Metabolic predispositions and increased risk of colorectal adenocarcinoma by anatomical locations: a large population-based cohort study in Norway

Whether different definitions of metabolic syndrome (MetS) are differently associated with colorectal adenocarcinoma (CA) by anatomical location is unclear. A population-based cohort study, the Cohort of Norway (CONOR) Study, was conducted in Norway from 1995 to 2010. Anthropometric measurements, blood samples, and lifestyle data were collected at recruitment. CAs were identified through linkage to the Norwegian Cancer Register. A composite index of MetS as defined by the International Diabetes Federation (IDF) or/and the National Cholesterol Education Program's Adult Treatment Panel III (ATP III) and single components of MetS, including anthropometric factors, blood pressure, lipids, triglycerides, and glucose, were analyzed. Cox proportional hazards regression was performed to estimate hazard ratios and 95% confidence intervals. Significant associations between single MetS components and CA, except for reduced high-density lipoprotein cholesterol and nonfasting glucose levels, were observed. MetS defined by 2 criteria separately showed a similar association with CA in general, and MetS defined by both the IDF and ATP III showed consistent results. Stronger associations were observed in the proximal colon among men (IDF: hazard ratio (HR) = 1.51, 95% confidence interval (CI): 1.24, 1.84; ATP III: HR = 1.40, 95% CI: 1.15, 1.70) and in the rectum among women (IDF: HR = 1.42, 95% CI: 1.07, 1.89; ATP III: HR = 1.43, 95% CI: 1.08, 1.90).Swedish Society of MedicineKarolinska InstitutetSwedish Research CouncilAccepte

Пародонтопротекторное действие гексафторосиликатов 2-, 3-, 4-пиридинуксусной кислоты и 2,4-диамино-6-гидроксипиримидина у крыс

ФТОРПРЕПАРАТЫПИРИДИНУКСУСНАЯ КИСЛОТАГЕКСАФТОРОСИЛИКАТЫКАРИЕС ЗУБОВПЕРИОДОНТА БОЛЕЗНИДИСБИОЗЖИВОТНЫЕ ЛАБОРАТОРНЫЕКРЫСЫЭКСПЕРИМЕНТЫ НА ЖИВОТНЫХВ работе определяли пародонтопротекторное действие оральных аппликаций геля, содержащего гексафторосиликаты 2-пиридинуксусной кислоты (ГФС-2-ПУК), 3-пиридинуксусной кислоты (ГФС-3-ПУК), 4-пиридинуксусной кислоты (ГФС-4-ПУК) и 2,4-диамино-6-гидроксипиримидина (ГФС-ДАГП) у крыс, которых содержали на кариесогенном (высокосахарозном) рационе. Состояние десны оценивали по уровню маркеров воспаления (МДА, эластаза), микробной обсемененности (уреаза), неспецифического иммунитета (лизоцим), антиоксидантной защиты (каталаза), а также по степени дисбиоза и индекса АПИ. Результаты исследований показали, что КГР вызывает увеличение активности лизоцима и уреазы в десне, степени дисбиоза и снижение активности каталазы и индекса АПИ. Оральные аппликации гелей снижают в десне активность уреазы и содержание МДА. Таким образом, результаты изучения свойств гексафторосиликатов 2-, 3-, 4-пиридинуксусной кислоты свидетельствуют об их пародонтопротекторном действии, причем наиболее перспективным объектом дальнейшего изучения является ГФС-4-ПУК

Ökad jämställdhet genom ett kvinnligt nätverk? Om jämställdhetsarbete i ett företag i byggbranschen

I denna uppsats belyser vi hur jämställdhetsarbete kan bedrivas inom en organisation genom att studera ett kvinnligt nätverk hos ett stort svenskt företag i byggbranschen. Syftet med vårt arbete är att bidra med en kritisk diskussion om nytta och funktion av praktiskt jämställdhetsarbete i en samtida arbetslivskontext. Frågeställningen blir därmed: Hur fungerar jämställdhetsarbetet inom det undersökta kvinnliga nätverket; Vad är bra, vad är problematiskt, och hur kan det bli bättre? Uppsatsen baseras på en kvalitativ undersökning i form av semistrukturerade intervjuer gjorda med åtta kvinnliga anställda på företaget, samt på en analys av nätverkets projektplan. I arbetet kommer vi fram till att nätverket har en potential, då man från företagets sida satsar tid, pengar och kraft på nätverksarbetet. Dock identifierar vi en rad olika problem med hur nätverksarbetet bedrivs. Vi menar att sättet man bedriver nätverksarbetet på gör att det inte går att åstadkomma särskilt stora förändringar vad gäller jämställdheten i organisationen. För att en förändring ska ske föreslår vi att man hos nätverksmedlemmarna implementerar en teoretiskt förankrad grundförståelse för genusfrågor i organisationer. Samt att man fokuserar på att det kvinnliga nätverket kan fylla funktionen som ett socialt kapital där nätverksmedlemmarna drar nytta av varandras tillgångar

Anthropometry-based obesity phenotypes and risk of colorectal adenocarcinoma : a large prospective cohort study in Norway

