Randomized controlled trial of bipolar diathermy vs ultrasonic scalpel for closed hemorrhoidectomy

AIM:To compare hemorrhoidectomy with a bipolar electrothermal device or hemorrhoidectomy using an ultrasonically activated scalpel.METHODS:Sixty patients with grade Ⅲ or Ⅳ hemorrhoids were prospectively randomized to undergo closed hemorrhoidectomy assisted by bipolar diathermy(group 1) or hemorrhoidectomy with the ultrasonic scalpel(group 2).Operative data were recorded,and patients were followed at 1,3,and 6 wk to evaluate complications.Independent assessors were assigned to obtain postoperative pain scores,oral analgesic requirement and satisfaction scores.RESULTS:Reduced intraoperative blood loss median 0.9 mL(95% CI:0.8-3.7) vs 4.6 mL(95% CI:3.8-7.0),P = 0.001 and a short operating time median 16(95% CI:14.6-18.2) min vs 31(95% CI:28.1-35.3) min,P < 0.0001 was observed in group 1 compared with group 2.There was a trend towards lower postoperative pain scores on day 1 group 1 median 2(95% CI:1.8-3.5) vs group 2 median 3(95% CI:2.6-4.2),P = 0.135.Reduced oral analgesic requirement during postoperative 24 h after operation median 1(95% CI:0.4-0.9) tablet vs 1(95% CI:0.9-1.3) tablet,P = 0.006 was observed in group 1 compared with group 2.There was no difference between the two groups in the degree of patient satisfaction or number of postoperative complications.CONCLUSION:Bipolar diathermy hemorrhoidectomy is quick and bloodless and,although as painful as closed hemorrhoidectomy with the ultrasonic scalpel,is associated with a reduced analgesic requirement immediately after operation.

Breast Cancer: Knowledge, Attitudes on Risk Factors and Means of Screening by Medical Students from Lomé, Togo

Background: Breast cancer is the leading cause of cancer-related death in women around the world. The objective of this study was to assess knowledge and attitudes about breast cancer screening among students in the Faculty of Health Sciences at the University of Lomé. Methods: This was a prospective descriptive transversal study conducted among students enrolled in the Faculty of Health Sciences (FSS) of the University of Lomé (UL) in the 2019 school year account 2020. The purpose of this study was to assess the knowledge and attitudes of medical students about breast cancer screening. Results: In total, the questionnaire was completed by 934 students, for a response rate of 57.1%. The most frequently mentioned risk factors were the presence of a family history of breast cancer (n = 799, 85.55%) and the use of oral or injectable contraceptives (n = 606, 64.88%). There is a statistically significant link between the participants’ knowledge of the self-examination and clinical examination of the breasts and certain socio-demographic characteristics, namely age (OR = 0.2, 95% CI [0.11 - 0.75], p-value < 0.0001), the level of study (OR = 1.5, 95% CI [0.55 - 2.46], p-value = 0.0054), the follow-up of a course on breast cancer (OR = 2.63, 95% CI [0.32 - 4.33], p-value = 0.009) and the effectiveness of an internship in a gynecology-obstetrics department (OR = 0.77, 95% CI [0.49 - 2.56], p-value < 0.0001). Similarly, there is a statistically significant link between participants’ knowledge of mammography and certain socio-demographic characteristics, namely age (OR = 0.75, 95% CI [0.50 - 0.84], p-value = 0.0005), the level of study (OR = 1.92, 95% CI [1.11 - 3.46], p-value < 0.0001), the follow-up of a course or training on breast cancer (OR = 2.44, 95% CI [0.08 - 3.91], p-value < 0.0001) and the effectiveness of an internship in a gynecology-obstetrics department (OR = 0.62, 95% CI [0.33 - 0.85], p-value < 0.0001). Conclusion: Knowledge and attitudes related to breast cancer screening have been found to be generally satisfactory to medical students. Active measures are needed to develop educational programs for health personnel, which could enable them to disseminate knowledge and positively influence patient attitudes.

Dietary fat intake of Japanese male children and its associated factors: Results of the 1995 National Nutrition Survey in Japan

Aim: To clarify the factors associated with reported dietary fat intake by Japanese male children. Methods: This study is based on the data of a nationally representative cross-sectional study in Japan. Three hundred and seventy-seven male children (age, 6 - 11 years) whose households were sampled in the 1995 Comprehensive Survey of Living Conditions of the People on Health and Welfare, and the 1995 National Nutrition Survey and whose parents were identified through record linkage between the 2 survey data sets were enrolled. Results: The final dataset in this study consisted of 377 boys with 329 of their parents. Fifty-two boys were found to be overweight (13.8%). The reported dietary fat intake was higher among the overweight boys than among the non-overweight boys. Maternal obesity was significantly associated with obesity in male children. Boys who frequently consumed foods from the “fats and lipids” group and the “meat” groups, and children from nuclear families rather than 3- generation families reported high dietary fat intake. In addition, parental fat intake was also significantly associated with fat intake of male children. Conclusions: Child and parental dietary habits along with the household status should be considered when implementing nutritional education programmes to control dietary fat intake and reduce the obesity risks of male children.

