The Impact of Platelet-Rich Plasma Application during Cesarean Section on Wound Healing and Postoperative Pain: A Single-Blind Placebo-Controlled Intervention Study.

Background/Objectives: The aim of this study was to evaluate if platelet-rich plasma (PRP) application into the wound during cesarean delivery improves wound healing and reduces pain in the postoperative period. Materials and Methods: A total of 46 patients undergoing cesarean section (CS) were included in this single-blind placebo-controlled intervention study: 23 women in the PRP group and 23 in the placebo group. Every patient was asked to evaluate pain by using the Visual Analogue Scale (VAS) immediately after surgery, as well as 6 and 12 h after the surgery. The use of analgetics was also recorded. The postoperative scar was assessed using the Patient and Observer Scar Assessment Scale (POSAS). Results: There was no case of wound dehiscence in either group. Significant differences between the groups in the scar quality assessment were detected in both patient and doctor POSAS results on days 8, 30 and 90 after surgery in the favor of the PRP group. There was no difference in the pain intensity assessment on the VAS recorded after surgery, but PRP patients required fewer paracetamol doses per day than the control group. Conclusions: PRP application during CS significantly improved wound healing in both short- and long-term assessment. Although it did not influence postoperative pain intensity, it may reduce the use of analgetics after surgery.

Selenium dietary intake and survival among CRC patients.

Background: Despite advances in prevention and treatment, colorectal cancer remains the second most common cause of cancer death. To date, little is known about the role of prediagnostic selenium intake in colorectal cancer survival. Objective: The purpose of the study was to verify whether selenium intake in habitual diet before diagnosis is associated with survival in colorectal cancer patients. Study design: This was a prospective observation of patients primarily recruited for a case-control study between 2000 and 2012 in Cracow, Poland. A group of 671 incident cases of colorectal cancer was included. Habitual diet was assessed using a validated 148-item food questionnaire. 338 deaths were identified throughout 2017 by the Polish National Vital Registry. To evaluate the impact of dietary selenium on survival, the multivariable Cox regression model was used. Results: After standardization for several potential confounders (including key determinants, such as radical surgery, chemotherapy, tumor stage, and dietary factors), a decrease in the risk of death from colorectal cancer was observed in the group with higher dietary selenium intake (≥48.8 µg/day, group mean: 63.9 µg/day) compared to the group with lower dietary selenium intake (<48.8 µg/day, mean: 38.5 µg/day) (HR=0.73; 95% CI: 0.54-0.98) (the median was used for categorization). Conclusion: Our study suggests selenium as an additional dietary factor which may be associated with survival among colorectal cancer patients referred to surgery. Due to the observational nature of the study, the results should be taken with caution. These preliminary findings, however, provide the basis for well-structured clinical trials.

Gender-related differences in the multi-pathway effect of social determinants on quality of life in older age-the COURAGE in Europe project.

PURPOSE: Gender-related differences in life expectancy, prevalence of chronic conditions and level of disability in the process of ageing have been broadly described. Less is known about social determinants, which may have different impacts on quality of life in men and women. The investigation aims to reveal gender-related differences in social determinants on quality of life assessed by a multi-pathway model including health, social, demographic and living place characteristics. METHODS: The study group consisted of 5099 participants aged 50+ representing general populations of three different European regions (Finland, Poland, Spain) who participated in COURAGE in EUROPE Project. Standardized tools were used to measure quality of life (WHOQOL-AGE) and social determinants (COURAGE Social Network Index, OSLO-3 Social Support Scale, UCLA Loneliness Scale, participation scale and trust). A multipath model considering exogenous predictors (demographic, economic), mediators (social) and endogenous outcome (QOL) was created to reveal the role of determinants. Gender-related differences were investigated across three age categories: 50-64; 65-79 and 80+. RESULTS: The model (RMSEA = 0.058; CFI = 0.939) showed the effects of all of the investigated determinants. Gender-related differences in the association between social constructs and QOL were observed for social networks in the group of 80+, for social support in the group of 50-64 and 65-79 years, and for social participation in the group of 65-79 years. Males benefited more (in QOL) from social networks and social support, and women from social participation. CONCLUSIONS: The research provides valuable knowledge about the role of social determinants in QOL considering complex relations between different social constructs. Additionally, the results showed gender-related differences in the associations between social networks, social support, social participation and QOL, suggesting that men might benefit more from the interventions in the first two. Although our research did not investigate the effects of interventions, the results show directions for future investigations, how to shape social interventions at the population level to improve quality of life of older adults, and thus help achieve successful ageing.

