Nutritional Strategy for Cancer-From Prevention to Aftercare.

In recent decades, there has been a noteworthy increase in the efficacy of oncological treatments for a variety of neoplasms, which has improved the overall results and survival rates in cancer therapy [...].

Infection with the multidrug-resistant Klebsiella pneumoniae New Delhi metallo-B-lactamase strain in patients with COVID-19: Nec Hercules contra plures?

Background: During the coronavirus disease 2019 (COVID-19) pandemic, in patients treated for SARS-CoV-2 infection, infections with the Klebsiella pneumoniae bacteria producing New Delhi metallo-B-lactamase (NDM) carbapenemase in the USA, Brazil, Mexico, and Italy were observed, especially in intensive care units (ICUs). This study aimed to assess the impact of Klebsiella pneumoniae NDM infection and other bacterial infections on mortality in patients treated in ICUs due to COVID-19. Methods: The 160 patients who qualified for the study were hospitalized in ICUs due to COVID-19. Three groups were distinguished: patients with COVID-19 infection only (N = 72), patients with COVID-19 infection and infection caused by Klebsiella pneumoniae NDM (N = 30), and patients with COVID-19 infection and infection of bacterial etiology other than Klebsiella pneumoniae NDM (N = 58). Mortality in the groups and chosen demographic data; biochemical parameters analyzed on days 1, 3, 5, and 7; comorbidities; and ICU scores were analyzed. Results: Bacterial infection, including with Klebsiella pneumoniae NDM type, did not elevate mortality rates. In the group of patients who survived the acute phase of COVID-19 the prolonged survival time was demonstrated: the median overall survival time was 13 days in the NDM bacterial infection group, 14 days in the other bacterial infection group, and 7 days in the COVID-19 only group. Comparing the COVID-19 with NDM infection and COVID-19 only groups, the adjusted model estimated a statistically significant hazard ratio of 0.28 (p = 0.002). Multivariate analysis revealed that age, APACHE II score, and CRP were predictors of mortality in all the patient groups. Conclusion: In patients treated for SARS-CoV-2 infection acquiring a bacterial infection due to prolonged hospitalization associated with the treatment of COVID-19 did not elevate mortality rates. The data suggests that in severe COVID-19 patients who survived beyond the first week of hospitalization, bacterial infections, particularly Klebsiella pneumoniae NDM, do not significantly impact mortality. Multivariate analysis revealed that age, APACHE II score, and CRP were predictors of mortality in all the patient groups.

Association between skin lymphangiogenesis parameters and arterial hypertension status in patients: An observational study.

BACKGROUND: Recent studies have indicated that the skin lymphatic system and interstitium may play a role in the pathophysiology of arterial hypertension (AH). OBJECTIVES: We aimed to determine whether the set of pathway parameters described previously in rodents would allow for the distinction between hypertensive and normotensive patients. MATERIAL AND METHODS: Molecular and histopathological parameters from the skin and blood of patients with AH (AH group, n = 53), resistant AH (RAH group, n = 32) and control (C group, n = 45) were used, and a statistical multivariate bootstrap methodology combining partial least squares-discriminant analysis (PLS-DA) and selectivity ratio (SR) were applied. RESULTS: The C vs RAH model presented the best prediction performance (AUC test = 0.90) and had a sensitivity and specificity of 73.68% and 83.33%, respectively. However, the parameters selected for the C vs AH group model were the most important for the pathway described in the rodent model, i.e., greater density of the skin lymphatic vessels (D2-40 expression) and greater number of macrophages (CD68 expression), higher expression of the messenger ribonucleic acid (mRNA) of nuclear factor of activated T cells 5 (NFAT5), vascular endothelial growth factor C (VEGFC) and podoplanin (PDPN) in the skin, greater concentration of hyaluronic acid (HA) in the skin, and lower serum concentration of VEGF-C. CONCLUSIONS: Our study suggests that the NFAT5/VEGF-C/lymphangiogenesis pathway, previously described in rodent studies, may also be present in human HA. Further experiments are needed to confirm our findings.

Quality of Life and Pain in Patients With Chronic Pancreatitis.

