Risk factors for surgical site infections in rectal cancer patients

Introduction. Rectal cancer surgery is associated with high rates of post-operative complications in which the most common are Surgical Site Infections (SSI). Materials and methods. Factors responsible for SSI incidence were retrospectively analysed in rectal cancer patients who had undergone surgery at a single centre for oncology between July 2012 and July 2016. The study end-point was patients’ contracting SSI. Statistical analyses were performed by the ‘Statistica 12’ package consisting of the Pearson’s Chi-squared test (χ2), the Kruskal-Wallis test and the Mann-Whitney U-test (with continuity correction). Qualitative variables were analysed using log-linear analysis. The likelihoods of SSI incidence were compared by using odds ratios within 95% confidence limits. Results. Amongst the 187 patient subjects under observation during their 30 day follow-up, 44 (23.5%) suffered from post-operative complications of which SSI were the most common at 27 (14.4%). In those patients with advanced stage IV cancer, SSI occurred 3-fold more compared to patients with lower stage cancers; respectively 27.3% vs 11.7%, p = 0.021. Multivariate analysis demonstrated that the highest SSI risk was in patients having a low-lying tumour (≤ 5 cm from the anal rim; OR 2.31 (95% CI of 1.15 to 4.62), p = 0.019 and those patients who had undergone Hartmann’s procedure; OR 1.85 (95% CI of 1.04 to 3.31), p = 0.038. Conclusions. Surgical site infections in rectal cancer patients undergoing surgery occur significantly more in those at advanced stage IV rectal cancer where the tumour is low-lying (0–5 cm from the anal rim) and after having undergone the Hartmann’s procedure

Selected nutritional risk parameters in patients with laryngeal cancer — a comparison with other patients hospitalized in a Department of Laryngology and patients with colorectal cancer

Background: It is assumed that neoplasm greater in size may affect a patients’ nutritional status and prognosisstronger than smaller one. The aim of this study was to compare the nutritional status and prognosisof patients with laryngeal cancer (LC), recognized as tumour smaller in size, and patients with colorectalcancer (CRC) who were hospitalized in our hospital during the one year period. Methods: The retrospective review of medical documentation of all 1,134 patients hospitalized in a Departmentof Otolaryngology. Results: The laryngeal tumour was smaller than colorectal. Nutritional risk concerned 9% of patients withLC, was greater than in patients with other laryngeal disorders (1.4%), and lower than in patients withCRC (37%). A Nutritional Risk Screening (NRS) 2002 score ≥ 3 was the only significant factor influencingthe risk of in-hospital all-cause mortality, 14- and 30-day readmissions in patients with LC, and the risk of14-day rehospitalization in patients with CRC. Conclusions: Risk of malnutrition in patients with LC was lower than in counterparts with CRC, and concern9% and 37% of patients, respectively. Nutritional risk diagnosed in patients with LC had a strongerassociation with the prevalence of the measured outcomes (in-hospital death, the risk of 14-day and30-day readmission, length of hospitalization) than in individuals with CRC

Nutritional and functional status as indices of short- and long-term prognosis in patients undergoing surgery due to colorectal cancer

Introduction: Nutritional status and body composition parameters would seem to be reasonable prognostic factors in patients with colorectal cancer (CRC). The study aimed to investigate the relationships between numerous parameters of nutritional status and prognosis in patients undergoing surgery due to CRC. Material and methods: Clinical nutritional assessment and biochemical determinations were performed on 110 patients who underwent elective surgery due to primary CRC. Body composition was also analyzed using bioelectrical impedance (BIA) and computed tomography (CT) scans at the third lumbar (L3) vertebra using OsiriX software. Results: Patients who failed to attend a visit 3 months after surgery (n = 15; 13.6%) were more likely to be sarcopenic, with lower baseline functional status, handgrip strength, skeletal muscle (SM) parameters in BIA and a smaller SM area in CT. Compared to those who died during, on average, 3.6 years of follow-up (n = 33; 30%), patients who survived had, at baseline, a significantly higher Mini-Nutritional Assessment (MNA) score, lower waist-to-height ratio (WHtR), and higher scores on functional status scales. In a Cox’s proportional-hazards model, in addition to an advanced WHO CRC stage, scores for MNA (HR; 95% CI: 0.85; 0.74–0.98; p = 0.021), Patient-Generated Subjective Global Assessment (PG-SGA), instrumental activities of daily living (IADL), and WHtR (3.68; 1.03–13.13; p = 0.049) were independent risk factors for death. Conclusions: Patients’ functional status 3 months after surgery due to CRC was related to baseline SM strength, mass, and functional performance, whereas 3.5-year mortality was associated with lower MNA and IADL scores and higher WHtR and PG-SGA scores

Super-resolution visualization of chromatin loop folding in human lymphoblastoid cells using interferometric photoactivated localization microscopy.