Can consumption of raw vegetables decrease the count of sister chromatid exchange? Results from a cross-sectional study in Krakow, Poland.

BACKGROUND: Sister chromatid exchange (SCE) is a widely used sensitive cytogenetic biomarker of exposure to genotoxic and cancerogenic agents. Results of human monitoring studies and cytogenetic damage have revealed that biological effects of genotoxic exposures are influenced by confounding factors related to life-style. Vegetable and fruit consumption may play a role, but available results are not consistent. The purpose of the study was to investigate the effect of consumption of raw and cooked vegetables and fruits on SCE frequency. METHODS: A total of 62 participants included colorectal cancer (CRC) patients, hospital-based controls and healthy laboratory workers. SCE frequency was assessed in blood lymphocytes. Frequency of vegetable and fruit consumption was gathered by structured semi-quantitative food frequency questionnaire. RESULTS: SCE frequency was lowest among hospital-based controls (4.4 ± 1.1), a bit higher in CRC patients (4.5 ± 1.0) and highest among laboratory workers (7.4 ± 1.2) (p < 0.05). Multivariable linear regression showed a significant inverse effect (b = -0.20) of raw vegetable consumption, but not so for intake of cooked vegetables and fruits. CONCLUSIONS: The results of the study have shown the beneficial effect of consumption of raw vegetables on disrupted replication of DNA measured by SCE frequency, implying protection against genotoxic agents. Further effort is required to verify the role of cooked vegetables and fruits.

The association between obesity and back pain in nine countries: a cross-sectional study.

BACKGROUND: The association between obesity and back pain has mainly been studied in high-income settings with inconclusive results, and data from older populations and developing countries are scarce. The aim of this study was to assess this association in nine countries in Asia, Africa, Europe, and Latin America among older adults using nationally-representative data. METHODS: Data on 42116 individuals ≥50 years who participated in the Collaborative Research on Ageing in Europe (COURAGE) study conducted in Finland, Poland, and Spain in 2011-2012, and the World Health Organization's Study on Global Ageing and Adult Health (SAGE) conducted in China, Ghana, India, Mexico, Russia, and South Africa in 2007-2010 were analysed. Information on measured height and weight available in the two datasets was used to calculate Body Mass Index (BMI). Self-reported back pain occurring in the past 30 days was the outcome. Multivariable logistic regression analysis was used to assess the association between BMI and back pain. RESULTS: The prevalence of back pain ranged from 21.5% (China) to 57.5% (Poland). In the multivariable analysis, compared to BMI 18.5-24.9 kg/m(2), significantly higher odds for back pain were observed for BMI ≥35 kg/m(2) in Finland (OR 3.33), Russia (OR 2.20), Poland (OR 2.03), Spain (OR 1.56), and South Africa (OR 1.48); BMI 30.0-34.0 kg/m(2) in Russia (OR 2.76), South Africa (OR 1.51), and Poland (OR 1.47); and BMI 25.0-29.9 kg/m(2) in Russia (OR 1.51) and Poland (OR 1.40). No significant associations were found in the other countries. CONCLUSIONS: The strength of the association between obesity and back pain may vary by country. Future studies are needed to determine the factors contributing to differences in the associations observed.

The validity of the instrument to evaluate social network in the ageing population: the Collaborative Research on Ageing in Europe Social Network Index.