INTRODUCTION: The quality of life (QoL) of patients with chronic conditions is a function of factors associated with the illness, its natural course, and treatment as well as those related to the patient. Chronic pancreatitis (CP) is a critical public health problem. Chronic pancreatitis patients can experience chronic pain with different mechanisms, malabsorption, diabetes, and cachexia. OBJECTIVE: Chronic pancreatitis (CP) is a critical public health problem. CP patients can experience chronic pain with different mechanisms, malabsorption, diabetes, and cachexia. The aim of the study was to assess the Quality of Life (QoL) of patients with CP and identify factors affecting QoL. METHODS: 104 patients diagnosed with CP from the hospital in Wroclaw, Poland, were included. The study was conducted using our own questionnaire, the World Health Organization Quality of Life-BREF (WHOQOL-BREF) scale, the 36-Item Short Form Health Survey (SF-36), and the Visual Analog Scale (VAS). RESULTS: The mean total SF-36 score was 47.7, with the highest mean rating for the physical functioning domain. The mean VAS pain score was 5.13. Pain intensity was significantly correlated with impairments in activities of daily living (P = 0.001), the need to reduce their duration (P = 0.001), and the performance of physical activity (P = 0.003). Comorbidities, education, and age have a significant relationship with only some domains of SF-36. CONCLUSIONS: One aspect that has an impact on QoL impairment is pain which perception is governed by the same brain regions in which abnormalities result in depression and anxiety. QoL in CP patients also depends on the patient's age, comorbidities, and level of education.

Prognostic Potential of Nectin Expressions in Colorectal Cancer: An Exploratory Study.

Colorectal cancer (CRC) is a pressing global health challenge, with an estimated 1.9 million new cases in 2020. Ranking as the third most diagnosed cancer globally, CRC accounts for nearly 930,000 cancer-related deaths annually. Nectins, immunoglobulin-like adhesion molecules, are pivotal in intercellular adhesion formation and cellular function regulation. Altered nectin expression patterns have been identified in various cancers. However, the intricacies of their role in cancer development and progression remain underexplored. This study aimed to evaluate the expression of specific nectins in CRC tumors, explore their association with clinicopathological factors, and ascertain their potential as prognostic indicators for CRC patients post-resection. We retrospectively analyzed the medical records of 92 CRC patients who underwent surgical treatment between 2013 and 2014. Tumor specimens were re-evaluated to determine nectin expression using immunohistochemistry. The study identified heterogeneous expressions of nectin-2, -3, and -4 in 58%, 62.6%, and 87.9% of specimens, respectively. Elevated nectin-4 expression correlated with worse 5-year and overall survival rates, presenting a negative prognostic value (HR = 4, 95% CI: 2.4-6.8, p < 0.001). Conversely, reduced nectin-3 expression was linked to poorer CRC prognosis (HR = 0.54; 95% CI: 0.31-0.96; p = 0.036). Nectin-4 expression positively correlated with elevated carcinoembryonic antigen (CEA) levels and advanced disease stages. In contrast, nectin-3 expression negatively correlated with CEA levels, tumor size, presence of distant metastases, and disease stage. Notably, tumors in the right colon were statistically more likely to express nectin-2 compared to those in the left. This study underscores the potential prognostic significance of nectins in CRC. The high prevalence of nectin-4-expressing cells offers promising avenues for further evaluation in targeted therapeutic interventions with already available agents such as PADCEV.

Intraoperative parameters and postoperative follow-up of foam-based intraperitoneal chemotherapy (FBIC).

