Conectar
Oxaliplatin, a key drug in the treatment of colorectal cancer (CRC), can cause oxaliplatin-induced peripheral neuropathy (OIPN) in a dose-dependent manner. These symptoms can severely affect daily life, and chronic OIPN often limits treatment continuation because of its correlation with the cumulative dose of oxaliplatin. Currently, effective preventive measures are unavailable. However, surgical glove compression therapy may reduce paclitaxel-induced neuropathy, suggesting its potential in preventing OIPN.
This multicentre, randomised, open-label, phase II/III trial evaluates surgical glove compression therapy to investigate the possible preventive effects of OIPN in patients with CRC receiving adjuvant capecitabine plus oxaliplatin chemotherapy. Patients with stage III CRC undergoing curative surgery will be enrolled and randomised into two groups. The intervention group will wear two layers of tight-fitting surgical gloves from 30 min before to 30 min after oxaliplatin infusion, whereas the control group will receive standard care. The primary endpoint is the incidence of grade ≥2 chemotherapy-induced peripheral neuropathy (CIPN) based on the Common Terminology Criteria for Adverse Events criteria. Secondary endpoints include quality of life assessments (Functional Assessment of Cancer Therapy/Gynecological Oncology Group-Neurotoxicity-12 and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy 20-item), duration and extent of OIPN as assessed using the Debiopharm Neurologic and Sensory Toxicity Criteria, chemotherapy completion rates, and adverse events. To detect a significant reduction in the incidence of CIPN, 170 patients will be enrolled (36% in the control group vs 15% in the intervention group). The planned case enrolment period is from 1 November 2024 to 31 October 2026.
This trial was approved by the Institutional Review Board of Hiroshima University, Japan (approval no. CRB2024-0008), and has been registered with the Japan Registry of Clinical Trials (jRCTs062240066). The results of this study will be submitted for publication in a peer-reviewed journal and shared with the scientific community at international conferences.
jRCTs062240066
Kangaroo Care is an effective practice recommended by WHO for newborns, especially preterm infants, to reduce mortality and morbidity and improve health outcomes. Understanding parents' experiences with Kangaroo Care is vital as it can significantly influence uptake and sustained practice; however, experiences may vary across healthcare systems.
To explore parents' experiences of Kangaroo Care in neonatal units and to examine differences across international health systems.
A qualitative meta-synthesis.
A systematic search of the literature was carried out over seven databases, including CINAHL, MEDLINE ALL, EMBASE, PsycINFO, Maternity & Infant Care, Scopus and Cochrane Library. Qualitative studies published in English from 2010 to January 2024 were included. Data extraction and quality appraisal, using the CASP Qualitative Checklist, were undertaken. Meta-synthesis of the included qualitative findings was carried out. The findings were reported following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guideline. The protocol was registered on PROSPERO (CRD42023483347).
Twenty-five studies were included and four themes were identified: parental fulfilment from Kangaroo Care, Hardship in Kangaroo Care practice, Roadblocks and difficulties in adopting and Building bridges to encourage and support Kangaroo Care.
This review underscores the multifaceted nature of parental experiences, including positive and challenging aspects, as well as significant barriers and facilitators that influenced Kangaroo Care implementation. By understanding these experiences and factors that hinder and enable, healthcare systems and professionals can better support and empower parents to improve the effectiveness of Kangaroo Care.
Kangaroo Care is lifesaving, particularly in low-income countries, but can be a challenge for parents providing it. By addressing deficiencies in infrastructure and resources, barriers can be minimised, thereby encouraging the practice of Kangaroo Care. This is especially important in lower-middle- and low-income countries where the practice is most effective and the practice is lowest.
This project is a meta-synthesis; therefore, no patient or public contribution was deemed necessary.
To evaluate the risk of invasive pneumococcal disease (IPD) and non-bacteraemic pneumonia (NBP)/acute otitis media (AOM)/sinusitis in Japanese individuals under 19 years of age with chronic medical conditions (CMCs) compared with those without.
An observational, retrospective, cohort study.
A large, longitudinal health insurance claims database in Japan (JMDC database).
A total of 12.3 million individuals aged
Adjusted incidence rate ratios (IRRs) for IPD and NBP/AOM/sinusitis for individuals with CMCs versus those without CMCs were calculated using multivariate Poisson regression models with age and sex as covariates.
The incidence rate of IPD was higher in individuals with a CMC (0.9 (95% CI: 0.8 to 0.9)) than in those without (0.1 (95% CI: 0.1 to 0.1)). A similar trend was observed for the incidence rate of NBP/AOM/sinusitis, with rates of 928.7 (95% CI: 927.4 to 929.9) in individuals with a CMC compared with 433.2 (95% CI: 432.8 to 433.7) in those without. The risk of IPD increases with the number of CMCs. The IRRs for IPD for those with one CMC and with two or more CMCs were 7.2 (95% CI: 6.4 to 8.1) and 128.1 (95% CI: 114.8 to 143.0), respectively, compared with individuals without a CMC. The IRRs for IPD in the immunocompromised and immunocompetent groups were 156.1 (95% CI: 133.4 to 182.7) and 16.3 (95% CI: 14.6 to 18.1), respectively. The IRRs for NBP/AOM/sinusitis were 1.9 (95% CI: 1.9 to 1.9) and 2.1 (95% CI: 2.1 to 2.2) for individuals with one CMC and with two or more CMCs, respectively.