UNLABELLED: The aim of the study was to create a simplified, easy implementable multidimensional instrument to assess all relevant elements of the structure and function of social network within individuals across different European countries and to provide the tool for health professionals and policy makers. The analysis was based on the sample of 10 446 non-institutionalized adult population from Finland, Poland and Spain. The Social Network Questionnaire Collaborative Research on Ageing in Europe Social Network Index (COURAGE-SNI) was part of the COURAGE questionnaire. The indicators of the functioning of social network ties (close relations), frequency of direct contact and general support were evaluated. Functions were assess within the main structural components as spouse, parents, children, grandchildren, other relatives, friends, coworkers and neighbours. The exploratory factor analysis revealed five main latent components of social network with one component composed of hierarchical part. The confirmatory factor analysis provided an acceptable fit for the model. The generalize partial credit model was used to calculate factor scores for five components of the COURAGE-SNI considering the social networks of 'spouse/partner', 'parents', 'other family members', 'neighbours' and 'friends and co-workers'. The scores for every component were recalculated so as to provide the social network saturation ranged from 0 (the lowest) to 100% (the highest possible). Finally, the COURAGE-SNI score was obtained as the sum of weighted information calculated by the item response theory procedure for every aforementioned component. In summary, the COURAGE-SNI showed good reliability and content validity and seems to be a promising tool for the assessment of the social network phenomenon across European countries. KEY PRACTITIONER MESSAGE: The Courage-SNI is a new tool to assess the construct of social network in population studies. The Courage-SNI is an instrument useful to identify high risk groups or populations whose social network is poorer.

The COURAGE Built Environment Outdoor Checklist: an objective built environment instrument to investigate the impact of the environment on health and disability.

UNLABELLED: A tool to assess the built environment, which takes into account issues of disability, accessibility and the need for data comparable across countries and populations, is much needed. The Collaborative Research on Ageing in Europe (COURAGE) in Europe Built Environment Outdoor Checklist (CBE-OUT) helps us to understand when features of the neighbourhood environment have either a positive or negative impact on the accessibility of neighbourhoods for healthy ageing. The CBE-OUT is composed of 128 items that can be recorded when present in the evaluated environment. Audits were performed in households randomly selected from each cluster of the sample for Finland, Poland and Spain, following precise rules defined by experts. Global scores were computed both section by section and in the overall checklist, rescaling the resulting scores from 0 (negative environment) to 100 (positive). The total number of completed CBE-OUT checklists was 2452 (Finland, 245; Poland, 972; and Spain, 1235). Mean global score for our sample is 49.3, suggesting an environment composed both of facilitating and hindering features. Significant differences were observed in the built environment features of the three countries and in particular between Finland and the other two. The assessment of features of built environment is crucial when thinking about ageing and enhanced participation. The COURAGE in Europe project developed this tool to collect information on built environment in an objective evaluation of environmental features and is a recommended methodology for future studies. KEY PRACTITIONER MESSAGE: The CBE-OUT checklist is an objective evaluation of the built environment and is centred on technical measurement of features present in the environment and has its foundations in the concepts of disability and accessibility operating in the International Classification of Functioning, Disability and Health (ICF) model. The CBE-OUT checklist can be analysed using both the total score and the single section score, allowing an evaluation of the facilitating or hindering role of the environment and is usable for predictive analysis of ageing trends. The CBE-OUT checklist makes it possible to collect information about the built environment by means of an objective evaluation of environment features and is a recommended methodology for future studies about the built environment.

The determinants of spread of Ebola virus disease - an evidence from the past outbreak experiences.

The paper summarizes available evidence regarding the determinants of spread of Ebola virus disease, including health care and community related risk factors. It was observed that the level of uncertainty for the estimations is relatively high which may hinder to make some predictions for the future evolution of EVD outbreak. The natural history of EVD has shown that the disease may pose a problem to developed countries and may present a thread to individuals. Although observed modes of transmission mainly include direct contact and contaminated staff, high case fatality ratio and frequent contacts among individuals in developed countries are among determinants which may lead to the development of the EVD outbreak.