Background: For decades, intraperitoneal chemotherapy (IPC) has been delivered into the abdominal cavity as a liquid solution. Recently the concept of foam as a carrier-solution for IPC was suggested. This in-vivo swine study aims to evaluate the safety, intraoperative parameters, limitations and postoperative complications of foam-based intraperitoneal chemotherapy (FBIC). Methods: Three 65-day-old swine received FBIC with doxorubicin in a laparoscopy setting. Intraoperative parameters were monitored throughout the procedure and an extensive postoperative laboratory monitoring was conducted for 7 days. At day seven an autopsy was performed for further evaluation. Results: The insufflation of FBIC caused a temporary rise in blood pressure and a simultaneous drop in heart rate. Capnography detected a continuous increase in end-tital CO2 levels. A temporary drop of intraabdominal temperature was noted. Postoperative blood and serum laboratory results did not indicate any organ failure. No indication of intraperitoneal infections was noted and no structural tissue changes were visible in the autopsy. Discussion: The application of FBIC appears to be a feasible approach regarding intraoperative anesthesiology and postoperative surgical management. A lack of postoperative structural changes on the seventh day were a promising sign of safety and biocompatibility. Surgical reintervention would have been possible. To discuss a possible clinical application, further studies are required to investigate long-term safety, pharmacodynamics and the antitumoral potential of FBIC.

A Single-Center Study of the Impact of the COVID-19 Pandemic on the Organization of Healthcare Service Delivery to Patients with Head and Neck Cancer.

The aim of this study was to identify and assess the impact of the COVID-19 pandemic on the diagnosis and treatment of head and neck cancer (HNC) patients of the Department of Otolaryngology, Head and Neck Surgery of the 4th Military Teaching Hospital in Wroclaw for whom oncological treatment was planned by a cancer case board between March 2018 and February 2022. We analysed the medical records of 625 patients. In order to verify whether the relationships between the analysed features were statistically significant, the chi-square test of independence and the Student's t-test for independent samples were used (p < 0.05). Our analysis showed that the impact of the pandemic on the organization of health service delivery to HNC patients was not uniform. The largest difference in the number of formulated treatment plans was observed at the beginning of the pandemic (22.1% reduction compared with the year before the pandemic). During the pandemic, the proportion of patients admitted on the basis of a DILO (diagnosis and oncological treatment) card issued by a primary care physician, instead of a regular referral to hospital, issued also by a primary care physician, was significantly higher compared with the that during the pre-pandemic period. The majority of cancer patients with a oncological treatment planned during the pandemic lived in urban areas. During the pandemic, the number of patients with more-advanced-stage cancer, assessed on the basis of the type of planned treatment (radical vs. palliative), did not increase compared with that during the pre-pandemic period. However, our follow-up period was quite short. It is necessary to intensify activities aimed at promoting health and increasing health awareness in people living in rural areas and setting long-term priorities and objectives for health policies at the national, regional and local levels, with particular focus on this group of people.

Drug Distribution and Penetration of Foam-Based Intraperitoneal Chemotherapy (FBIC).

For decades, intraperitoneal chemotherapy (IPC) was used as a liquid solution for the treatment of peritoneal metastasis. Due to its advantageous physical properties, foam-based intraperitoneal chemotherapy (FBIC) was recently proposed as a treatment for peritoneal metastasis. For the first time, this study intends to examine the feasibility, expansion, drug distribution, and penetration of FBIC in vivo. Three swine received contrast-enhanced FBIC doxorubicin delivered using a bicarbonate carrier system. During the procedure, intraoperative blood analyses and periumbilical diameter, as well as foam distribution, penetration, and expansion of the FBIC were analyzed. The swine received an abdominal CT scan to evaluate the contrast distribution. Furthermore, a hematoxylin-eosin (HE) staining of peritoneal samples was performed, and fluorescence microscopy was conducted. FBIC was performed without complications. The periumbilical diameter peaked after 5 min and then decreased. Blood analyses showed changes in blood parameters, with a reduction in the pH levels of serum calcium and potassium. CT scan detected contrast-enhanced FBIC throughout the abdominal cavity. Fluorescence microscopy confirmed that all areas were exposed to doxorubicin and no pathologies were detected in the HE histology. Our preliminary results are quite encouraging and indicate that FBIC is a feasible approach. However, in order to discuss possible clinical applications, further studies are required to investigate the pharmacologic, pharmacodynamic, and physical properties of FBIC.

Sodium accumulation in the skin is associated with higher density of skin lymphatic vessels in patients with arterial hypertension.