The three-dimensional (3D) genome structure plays a fundamental role in gene regulation and cellular functions. Recent studies in 3D genomics inferred the very basic functional chromatin folding structures known as chromatin loops, the long-range chromatin interactions that are mediated by protein factors and dynamically extruded by cohesin. We combined the use of FISH staining of a very short (33 kb) chromatin fragment, interferometric photoactivated localization microscopy (iPALM), and traveling salesman problem-based heuristic loop reconstruction algorithm from an image of the one of the strongest CTCF-mediated chromatin loops in human lymphoblastoid cells. In total, we have generated thirteen good quality images of the target chromatin region with 2-22 nm oligo probe localization precision. We visualized the shape of the single chromatin loops with unprecedented genomic resolution which allowed us to study the structural heterogeneity of chromatin looping. We were able to compare the physical distance maps from all reconstructed image-driven computational models with contact frequencies observed by ChIA-PET and Hi-C genomic-driven methods to examine the concordance between single cell imaging and population based genomic data

Challenges and strategies of children and adolescents with inflammatory bowel disease: a qualitative examination

© 2007 Nicholas et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Anxiety and avoidance in psychogenic nonepileptic seizures: the role of implicit and explicit anxiety

This study examined implicit and explicit anxiety in individuals with epilepsy and psychogenic nonepileptic seizures (PNESs) and explored whether these constructs were related to experiential avoidance and seizure frequency. Based on recent psychological models of PNESs, it was hypothesized that nonepileptic seizures would be associated with implicit and explicit anxiety and experiential avoidance. Explicit anxiety was measured by the State-Trait Anxiety Inventory; implicit anxiety was measured by an Implicit Relational Assessment Procedure; and experiential avoidance was measured with the Multidimensional Experiential Avoidance Questionnaire. Although both groups with epilepsy and PNESs scored similarly on implicit measures of anxiety, significant implicit–explicit anxiety discrepancies were only identified in patients with PNESs (p < .001). In the group with PNESs (but not in the group with epilepsy), explicit anxiety correlated with experiential avoidance (r = .63, p < .01) and frequency of seizures (r = .67, p < .01); implicit anxiety correlated with frequency of seizures only (r = .56, p < .01). Our findings demonstrate the role of implicit anxiety in PNESs and provide additional support for the contribution of explicit anxiety and experiential avoidance to this disorder

The impact of self-efficacy, alexithymia and multiple traumas on posttraumatic stress disorder and psychiatric co-morbidity following epileptic seizures: A moderated mediation analysis

This study investigated the incidence of posttraumatic stress disorder (PTSD) and psychiatric co-morbidity following epileptic seizure, whether alexithymia mediated the relationship between self-efficacy and psychiatric outcomes, and whether the mediational effect was moderated by the severity of PTSD from other traumas. Seventy-one (M=31, F=40) people with a diagnosis of epilepsy recruited from support groups in the United Kingdom completed the Posttraumatic Stress Diagnostic Scale, the Hospital Anxiety and Depression Scale, the Toronto Alexithymia Scale-20 and the Generalized Self-Efficacy Scale. They were compared with 71 people (M=29, F=42) without epilepsy. For people with epilepsy, 51% and 22% met the diagnostic criteria for post-epileptic seizure PTSD and for PTSD following one other traumatic life event respectively. For the control group, 24% met the diagnostic criteria for PTSD following other traumatic life events. The epilepsy group reported significantly more anxiety and depression than the control. Partial least squares (PLS) analysis showed that self-efficacy was significantly correlated with alexithymia, post-epileptic seizure PTSD and psychiatric co-morbidity. Alexithymia was also significantly correlated with post-epileptic seizure PTSD and psychiatric co-morbidity. Mediation analyses confirmed that alexithymia mediated the path between self-efficacy and post-epileptic seizure PTSD and psychiatric co-morbidity. Moderated mediation also confirmed that self-efficacy and PTSD from one other trauma moderated the effect of alexithymia on outcomes. To conclude, people can develop posttraumatic stress disorder symptoms and psychiatric co-morbidity following epileptic seizure. These psychiatric outcomes are closely linked with their belief in personal competence to deal with stressful situations and regulate their own functioning, to process rather than defend against distressing emotions, and with the degree of PTSD from other traumas. © 2013 Elsevier Ireland Ltd