The evolution of Ebola virus disease outbreaks.

The paper presents general information regarding descriptive epidemiology of Ebola virus disease (EVD) outbreaks. Some observations have shown the decrease in case fatality ratio after several generations of patient-to-patient passage. An increase in the frequency of EVD outbreaks across decades was also noticed. The knowledge about the past outbreaks may provide crucial information about the evolution of EVD epidemic, which may be useful for future preventions.

[Ebola virus disease]. / Ebola virus disease.

Ebola is one of the most virulent zoonotic RNA viruses causing in humans haemorrhagic fever with fatality ratio reaching 90%. During the outbreak of 2014 the number of deaths exceeded 8.000. The "imported" cases reported in Western Europe and USA highlighted the extreme risk of Ebola virus spreading outside the African countries. Thus, haemorrhagic fever outbreak is an international epidemiological problem, also due to the lack of approved prevention and therapeutic strategies. The editorial review article briefly summarizes current knowledge on Ebola virus disease epidemiology, etiology, pathogenesis, clinical presentation, diagnosis as well as possible prevention and treatment.

[Socio-demographic differences in the prevalence of cardiovascular diseases among women and men in Poland--results from the Courage in Europe Project]. / Demograficzno-spoleczne rócznice w wystepowaniu chorób ukladu krazenia u kobiet i mezczyzn w Polsce--wyniki badania Courage in Europe.

The aim of the study was to assess differences in cardiovascular diseases (CVD) (hypertension, coronary artery disease - CAD, stroke) in women and men in relation to demographic and social characteristics in adult population in Poland. Study was performed in the representative group of 4071 individuals (18+) in Poland. Face to face interviews were done using structured questionnaire. Chi-squared test and decision tree analysis have been used to assess the presence of difference between groups and to determine characteristics typical for the ill. Age was a factor significantly associated with the diversity of CVD prevalence in women and men. Similar role played the level of education and marital status. Low income was additional significant determinant of the CVD for both women and men. Analysis based on decision trees additionally confirmed the differences in characteristics of ill persons in younger age groups. Our results indicate that especially in younger age groups it may be more than expected number of women suffering from early stage ischemic heart disease. Due to atypical or less severe symptoms some cases remain probably undiagnosed on the level of health care system. Our finding is supported by the consistency between the frequency of physician diagnosed CAD and WHO algorithm in 60-79 age category.

Impact of bilateral mediastinal lymph node dissection on pulmonary function during the early postoperative period after curative-intent lung surgery for cancer: a randomized study.

Background: Bilateral lymph node dissection is not a standard surgical treatment for non-small cell lung carcinoma. However, data from anatomical studies showing lymph flow to the contralateral mediastinal lymph nodes have prompted attempts to extend lymph node dissection to the contralateral mediastinum. Little is known about the functional effects of extended lymphadenectomy. This study aimed to determine whether bilateral mediastinal lymphadenectomy (BML) performed as part of lung cancer surgery leads to more severe impairment of respiratory function than standard systematic lymph node dissection (SLND). Methods: Respiratory function data were derived from a randomized clinical study (BML-1), which included patients with non-small cell lung cancer (NSCLC) who underwent curative-intent lung resection with standard SLND or BML. Lung function tests were performed preoperatively and on postoperative days 1, 3-5, 7-9, and 30-32. Results: Data from 89 patients were available for the final analysis of the BML-1 study: 40 and 49 underwent BML and SLND, respectively. Complete respiratory function test data were available for 35 patients. The age, sex, Thoracoscore, revised cardiac risk index, dyspnea score, lobar location of the tumor, histology, preoperative pulmonary function test results, and type of lung resection were comparable for both groups. The vital capacities (VCs) were not different on postoperative days 1, 3-5, 7-9, and 30-32 (P=0.49, 0.66, 0.18, and 0.16, respectively). The forced expiratory volumes in 1st second (FEV1) obtained at the same time points were not different (P=0.40, 0.72, 0.81, and 0.32, respectively). Conclusions: BML was not associated with a more severe deterioration of respiratory function than standard (unilateral) lymph node dissection.