PURPOSE: Recent studies, conducted mainly on the rodent model, have demonstrated that regulatory pathway in the skin provided by glycosaminoglycans, nuclear factor of activated T cells 5 (NFAT5), vascular endothelial growth factor C (VEGF-C) and process of lymphangiogenesis may play an important role in extrarenal regulation of sodium (Na+) balance, body water volume, and blood pressure. We aimed to investigate the concentrations and relations among the main factors of this pathway in human skin to confirm that this regulatory axis also exists in humans. PATIENTS AND METHODS: Skin specimens from patients diagnosed with arterial hypertension and from control group were histologically and molecularly examined. RESULTS: The primary hypertensive and control groups did not differ in Na+ â€‹concentrations in the skin. However, the patients with hypertension and higher skin Na+ concentration had significantly greater density of skin lymphatic vessels. Higher skin Na+concentration was associated with higher skin water content. In turn, skin water content correlated with factors associated with lymphangiogenesis, i.e. NFAT5, VEGF-C, and podoplanin (PDPN) mRNA expression in the skin. The strong mutual pairwise correlations of the expressions of NFAT5, VEGF-C, vascular endothelial growth factor D (VEGF-D) and PDPN mRNA were noted in the skin in all of the studied groups. CONCLUSIONS: Our study confirms that skin interstitium and the lymphatic system may be important players in the pathophysiology of arterial hypertension in humans. Based on the results of our study and existing literature in this field, we propose the hypothetical model which might explain the phenomenon of salt-sensitivity.

Clinical Significance of Nectins in HCC and Other Solid Malignant Tumors: Implications for Prognosis and New Treatment Opportunities-A Systematic Review.

The nectin family comprises four proteins, nectin-1 to -4, which act as cell adhesion molecules. Nectins have various regulatory functions in the immune system and can be upregulated or decreased in different tumors. The literature research was conducted manually by the authors using the PubMed database by searching articles published before 2023 with the combination of several nectin-related keywords. A total of 43 studies were included in the main section of the review. Nectins-1-3 have different expressions in tumors. Both the loss of expression and overexpression could be negative prognostic factors. Nectin-4 is the best characterized and the most consistently overexpressed in various tumors, which generally correlates with a worse prognosis. New treatments based on targeting nectin-4 are currently being developed. Enfortumab vedotin is a potent antibody-drug conjugate approved for use in therapy against urothelial carcinoma. Few reports focus on hepatocellular carcinoma, which leaves room for further studies comparing the utility of nectins with commonly used markers.

Direct-Acting Oral Anticoagulant Therapy in Cancer Patients-A Review.

Venous thromboembolism (VTE) is an important aspect in cancer patients. There are various pharmacological methods used for thrombotic event treatment. DOACs (direct-acting oral anticoagulants) are gaining popularity among both physicians and researchers and are slowly starting to replace VKAs (vitamin K antagonists), thus becoming a substitute or alternative option for LMWHs (low-molecular-weight heparins). In this article, we present DOACs' main therapeutic advantages and disadvantages in patients with cancer. The only major concern with using DOACs is the higher risk of bleeding; however, there are discrepancies in this matter. There are still some types of cancer for which DOACs are not recommended. Specific cancer types may influence the efficacy of DOAC therapy. Additionally, race and ethnicity may affect therapy in cancer patients with DOACs. A sizeable number of clinical trials are focused on comparing DOACs with other anticoagulants. The current guidelines of different scientific associations are not unanimous in their DOAC assessments. There is still a need for more evidence of DOACs' potential advantages over other methods of anticoagulation in cancer patients to facilitate their position in this recommendation. This literature review presents the current state of knowledge about the use of DOACs in patients with neoplastic growth.

Diet as a Factor Supporting Lung Cancer Treatment-A Systematic Review.

