincare practices in extremely preterm infants

Background Globally,are skincare practices and skin injuries in extremely preterm infants comparable?This study describes skin injuries,variation in skincare practices and investigates any association between them.Methods A web-based survey was conducted between February 2019 and August 2021.Quantifying skin injuries and describing skincare practices in extremely preterm infants were the main outcomes.The association between skin injuries and skincare practices was established using binary multivariable logistic regression adjusted for regions.Results Responses from 848 neonatal intensive care units,representing all geographic regions and income status groups were received.Diaper dermatitis(331/840,39%)and medical adhesive-related skin injuries(319/838,38%)were the most common injuries.Following a local skincare guideline reduced skin injuries[medical adhesive-related injuries:adjusted odds ratios(aOR)=0.63,95%confidence interval(CI)=0.45–0.88;perineal injuries:aOR=0.66,95%CI=0.45–0.96;local skin infections:OR=0.41,95%CI=0.26–0.65;chemical burns:OR=0.46,95%CI=0.26–0.83;thermal burns:OR=0.51,95%CI=0.27–0.96].Performing skin assessments at least every four hours reduced skin injuries(abrasion:aOR=0.48,95%CI=0.33–0.67;pressure:aOR=0.51,95%CI=0.34–0.78;diaper dermatitis:aOR=0.71,95%CI=0.51–0.99;perineal:aOR=0.52,95%CI=0.36–0.75).Regional and resource settings-based variations in skin injuries and skincare practices were observed.Conclusions Skin injuries were common in extremely preterm infants.Consistency in practice and improved surveillance appears to reduce the occurrence of these injuries.Better evidence regarding optimal practices is needed to reduce skin injuries and minimize practice variations.