Does dietary calcium interact with dietary fiber against colorectal cancer? A case-control study in Central Europe.

BACKGROUND: An unfavorable trend of increasing rates of colorectal cancer has been observed across modern societies. In general, dietary factors are understood to be responsible for up to 70% of the disease's incidence, though there are still many inconsistencies regarding the impact of specific dietary items. Among the dietary minerals, calcium intake may play a crucial role in the prevention. The purpose of this study was to assess the effect of intake of higher levels of dietary calcium on the risk of developing of colorectal cancer, and to evaluate dose dependent effect and to investigate possible effect modification. METHODS: A hospital based case-control study of 1556 patients (703 histologically confirmed colon and rectal incident cases and 853 hospital-based controls) was performed between 2000-2012 in Krakow, Poland. The 148-item semi-quantitative Food Frequency Questionnaire to assess dietary habits and level of nutrients intake was used. Data regarding possible covariates was also collected. RESULTS: After adjustment for age, gender, education, consumption of fruits, raw and cooked vegetables, fish, and alcohol, as well as for intake of fiber, vitamin C, dietary iron, lifetime recreational physical activity, BMI, smoking status, and taking mineral supplements, an increase in the consumption of calcium was associated with the decrease of colon cancer risk (OR = 0.93, 95% CI: 0.89-0.98 for every 100 mg Ca/day increase). Subjects consumed >1000 mg/day showed 46% decrease of colon cancer risk (OR = 0.54, 95% CI: 0.35-0.83). The effect of dietary calcium was modified by dietary fiber (p for interaction =0.015). Finally, consistent decrease of colon cancer risk was observed across increasing levels of dietary calcium and fiber intake. These relationships were not proved for rectal cancer. CONCLUSIONS: The study confirmed the effect of high doses of dietary calcium against the risk of colon cancer development. This relationship was observed across different levels of dietary fiber, and the beneficial effect of dietary calcium depended on the level of dietary fiber suggesting modification effect of calcium and fiber. Further efforts are needed to confirm this association, and also across higher levels of dietary fiber intake.

Leptin and interferon-gamma as possible predictors of cesarean section among women with hypertensive disorders of pregnancy.

BACKGROUND: This study was designed to evaluate maternal levels of leptin and interferon-gamma (IFN-gamma) in pregnancy complicated with hypertension and to assess the role of cytokines in predicting the risk of cesarean section. MATERIAL/METHODS: This was a cohort study with a prospective follow-up. After proportional sampling procedure, the study included the follow-up of 40 women with hypertensive disorders of pregnancy (pregnancy-induced hypertension [PIH] or preeclampsia [PE]) and 40 uncomplicated pregnancies. Women were followed from the time of admission to the delivery. Levels of leptin and interferon-gamma were measured in serum samples from all women. A p-value <0.05 was considered as significant. RESULTS: Significant increase in IFN-gamma and leptin concentration in women with pre-eclampsia was observed. We found a significant 1.4-fold increase in the risk of birth by cesarean section associated with the increase of the IFN-gamma concentration by 0.1 pg/ml and almost 3-fold increase in the risk associated with the increase of the leptin concentration. CONCLUSIONS: IFN-γ and leptin might be risk markers of cesarean section in hypertension disorders of pregnancy, but further studies supporting this evidence are needed.

Calcium intake may explain the reduction of colorectal cancer odds by dietary selenium - a case-control study in Poland.