The purpose of this study was to summarize the evidence from epidemiological studies concerning associations between diet and the effectiveness of treatment for lung cancer. For this review, a literature search has been conducted in the EMBASE and PubMed databases, including papers published between 1977 and June 2022. The term "lung cancer" was used in conjunction with "diet". Footnotes from the selected papers were also analyzed. The present study is in line with the recommendations included in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The review included studies involving adults, including randomized controlled trials (RCTs) and cohort and observational studies. In total, 863 papers were found, with duplicates excluded. Ultimately, 20 papers were reviewed. The present systematic review indicates that vitamin A, ascorbic acid (vitamin C), vitamin E, selenium, and zinc-as antioxidants-can strengthen the body's antioxidant barrier. Furthermore, preoperative immunonutrition may not only improve perioperative nutritional status following induction chemoradiotherapy in lung cancer surgery patients but also reduce the severity of postoperative complications. Similarly, a protein supply may exert a beneficial effect on human health by increasing average body weight and muscle mass. Omega-3 fatty acid content in the diet and the consumption of their main source, fish, may have some regulatory effect on inflammation in patients with lung cancer treated with chemotherapy and radiotherapy. In addition, n-3 fatty acids inhibit tumor cell proliferation and may reduce the toxicity of chemotherapy. Increased energy and protein intake are strongly associated with improved quality of life, functional outcomes, hand grip strength, symptoms, and performance in patients with lung cancer. The use of a supportive diet should be the standard of care, alongside pharmaceutical therapy, in treatment for patients with lung cancer.

Effect of nutritional status on psychological functioning and coping in patients with lung cancer.

OBJECTIVES: Lung cancer is the most common cancer. In patients with lung cancer, malnutrition may result in shorter overall survival, poorer treatment response, increased risk for complications and impaired physical and mental function. The aim of this study was to assess the effects of nutritional status on the psychological functioning and coping in patients with lung cancer. METHODS: The present study included 310 patients treated for lung cancer at the Lung Center between 2019 and 2020. The standardized instruments were used: Mini Nutritional Assessment (MNA) and Mental Adjustment to Cancer (MAC). Of the 310 patients, 113 (59%) were at risk for malnutrition and 58 (30%) had malnutrition. RESULTS: Patients with a satisfactory nutritional status and those at risk for malnutrition reported statistically significantly higher levels of constructive coping compared with patients with malnutrition (P = 0.040). Patients with malnutrition were more likely to have more advanced cancer: T4 tumor (60.3 versus 38.5; P = 0.007), distant metastases: M1 or M2 (43.9 versus 28.1; P = 0.043), tumor metastases (60.3 versus 39.3; P = 0.008) and brain metastases (19 versus 5.2: P = 0.005). Patients with malnutrition were more likely to have higher levels of dyspnea (75.9 versus 57.8; P = 0.022) and a performance status of ≥2 (69 versus 44.4; P = 0.003). CONCLUSIONS: Malnutrition is significantly more common in patients using negative strategies for coping with cancer. Lack of constructive coping is a statistically significant predictor of increased risk for malnutrition. Advanced cancer stage is a statistically significant independent predictor of malnutrition, increasing the risk of malnutrition by more than twofold.

Quality of Life, Psychological Distress, and Nutritional Status of Polish Patients with Head and Neck Cancer Treated with Radiotherapy.

INTRODUCTION: Head and neck cancer (HNC) is a global epidemiological and clinical problem. In 2020, it was the seventh most common type of cancer worldwide. In 2019, HNC was the fourth most common cause of cancer death among men in Poland. Radiotherapy plays an important role in the treatment of patients with HNC at all clinical stages. However, it is associated with a significant rate of early and late adverse effects. As head and neck cancers are located close to vital anatomical structures, both the local progression of the disease and the treatments used can cause serious problems for patients with HNC, reducing their health-related quality of life (HRQoL) as well as increasing the risk of depressive disorders. Despite this, the current literature lacks research on these aspects of the therapeutic process in the Polish population. The aim of this study was to assess the early impact of radiotherapy on HRQoL outcomes, psychological distress, nutritional status, and overall performance of patients with HNC. METHODS: The study was carried out among 85 patients with HNC treated in the Inpatient Radiotherapy Unit of the Radiotherapy Department of the Lower Silesian Oncology Center in Wroclaw. The patients were asked to complete a set of questionnaires, including the EORTC QLQ-H&N35, the BDI, the NRS-2002, and the ECOG scale, at two time points: before the initiation of radiotherapy treatment and after a course of radiotherapy. The period between the assessments was 7 to 8 weeks. RESULTS: Our findings demonstrated a negative impact of radiotherapy on scores in all the cancer-specific symptom and functioning scales used in the study. As regards functioning scales, the largest differences were observed for senses and swallowing, whereas with symptoms scales, the largest differences were noted for "sticky saliva" and "dry mouth". Over half of the patients included in the study required nutritional support after radiotherapy treatment. We found statistically significant differences in the levels of depressive symptom severity before and after radiotherapy treatment. CONCLUSION: The present study showed significant changes in the physical and psychological functioning and nutritional status of the patients with HNC studied after radiotherapy treatment, which may have an impact on the effectiveness of cancer treatment.

