9 research outputs found

    Variation in postoperative outcomes of patients with intracranial tumors: insights from a prospective international cohort study during the COVID-19 pandemic

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    Background: This study assessed the international variation in surgical neuro-oncology practice and 30-day outcomes of patients who had surgery for an intracranial tumor during the COVID-19 pandemic. Methods: We prospectively included adults aged ≄18 years who underwent surgery for a malignant or benign intracranial tumor across 55 international hospitals from 26 countries. Each participating hospital recorded cases for 3 consecutive months from the start of the pandemic. We categorized patients’ location by World Bank income groups (high [HIC], upper-middle [UMIC], and low- and lower-middle [LLMIC]). Main outcomes were a change from routine management, SARS-CoV-2 infection, and 30-day mortality. We used a Bayesian multilevel logistic regression stratified by hospitals and adjusted for key confounders to estimate the association between income groups and mortality. Results: Among 1016 patients, the number of patients in each income group was 765 (75.3%) in HIC, 142 (14.0%) in UMIC, and 109 (10.7%) in LLMIC. The management of 200 (19.8%) patients changed from usual care, most commonly delayed surgery. Within 30 days after surgery, 14 (1.4%) patients had a COVID-19 diagnosis and 39 (3.8%) patients died. In the multivariable model, LLMIC was associated with increased mortality (odds ratio 2.83, 95% credible interval 1.37–5.74) compared to HIC. Conclusions: The first wave of the pandemic had a significant impact on surgical decision-making. While the incidence of SARS-CoV-2 infection within 30 days after surgery was low, there was a disparity in mortality between countries and this warrants further examination to identify any modifiable factors

    Interaction between T Cells and Endothelial Cells: Insights into Immune Response and Vascular Health among Children

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    The functioning of T cells, key players in the immune response, is inherently influenced by specific nutrients. Understanding how dietary factors influence T cell function is pivotal in the context of child health. Eendothelial cell antigen presentation to T cells influences the outcome of several immune system functions. However, the consequences of these interactions are still discussed, with different responses observed depending on the phenotype and functional reactivity of both cells. Relating our findings to specific nutrition-related diseases in children, such as obesity, diabetes, and cardiovascular issues, establishes a direct link between T cell-endothelium interactions and pediatric health outcomes. The role of nutritional interventions extends beyond meeting basic dietary needs; it plays a dynamic role in shaping immune responses in children. Recognizing the interconnectedness of nutrition and immunology allows for developing targeted strategies. In this study, we find a close relationship between T lymphocytes (CTL) and endothelium, which is required and important for proliferation and differentiation to determine the size of the cell mass in the circulation. With an eye towards therapeutic opportunities, this review discusses in detail the link between both, how they are each activated, their substrates, and their regulation, and maps out how they interact

    Hematological and biochemical parameters among obese students at the PSAU, Alkharj, KSA

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    Management of obesity represents a global problem that challenges the provision of healthcare services in most countries. Saudi Arabia ranked number 29 on a 2007 list of countries with 6% of its population being overweight (BMI > 25).In a university setting, we studied hematological parameters (including whole blood counts, haemoglobin and platelets), the presence of basophilia, iron levels and lipid profiles in obese students, and also in non-obese student controls. We found a significant increase in whole blood count in obese compared to healthy individuals, and also found a high level of basophilia compared to healthy controls.  We also report that the obese student group suffered from low iron levels, and also a reduced total iron binding capacity, as compared to healthy controls. Levels of cholesterol and triglycerides was significantly higher in obese students compared to healthy controls. This study can be interpreted that universities across the Kingdom, and beyond, should consider targeting obesity management in their students to try to reduce the prevalence of obesity and associated disorders, and to support such healthcare programs by offering a variety of environmental, physical exercise and nutritional interventions

    Relationship between obesity and immunological parameters among students at the PSAU University-Alkharj, KSA

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    Obesity represents a major worldwide health problem, all aspects of which have not fully defined, nor fully understood.  In the current study, we investigated a population of university students in terms of the relationship between incidence of obesity in individuals (n=171),within this larger cohort (n=500), with the comorbidities that these high BMI individuals also carried. We also report important statistical differences in blood levels each of cardiac-related protein (CRP)(p=0.002), IL-6(p=0.005), &leptin(p=0.02), when we related the blood values with individual student BMIs which were used as a measure of obesity

    Relationship Between Obesity and Immunological Parameters Among Students at the PSAU University-Alkharj, KSA

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    Obesity represents a major worldwide health problem, all aspects of which have not fully defined, nor fully understood.  In the current study, we investigated a population of university students in terms of the relationship between incidence of obesity in individuals (n=171),within this larger cohort (n=500), with the comorbidities that these high BMI individuals also carried. We also report important statistical differences in blood levels each of cardiac-related protein (CRP)(p=0.002), IL-6(p=0.005), &leptin(p=0.02), when we related the blood values with individual student BMIs which were used as a measure of obesity

    Hematological and Biochemical Parameters Among Obese Students at the PSAU, Alkharj, KSA

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    Management of obesity represents a global problem that challenges the provision of healthcare services in most countries. Saudi Arabia ranked number 29 on a 2007 list of countries with 6% of its population being overweight (BMI > 25).In a university setting, we studied hematological parameters (including whole blood counts, haemoglobin and platelets), the presence of basophilia, iron levels and lipid profiles in obese students, and also in non-obese student controls. We found a significant increase in whole blood count in obese compared to healthy individuals, and also found a high level of basophilia compared to healthy controls.  We also report that the obese student group suffered from low iron levels, and also a reduced total iron binding capacity, as compared to healthy controls. Levels of cholesterol and triglycerides was significantly higher in obese students compared to healthy controls. This study can be interpreted that universities across the Kingdom, and beyond, should consider targeting obesity management in their students to try to reduce the prevalence of obesity and associated disorders, and to support such healthcare programs by offering a variety of environmental, physical exercise and nutritional interventions

    The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

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    The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery

    The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

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    AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease
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