BACKGROUND: Colorectal cancer (CRC) has been placed among top three cancer sites in high income countries. Although there are several inconsistencies across studies it is widely accepted that diet contributes to approximately 70% of CRC. Several dietary factors have been investigated; however, the knowledge about the role of trace elements and their interplay with other dietary factors in CRC odds is limited. The aim of the study was to estimate the odds ratio of colorectal cancer associated with the content of selenium in diet, and to check whether dietary calcium is a modifier of selenium effect in the population characterized by low selenium intake. METHODS: Face-to-face interviews were used to gather data on dietary habits (by 148-item semi-quantitative food frequency questionnaire) and covariates among 683 histologically confirmed incident colorectal cancer cases and 759 hospital-based controls in a case-control study. Data was collected in a period between 2000 and 2012. SETTING: Lesser Poland, Central Europe. Logistic regression models were used to assess the role of dietary selenium intake and calcium-selenium interaction in colorectal cancer odds. RESULTS: After the adjustment for several covariates dietary selenium was associated with the decrease of colorectal cancer odds by 8% (OR = 0.92, 95%CI: 0.84-0.99 for every 10µg Se/day increase). In individuals with lower (< 1000 mg/day) calcium content the odds of colorectal cancer was decreased by 13%(for every 10µg Se/day) and by 44% and 66% depending on the categories of selenium intake (60 to < 80 µg/day and ≥ 80 µg/day, respectively). The effect of dietary selenium was modified by dietary calcium (p for interaction < .005). CONCLUSIONS: The study has shown a beneficial effect of dietary selenium for colorectal cancer and a modification effect of dietary calcium in a population characterized by lower levels of selenium intake. The results provide the basis for well-planned controlled trials to confirm the findings.

Evaluation of the prevalence of folic acid supplementation before conception and through the first 12 weeks of pregnancy in Polish women at high risk of fetal anomalies.

OBJECTIVES: Local and international organizations recommend folic acid (FA) supplementation in the periconceptional period. This study aimed to analyse the prevalence of periconceptional supplementation with FA in women at high risk of fetal anomalies refferred for first trimester screening. MATERIAL AND METHODS: Our analysis involved 1,455 women at high risk of fetal anomalies refferred for first trimester screening. FA supplementation was assessed by face-to-face interviews conducted by doctors performing first trimester screening for aneuploidy. RESULTS: FA supplementation before pregnancy was reported by 46.8% of the women and during the first trimester by 57.2% of those studied. Women used FA supplementation more frequently if they had a history of at least one miscarriage (OR 2.2, 95% CI 1.70-2.83; p < 0.001), a history of assissted reproductive techniques (OR 2.25, 95% CI 1.18-4.31; p = 0.014), or were aged between 30 and 34 (OR 2.87, 95% CI 1.47-5.58; p = 0.002). Among 122 women with a history of fetal defects only 50% confirmed FA supplementation before pregnancy and 62.2% during pregnancy (p = 0.488). A similar frequency of FA supplementation was noted among women with epilepsy, diabetes, and hypertension. Less frequent taking of FA was noted among women at least third and subsequent pregnancies (p < 0.001). In the current pregnancy, neural tube defects (NTDs) were less frequent by 86% in the group of women with FA supplementation than in the non-supplementation group (1 case vs 6 cases, respectively) and for other fetal defects by 62.5% (24 vs 40 cases, respectively). CONCLUSIONS: We found an unsatisfactory compliance with recommendations for the use of folic acid supplementation during periconceptional period among women at high risk of fetal defects and folate deficiency, that could have negative effects on the health of child and mother. The study results show the need to increase the awareness of FA supplementation during periconceptional period especially in women with high risk of fetal anomalies.

Genotoxicity Associated with 131I and 99mTc Exposure in Nuclear Medicine Staff: A Physical and Biological Monitoring Study.