Emotion processing and psychogenic non-epileptic seizures: A cross-sectional comparison of patients and healthy controls

Purpose This exploratory study aimed to examine emotion-processing styles in patients with psychogenic non-epileptic seizures (PNES), compared to healthy individuals, and to explore associations of emotion processing with other psychological measures and seizure frequency, using the new Emotional Processing Scale (EPS-25), which had not previously been used in this patient group. Methods Fifty consecutive patients with PNES referred for psychotherapy completed a set of self-report questionnaires, including the Emotional Processing Scale (EPS-25), Clinical Outcome in Routine Evaluation (CORE-10), Short Form-36 (SF-36), Patient Health Questionnaire (PHQ-15), and Brief Illness Perception Questionnaire (BIPQ). Responses on the EPS-25 were compared to data from 224 healthy controls. Results Patients with PNES had greater emotion processing deficits across all dimensions of the EPS-25 than healthy individuals (suppression/unprocessed emotion/unregulated emotion/avoidance/impoverished emotional experience). Impaired emotion processing was highly correlated with psychological distress, more frequent and severe somatic symptoms, and a more threatening understanding of the symptoms. Emotion processing problems were also associated with reduced health-related quality of life on the mental health (but not the physical health) component of the SF-36. The unregulated emotions sub-scale of the EPS was associated with lower seizure frequency. Conclusion The results showed clear impairments of emotion processing in patients with PNES compared to healthy individuals, which were associated with greater psychological distress and reduced mental health functioning. These findings seem to support the face validity of the EPS-25 as a measure for PNES patients and its potential as a tool to assess the effectiveness of psychological interventions

Czynniki ryzyka wystąpienia zakażenia miejsca operowanego u chorych na raka odbytnicy

Wstęp. Operacja raka odbytnicy związana jest z dużym odsetkiem powikłań pooperacyjnych. Najczęściej występującym powikłaniem jest zakażenie miejsca operowanego (ZMO). Materiał i metody. Retrospektywnej analizie poddano czynniki wystąpienia ZMO u chorych operowanych w jednym ośrodku z powodu raka odbytnicy od czerwca 2012 do czerwca 2016 r. Punktem końcowym badania było wystąpienie ZMO. Do analizy statystycznej zastosowano pakiet Statistica 12: test Chi-kwadrat Pearsona, test Kruskala-Wallisa i test U Manna-Whitneya (z poprawką na ciągłość). Analizę log-liniową zastosowano do analizy zmiennych jakościowych. Do porównania prawdopodobieństwa wystąpienia ZMO zastosowano iloraz szans i jego 95-procentowy przedział ufności. Wyniki. Wśród 187 analizowanych chorych w obserwacji 30-dniowej powikłanie pooperacyjne wystąpiło u 44 (23,5%) chorych. Najczęściej rozpoznawanym powikłaniem było ZMO — 27 (14,4%). Stwierdzono, że w grupie chorych z IV stopniem zaawansowania raka ZMO wystąpiło trzykrotnie częściej w porównaniu do chorych z niższym stopniem zaawansowania (27,3% vs 11,7%; p = 0,021). Na postawie analizy wieloczynnikowej stwierdzono, że największe ryzyko wystąpienia ZMO było u chorych z niską lokalizacją guza nowotworowego (≤ 5 cm od brzegu odbytu) (OR 2,31 [95% CI 1,15–4,62]; p = 0,019) i u chorych po operacji Hartmanna (OR 1,85 [95% CI 1,04–3,31]; p = 0,038). Wniosek. Zakażenie miejsca operowanego u chorych na raka odbytnicy występuje znamiennie częściej w IV stopniu zaawansowania raka odbytnicy, z guzem zlokalizowanym nisko (0–5 cm od brzegu odbytu) i po operacji Hartmanna