Preeclampsia is an important cause of maternal and fetal morbidity and mortality. Although the diagnostic and prognostic values of circulating placental growth factor (PlGF) have been extensively studied, urinary PlGF represents an excellent alternative to facilitate sample collection in the follow-up of pregnant women. The aim of this study is to determine whether urinary PlGF levels throughout pregnancy can predict severe maternal, fetal/placental and neonatal complications in women with hypertensive disorders in pregnancy.
Studies that evaluated pregnant women with hypertensive disorders and at least one measurement of urinary PlGF will be included. Studies that measure urinary PlGF after the occurrence of the complications will be excluded. The main outcome will consist of severe maternal complications in women with hypertensive disorders in pregnancy. Secondary outcomes will consist of severe fetal/placental and neonatal complications as defined by the International Collaboration to Harmonize Outcomes for Pre-eclampsia. Prospective cohort studies and case–controls studies reporting original data will be included. Studies will be identified by searching MEDLINE and SCOPUS databases. The first literature search was conducted on 2 March 2020, and another search will be performed before analyses. All eligible studies will be assessed for risk of bias with a standardised 10-items study quality assessment tool adapted from the Study Quality Assessment tools developed by the National Institutes of Health (NIH). Summary of ORs and 95% CIs will be reported to evaluate the association between urinary PlGF levels and hypertensive disorders in pregnancy and its complications. A random-effect meta-analysis will also be performed.
Review by an ethics committee will not be required for this systematic review. This study will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and will be submitted for publication in a peer-reviewed journal as well as for presentation at conferences targeting different stakeholders, including researchers, physicians and patients.
Evidence about the impact of systematic nursing surveillance on risk of acute deterioration of patients with COVID-19 and the effects of care complexity factors on inpatient outcomes is scarce. The aim of this study was to determine the association between acute deterioration risk, care complexity factors and unfavourable outcomes in hospitalised patients with COVID-19.
A multicentre cohort study was conducted from 1 to 31 March 2020 at seven hospitals in Catalonia. All adult patients with COVID-19 admitted to hospitals and with a complete minimum data set were recruited retrospectively. Patients were classified based on the presence or absence of a composite unfavourable outcome (in-hospital mortality and adverse events). The main measures included risk of acute deterioration (as measured using the VIDA early warning system) and care complexity factors. All data were obtained blinded from electronic health records. Multivariate logistic analysis was performed to identify the VIDA score and complexity factors associated with unfavourable outcomes.
Out of a total of 1176 patients with COVID-19, 506 (43%) experienced an unfavourable outcome during hospitalisation. The frequency of unfavourable outcomes rose with increasing risk of acute deterioration as measured by the VIDA score. Risk factors independently associated with unfavourable outcomes were chronic underlying disease (OR: 1.90, 95% CI 1.32 to 2.72; p
The systematic nursing surveillance of the status and evolution of COVID-19 inpatients, including the careful monitoring of acute deterioration risk and care complexity factors, may help reduce deleterious health outcomes in COVID-19 inpatients.
The Colon Cancer Screening Centre (CCSC) biorepository (Calgary, Canada) supports a wide range of research topics related to colorectal cancer (CRC) by collecting, and storing biospecimens (blood, urine, normal colon tissue) from consenting patient participants. Housing unique biospecimens along with detailed participant lifestyle and health history questionnaire data, the CCSC biorepository can support a variety of research related to CRC risk factors, biomarkers, genetic causes and more.
Currently, 2292 average risk CRC patients have consented to participate in the CCSC cohort and have provided stored biospecimens. The collected samples and data provide important high-quality materials for research, discovery and evaluation related to CRC screening and carcinogenesis and is available for access by outside researchers. In addition to biological samples, the CCSC collects detailed patient information on their lifestyle, physical activity and dietary patterns through questionnaires at the time of their enrolment.
The majority of participants (75%) are between 50 and 64 years of age. Women make up 46% (1055) of the cohort. Additional characteristics of the cohort included 44% reporting a body mass index of 25–30 kg/m2 (overweight), 53% having never smoked tobacco and 13% having a family member with CRC.
The CCSC cohort plans to include the recruitment of high risk CRC cohorts. High-risk participants would comprise patients with a positive faecal immunochemical test and family history of CRC.