香港对于结核病的接触者检查是有用的

背景:香港政府结核病与胸部疾病中心的结核病控制规程。 目的:确定香港对结核病家庭接触者的检查结果。 设计:从在胸部疾病中心登记治疗的5757例中随机选择970首发病例,对其所有家庭接触者进行回顾性队列研究。 结果:在确定的2678名家庭接触者(首发病例的3倍)中,检查率为90％;发现41例活动性病例,比率为1720/100000(95％CI1238-2329)。比率在两端年龄组最高,≤5岁的儿童组为3604/100000(95％CI 990-3615),在>60岁年龄组的人群中为3547/100000(95％CI 1456-6489)。痰涂片和培养阳性的首发病例其接触者病例率最高,为2904/100000(95％CI 1869-4873);但细菌学为阴性病人的接触者病例率也高,为1478/100000(95％CI678-2789)。通过接触者追踪确定的阳性病例可能是源病例而不是继发病例。≤5岁的儿童结核菌素为阳性为8％,香港对所有的新生儿都予BCG接种,在过去的30年覆盖率为99％,很难估算这些儿童的感染率。 结论:香港作为结核病的中等负担地区,对接触者进行调查是主动发现活动性病例的一个非常有效的措施。

不列颠哥伦比亚省以人口为基础的耐药结核病危险因素研究

背景:加拿大不列颠哥伦比亚的省级结核病(TB)工作。目的:调查不列颠哥伦比亚省抗结核药物耐药的相关危险因素,并确定不同耐药类别危险因素的特征是否有所不同。设计:应用省级结核病服务的人群资料,所有在1990-2001年间结核分枝杆菌培养阳性的病例均被包括在本研究中。应用Logistic回归分析评估耐药的危险因素。结果:在3041个合格结核病例中,295例(10％)耐药。耐药性的重要危险因素为青年、国外出生、少数民族、TB复发和初次诊断的地点。国外出生的研究对象(OR=3．18,95％CI:2．26-4．49)出现耐药的危险性是加拿大出生研究对象的3倍多。不同种族人群中,华裔(OR=2．32,95％CI:1．51-3．57)、东南亚裔(OR=2．92, 95％CI:1．88-4．52)和其他亚裔(OR=4．40,95％CI: 2．77-7．01)出现耐药的危险性是高加索裔的2-4倍。复发病例(OR=2．69,95％CI:1．91-3．77)出现耐药的危险性是新病例的3倍。结论:本文对大人群基础队列中的耐药结核病危险因素进行了分析和定量评价,并确定了发达国家的耐药结核病高危病人群体。

Multi-class cancer classification through gene expression profiles: microRNA versus mRNA

Both microRNA （miRNA） and mRNA expression profiles are important methods for cancer type classification. A comparative study of their classification performance will be helpful in choosing the means of classification. Here we evaluated the classification performance of miRNA and mRNA profiles using a new data mining approach based on a novel SVM （Support Vector Machines） based recursive fea- ture elimination （nRFE） algorithm. Computational experiments showed that information encoded in miRNAs is not sufficient to classify cancers; gut-derived samples cluster more accurately when using mRNA expression profiles compared with using miRNA profiles; and poorly differentiated tumors （PDT） could be classified by mRNA expression profiles at the accuracy of 100% versus 93.8% when using miRNA profiles. Furthermore, we showed that mRNA expression profiles have higher capacity in normal tissue classifications than miRNA. We concluded that classification performance using mRNA profiles is superior to that of miRNA profiles in multiple-class cancer classifications.

Demand for longer quarantine period among common and uncommon COVID-19 infections: a scoping review

Background:As one of the non-pharmacological interventions to control the transmission of COVID-19,determining the quarantine duration is mainly based on the accurate estimates of the incubation period.However,patients with coarse information of the exposure date,as well as infections other than the symptomatic,were not taken into account in previously published studies.Thus,by using the statistical method dealing with the interval-censored data,we assessed the quarantine duration for both common and uncommon infections.The latter type includes the presymptomatic,the asymptomatic and the recurrent test positive patients.Methods:As of 10 December 2020,information on cases have been collected from the English and Chinese databases,including Pubmed,Google scholar,CNKI(China National Knowledge Infrastructure)and Wanfang.Official websites and medias were also searched as data sources.All data were transformed into doubly interval-censored and the accelerated failure time model was applied.By estimating the incubation period and the time-to-event distribution of worldwide COVID-19 patients,we obtain the large percentiles for determining and suggesting the quarantine policies.For symptomatic and presymptomatic COVID-19 patients,the incubation time is the duration from exposure to symptom onset.For the asymptomatic,we substitute the date of first positive result of nucleic acid testing for that of symptom onset.Furthermore,the time from hospital discharge or getting negative test result to the positive recurrence has been calculated for recurrent positive patients.Results:A total of 1920 laboratory confirmed COVID-19 cases were included.Among all uncommon infections,34.1%(n=55)of them developed symptoms or were identified beyond fourteen days.Based on all collected cases,the 95th and 99th percentiles were estimated to be 16.2 days(95%Cl 15.5-17.0)and 22.9 days(21.7-24.3)respectively.Besides,we got similar estimates based on merely symptomatic and presymptomatic infections as 15.1 days(14.4-15.7)and 21.1 days(20.0-22.2).Conclusions:There are a certain number of infected people who require longer quarantine duration.Our findings well support the current practice of the extended active monitoring.To further prevent possible transmissions induced and facilitated by such infectious outliers after the 14-days quarantine,properly prolonging the quarantine duration could be prudent for high-risk scenarios and in regions with insufficient test resources.