First In Vivo Applicational Data of Foam-Based Intrathoracic Chemotherapy (FBiTC) in a Swine Model.

BACKGROUND: For decades, both intraperitoneal and pleural chemotherapy (IPC) have been delivered as a liquid solution. Recent studies suggest that foam carriers outperform liquid carriers for locoregional chemotherapy. For the first time, this study aims to evaluate the feasibility, safety, and characteristics of foam-based intrathoracic chemotherapy (FBiTC) in an in vivo setting. METHODS: In this study, contrast-enhanced FBiTC with doxorubicin was delivered via video-assisted thoracoscopy (VAT) in three swine under general anesthesia. Intraoperative and postoperative parameters, blood analyses, vital signs, and anesthesiologic data were collected. Additionally, an intraoperative computer tomography (CT) scan was performed, and histological tissue sections were collected and further analyzed using fluorescence microscopy. RESULTS: FBiTC was delivered without major complications. End-tidal capnometry detected increased CO2 levels with reduced peripheral oxygen saturation and increased blood pressure and heart rate. No major intra- or postoperative complications were observed. CT scans confirmed a multidirectional distribution pattern of foam. Postoperative laboratory workup did not reveal any critical changes in hemoglobin, white blood count, or platelets. There was no evidence of critical kidney impairment or liver function. Fluorescence microscopy of tissue specimen detected doxorubicin in pleural tissues. DISCUSSION: Our preliminary results are encouraging and indicate that FBiTC is feasible. However, to consider a possible clinical application, further studies are required to investigate the pharmacologic, pharmacodynamic, and physical properties of FBiTC and to ensure the safety of the overall procedure regarding oxygenation levels and capnography parameters.

Impact of Loneliness on Functioning in Lung Cancer Patients.

Lung cancer is the leading cause of cancer death and carries a greater degree of stigma. Lung cancer stigma contributes to social isolation and increases loneliness, which has an impact on quality of life, increases depressive symptoms and hence affects all aspects of functioning. Functioning is assessed in five dimensions (physical, psychological, cognitive, social and life roles). The aim of the study was to assess the impact of loneliness on the functioning, nutritional status and quality of life of patients with lung cancer. METHODS: The survey study was conducted among 310 lung cancer patients. The patients were asked to complete the Mini-MAC, HADS-M, MNA, EORTC QoL, AIS and VAS questionnaires. RESULTS: In total, 136 patients were lonely and 174 were married or in a relationship. Lonely patients had significant difficulty accepting their illness and demonstrated higher levels of depression. The factors most strongly associated with loneliness were being unemployed, age 61 or over and a less score in the constructive coping strategies. CONCLUSIONS: Loneliness is a significant factor affecting the functioning of patients with lung cancer. It increases the risk of anxiety and depression, reduces levels of illness acceptance, reduces levels of constructive coping and increases the risk of malnutrition.

Nectins and Nectin-like Molecules in Colorectal Cancer: Role in Diagnostics, Prognostic Values, and Emerging Treatment Options: A Literature Review.

In 2020, colorectal cancer was the third most common type of cancer worldwide with a clearly visible increase in the number of cases each year. With relatively high mortality rates and an uncertain prognosis, colorectal cancer is a serious health problem. There is an urgent need to investigate its specific mechanism of carcinogenesis and progression in order to develop new strategies of action against this cancer. Nectins and Nectin-like molecules are cell adhesion molecules that take part in a plethora of essential processes in healthy tissues as well as mediating substantial actions for tumor initiation and evolution. Our understanding of their role and a viable application of this in anti-cancer therapy has rapidly improved in recent years. This review summarizes the current data on the role nectins and Nectin-like molecules play in colorectal cancer.