Nuclear medicine staff are constantly exposed to low doses of ionizing radiation. This study investigated the level of genotoxic effects in hospital employees exposed to routinely used 131I and 99mTc in comparison with a control group. The study compared the results of physical and biological monitoring in peripheral blood lymphocytes. The effects of confounding factors, such as smoking status and physical activity, were also considered. Physical dosimetry monitoring revealed differences in the individual annual effective dose as measured by finger ring dosimeter and whole-body dosimeter between the 131I- and 99mTc-exposed groups. The DNA damage studies revealed differences between the groups in terms of excess premature chromosome condensation (PCC) fragments and tail DNA. Physical activity and smoking status differentiated the investigated groups. When assessed by the level of physical activity, the highest mean values of tail DNA were observed for the 99mTc group. When assessed by work-related physical effort, excess PCC fragments were significantly higher in the 131I group than in the control group. In the investigated groups, the tail DNA values were significantly different between non-smokers and past or current smokers, but excess PCC fragments did not significantly differ by smoking status. It is important to measure exposure to low doses of ionizing radiation and assess the potential risk from this exposure. Such investigations support the need to continue epidemiological and experimental studies to improve our understanding of the mechanisms of the health effects of radionuclides and to develop predictive models of the behavior of these complex systems in response to low-dose radiation.

A divisive hierarchical clustering methodology for enhancing the ensemble prediction power in large scale population studies: the ATHLOS project.

The ATHLOS cohort is composed of several harmonized datasets of international groups related to health and aging. As a result, the Healthy Aging index has been constructed based on a selection of variables from 16 individual studies. In this paper, we consider additional variables found in ATHLOS and investigate their utilization for predicting the Healthy Aging index. For this purpose, motivated by the volume and diversity of the dataset, we focus our attention upon data clustering, where unsupervised learning is utilized to enhance prediction power. Thus we show the predictive utility of exploiting hidden data structures. In addition, we demonstrate that imposed computation bottlenecks can be surpassed when using appropriate hierarchical clustering, within a clustering for ensemble classification scheme, while retaining prediction benefits. We propose a complete methodology that is evaluated against baseline methods and the original concept. The results are very encouraging suggesting further developments in this direction along with applications in tasks with similar characteristics. A straightforward open source implementation for the R project is also provided (https://github.com/Petros-Barmpas/HCEP). Supplementary Information: The online version contains supplementary material available at 10.1007/s13755-022-00171-1.

IL-6 serum levels predict postoperative morbidity in gastric cancer patients.

BACKGROUND: Despite progress in surgical techniques and perioperative care, gastrectomy remains a procedure of significant morbidity. Several scoring systems and clinical measures have been adopted to predict postoperative complications in gastric cancer patients. The aim of this study was to investigate whether high serum levels of interleukin 6 (IL-6) in the early postoperative period may be a prognostic factor of postoperative morbidity. METHODS: A group of 99 consecutive patients with resectable gastric cancer were enrolled. The mean age was 62.9 years and the male/female ratio was 72:27. Subtotal gastric resection was performed in 22 patients and total gastric resection in 77. The IL-6 serum level was measured on the 1st postoperative day (POD). RESULTS: Complications were recorded in 28 patients (28.3%). The observed case-fatality rate was 3.03%. An IL-6 serum level of >288.7 pg/ml on the 1st POD in univariate and multivariate Cox proportional hazard models was an independent prognostic factor for overall complications and infective complications. CONCLUSION: Our study showed an association between perioperative IL-6 serum levels and postoperative morbidity in gastric cancer patients. The IL-6 serum level on the 1st POD was shown to be an independent prognostic factor for both overall complications and infective complications.

Development and Validation of a Self-Neglect Scale Among Older People: The Study on Challenges for Neglect and Self-Neglect in Poland.

The study aimed to develop and validate a tool to recognize the presence and to evaluate the level of self-neglect in community-dwelling older people. The cross-sectional study included 2,894 face-to-face interviews with randomly selected individuals from among the general population, social service users, and hospital patients. In addition, specially trained interviewers assessed the physical appearance and standards of living. Reliability, content, and construct validity were assessed. The Item Response Theory was used. The following scales were developed: the Self-Reported Self-Neglect Scale (SRSNS), the Objective Assessment of the Level of Self-Neglect-Physical Appearance (OALSN-PA) scale, concerning physical health risks based on the appearance of an individual, and the Objective Assessment of the Level of Self-Neglect-Standards of Living Arrangements (OALSN-SLA) scale, which assesses the physical and personal living conditions. The brevity of the scales makes them useful for the daily practice of health care and social care professionals.