BACKGROUND: It is unclear whether obesity phenotypes measured by different anthropometric indices are associated with a risk of colorectal adenocarcinoma by anatomical location. METHODS: We compiled harmonized population-based cohort studies (Cohort of Norway, CONOR) with 143,477 participants that were conducted between 1994 and 2010. General, abdominal, and gluteofemoral obesity were assessed by body mass index (BMI, kg/m(2)), waist circumference (cm), and hip circumference (cm). Other measures examined were waist to hip ratio, waist to height ratio, and body adiposity index. We performed Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of obesity relative to a risk of colorectal adenocarcinoma. RESULTS: In total, 2,044 incident cases of colorectal adenocarcinoma were identified. We observed a positive association between waist circumference (high versus low) and adenocarcinoma in the proximal colon (HR = 1.9, 95% CI = 1.5, 2.5) and distal colon (HR = 1.7, 95% CI = 1.3, 2.3) when adjusted for BMI. The association with waist circumference was especially strong in men. BMI was not associated with adenocarcinoma in the colon or rectum after adjusting for waist circumference. We found no association between hip circumference and colorectal adenocarcinoma. When adjusted for BMI plus waist circumference, body adiposity index was negatively associated with adenocarcinoma in the proximal or distal colon. CONCLUSION: Abdominal obesity, but not general or gluteofemoral obesity, was associated with an increased risk of adenocarcinoma in the proximal and the distal colon, especially in men. Muscularity may be negatively associated with risk of colon adenocarcinoma.Swedish Research CouncilAccepte

National differences in implementation of minimally invasive surgery for colorectal cancer and the influence on short-term outcomes

Background: The timing and degree of implementation of minimally invasive surgery (MIS) for colorectal cancer vary among countries. Insights in national differences regarding implementation of new surgical techniques and the effect on postoperative outcomes are important for quality assurance, can show potential areas for country-specific improvement, and might be illustrative and supportive for similar implementation programs in other countries. Therefore, this study aimed to evaluate differences in patient selection, applied techniques, and results of minimal invasive surgery for colorectal cancer between the Netherlands and Sweden. Methods: Patients who underwent elective minimally invasive surgery for T1-3 colon or rectal cancer (2012–2018) registered in the Dutch ColoRectal Audit or Swedish ColoRectal Cancer Registry were included. Time trends in the application of MIS were determined. Outcomes were compared for time periods with a similar level of MIS implementation (Netherlands 2012–2013 versus Sweden 2017–2018). Multilevel analyses were performed to identify factors associated with adverse short-term outcomes. Results: A total of 46,095 Dutch and 8,819 Swedish patients undergoing MIS for colorectal cancer were included. In Sweden, MIS implementation was approximately 5 years later than in the Netherlands, with more robotic surgery and lower volumes per hospital. Although conversion rates were higher in Sweden, oncological and surgical outcomes were comparable. MIS in the Netherlands for the years 2012–2013 resulted in a higher reoperation rate for colon cancer and a higher readmission rate but lower non-surgical complication rates for rectal cancer if compared with MIS in Sweden during 2017–2018. Conclusion: This study showed that the implementation of MIS for colorectal cancer occurred later in Sweden than the Netherlands, with comparable outcomes despite lower volumes. Our study demonstrates that new surgical techniques can be implemented at a national level in a controlled and safe way, with thorough quality assurance.</p

Superiority of Serum Cystatin C Over Creatinine in Prediction of Long-Term Prognosis at Discharge From ICU

MB, BR, CRM and JM have received the Baxter “INVESTIGATOR INITIATED RESEARCH ACUTE CARE GRANT”

National differences in implementation of minimally invasive surgery for colorectal cancer and the influence on short-term outcomes

Background: The timing and degree of implementation of minimally invasive surgery (MIS) for colorectal cancer vary among countries. Insights in national differences regarding implementation of new surgical techniques and the effect on postoperative outcomes are important for quality assurance, can show potential areas for country-specific improvement, and might be illustrative and supportive for similar implementation programs in other countries. Therefore, this study aimed to evaluate differences in patient selection, applied techniques, and results of minimal invasive surgery for colorectal cancer between the Netherlands and Sweden. Methods: Patients who underwent elective minimally invasive surgery for T1-3 colon or rectal cancer (2012–2018) registered in the Dutch ColoRectal Audit or Swedish ColoRectal Cancer Registry were included. Time trends in the application of MIS were determined. Outcomes were compared for time periods with a similar level of MIS implementation (Netherlands 2012–2013 versus Sweden 2017–2018). Multilevel analyses were performed to identify factors associated with adverse short-term outcomes. Results: A total of 46,095 Dutch and 8,819 Swedish patients undergoing MIS for colorectal cancer were included. In Sweden, MIS implementation was approximately 5 years later than in the Netherlands, with more robotic surgery and lower volumes per hospital. Although conversion rates were higher in Sweden, oncological and surgical outcomes were comparable. MIS in the Netherlands for the years 2012–2013 resulted in a higher reoperation rate for colon cancer and a higher readmission rate but lower non-surgical complication rates for rectal cancer if compared with MIS in Sweden during 2017–2018. Conclusion: This study showed that the implementation of MIS for colorectal cancer occurred later in Sweden than the Netherlands, with comparable outcomes despite lower volumes. Our study demonstrates that new surgical techniques can be implemented at a national level in a controlled and safe way, with thorough quality assurance.</p

The Importance of the Pathologist’s Role in Assessment of the Quality of the Mesorectum

Total mesorectal excision (TME) is considered standard of care for rectal cancer treatment. Failure to remove the mesorectal fat envelope entirely may explain part of observed local and distant recurrences. Several studies suggest quality of the mesorectum after TME surgery as determined by pathological evaluation may influence prognosis. We aimed to determine the prognostic value of the plane of surgery as well as factors influencing the likelihood of a high-quality specimen by reviewing the literature. A pooled meta-analysis of relevant outcome data was performed where appropriate. A muscularis propria resection plane was found to increase the risk of local recurrence (RR 2.72 [95 % CI 1.36 to 5.44]) and overall recurrence (RR 2.00 [95 % CI 1.17 to 3.42]) compared to an (intra)mesorectal plane. Plane of surgery is an important factor in rectal cancer treatment and the documentation by pathologists is essential for the improvement of TME quality and patient outcome