Fatigue, Depression, and Anxiety in Patients with COPD, Asthma and Asthma-COPD Overlap.

INTRODUCTION: Asthma and COPD are extremely common respiratory diseases that have a serious impact on people's lives around the world. A disease characterized by symptoms characteristic for asthma and COPD is called asthma-COPD overlap (ACO). Fatigue and certain psychological disorders such as anxiety and depression are important comorbidities in these diseases. The purpose of this study was to assess the prevalence of fatigue, anxiety, and depression in patients with asthma, COPD, and ACO and to also consider their mutual correlations. MATERIAL AND METHODS: A total of 325 patients were enrolled in the study. There were 159 women and 166 men and their mean age was 63. Two standardized questionnaires were used: the Modified Fatigue Impact Scale (MFIS) and the Hospital Anxiety and Depression Scale (HADS). RESULTS: The mean total MFIS score for all patients was 33.03. Patients with asthma generally scored lower than patients with COPD and ACO. There were no statistical differences in the HADS for anxiety between the groups, although around half of the patients registered a score indicating some level of disorder. Patients with COPD and ACO were proven to suffer more from depression than patients with asthma. The HADS and MFIS scores were found to correlate significantly and positively. CONCLUSIONS: Our study showed that patients with COPD, asthma, and ACO generally suffered from an increased level of fatigue and depression. Anxiety was high in all groups, but it was at a similar level for patients suffering from each of the three diseases under consideration. It is important to treat the physical symptoms as well as the psychological disorders since they greatly impact on the patient outcomes.

Mental health status of infected children between 7 to 12 years old in Fangcang Shelter Hospital during the COVID-19 Shanghai lockdown in 2022: a cross-section study.

Background: There has been an increase in research on the potential adverse effects on children's mental health, especially depression and anxiety, during the coronavirus disease 2019 (COVID-19) pandemic over the past few months. Therefore, the aim of the present study was to investigate depression and anxiety symptoms among children in shelter hospitals during the 2022 Shanghai lockdown. Methods: A total of 98 infected children aged 7-12 years were enrolled in this study between April 19 and June 4, 2022. The Children's Depression Inventory (CDI), Anxiety Scale for Children-Autism Spectrum Disorder (ASC-ASD), and Anxiety Scale or Children-Autism Spectrum Disorder Parent Form (ASC-ADS-P) were used to assess children's depression and anxiety symptoms. Children's guardians completed the survey by verbally asking their child/children the questions. The guardians additionally completed the ASC-ASD-P. Results: The prevalence of depression and anxiety was 12.2% and 13.3%, respectively. A total of 66 respondents reported no physical symptoms. Linear regression showed that myalgia [7.198, 95% confidence interval (CI): 3.163-11.232], headache (7.189, 95% CI: 3.842-10.535) coryza (5.362, 95% CI: 2.654-8.070), and number of quarantine days (4.378, 95% CI: 3.409-5.348) were significantly correlated with higher levels of depression, whereas chills (14.337, 95% CI: 9.799-18.875), coryza (9.309, 95% CI: 6.467-12.152), headache (7.193, 95% CI: 3.182-11.204), myalgia (5.571, 95% CI: 0.684-10.459), number of quarantine days (3.190, 95% CI: 1.796-4.584), and gender (male) (-4.137, 95% CI: -6.609 to 1.665) were associated with anxiety scores. Persistent fever was correlated with depression (P=0.007), whereas physical discomfort, such as persistent fever, cough, sore throat, headache, myalgia, and coryza were correlated with anxiety (all P<0.05). Conclusions: The findings of the present study indicated a moderate prevalence of depression and anxiety among infected children in a shelter hospital during the 2022 Shanghai lockdown. Therefore, the findings of this study could provide scientific basis for the development of targeted psychological intervention. It could be helpful for policy-makers to focus on psychological health among infected children and help to optimize future interventions.