Commentary on: Serfaty M, King M, Nazareth I, et al. Manualised cognitive-behavioural therapy in treating depression in advanced cancer: the CanTalk RCT. Health Technol Assess 2019;23:1–106.
Cognitive behavioural therapy (CBT) is not effective for depression in advanced cancer but might be effective to address other psychological symptoms. Psychological symptoms and needs in advanced cancer patients should be assessed promptly to tailor interventions. Nurse-led interventions should be further evaluated to identify whether they are appropriate for more timely management of psychological needs.
Cognitive behavioural therapy (CBT) is not effective for depression in advanced cancer but might be effective to address other psychological symptoms.
Psychological symptoms and needs in advanced cancer patients should be assessed promptly to tailor interventions.
Nurse-led interventions should be further evaluated to identify whether they are appropriate for more timely management of psychological needs.
Patients suffering from cancer must face the illness itself, but also a lot of adversity throughout it. Indeed, there are multiple effects and side effects of cancer and a notable side effect is depression. Depression can affect up to 40% of cancer patients.
The Scleroderma Patient-centered Intervention Network (SPIN) Cohort uses the cohort multiple randomised controlled trial design to embed trials of online self-care interventions for people living with systemic sclerosis (SSc; scleroderma). To offer interventions to patients interested in using them, participants complete signalling items that query about the likelihood that patients would agree to participate in nine different hypothetical online programmes addressing common SSc-related problems. It is not known what factors influence patient-reported interest in participating in a particular online intervention and if intervention-specific signalling questions provide unique information or replicate broader characteristics, such as overall willingness to participate or self-efficacy. This study assessed factors that explain responses to intervention-specific signalling items.
SPIN Cohort participants enrolled at 42 centres from Canada, the USA, the UK, France, Spain and Mexico who completed study questionnaires from March 2014 to January 2018 were included.
Demographic and disease characteristics, self-efficacy and symptoms related to each specific intervention were completed in addition to signalling items. General likelihood of using interventions was calculating by taking the mean score of the remaining signalling questions.
1060 participants with complete baseline data were included in the analyses.
For all individual signalling questions, controlling for other variables, the mean of the remaining signalling questions was the strongest predictor (standardised regression coefficient β from 0.61 (sleep) to 0.80 (self-management)). Smaller, but statistically significant, associations were found with the symptom associated with the respective signalling question and with general self-efficacy for 7 of 9 signalling questions.
The main factor associated with patients’ interest in participating in a disease-specific online self-care intervention is their general interest in participating in online interventions. Factors that may influence this general interest should be explored and taken into consideration when inviting patients to try online interventions.
To further the understanding of the pathophysiological mechanisms underlying tension-type headache (TTH) by comparing the endurance and strength of neck extensor muscles under acute muscle fatigue in participants with TTH and asymptomatic participants.
We conducted a cross-sectional analysis of neck extensor muscle performance. Asymptomatic participants and participants with TTH were recruited via social media platforms and from the Université du Québec à Trois-Rivières community and employees. A total of 44 participants with TTH and 40 asymptomatic participants took part in an isometric neck extensor endurance task performed at 60% of their maximum voluntary contraction. Inclusion criteria for the headache group were to be older than 18 years old and to fulfil the International Headache Society classification’s criteria for either frequent episodic or chronic TTH. Clinical (self-efficacy, anxiety, neck disability and kinesiophobia) and physical parameters (neck extensors maximum voluntary contraction, endurance time, muscle fatigue) as well as characteristics of headache episodes (intensity, frequency and associated disability) were collected for all participants. Surface electromyography was used to document upper trapezius, splenius capitis and sternocleidomastoids muscle activity and muscle fatigue.
Both groups displayed similar neck extensor muscle endurance capacity with a mean difference of 6.2 s (p>0.05) in favour of the control group (control=68.1±32.3; TTH=61.9±20.1). Similarly, participants in the headache group showed comparable neck extensor muscle strength (95.9±30.4 N) to the control group (111.3±38.7 N). Among participants with TTH, those scoring as severely incapacitated by headaches were the ones with higher neck-related disability (F[1,44]=10.77; p=0.002), the more frequent headache episodes (F[1,44]=6.70; p=0.01) and higher maximum headache intensity (F[1,44]=10.81; p=0.002).
A fatigue task consisting of isometric neck extension cannot efficiently differentiate participants with TTH from asymptomatic participants.