Individuals aged
This study aims to describe the characteristics of hospitalised COVID-19 patients in a tertiary care hospital close to an international airport in Japan and to compare these characteristics among different waves during the pandemic.
Retrospective observational study.
Tertiary care centre in Japan.
All patients diagnosed with COVID-19 who were hospitalised between January 2020 and April 2022 were included.
Clinical characteristics, characteristics of admission, treatments and outcomes were investigated and compared among six pandemic waves.
A total of 827 patients were included. The median age was 58.0 years. More than half of the patients (58.3%) had at least one comorbidity. The majority of patients (89.0%) were domestically infected patients admitted under the Infectious Diseases Law, while the remaining patients (11.0%) were those diagnosed during airport quarantine and admitted under the Quarantine Act. Hospital-acquired COVID-19 infection occurred in 7.0% of cases, and mainly during the sixth wave. Overall, some form of oxygen therapy, high-flow oxygen devices, invasive mechanical ventilation (IMV) and extracorporeal membrane oxygenation was provided in 46.3%, 10.4%, 4.5% and 1.5% of cases, respectively. Only 1.8% of patients were treated in the intensive care unit (ICU), and 59.5% of patients on IMV were managed in the non-ICU ward. The in-hospital mortality rate was 5.8%. Median age, percentages of some comorbidities, vaccination coverage, medications for COVID-19, types of supportive care and ICU admissions differed significantly among waves.
This study suggests that patient characteristics, vaccination coverage, standard of treatment and severity of illness changed across waves during the COVID-19 pandemic. Intensive care delivery in non-ICU wards was unavoidable due to limited ICU capacity, which may be a key consideration when preparing for future pandemics.
To evaluate the time-dependent predictive performance of inflammatory markers for 30-day all-cause mortality in patients with suspected infection.
Retrospective cohort study.
The ambulatory care division of the department of general medicine or the emergency department of a single acute care hospital in Japan, from April 2015 to March 2017.
The participants were 977 consecutive adult patients with suspected infection defined as those who underwent at least two sets of blood culture.
The primary outcome, ascertained from electronic medical records, was 30-day all-cause mortality. The predictive performance of three inflammatory markers (C-reactive protein (CRP), neutrophil-to-lymphocyte ratio and red cell distribution width (RDW)) was assessed across four time intervals from symptom onset to hospital presentation: ≤6, >6 to ≤24, >24 to ≤72, and >72 hours.
Time from symptom onset to hospital presentation influenced the predictive performance of inflammatory markers for 30-day all-cause mortality, and CRP ≥15 mg/dL was the most useful for identifying patients at higher risk of mortality within 6 hours (positive likelihood ratio (LR+) 7.7); however, this association weakened over time (LR+ 1.3 at >72 hours). Conversely, RDW ≥16% became more informative later in the course (LR+ 4.1 at >72 hours). For identifying patients at lower risk of 30-day all-cause mortality, CRP
These findings suggest the potential utility of CRP for ruling in high-risk patients within 6 hours from symptom onset, and of RDW for both ruling in and ruling out patients after 72 hours, thereby suggesting that time-dependent variations are important when interpreting inflammatory markers in emergency care settings. However, caution is needed when interpreting these findings because of the retrospective design of this study and potential selection bias.
by Maria Cecilia Rasuk, Alfonsina Palladini, Andrea Moyano, Viviana Díaz, Antonella Giudice, Gisela Castillo, Solana Abraham, Juan Rull, Anja Poehlein, Rolf Daniel, Julian Rafael Dib
The Mediterranean fruit fly (Ceratitis capitata Wied.) is an agricultural pest of significant economic importance. This species has been globally managed using the Sterile Insect Technique (SIT). Insects, including tephritid flies, harbor a diverse gut microbiota that plays critical roles in their physiology, behavior, and overall fitness, suggesting that microbial communities may profoundly influence the biology of this pest. The aim of this study was to characterize the fungal and bacterial gut microbial communities of C. capitata from Tucumán, Argentina, and to assess their response to antimicrobial treatment using amplicon-based 16S rRNA gene and ITS region sequencing. Both control and treated flies were dominated by Proteobacteria (bacteria) and Zygosaccharomyces (fungi). Antimicrobial treatment induced significant shifts in bacterial and fungal composition, reducing diversity and altering gut community structure. Untreated flies exhibited a diverse and structured bacterial gut community dominated by the family Enterobacteriaceae, while antibiotic-treated communities were dominated by Rhizobiaceae. Despite these shifts, fungal communities in both treated and untreated groups were consistently dominated by the genus Zygosaccharomyces. Functional predictions revealed notable changes in metabolic pathways following antibiotic treatment, including increased gene abundance for ABC transporters and the phosphotransferase system, and decreased representation of genes involved in antibiotic biosynthesis and two-component systems. These results indicate significant alterations in bacterial metabolism and stress response mechanisms induced by the treatment. Such changes may help explain the underperformance of irradiated, mass-reared males within the context of SIT. This study provides new insights into the structural and functional dynamics of the C. capitata gut microbiome under disturbance. These findings have implications for understanding the ecological roles of microbial communities in this pest and their potential impact on fly health and fitness. Identification of dominant gut bacterial and fungal groups may support the development of probiotic diets, enhancing the efficiency of SIT application.Rev Enferm;39(6): 50-4, 2016 Jun. . [Artículo]
FreshRSS 